There is no more important question for Congress than answering how we can ensure access to affordable healthcare for all Americans. While Greg Gianforte doesn’t believe that those living in poverty should have access to healthcare and those of us in the middle class should have to risk bankruptcy to get it, the five Democratic candidates to replace him have offered thoughtful, specific policies to protect the gains we’ve made and improve access.
Read their answers below.
Question 4. Explain your position on healthcare reform and explain why it would both be the most effective policy and the most politically viable path to improve health care.
Our health care system is broken for many, including those on the individual market. My campaign has consistently laid out a realistic plan for lowering health care costs and expanding coverage:
- In the immediate term, we must stabilize the individual market by funding ACA subsidies to consumers and insurers. We should change federal law to allow Medicare to bargain for drug costs, like Medicaid and the VA already can. We need mandatory, long-term funding for CHIP and Federally Qualified Community Health Centers so that Congress stops using those programs as political footballs.
- In the medium term, allow those 55 and older to buy into Medicare’s full range of benefits. This will make the Medicare population relatively more healthy, thus reducing rates overall; and it will make the individual market relatively healthier as well, reducing their costs.
- In the long-term, use this Medicare expansion as a foundation for a national dialogue on a more broadly applicable public option and push hard to make it law. Moving to a full public option now would require significant tax increases that would never make it past this President, even if Congress becomes significantly more Democratic in November. A nationwide dialogue around a public option — an opportunity that we missed in 2009 — would build the legislative support necessary to make Medicare for All a reality.
As a state legislator, I lowered health care costs and expanded access. I did not make promises to Montana that I could not keep; I worked on actual solutions to pressing health care issues and delivered results to my constituents.
When I was campaigning for the Legislature, I met a man named Brendan, who had recently been diagnosed with stage-four glioblastoma — brain cancer. His prognosis was bad. He hoped he could enroll in a clinical trial in North Carolina, testing a promising new treatment that could help him fight the disease. Then he learned that insurance companies refused to cover standard care — such as chemotherapy — for patients that enrolled in such trials.
When I got to Helena, I worked with Brendan and other strong, inspirational patients to require insurers to cover standard care, making affordable, life-saving cancer treatments feasible for everyday Montanans. I advanced legislation to better protect those in the individual market from discrimination by insurers. I voted to expand Medicaid, which now provides health care coverage to 91,000 Montanans.
Health care reform is deeply personal to me. When I was 11, my mother was diagnosed with early-onset Alzheimer’s. I joined my father as her caregiver for seven years until she passed away. I know first-hand how sickness challenges families. It is critical that we have a representative in Congress who both understands how important health care coverage is to our lives and families and knows how to get results on these issues.
Every American deserves healthcare. I want to empower individuals to obtain the treatment they need at costs they can afford. I want a system based on science, economics, and sound research. We are moving in that direction. The Affordable Care Act created a better health insurance system than the one we had before it, but we have not completed our work. Now that we’ve road-tested the Affordable Care Act, we can improve it based on our experiences.
Jumping one-sixth of the economy to a third system in ten years will increase costs and create more problems. Moreover, I do not trust this government to manage my health care or to manage a single-payer system. It is deliberately sabotaging the system we have. We can improve the existing by replicating the market to decrease prescription drugs costs and by paying people for signing up on the health care insurance exchanges.
First, by replicating the international market in the United States, we can lower prescription drug prices. Prescription drug prices are unreasonable, and they are rising at four times the rate of wages. In the meantime, pharmaceutical companies are making higher profits than any other industry. Some Montanans have told me that they had intended to retire but needed to work just to pay for their prescription drugs. We can remove some obstacles to lower prices.
Right now, most countries cost-control their prescription drugs, while the United States pays monopoly prices. In other words, pharmaceutical companies charge whatever Americans will pay. Americans cannot buy prescription drugs on the international market because Congress has concluded that importing prescription drugs risks importing dangerous, counterfeit ones. We face the same problems we faced in 2000, when I worked for Brian Schweitzer as his driver. I rode the buses to Canada for cheaper prescription drugs. That frustrated me then, and it continues to frustrate me.
Nonetheless, we can lower prescription drug prices even within these constraints. Americans could benefit from market forces without physically moving the prescription drugs around the world. It could prohibit pharmaceutical companies from selling prescription drugs at higher prices in the United States than Americans could buy them on the international market from developed countries. Then, pharmaceutical companies could either accept Americans paying lower prices, or they could renegotiate with other countries to raise their cost-controlled prices. That system would encourage other nations to help pay the pharmaceutical companies’ research and development costs. And by restoring market forces, Americans would pay far less for their prescription drugs.
Second, the United States can encourage more people to sign up for the health care exchange by paying them $200 when they do. Encouraging more Americans to buy health care on the exchange will decrease insurance premiums by spreading the risk more broadly. Five percent of patients consume fifty percent of health insurance dollars. That five percent likely bought insurance the moment they could. Expanding the pool of people paying premiums would decrease costs for everyone.
As you may know, completing the paperwork to sign up for health care on the government exchange takes time and effort. The website asks tough questions and requires research. Those complications and the time commitments—right in middle of the holiday season every year—create barriers that prevent people from signing up on the health care exchange.
Instead of adding a burden, the United States could pay new enrollees $200 for signing up. That would give them more money to buy presents right when they need it. More people signing up will push premiums costs down. And encouraging more people to enroll would help them, too. They will get $200 and they will have health insurance.
These two ideas will make large differences for many people. They will push down on costs and premiums, and that will make health insurance more affordable for all Americans
There is no doubt in my mind that healthcare reform is one of the single biggest issues facing our country right now. Quality affordable medical care is essential for a healthy, prosperous life and is the foundation of vital communities, so approaching this issue thoughtfully is critically important. The most practical fast way to improve healthcare will require us to improve the Affordable Care Act, continue the work to overhaul Veterans Administration Hospitals and health care, and fully fund Indian Health Services as required by treaty.
One of the single most rewarding experiences in this campaign has been the trust Montanans have shown by sharing their healthcare stories with me. A young woman in Butte told me about how she was diagnosed with cancer in her 20’s and was only able to afford her treatment costs because she was covered under the ACA. I had a small business owner in his 60’s tell me how when Congressional Republicans try and kill the ACA, they try and kill him. When I think about what my healthcare policy should be, I think of those stories.
The passage of the ACA played a critical role in providing access to care for thousands of Montanans, some of whom were getting health insurance for the first time. It helped our critical access hospitals, which are the economic lifeblood of rural communities. We can make immediate improvements by attacking prescription drug costs, incentivizing the patients’ health over costly procedures, requiring transparency in pricing, and offering a public option like Medicare in some places where there just isn’t enough competition in the insurance marketplace.
Making those three changes to the ACA, as well as fixing the VA and fully funding Indian Health Services, are all important steps I believe our congressional delegation can take to improving the accessibility, cost and quality of healthcare.
The fundamental truth is that we have to provide healthcare to everyone. The best way to achieve that is to expand Medicare so it’s available to all. This won’t prevent private insurers and the free market from strengthening our healthcare system with innovation, but it will empower entrepreneurs and small businesses to invest in better jobs and grow their businesses instead of jumping through hoops. It will ensure that working people won’t go bankrupt because of a health emergency. Once we get everyone covered, we can finally get exploding costs under control.
I believe in putting people’s health above insurance company and industry profits. A recent Pew Research Poll found that 60% of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. http://www.pewresearch.org/fact-tank/2017/06/23/public-support-for-single-payer-health-coverage-grows-driven-by-democrats/
I will work hard to protect access to affordable healthcare for all Montanans including children, seniors and veterans. This includes rural healthcare facilities and those provided in reservation communities. I will champion legislation that halts the pharmaceutical industry’s practice of predatory pricing of medications.
I share Montanans’ concern about access to affordable healthcare. Issues that need to be addressed immediately include the latest tax reform that eliminates the Patient Protection and Affordable Care Act individual mandate as well as the sustainability of Medicaid expansion. Those, combined with potential future cuts to Medicare in reaction to the federal deficit as well as increased pressure on mental health services, point to the need to establish universal coverage. It is not acceptable that the United States is the only democracy in the world that does not provide some form of government supported healthcare for all.
Healthcare workforce issues are of significance to Montana, as well as critical access hospitals, long-term care, Veteran’s Administration healthcare facilities, mental health care services and Indian Health Services. I will also focus on legislation that addresses paid medical leave for family members.
Being able to obtain primary care, defined healthcare benefits, and affordable medications must be available to all Montanans. Women’s healthcare including mammograms, cancer screenings, prenatal services, and family planning are fundamental rights that must be included in all healthcare policies.
How Montana manages affordable healthcare in the future will be a challenge. Washington DC is cutting critical resources and care, but I will continue to champion for solutions that work. While serving as a Montana Senator, I sponsored a bill that demanded accountability for long-term assisted living and I will continue to advocate for critical services and research supporting our aging population.