The way to fix the Affordable Care Act, Democratic and Republican candidates in West Virginia seem to agree, is to use common sense.
“Making common sense reforms, like allowing people to buy health insurance across state lines,” said Alex Mooney, the Republican candidate for Congress in West Virginia’s 2nd Congressional District.
“We have to have a common sense approach when it comes to our businesses, especially our small businesses,” said Secretary of State Natalie Tennant, the Democratic candidate for Senate.
“I have a long history of supporting common sense, fiscally responsible reforms to our health-care system and that is the approach I’m going to take,” said state Sen. Evan Jenkins, the Republican candidate in the state’s 3rd Congressional District.
In reality, despite the consensus behind common sense, candidates from the two parties agree on very little when it comes to President Obama’s signature health-care law.
Mooney and Jenkins, along with Rep. Shelley Moore Capito, R-W.Va., the Republican candidate for Senate, want to repeal the law entirely and replace it with other, often unspecified, changes.
Tennant, along with Rep. Nick Rahall, D-W.Va., and Nick Casey, the Democratic candidate in the 2nd District, want to keep the law, but fix certain parts of it that they say aren’t working.
Another reality is that, after surviving a government shutdown, the law known as Obamacare is very unlikely to be repealed while the president is named Obama — something that a Capito spokeswoman acknowledged.
The law is already in effect in West Virginia and around the country. About 19,000 West Virginians have bought private insurance through the federal exchange. Some of those people already had insurance or were replacing canceled plans that didn’t comply with requirements of the new law, but most were not. Fred Earley, the president of Highmark West Virgina, the only insurer offering coverage on West Virginia’s exchange, said that about two-thirds of those sign-ups were new customers.
More than 123,000 West Virginians have signed up for Medicaid since Gov. Earl Ray Tomblin decided to expand the program under the national health-care law.
While repealing the law would eliminate the funding for expanded Medicaid — the federal government pays all the costs for the first three years and 90 percent of the costs thereafter — neither Capito nor Jenkins would say whether or not they think the state should continue to move forward with the Medicaid expansion.
Capito declined an interview request.
Amy Graham, her campaign spokeswoman, said in an email that the congresswoman wants to fix “the harmful parts of the law while making sure West Virginians who depend on Medicaid are still able to get covered without bankrupting the state.”
Asked repeatedly whether he thinks the state should continue to move forward with expanded Medicaid, Jenkins, a former Democrat who switched parties to run for Congress, declined to answer.
“I’m trying to be very clear that it’s not as simple as getting a yes or no in a particular box,” Jenkins said. “We ought to be addressing the uninsured population through more of a bipartisan, everybody-at-the-table transparent process.”
He said that he wished the state had looked at a hybrid approach, like ones used in Iowa and Arkansas, where the state accepts federal money for expanded Medicaid, but uses it to buy private insurance for low-income people.
Rahall also declined an interview request, but said in an email that a repeal would “take us backwards.”
“The lady in Greenbrier County who told me she can now go for her first check up in 10 years,” Rahall wrote, “And the man who wrote to me from Hinton to say he now has a policy that would prevent him from going bankrupt should he become ill are counting on us to make health care affordable and accessible.”
Tennant, in a phone interview, spoke in personal terms of one of the law’s primary goals — eliminating insurance companies’ ability to deny coverage because of pre-existing conditions.
Her daughter, Delaney, had open-heart surgery when she was a week old, which saved her life, but also counted as a pre-existing condition, Tennant said.
When she and her husband started a small media company, he called to get their family health insurance, she said.
“I came home and he looked at me and he said, ‘Natalie, they said that they would cover me and you, but they wouldn’t cover Delaney,’” Tennant said. “I will fight that. We will never go back to the days where insurance companies can deny coverage.”
Capito’s campaign said she also would like to keep the ban on discriminating against pre-existing conditions, but offered no details on how she would accomplish that if the law is repealed. If there was a ban on discriminating against pre-existing conditions but no individual mandate to make healthy people sign up for insurance, insurers have said that people could just wait until they get sick to buy insurance.
Capito, Tennant and Casey, the Democrat in the 2nd District, all said they would like to change a part of the law that has yet to go into effect — the employer mandate.
That aspect of the law, one of many that has been delayed by the Obama administration, would impose penalties on businesses with more than 50 employees who do not offer health insurance to full-time workers.
The provision defines full time as working more than 30 hours a week, something that they said would discourage hiring.
“Thirty hours is just such an odd-ball number; you know most people don’t work 30-hour weeks,” Casey said. “I don’t think most employers I know want to hire people on a part-time basis.”
Mooney, a former state senator from Maryland, was the most emphatic in calling for the law’s repeal.
He said that passing tort reform and allowing insurance to be sold across state lines would achieve similar goals of expanded coverage.
“I just have a fundamental belief that if you let the free market take care of it by not over-regulating it, not mandating it, not having so many lawsuits, it will be more affordable for everybody, including those with pre-existing conditions,” Mooney said.
Earley, the president of Highmark, said he didn’t see that selling insurance across state lines would add a lot of value for his company or for consumers. When the insurance exchange opens again in November, his company will no longer be the only one in selling in West Virginia.
A Kentucky-based non-profit has said it will open a branch here to sell on the state exchange. He said his company is planning for the future under the assumption that the law will not be repealed or replaced.
Casey was blunter about it.
“If they want to say, ‘let’s repeal it,’” he said of Republicans, “they’re just whistling Dixie in the wind.”
Reach David Gutman
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