Last week, I asked on Facebook and Twitter for questions you have about President Obama’s healthcare law.  In particular, the Facebook posts sparked a lively discussion, and Arkansans on both sides of the issue shared their thoughts.  I want to thank all of you who posted for maintaining respectful dialogue and for bringing informative points to the table. 

The postings also spurred some excellent questions.  The Supreme Court heard oral arguments on the constitutionality of the law this week, so I wanted to take some time to answer those questions.

QUESTIONS FROM TWITTER

@JohnBoozman Shouldn't individual’s health insurance be a choice like auto insurance? Are insurers controlling the cost?
-G. Leddin from Springdale (‏@TruthOut4All)
Americans should be able to choose their healthcare insurance, just as they do their auto insurance.  ObamaCare federalizes health insurance regulations, reduces choice, and undermines the state of Arkansas. Instead, we should expand options and improve the marketplace so insurers compete for your business and drive down costs.  Hand-in-hand with that is the issue of portability.  People should not be afraid to switch jobs or start their own business because they will have to pay more for healthcare in the open market.

@JohnBoozman Why do you call it #ObamaCare isn't it the affordable care act? That would be misrepresentation correct? #AskGOP
- Ryan in Arkansas (@rmbrewer03)
No misrepresentation at all.  Just as President Reagan built his legacy in part on his economic policy and President George W. Bush is remembered largely for his tax cuts, President Obama wants to make his healthcare law a cornerstone of his Presidency.  Reaganomics became shorthand for President Reagan’s economic policy. The Economic Growth and Tax Relief Reconciliation Act of 2001 and The Jobs and Growth Tax Relief Reconciliation Act of 2003 are never referred to by name, but are instead called “The Bush Tax Cuts.”  This is no different. 

@JohnBoozman #ASKGOP Why did the price tag double for #ObamaCare?
- Shavaun in Arkansas (@Shavaun66)
The costs of the President’s health care bill are staggering.  When he signed the bill, President Obama claimed it would cost $900 billion.  But the true cost of the bill is three times that amount.  The authors of the law loaded it with sunny projections and budget gimmicks, including the double counting of Medicare savings. They also ignored implementation costs.  Worse still, they counted six years of spending, not ten.  When one calculates the full ten year implementation window (2014–2023), and all the elements of the bill, the true and honest price tag is $2.6 trillion. Senate Budget Ranking Member Jeff Sessions (R-AR) and his staff at the Committee have put together an excellent breakdown of the real costs of the law.  You can read it here. 

@JohnBoozman Why don't Republicans accept the health care plan? And just where is the Republican plan to help with health care?
- Rodger Austin‏ from Rogers (@hawgcaller)
I can’t speak for all Republicans, but I can say as a former small business owner and a medical provider, I believe that the President and his allies in Congress went about addressing this problem in the wrong manner. 

We face a serious crisis.  Healthcare costs are crippling Americans.  Many Americans lack access to quality healthcare. This is stifling our nation’s overall economic development. Physicians and hospitals face real difficulties when it comes to providing accessible and affordable healthcare.

But there is a right way and a wrong way to approach this problem.  The President’s healthcare law is the wrong way. 

It will not lower healthcare costs, it will drive them up.  It is not deficit-neutral, it is a budget buster. It will not protect Medicare, it will bankrupt it.  And it will not help our economy, it will further stall recovery.

What we really need is healthcare reform that is based on free-market principles. 

We need to:

• Help transition the employer-based private insurance market towards one that allows for flexibility, choice, and fairness;  
• Institute provider payment and insurance coverage reforms that empower individuals with incentives to make smart healthcare decisions and minimize waste; 
• Usher in reforms that increase healthcare insurer, provider, and product information to improve competition and smart decision-making;
• Restructure our Medicaid safety net through state flexibility, patient accountability, and outcome-centered payment reforms;
• Expand health savings accounts and flexible savings accounts that reward commonsense health spending and minimize waste;
• Implement medical malpractice reform designed to minimize defensive medicine that needlessly drives up healthcare costs and malpractice insurance;
• Reform open-ended, government health benefit plans;
• Establish comprehensive Medicare fee-for-service reforms that reward outcomes instead of healthcare utilization;
• Eliminate the waste, fraud, and abuse that make up 20% of all Medicare spending; 
• Reward proactive primary care physicians and healthcare delivery systems that keep patients healthy, prevent hospitalizations, and minimize hospital readmissions;
• Reform health coverage for duel eligible, low-income elderly and persons with disabilities enrolled in both Medicare and Medicaid; and
• Invest in smart chronic disease prevention, awareness, and education

QUESTIONS FROM FACEBOOK

Hey John - Why are we being forced into healthcare?  Are we not a free country any more how come you guys are not stopping Obamacare?
Brian Don Terry from Springdale
I have strong concerns about the constitutionality of the individual mandate.  If the government can force you to buy a product like health insurance, where does this end?  That is the crux of the case that the Supreme Court is considering this week, and I am hopeful the Court will decide accordingly.

However, we cannot rely solely on the Court. This approach to the problem of rising health care costs and the large number of uninsured Americans is entirely wrong.  That is why I voted against it when I was serving in the U.S. House of Representatives.  It is also why I voted to repeal this law in the Senate.  Unfortunately, our repeal efforts have been met with filibusters by the Senate Majority. I will continue to work toward repealing Obamacare and replacing it with commonsense reforms that lower costs, expand coverage, improve quality, and preserve choice.

You want to throw all of the young people that now have insurance through their parents off of insurance? You want to bring back denial of insurance for children due to pre-existing conditions?? You and your party have no other ideas to fix the health care situation in this country. Bring in a decent program and I may consider something else. But right now, your party has NO solutions to the huge problem we have. What do you have to offer to take the place of Affordable Health care Act? Just what???
Patricia Slice from Jordan

Great question. While I am supportive of covering pre-existing conditions and allowing parents the option to cover an older child until they are able to afford their own healthcare insurance, there are many ways to address  this that don’t require spending $2.6 trillion. 

This law is a really bad deal for young people. ObamaCare’s banding and insurance pricing controls will disproportionally burden young people. Apart from the federal debt burden, which will harm Americans for generations to come, young people will see a dramatic increase in healthcare premiums.  In states like New York that have imposed these sorts insurance regulations, young people have to pay $900 in monthly health insurance premiums.

In addition, we need to take a step back from the rhetoric that implies the other side is inherently opposed to solving the problem if they disagree with a particular approach.  It is a false dichotomy to say that if you don’t support the President’s approach you do not want to extend coverage to children with pre-existing conditions.  That is certainly not the case. 

My colleagues and I on the Republican side of the aisle certainly understand the problem and are working to fix it, but we strongly disagree with the direction this Administration has taken on the issue.  The President wants to solve the problem by expanding government; we want to empower individuals.  The President’s law gives bureaucrats the power to make your medical decisions; we want a patient-centered approach that ensures that you and your doctor are the only people making healthcare choices. And his law shows a disregard for the financial reality we face.  We can reform our healthcare system and increase access for all Americans without adding trillions to our already staggering amount of debt.

My response to Mr. Austin’s question above gives you a more detailed description of how my Republican colleagues and I would approach the problem.  We simply do not agree that the President’s massive expansion of government is the right way to address the issue.  And poll after poll shows that most Arkansans share this feeling.

How about a question ....with the failure of the post office.....social security going broke....rampant fraud with food stamps, Medicare and numerous other government programs......what makes Washington think they can successfully be in charge of healthcare?
Joseph Elster from Arkansas

This is an excellent question.  The Obama Administration adheres to a belief that the government can solve all of our nation’s problems.  I strongly disagree. I believe a smaller government allows people to make their own decisions.

The American people realize that we cannot continue this government expansion. We can’t afford to fund the unsustainable programs that already exist.  Now, President Obama wants to add a new multi-trillion dollar program to our long list of financial obligations. Washington’s reckless spending will inevitably end with an economic collapse unless we dramatically change course. If we continue down this path, we risk going the direction of Greece, Ireland and Portugal, each facing economic crises that have pushed them to brink of default. 

In particular, seniors understand that you can’t add 30 percent more patients to the Medicare & Medicaid rolls, cut physician payments, reduce hospital investments, and expect better results. Something’s got to give and it is going to be quality of care. This law will lead to healthcare rationing.

When you put bureaucrats in between Americans and their physicians, it will ultimately decrease quality of care. We need to put patients in control and force insurance companies to compete for their business, instead of allowing the government to dictate our healthcare needs. That is the approach I will work to implement when we replace this law with real healthcare reform.

An amendment to the Highway Bill that would have approved construction of the Keystone XL pipeline failed in large part due to President Obama’s lobbying against the project.

Amazingly that hasn’t stopped the President from touting his support for the energy project that the U.S. Chamber of Commerce and every major labor union estimated would have created 250,000 jobs over the course of the project, including 20,000 workers that would have been on the job immediately. 

After rejecting the Keystone XL pipeline, President Obama is now claiming credit for speeding up the southern portion of the project. In reality, he doesn’t have to sign off on the southern, domestic portion of the pipeline, which is only 29% of the project. He just needs to authorize the portion of that crosses transnational borders, which he refuses to do.

During a visit yesterday to Cushing, Oklahoma he said this project is a priority and fast tracked the project.  As the Bloomberg report on his visit revealed, the President’s promise “won’t speed up the project, which already is slated to start construction as soon as June.”  The reality is this portion of the project is moving forward in a timely manner despite the president, not as a result of anything he has done.

With gas prices nearing $4 nationwide we need to develop all American energy resources and this can be done in environmentally sound ways. I encourage President Obama to work with Congress to produce an energy policy that would decrease our dependence on foreign oil. A perfect place to start would be for the President to quit working against Congress and instead join with us to finish the remaining two-thirds of the Keystone Pipeline.

Recent news reports detailing the gridlock in Washington accurately show the difficulty of working in Congress and passing legislation that the American people deserve. 

My colleagues on the Senate Homeland Security and Governmental Affairs Committee yesterday heard recommendations on how to improve Congress and make it more efficient and productive.

 Witnesses at the hearing “Raising the Bar for Congress: Reform Proposals for the 21^st Century,” testified about proposals that would help Congress accomplish more. 

Among those proposals was the “No Budget, No Pay” legislation that I am proud to cosponsor. This bill would prohibit members of Congress from being paid if they do not pass a long-term budget each fiscal year. Arkansas News Bureau’s Steve Brawner wrote about this in a recent column. 

This legislation makes sense. It’s been well over 1000 days since a binding federal budget resolution has been passed in the Senate. We are required to adopt a budget resolution but there is no penalty for failing to do so. 

This hurts the American people and our fiscal future. American families don’t operate like this and neither should the federal government. I hope the members of the committee take a good look at this legislation and give it due consideration. This is an honest approach at restoring confidence in Congress.

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