U. S. Rep. Matthew Cartwright offered a reality check on the new federal Affordable Care Act – less affectionately known as Obamacare – and shot down some myths during his 90-minute town hall meeting in Northampton County Monday afternoon.
The freshman Congressman, a Democrat who represents the 17th District, was joined at the front of the room in the Wilson Community Center by Athena Ford, advocacy director at the Pennsylvania Health Care Access Network, and Jim Palmquist, president of the Pennsylvania chapter of AARP.
Most of the town meeting was spent responding to questions and comments submitted in writing by 85 people in the audience. A few people just blurted out remarks, but Cartwright graciously responded to them as well.
Cartwright told the audience: “I am here to listen to your concerns and your thoughts, because I am absolutely committed to making changes to this law that make sense and make it work for all Americans.
“What I am not open to is giving up on the Affordable Care Act’s goal of universal access to health care and its steps to bring down insurance costs by increasing preventive medicine and competition, ending the practice of denying coverage to people with pre-existing conditions and banning annual and lifetime limits for health care coverage.
“They were unquestionably the right steps to take for this nation.”
The Congressman explained at the outset that he was not there to talk about politics, but to explain the nuts and bolts of the new health care law, which takes effect Jan. 1. He encouraged people to talk with him one-on-one about politics after the meeting.
Cartwright did not seem to take offense at criticisms aimed at Congress and Obamacare, at one point saying: “I can take it. I’m not in it for the money. I’m trying to do a good job.”
The conversation ranged from “young invincibles” who don’t think they need health insurance to sealing up the “doughnut hole” in Medicare coverage for seniors.
The audience laughed in response to one question, which asked if Cartwright had read the entire health care bill before voting on it.
“I didn’t vote on it,” said Cartwright. “I wasn’t in Congress when that came up for a vote. And I still haven’t read all of it. It’s like 2,700 pages.” But he added he has read summaries, “so the salient points get reviewed. We know where the controversial parts are and the things that really matter to Americans.”
One woman got into an argument with several others in the audience when she said the government is mandating what kind of insurance she should have. She said people are smart enough to make that decision for themselves and the government is taking away individual rights.
When Cartwright suggested that’s a valid but political viewpoint, the woman snapped: “No it isn’t.”
Several other snapped back: “Yes it is.”
The written questions, many about specific circumstances, were read to the three-member panel by Wilson Mayor David Perusso.
Ford recommended people with specific questions about the health care act can get help by going to localhelp.healthcare.gov and then typing in their zip code to find a certified application counselor.
It was the third and final town hall meeting on the new health care law that was scheduled by the 52-year-old Cartwright, who lives in Moosic, Lackawanna County.
“Obviously, the roll-out of this health care law has been pretty rocky and the problems with it have been unacceptable,” he acknowledged.
“The website doesn’t work the way it’s supposed to. I hope that they get that fixed as soon as possible. It must be fixed for this thing to work.
He added: “The administration in Washington should have been much more forthcoming and honest with itself and with the public about the website’s shortcomings. The job now is to get the site working and getting it done right.
“The President also should have been accurate – and he has acknowledged as much -- about keeping certain policies in effect. The fact is policies that don’t meet the minimum coverage standards were always subject to cancellation. The President should have said that from the beginning.”
Cartwright said he is concerned about whether the law will result in higher insurance costs for some current policy holders. “I want a better system to the uninsured, for seniors and for working middle-class families and I’m open to adjustments on this Affordable Care Act to achieve it.”
Benefits of new law
“Over 70 percent of Americans are incredibly confused when it comes to what’s in the law,” said Ford. “A huge percentage of folks still don’t even know the law exists. And even more are very confused about what it means and what it does for them.
“A lot of folks think the health care law helps uninsured people get access to coverage and it does that very well. But the majority of what’s written is giving people who have insurance new rights and new protections.”
For a decade, said Ford, health insurance premiums were rising five times faster than wages. “The health care law is never going to get premiums back down to where they were in the 90s, but what it can do is slow that increase and that’s what a lot of Americans really need.”
Cartwright said the new law allows parents to keep children on their policies until they are 26 years old. It gives small businesses better purchasing power when they go to buy health insurance plans for their employees, “with new tax credits to ease the burden of providing employees with health coverage.”
Ford said insurance companies no longer will be able to charge people more if they have a pre-existing health condition, such as if they have had a heart attack.
They also no longer can charge women more than men. And they can only charge their oldest policy holders three times as much as they charge their youngest, healthiest policy holders.
“They can still charge you more for smoking,” said Ford, suggesting that gives people another reason to make a New Year’s resolution to quit.
Palmquist said AARP did not get everything it wanted in the new health care law, but supports it because a “tremendous” number of 50-65-year-olds don’t have any health coverage.
Ford said insurance companies now can take away medical coverage only “if they can prove you were trying to commit fraud” – not because you get sick and start costing them money. She said lifetime limits on insurance policies also are going away. She said insurance companies even must give money back to people if they start charging more than needed for care.
Cartwright recommended when pricing policies, “don’t just take the word of one insurance company -- typically your own insurance company -- that writes you a letter. Wait to see what else is available. See what other companies have to offer. What we’re up to here is we’re spurring competition among insurance companies. That’s one of the big picture goals of this law.”
Cartwright said the law improves Medicare’s prescription drug coverage for seniors by gradually closing the Medicare Part D “doughnut hole” until it no longer exists by 2020.
Ford explained that “doughnut hole” requires seniors to pay thousands of dollars for prescription drugs. She said “that’s where we hear the horror stories of seniors ripping pills in half and choosing between food and medicine.
“If you’re a low income senior, you won’t have to sell your house before you can get help paying for your prescription drugs.”
Ford said the law also gives money to states so low-income workers can go into Medicaid. “Pennsylvania hasn’t accepted those funds yet. All the states surrounding us have. In Pennsylvania, about 400,000 people won’t be eligible for coverage come Jan.1.”
“I regret that position on the part of the governor,” said Cartwright. “I oppose that position. I think it’s the wrong thing to do. This is basically Pennsylvania turning its back on federal assistance to get these folks insured. A big part of me thinks he’s only doing that to make a political point, to stick the President in the eye.”
The audience applauded.
Ford said most Americans must have health insurance beginning next year. Those who do not sign up next year must pay a penalty of $95 or one percent of their income, whichever is higher. She said in 2015 that increases to $325 or two percent of income. In 2016, it is more than $600 or 2.5 of income.
“The idea behind these penalties is to get people to sign up for health care,” said Cartwright. “What we’re after are what they call the young invincibles, the young people who are never going to get sick.
“Please encourage them to get the insurance. They will be amazed at how cheap it is. Yeah, they’re young and healthy. But they’re also the most likely to have catastrophic accidents.
“We need to get them signed up for a couple of reasons. We need their premium dollars to help support the whole system. If all we get are older, sicker people to sign up, it’s not going to work. At some point we’ve got to stop being the me generation and pull together and share the sacrifice.
“But even more than that, you’re only young and healthy until you’re not. That’s been the biggest burden on our health care system.
“Hospitals absorb the uninsured care, over and over. If you show up in an emergency room, they pretty much have to treat you. And people know that. But eventually hospitals can’t absorb any more. They stop circling the drain and they go down it.
“One of the reasons I’ve supported this law is it strengthens our hospitals. In the 17th Congressional District, we lost two community hospitals in the last two years. Instead of a five-minute ride to the hospital, it’s a 25-minute ride and that can be the difference between life and death in certain circumstances.”
He later said those hospitals were St. Catherine’s in Ashland, Schuylkill County and. Marian Community Hospital in Carbondale, Lackawanna County.
Cartwright confirmed that the vast majority of Americans are not losing their health insurance coverage because of the new law and agreed that fact is not being covered by the media. He said only four or five percent of Americans are being dropped by their insurance companies. “It doesn’t mean they’re not important and we shouldn’t address that.”
“The first myth that went around was that Congress exempted itself from the Affordable Care Act,” said Cartwright. “It did not.”
He was applauded when he said he soon will be enrolling himself and his family in an Affordable Care Act health insurance plan, as will everyone on his staff.
One written question said taxpayers will pick up 72 percent of Cartwright’s health care costs though the federal government, and asked why Cartwright thought he deserved that.
“I don’t know how that got into effect in Congress,” he said. “If that proves to be horrendously unpopular I’m willing to address that.”
Palmquist of AARP said most companies contribute 60 to 70 percent of employee health care costs.
“It’s true that maybe a few companies have eliminated their health coverage,” said Palmquist, “but the vast majority of companies have not eliminated their health coverage.”
One written comment said Obamacare forces everyone to pay for abortions.
Cartwright said since 1977, the federal law stipulates federal tax dollars cannot go to providing abortions in this country. He said he is a pro-life Catholic who supports that law.
When he said the Affordable Care Act does not pay for abortions with federal tax dollars, several people in the audience said: “Yes it does.”
“Actually, no it doesn’t,” insisted Ford, who then explained why.
Cartwright said another myth is that $700 billion is being taken out of Medicare to pay for the Affordable Care Act. Ford said the health care law actually puts a big chunk of money into the Medicare trust fund, to help extend the life of Medicare.
Palmquist was applauded when he said Medicare is more efficient than private health care, because 97 percent of the money put into Medicare goes to giving benefits to individuals, while many for-profit insurance companies allocate only 80 percent.
He also was applauded when he said people with insurance have gone bankrupt and lost their homes because of medical problems, adding it’s terrible to bankrupt people because their policies didn’t cover them
Ford was cheered and applauded when she said her organization supported government-run health care, which she referred to as a public option program that is not part of the Affordable Care Act.