In Sickness and in Health

Congressional hopeful Martha McSally talks about gay marriage and Obamacare

Republican congressional candidate Martha McSally, who hopes to unseat U.S. Rep. Ron Barber next year, talked to the Weekly recently about a range of issues. Last week, we presented her thoughts on immigration. This week, she talks about gay marriage and the Affordable Care Act. This interview has been edited and condensed; you'll find the full interview online this week at

What about gay marriage? Are you evolving on that at all?

Am I evolving on that?

A lot of people seem to be evolving on that. You said last time out that you supported a constitutional amendment to limit marriage to one man and one woman. Now we have it in all these states.

I believe it's primarily a state issue. When you're answering these surveys, sometimes it's a "yes/no" question when really it should be an essay answer that's appropriate.

So you don't support a federal constitutional amendment anymore?

I am not planning on spending my political capital on that type of issue. The way it was framed to me was, "If everything changed in the country and if somehow there was the voice of the people to come forward"—which is what you would need to have for the constitutional amendment to come up—"is that something you would vote for or against?" I don't think that's a practical reality. If we have any kind of constitutional amendment come up, I think a balanced budget should be the priority. My focus is putting people back to work, getting the economy going again, saving Davis-Monthan and the A-10, making sure that we're able to get our debt under control, making sure we protect Social Security and Medicare, and getting our border secure.

So philosophically, on the question, you ...

Philosophically, I believe marriage is between one man and one woman, and it should be left to the states.

So the federal constitutional amendment, you would not support that any longer?

In a hypothetical situation, where the country has decided this is very important and they've gotten the support across the board in the country for it to come up—that's a hypothetical situation. That's not happening anytime soon.

On the Affordable Care Act: full repeal or fix what's there now?

A lot of people talk about "fix what's there now" like kids being able to stay on their parents' insurance until they're 26 or things like that. That's not the foundation of the Affordable Care Act. If we're talking about the foundation, like the legs of the stool of the Affordable Care Act, its foundation is that everybody gets into the game to help pay for everybody getting into the game. And the foundation is mandates, penalties and taxes. It doesn't fundamentally address bringing the cost of health care down to make it affordable and available. We're still paying a ridiculous amount of money for procedures. I'm not talking about the premiums and the things that have happened recently. So fundamentally, the structure of it is flawed. There are ways for us, hopefully, to bring the cost of health care down that make it affordable and available so people could actually choose to get health insurance instead of being ordered: "This is the health insurance we have for you and here are all the features in it."

But isn't the cost curve bending?

In the last month? Are you kidding me?

No, not in the last month. Over the last couple of years, you've seen the projections go down. The cost is still growing, but it's growing at a smaller rate.

But we're still paying, per capita, 50 percent more than the next country in the world on health care and we're not healthier for it. There are some other alternatives that are out there. Congressman Tom Price has one. He's a medical doctor in Congress and he's written up a plan that I've spent a little time studying. I don't necessarily agree 100 percent with it. He's trying to bring the cost down so that people can afford it, so they can choose to afford it and it's more available. There's visibility, there's competition, buying insurance across state lines, more preventative health care versus pay-for-service, where doctors get paid whenever they do something to you or give you a drug or do a procedure on you. Some reasonable reforms to the defensive medicine that some doctors are practicing to avoid frivolous lawsuits. I still want people who have been hurt to be able to file for those things if they have been hurt by a bad doctor, but I think there are some reasonable things we can do to bring down those costs so that they are not ordering unnecessary tests and those types of things. And that's not all federal-level stuff. There's some stuff that can be done at the state and local level and by the private sector. Fundamentally, the mandates, the penalties and the taxes that are the structure of Obamacare—people are starting to see, like, "Well, I liked my health-care plan." "Well, you just didn't know that it's not everything that you needed. The government knows better about what you need." That's just not what we're about as a country and people are discovering that every day now.

What about pre-existing conditions?

There's got to be a way to address (that) people with pre-existing conditions need to have the ability to have health insurance. And in a couple of the Republican alternatives, that's included in there, but the rest of the solution is not mandates, penalties and taxes. It's figuring out how to incentivize people getting into the game as opposed to mandating that they get into the game. Whether that's tax credits for individuals, where normally we just have tax credits for businesses for their medical costs—there are ways to do that without saying to a 27-year-old kid, "You've graduated from college, you still don't have a good job, you're totally in debt and now we're going to make you pay for somebody else's health care. Have we got deal for you!"

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