Hi, Indivisibles. We’ve been getting a lot of questions about what we’re planning to do in response to the white supremacist rally that is being planned for October. We are working in conjunction with a number of community groups and leaders to come up with a plan. Stay tuned for more info. In the meantime, please know that lots of people are coordinating on this and that we do expect to have an event planned. It might take some time because we want to make sure whatever we do is thoughtful, inclusive, and as safe as possible.
As of this morning, they still don’t have the votes to pass the ACA repeal bill. The changes they made to the bill to get conservatives on board have been too much for some of the more moderate Republicans to agree to vote for it. Current estimates are that if two more of the undecideds flip to no, this is not going to a vote. It’s not over yet, though.
Our understanding is that Rep. Peterson remains a no and that Rep. Cramer is a firm yes. If we get the sense that either of those might change, we will let you know right away. If you’re looking for an action to take, please call your friends and family in Republican districts and ask them to call their representatives to ask them to vote no.
Senator Heitkamp held a town hall yesterday in Fargo that was largely focused on health care. She was joined by Pat Gulbranson, CEO of Family HealthCare, Dr. Josh Wynne, Dean of UND Medical School, and Dr. Greg Glasner, CEO of Essentia, who were there to answer questions and share their perspectives. It was a helpful and informative conversation, and we thank Sen. Heitkamp for taking the time to talk to her constituents about this issue.
On the state of the ACA
Sen. Heitkamp said that the Medicaid expansion is working well. Concerns about the ACA are most often about exchanges. Because older people cannot be charged more than three times more than a younger person, the costs of getting insurance have been prohibitive for younger people.
On the Republican “Repeal and Replace” plan (the AHCA)
The Republican plan would phase out the Medicaid expansion. It would also change the funding of traditional Medicaid from mandated payments from the federal government to a lump sum that the states can decide how to use. Over 10 years, federal government spending on Medicaid would be reduced by $880 billion. The North Dakota legislature would have to allocate $250 million to make up for that shortfall.
According to Sen. Heitkamp, older Americans who do not qualify for Medicare will be hurt the most if the AHCA passes.
On what’s happening in North Dakota
Pat Gulbranson of Family HealthCare said that his organization serves low income and homeless people, and they are seeing increasing demand. They just built a West Fargo clinic and it is already too small. They have 15 dental chairs going every day and several hundred people on the waiting list. Their biggest challenge is workforce recruitment and retention. Family physicians, nurses, and support staff are hard to get.
Dr. Wynne of UND said that workforce recruitment is a big issue in health care in North Dakota. From a national perspective, we spend 50% more per person than any other country in the world. We spend more than $10,000 on each person in the US per year–18% of our GDP. The average person on Medicare puts $1 in and gets $3 out, which raises the national debt. In 10 years, we are going to spend 20% of all dollars on health care in US. We have a problem with how we are going to pay for health care.
Dr. Glasner of Essentia said that for him, uncertainty is the biggest problem with trying to deliver care. 60% of their patients are on Medicare or Medicaid. Not knowing what the law might be in a year or two makes it hard for them to plan. He also said that there are not enough doctors for everybody to have a primary care provider anymore.
On Medicare for All
Responding to a question on a single-payer system, Sen. Heitkamp said that everybody believes that a lot of the cost problems you see in health care costs are inefficiencies from not having single-payer, but Medicare and Medicaid are costs are expanding, too. The decision was made in 2010 to go with a market-based system–the question is how to we fix the system we have.
She would like to lower the Medicare eligibility age to 60. That would help lower costs on the exchanges, because older people are more expensive to insure.
On how to stop the AHCA
Sen. Heitkamp said to write our congressman and senators and state legislature to let them know about our opposition to the AHCA and our support for the Medicaid expansion.
On Medicaid funding
Sen. Heitkamp said that she will never support block-granting or per-capita cap funding for Medicaid, which is what the AHCA would have done.
On global health funding
Sen. Heitkamp supports funding for global health as a way to protect the US from future pandemics.
On reducing the costs of care
Dr. Glasner said that 50% of health care dollars are consumed 5% of the population, and that half of health care costs can be attributed to lifestyle choices. Diet and exercise can dramatically lower the cost of health care.
Dr. Glassner also said that if you want to see what’s blowing up hospital budgets, it’s drugs. A single course of treatment for Hepatitis C is $100,000+. Drugs for cancer can be $5,000 to $8,000 per month. It’s very difficult to tell people they are not going to get the best drugs, and the best drugs are often very expensive.
Sen. Heitkamp agreed that we have to find a way to reduce the costs of prescription drugs, but she said that it’s complicated. She does not support importation from Canada due to quality control issues.
If you’re just joining us after having read today’s Forum article, welcome! We’re happy to have you with us. Here is what you need to know about Indivisible FM.
- We are a group of progressive-leaning people in the Fargo-Moorhead area taking focused, local, and nonviolent action against regressive political agendas.
- We’re a part of the national Indivisible movement.
- Most weekdays, we send out an action that you can do. Typically, they involve some form of communication with our legislators. We call them on the phone, we fax them via text, we collect messages via Google Forms to pass on to them, and we attend their public events.
- We are also a place for area progressive groups to share their events, and we encourage our members to attend the ones they can, even if sometimes they are not of their particular area of interest. We all need to stand together.
If you’re ready to get to work with us, please join our Facebook group or sign up for our email list at the top of our website.
By Nicole Mattson
We had a productive and informative town hall with Rep. Collin Peterson last night. The Congressman took questions on health care for about 90 minutes.
You may recall that Rep. Peterson voted against the Affordable Care Act originally, so it was important for us to learn more about his views on health care as the Republicans in Congress regroup to take another run at repeal and replace. Here is what we learned.
- Republicans in the House and White House officials have both told Rep. Peterson that they do not want Democratic help on the bill to repeal the ACA. He said they have told him they are willing to work with Democrats on tax reform and infrastructure, but not health care.
- I asked him to go over what parts of the AHCA he was for and against. He said he does not believe a bill that takes away preexisting conditions, lifetime limits, staying on parents’ insurance until 26, or that block-grants Medicaid would pass Congress. The one thing he liked about the AHCA is that it adds high-risk pools.
- His main concern with the ACA is that many people on the individual market have premiums and deductibles that are so high that they effectively do not have health insurance because they can’t afford to use it. This is a particular problem for farmers, because they often have to buy their insurance on the individual market.
- He initially voted against the ACA because he thought it would be worse for Minnesota than the system we already had. He would be willing to consider asking the federal government for a waiver so that Minnesota could go back to our previous system, which he feels worked better.
- Many people raised “Medicare for All” as the solution to the problems with access to health care. Rep. Peterson said he is not opposed to the idea. There is a bill in Congress that would expand Medicare for everyone, which is sponsored by Rep. Conyers of Michigan. Rep. Peterson said he cannot take a position for or against it until it is scored by the Congressional Budget Office, but that isn’t likely to happen. I asked what would have to happen for the CBO to score it. He said that they only score bills that look like they have a chance of passing, so if the bill had some Republican support they may look at scoring it.
- Several people told stories of how they and their families rely on Medicare and Medicaid, and how they would be affected negatively by cuts to Medicaid.
- Toward the end of the town hall, I asked people to raise their hands if they care whether the Trump campaign colluded with Russia to win the election. A clear majority of the hands in the room went up. I told Rep. Peterson that I asked because I wanted him to see that.
After this town hall, I think we have much more clarity about Rep. Peterson’s positions on health care. We appreciate that he took the time to come to Moorhead to talk with us, and we hope to meet again soon to discuss other topics.