Over the past few months, elected officials in the U.S. House and Senate have conducted congressional hearings focused on reforming America's healthcare system.
Rep. Tom O'Halleran (D-District 1) has been touring his 58,600 square-mile territory for the past few weeks, and stopped by the Weekly office to provide an update on efforts in the House to fix a variety of health policies.
However, it seems that little will be accomplished in this political climate.
"In recognition of the amount of problems that have been created over the last couple of years, we've passed 14 bills on healthcare this session so far," O'Halleran said of the Democrat-controlled House. "They've all been sent to the Senate and appropriately put into some file cabinet."
O'Halleran has cited healthcare policy as one of the reasons he left the Republican Party after serving in both chambers of the Arizona legislature. After switching to the Democratic Party, he won the Congressional District 1 seat in 2016.
O'Halleran ran for U.S. Congress and won against former Republican Paul Babeu, the former Pinal County sheriff whose political career collapsed following multiple scandals.
The House is trying to stabilize the broken healthcare system so people can get the services and prescription drugs they need, O'Halleran said, while also attempting to determine what healthcare will look like in America in the future. He doesn't think that's been identified clearly yet, or will be even in the next year.
"The people that are in the middle, the American public or the veterans or whoever, are caught with this system that's more encouraging to address power struggles than define solutions to problems," he said.
Affordable Care Act
Morgan Tucker with Protect Our Care Arizona, a national healthcare campaign to protect the ACA from being repealed, said O'Halleran and other House members' work on healthcare legislation helps keep protections for patients with pre-existing conditions, but the bills aren't receiving support in the Senate.
In addition, the U.S. Supreme Court could still declare the entire ACA unconstitutional in the federal case Texas v. United States. A group of Republican attorney generals from various states—including Arizona Attorney General Mark Brnovich—have argued in court that the elimination of the individual mandate to purchase insurance means the entire law should be tossed.
"It basically argues that the entire Affordable Care Act is unconstitutional, starting with the mandate and then just going from there, kind of avalanche style, just dismantles the entire program, including the protections for pre-existing conditions," Tucker said.
The definition of a pre-existing condition is wide-ranging, and having one can cause a patient to experience a more difficult time accessing care, be stripped of their care, or have their rates skyrocket.
"Obviously the courts are changing, there's some changing of the guards, and we're very nervous about this court case which they think will probably come to a head July 11 or 12," she said.
O'Halleran said this court case will have "profound impacts" to the ongoing healthcare needs of American citizens.
"It sets a precedent so that all the stuff that's being worked on, whether it's Medicare for All, all these programs out there are now at risk of not even being able to get to the point where legislative counsel could say they're constitutional," he said.
PRESCRIPTIONS FOR ALL
O'Halleran says the House wants to address prescription drug costs from a transparency standpoint. They're trying to educate themselves and the public on how this "hidden system" works.
"You can't negotiate something you don't have any information on," he said. "So we're requiring CMS (Centers for Medicare and Medicaid Services) and other government agencies to not withhold information from us, even, to be able to negotiate."
House members are investigating Big Pharma. O'Halleran envisions a more open environment for identifying how much the government contributes to drug development, how much the company contributes, and how much the patient has to pay.
He said that right now Congress doesn't even have those numbers to understand what drug companies' profit levels are, because they've been allowed to withhold that information for years.
"You have to have information, and it's been a hidden system for so long," he said. "It's not even undercover, it is stealth. And nobody can find a way to get to it, and that's exactly what we're trying to do this month."
Arizona has been trying to address rural healthcare retention for two decades, according to O'Halleran, and not much has changed.
"If Medicaid expansion were to go away tomorrow, hospitals across this nation would start to close," he said. "They will acknowledge to you straight out that many of the hospitals couldn't stay open without Medicaid expansion, that's how important those types of programs are, and Medicaid itself."
With a lack of long-lasting incentives for doctors to work in rural areas, many citizens are faced with traveling long distances to see a doctor, and preventative care is scarce as a result.
"And there's no specialists," O'Halleran said. "Everything is a helicopter flight or a five-hour drive one way or the other. Even Flagstaff doesn't have the amount of specialists that it would need to get to a Trauma 1 level center."
He believes broadband internet connection in rural Arizona would transform the accessibility of healthcare for those residents.
Medicare for All
One of the House bills introduced this session plans to extend healthcare subsidies through the ACA, because it hasn't made a realistic difference in people's lives thus far.
O'Halleran said even citizens who work full-time jobs are eligible for subsidies because of the cost of the "outrageous" insurance system that is currently in place. The bill has been sent to the Republican-led Senate and O'Halleran expects it to go nowhere.
With these fundamental disagreements along party lines, O'Halleran has little confidence that the healthcare system will see the reforms it needs in the near future, let alone a new universal plan.
"Medicare for All is going to die a death, even if it passes the House," he said. "Is it good to kill it and try to get it revived again? My personal opinion is no. Let's work at it so we have something that's meaningful and we can educate the public on and move it through."
If the House doesn't fully prepare for that fight, O'Halleran says their bill will get torn apart in the Senate committee system alone and citizens will lose out on a chance at accessible health care.
"No matter what we say, these bills are going nowhere," he said. "So when we finally go through that, we have to have the strongest development of a bill that we can have because otherwise we're worse off than we were before."