Critical Care

Rep. O'Halleran blasts GOP healthcare legislation

U.S. Rep Tom O’Halleran

U.S. Rep. Tom O'Halleran represents Congressional District 1, which includes Oro Valley and Marana as well as much of eastern rural Arizona, Flagstaff and the Native American reservations in the Northern Arizona. The freshman Democrat recently appeared on Zona Politics with Jim Nintzel to talk about health care and other issues. This excerpt from that interview has been edited and condensed for clarity.

The U.S. Senate version of the Affordable Care Act repeal was released last week. You voted against the House version of this legislation. What do you think of the Senate version?

The Senate version is a little bit different. They're still going to do away with Medicaid expansion, which is so critical to Arizona and rural areas in particular. And secondly, they're going to actually—against the promises that have been made—impact Medicaid substantially. Many people look at Medicaid as a program for those who are poor and can't afford health insurance but much of that money goes toward those who are disabled and need long-term care.

In Arizona, if you're up to 138 percent of the federal poverty level, you can get health insurance through AHCCCS, which is the state's version of the Medicaid program. Talk a little bit out the impact of the proposed rollback.

It's going to impact our healthcare network, because you can't just take that much money out of the system. Right now, Medicaid is funded by the federal government with a state or local cost share. But a lot of the burden on the long-term care part of Medicaid is funded by county through property taxes or sales taxes, so that's a tremendous concern. There's a correlation there to increasing taxes on Arizonans. The estimate is between $2 billion and $3 billion in total costs, potentially, for Arizona. Our state can't afford that. So we'll see what the Congressional Budget Office numbers are, but the cost is going to be substantial. And then there's the impact to rural hospitals. We have a tremendous number of patients in all our hospitals, but particularly in rural areas where Medicaid expansion covers a major part of the patient load of those hospitals. So you're either going to see people who are able to afford health insurance again and go into a situation where our hospitals are going to be providing uncompensated care or people are going to be much sicker because they won't be able to get preventative care.

We saw something like that happen in Arizona when the Legislature rolled back an earlier expansion of Medicaid during a budget crisis during the Brewer administration. Hospitals saw a major financial hit when that happened.

They did, and that's one of the reasons that when the Medicaid expansion was renegotiated, the hospitals offered to become part of the funding source for the process. And there are other impacts. Some of our veterans rely on Medicaid dollars for their supplemental to Medicare. And the legislation still allows insurance companies to start to charge older people five times what younger people pay, so if you're 50 to 64 years old, you're going to get hit with a cost at a time in your life that is, quite frankly, the hardest time to have these kinds of cost burdens put upon you.

And when you hit that age, you're more likely to have health challenges as well.

Exactly. It's the greatest at-risk group of people we have and yet it's the group that's going to be impacted the most by either not having health insurance at all or by having health insurance that's not affordable. Don't get me wrong—the health insurance for those people today, because of the Affordable Care Act, is not working as far as our policy costs and deductibles are concerned. That's something we needed to look at in Congress but we should have done it in a way that was not political—that was based on sound business practice, such as identifying what the cost structure is, what are some of the solutions, going out and bringing experts in. This whole concept that we do something in the Senate—and in the House—but in the Senate, where at one time it was going to be 13 senators and it became a bunch of staffers from leadership and even people on the committee that was supposed to be putting this bill together didn't know what it was until last week.

Aside from the Medicaid rollback and the changes in the subsidies that help people afford health insurance, there's also the question of preexisting conditions. The legislation retains those protections but it does allow states to seek waivers so those protections could go away.

In other words, it doesn't keep them. It's like one of those tongue-in-cheek things. "We're going to keep preexisting conditions. Of course, we're going to turn everything over to the states and they don't have to do that." Well, then, preexisting conditions aren't taken care of.

There was the recent terrible shooting incident where a gunman opened fire on some of your Republican colleagues while they were practicing for a baseball game. What's happening in the aftermath of that?

The internal issues about both the citizens who visit our Capitol—because we have millions of people who come here every year—and the safety of congressional people and people who visit their town halls, law enforcement people are looking at that. But over and above that, we haven't had much discussion at all about the violence issues in America that we need to have a discussion on. People die every day from incidents like this. It's not just about terrorism, either. We as leaders need to promote the idea of people coming together again and not having this divisiveness within our society. We don't help that process by not being able to go out there and work with each other in a way that's going to help solve some of the problems that America faces.

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