First-person accounts of meetings with elected officials are always a good read. Thanks, Matt Chapman. -promoted by desmoinesdem
Friday afternoon, leaders of the Indivisible Central Iowa Leadership had a 30 minute meeting with Representative David Young. Tyler Higgs, Jess McCord, Bill Ekhardt, Jordan Hobfoll, Marie Herring, Mark Brooks and myself attended.
The topics scheduled for discussion were the repeal of the Affordable Care Act and its replacement with the American Health Care Act as well as the border wall with Mexico, two of the new president’s signature campaign promises during the election.
There is a transcript below with most of the Q & A. David Young is very approachable and easy to have discussions with. Like most political animals, getting some of the more controversial positions pinned down before a vote is taken can be difficult. If the goal is not to obfuscate but more a testing of which way the political wind is blowing, I think that’s a sign that positions can be moved. It is up to us then, either by having discussions or by just showing up to vote to get what we want and expect from our elected leaders.
I got to start out by asking if his stating that he would not vote for the bill to replace Obamacare with the American Health Care Act (as it didn’t get the vote count to pass it wasn’t brought to the House floor) was that because of the Freedom Caucus position that wants to repeal all social programs or was he concerned about the 200,000 Iowans on Medicaid.
His answer was “First of all we need to take time to air it out and see what’s in the proposal, there wasn’t time to see what’s in the proposal. They were making changes to try to pacify the Freedom Caucus (formerly the Tea Party) and the Tuesday Group (The Tuesday Group is an informal caucus of approximately 50 moderate Republican members in the House) It also wasn’t done in an open and transparent process. I think bad process will equal a bad policy in the end.” Young also said that people were texting and discussing but not having committee meetings on the bill.
He said he had concerns with premiums not coming down and that since Iowa was a state that took the Medicaid expansion, it was still unclear how the change would affect that program. He also said there was a $15 billion state stability fund but it was unclear what that was for. Was it for help with premiums, was it for Medicaid or high-risk pools?
DY “When it came down to the next day we were supposed to have a vote as it was on the anniversary date of the ACA being enacted I thought that was silly. Let’s get good policy and not just vote on a timeline.”
I then asked what would make you more likely to vote for the bill.
DY “I want to make sure that premiums, the cost curve goes down. Pre existing conditions, we talked about a community rating the other day, and I haven’t heard anything about that. There was some fear that that would go away and what would that do with pre existing conditions. I want to make sure there’s no cap.” (on benefits paid)
When asked about the AHCA being re-introduced by one of the leaders Young said, “I’m seeing what you’re seeing. Tweets and blips in the news. Were not voting on this next week.”
Community ratings were brought up and the plan to give states a waiver so that they could get rid of it. (It was also brought up earlier by Young) He was asked if he would support that. It was pointed out that the legislators here seem to be to the right of Young and there is concern that they would do just that, take the waiver.
(Community rating is a concept usually associated with health insurance, which requires health insurance providers to offer health insurance policies within a given territory at the same price to all persons without medical underwriting, regardless of their health status)
DY “So last night they were talking about an invisible high risk pool.* Does anyone know about that?”
DY “It seems that the White House is chasing the Freedom Caucus. The further you go that way then you loose the Tuesday group. And I’m not a member of the Freedom Caucus or the Tuesday Group.”
I pushed back to the Medicaid issue and said that if the AHCA had replaced the ACA that the funding for the Medicaid expansion would be gone. It is funded by taxing the very rich, people that is unimaginable how much wealth they have. Repealing the ACA would be a tax cut, and that’s who would benefit.
DY “With Medicaid there will still be some kind of federal support there. But it’s a matter of how much flexibility do you give the states.”
I still pressed the issue. I wanted to hear yes or no and wasn’t getting it.
DY “My understanding is that even with the bill passing everyone on Medicaid would still be funded. Isn’t it ten years before anyone loses their healthcare?”
Jordan or Bill “It’s three or four years. And if you leave the program you can’t get back on. It would die by attrition. Or they want to fund it with a block grant”
DY “Or they have a per Capita basis. They give states the flexibility if they want to stay the same, or whether or not they want a block grant.”
Jordan “If they choose a block grant it can’t be sustained as they will lose the money for it. And what’s not talked about is if we have something like 2008 again and many people lose their jobs and need medicaid it won’t be sustainable. It’s not setup to deal with that.”
Bill ”Intentionally not setup to deal with that.”
DY “The philosophy on that was, or the hope, everything works great when you set it on paper. Then the reality was that you would have more competition or more affordability through the regular insurance market so people would be able to move off that (Medicaid) and purchase cheaper insurance.”
Bill “The premise of that was that you would be moving people out of the high risk pool and into some other so that the insurance would be dropped. But as Jordan is describing the methods for getting people out of the high risk pools were not secure. I have two kids and they will have preexisting conditions and that’s great as long as their under our care, but at some point they’re going to have to have it from their employer or buy it on their own and that lack of security in these proposals is frankly cold hearted. It is not allowing for a safety net.”
DY “Is it cold hearted though.. to give states a voice in this. And I know that’s your fear right now with the current legislators. Now who is it up to in the state, I don’t know who gets the authority, is it the governor or the legislature. I don’t know what’s in play right now. And I’m not happy to tell you that. Things are moving from the Tuesday group, Leadership and the White House.
One last try from me on the ACA funding for Medicaid being cut.
DY “I don’t want to pull the rug out from anyone. I’m not let’s just repeal and hey let’s go back to (the way things were).”
Jordan “You couldn’t support the other bill the way it was. It sounds like what they’re bringing forward is the same bill with the ability of the states to opt out of the community rating and essential health benefits.” Jess “and pre existing conditions, it looks like a way to get them into the high risk pool.” Jordan “That is something you said you were uncomfortable voting for. Are you still against that?”
DY “I want to see the language. Preexisting conditions have always been a big concern of mine, it’s what I talk about first and foremost. I don’t think people should be discriminated on. Now if that changes to give States a say in that, that may be a game changer for me. I would like to have some conversations with our Governor or our soon to be Governor about what they think of that and ask what would you do with that?”
Jordan “You represent Iowans, so what is the Governor going to do with that?” I think what Jordan is getting at is Representative Young can’t pass the buck to the Governor.
DY ”And I’m having more and more conversations after what happened with Wellmark, with AETNA, with Medica, this group that nearly covers 1000 to 1500 people. I don’t think they’re going to expand coverage. They’ve seen the writing on the wall.”
Jordan “It’s going to be the same bill. 60,000 people are still going to lose insurance in the State. It looks like it’s worse on preexisting conditions which you say is a big issue of yours.”
DY “And a lot of others”
Jorden “And a lot of others”
Mark “And your colleagues in the house?”
DY “Oh yeah I think it’s bipartisan”
Jordan “So we know we’re not going to get a position from you here, you were against it before, we hope you stay against it if that’s what it is.”
DY “I want some kind of guarantee that people with pre existing conditions will not be discriminated against.”
Jordan “The whole process has been flawed, I think you said that. Why are we building on the whole flawed process. So why don’t we go back and have a real process, let’s go through committees. The public,I think only 17 percent approved it.”
DY laughing with us “Yeah.”
Jordan going into depth about pre existing conditions, 27 percent of people have them. People would be one step away from losing insurance. A job loss or economic downturn is all it would take.
DY “Thank you and the cap is still a concern as well.”
Jordan went into detail of these issues citing Kaiser studies on the high risk pools. 23% of insurance payouts are for the sickest 1%. That’s why these pools won’t work without massive subsidies from the Government or by raising premiums by multiplying them 23 times.
DY “Is that the consensus of you here today and Medicaid?”
Unanimous “Yes.”
Jordan “People with pre existing conditions shouldn’t get charged more for insurance and Medicaid” (are the issues)
Mark “My 23 year old Granddaughter. At twenty two years she is on Mom’s insurance. She doesn’t have a functioning kidney. She loses her mons insurance when she turns twenty six. If she loses insurance she’s gonna die. That’s what we’re looking at. And doggone it you’re not supposed to die before your Grandchildren. Just to put a face on it.”
Bill “If everyone is in the same pool it’s very simple, very clear, there’s no place to hide anything. When you’re saying that States should have rights you’re saying that States should have the right to discriminate against people, and I don’t think the States should have that right.”
DY “It’s a matter of, all states are different. States, if they have that authority, they are closer to you, so you can have that, you can go to your legislature and have your voice heard, and you can be able to advocate in a more clear fashion.”
Bill “I appreciate that. The other opportunity is to ship it to the states so they can put a lid on it, they don’t have the flexibility the way the federal government can put an umbrella over it. And that’s my concern, that in the midst of the ship to the States that at the national level there will be some kind of block grant, and then when things get tough,
States are stuck with it and the federal government isn’t touched, and then unable to help at the State level. Or are set up specifically not dynamic in so that if the States struggle, citizens lose coverage and its set up in a way that the Federal level is secured from it. That is my concern.”
Tyler “I’m more concerned about the process of, what you spoke out about this being hurried through. There’s rumors now that they’re working on this behind closed doors, and they want to get this passed by the President’s 100th day in office.”
DY “I don’t like arbitrary deadlines.”
Tyler “That’s what I was going to ask you. Will you commit to slowing this down so we can read the bill, have a discussion in committee.”
DY “When I put my hand up and said stop, that’s my commitment right there. I didn’t have to do that, but I felt strongly this is crazy. And the political hits came on me, big deal.” Representative Young shrugs his shoulders.
Jordan “So you aren’t going to vote on this next week?”
DY “We aren’t voting on this next week.”
Tyler “You have the budget this week.”
DY “That’s the other thing. Current funding for the government is through April 20th. And I think there is bipartisan report to not shut down the Government. To keep it going. There may be another short term continuing resolution maybe a week or two and then a longer package till the end of the fiscal year, maybe October first. The White house is pushing the border wall, and there’s some other pet projects on there. The border wall is a non starter on the continuing resolution.”
Jordan “Are you going to keep it clean?”
DY “Yes, I am. And the Speaker said, we’re not going to put the border wall on the CR, we’re going to do it on regular order as well. And checking in with my colleagues, Republican and Democrat, and district members from Texas all the way over to San Diego, both sides of the aisle say we know the needs at the border. Let the States have some authority on this. Different sectors have different needs and their opinion is going to way dramatically on this. And I have been against a wall from Tijuana to, wherever the Rio Grande. I’ve been to the wall, Texas Arizona and San Diego. In san Diego you need Coast Guard. In Cochise County, you have border patrol on horses. You also have to respect the issue of private property rights as well.”
Tyler “will you promise me I won’t have to pay for the wall. Donald Trump promised me.” We all had a laugh.
Jess “Can you see a circumstance where you can see funding the wall.”
DY “It depends on what it may be connected to. There could be a broader package, that is associated to that could increase funding for the NIH (National Institute of Health) or something. I think Congress wants to be fiscally responsible with this and not just throw money at the wall.”
Jordan “Are you being approached for funding for an increase in deportation forces, talking about a lot more officers.”
DY “They are talking about, from what I am hearing is more immigration lawyers. Is that what you’re hearing?”
Jordan “No. I’m hearing they want more ICE officers so they can deport people faster.”
DY “I’ll have to have a broader discussion with the Caucus so I can see what that money is for. I’m not for going around and knocking on doors.”
Jordan “Are you opposed where children are American citizens and parents haven’t had any illegal acts, and deporting the parents?”
DY “To me that’s not what you want to focus on. You focus on the criminal elements, People that are bad from wherever in the world (they’re from) A lot of people just focus on Mexico. There are bad people all over the country and I want the focus to be on them. From Moscow, to Rio De Janeiro I don’t care where they’re from.”
We talked a bit more about ICE, undocumented vs bad actors and the demonization of all immigrants when the criminal element in their communities is much lower than with native US citizens. There was also some comments on local law enforcement and the unwillingness of the undocumented to report crimes as the ICE raids and rhetoric from the last campaign has caused terrible fear in those communities.
As we were sharing and not getting much response from Representative Young I won’t go into more detail here. Frankly I think we need to take care with this issue. These people, in only my opinion, have been exploited for cheap labor for years. I think the fact that for all the blaming of social issues on them with little to no legislation or holding accountable the employers that profit off them is telling. There are lawmakers at the local and Federal level that are opportunist and would use them as a political football. That being said I am in no way claiming David Young is doing that. On the local level that is happening and I plan on jumping into that before and during the next session. The “You’re not welcome here – Sanctuary Cities” law that was floated last session being one.
At the end of the discussion Bill asked about the draft being brought back. I believe he served in Viet Nam and I agree with him on the position, if this is where he’s coming from, that bringing back the draft would make congress think twice before entering into any conflicts if their own children and grandchildren would be forced to serve. Of course that would assume that congress had a say in that. Current actions would question that they do.
Matt Chapman