"I think a town hall is a great display of democracy," U.S. Congressman James Comer said to a well-attended room on Murray State University's campus.
Comer has pledged to hold town halls in each county in Kentucky's first district. Murray marks his 30th. While there were moments of partisan applause and some jeering, the overall atmosphere was cordial. Comer discussed his position on the Graham-Cassidy health care reform bill, international trade and North Korea among other topics.
HEALTH CARE
Comer reiterated points he has made at previous town halls about Kentucky's relatively large percentage of people on Medicaid and lack of private insurance options. He said people with private insurance can't afford rising premiums. He said Medicare (a federal health insurance program mainly for people over 65) is "not even in the discussion now." Senator Bernie Sanders has proposed a single-payer "Medicare for All"legislation signaling a push towards the left on health care reform.
Comer said he supports Medicaid "as it was intended to do," a temporary safety net for people who lost their job, children from poor families, elderly people in nursing homes, single mothers and pregnant women. Medicaid was signed into law in 1965 for certain low-income people and others mentioned by Comer. The Affordable Care Act expanded this coverage.
"The overwhelming majority of people on Medicaid are not in the workforce," Comer said. This is true, most are children (nationally 43% according to Kaiser Family Foundation, reported by NPR). He said he supports Medicaid for the disabled and elderly (24% according to the same data, but 61% of spending). He said, however, able-bodied people at home on Medicaid is not sustainable (adults are 34% of the enrollment share and 19% of spending).
"If the state of Kentucky has to pay 10% of the health care cost for an additional 550,000 people that will bankrupt the state of Kentucky. Murray State will be cut to where they have zero financial aid from the state. The Calloway County school system will have zero aid from the state. The Murray school system will have no money from the state. It's all going to go into Medicaid and this pension problem that they have," he said. Kentucky currently chips in about 5% of the cost of Medicaid expansion (it was 100% federally subsidized until the end of last year) and would have to shoulder 10% by 2020.
On Graham-Cassidy, Comer said it will allow states to apply for waivers (this would include waivers from covering the "essential health benefits" in the Affordable Care Act designed to protect pre-existing conditions). Comer mentioned that the Kentucky legislature is considering work-requirements, which Governor Matt Bevin has proposed. "I think that's a good deal," Comer said. "What I want to see is a health care system in America that truly helps people that need help. But people that are able to work, then they have work requirements." He said states move quicker than the federal government for things like approving low-cost drugs.
He said a big part of the problem is poverty. "The best way to get you out of poverty is to provide an environment where you have access to a good paying job where you have a living wage that provides a health care benefit." Growing the economy means providing tax relief across the board, he said. People working two low-wage jobs trying to 'make ends meet' are "doing things right" and wants a program to subsidize health care and incentivize businesses to offer insurance. He said it's a problem when insurance companies cancel coverage when a customer gets sick.
"If you have pre-existing conditions and you're sick... those health insurance companies won't want to insure those people because they want to make money," he said, adding that the "best thing" the Affordable Care Act did was protect people with pre-existing conditions.
A question was asked about offering a single-payer system. Comer said he doesn't have confidence that the government can run a single-payer, citing issues with veterans affairs. He said he doesn't want to give up on competition, but doesn't like for-profit insurance companies. "I don't believe right now that single-payer is the way to go. If this health care bill (Graham-Cassidy) doesn't pass, if nothing's done for health care in the next three or four years, then, unfortunately, that's where the country's headed," he said.
Someone in the audience said the Republican Party is "cannon-balling" the Graham-Cassidy bill with no discussion, analysis or (nonpartisan) Congressional Budget Office score and called for a bipartisan plan instead of politicking. Comer said the CBO score would "undoubtedly" say millions will lose coverage, but adds that the majority are young people. "I think it's a bad deal that there's not a CBO score, but I think the CBO score on this one will be pretty similar to the CBO score on the last one," he said. The CBO score in June said a Senate bill to repeal and replace the Affordable Care Act would leave 22 million uninsured by 2026.
Comer said the Graham-Cassidy bill "will protect people with pre-existing conditions." He argued there's only one scenario where someone would lose, which is a 63-day lapse in not paying the Medicaid premium.
He added that a reason for pushing the bill through by the end of the month is because it's part of a budget reconciliation process, where it only needs a simple majority to pass (presumably no Democrats will vote for the bill and would filibuster the standard 60-vote process). He said it's also close to the open enrollment period (November 1 through December 15) and insurers are looking to see what will happen.
Following-up:
Comer said Graham-Cassidy is "about as good a consensus as we're going to get" in the effort to replace Obamacare. "I'm going to spend the next few days in communication with my hospital administrators and our health care providers and health care advocates across the district and then make a determination whether or not I support the bill." The American Medical Association opposes the plan.
He has vowed "with every last breath" to keep pre-existing condition coverage. There has been concern that Graham-Cassidy does not guarantee this coverage, as pointed out by NPR, BBCand others, as it allows states to waive the ACA's "essential health benefits," which were designed to protect pre-existing conditions, and could allow insurers to raise rates for certain conditions.
Comer said the bill allows consumers to have a choice to buy cheaper plans, "but if you've got a pre-existing condition already, you're going to keep the health care coverage with that pre-existing condition coverage clause in there." The only apparent reference to pre-existing conditions in the Graham-Cassidy bill involves a state outlining how it would "maintain access to adequate and affordable coverage for individuals with pre-existing conditions." (Graham-Cassidy section summary -- Graham-Cassidy bill language)
"You can't treat someone with a pre-existing condition, even in the Graham-Cassidy bill, any differently than you treat a healthy person," he said.
According to an Avalere assessment, by 2026, Kentucky would see a reduction of around $5 billion from federal expanded Medicaid funds through the block-grant program. On this, Comer said those who "truly qualify" for Medicaid, like people with disabilities and pregnant women living in poverty, will still benefit from the program. He said the bill presents people with a choice to have a more bare-bones plan or a more comprehensive plan that covers certain conditions. "And I believe that if you (states) apply for the waiver and give consumers a choice, I believe consumers will be happy with that because they can buy the health care package that will benefit their family the most at a price that they can afford."
"It's either pass Graham-Cassidy or keep Obamacare. I campaigned on a pledge to repeal and replace Obamacare. I believe this bill, thus far, from what I've heard talking to people, is our best our best option," he said.
NORTH KOREA
Comer said the general consensus a year ago was that North Korea was a poor country with a crazy dictator and didn't have any serious weapons. He said we have since learned that they probably do have nuclear weapons and their technology is more advanced than had been thought. He said an issue with taking action is that the United States has a poor history of initiating regime change. Knocking a missile out of the air isn't a problem for the U.S., he said, but then what? He said there's no agriculture or infrastructure and a general challenge for the intelligence community to infiltrate.
A question was asked whether it was appropriate for President Trump in his United Nations speech to use the term "Rocket Man" in describing Kim Jong-un. Comer said, "Well I wouldn't have said it, but he's [Trump] definitely outside of the box." Comer said that's what people wanted in the 2016 election, to some protest from the audience. He reiterated a point he's made in previous town halls that Trump won overwhelmingly in the first district.
INTERNATIONAL TRADE
Comer said President Trump's rhetoric on trade is something that 'spooks' him. Canada and Mexico are Kentucky's top agriculture and manufacturing export countries, he said, and wants good trade agreements with these countries.
"We have to have a good quality trade agreement. I'm not worried about the relationship we have with Canada. I do worry about the relationship we have with Mexico for a lot of different reasons," he said.
He said trade agreements have been good for the majority of industries in the first district, citing specifically the exports from the chemicals industrial park in Calvert City.
Comer said he recently spoke with members of the pork industry and said the United States needs to solidify a trade agreement with South Korea, who is a major importer of pork from the U.S. The industry has come out requesting free trade continues in any NAFTA, or likewise, renegotiations.
FARM BILL
U.S. Congressman James Comer said progress on the next farm bill is "fairly on schedule" and anticipates a vote by Halloween. Comer is on the House Committee on Agriculture. He spoke with students and faculty in Murray State's ag department before the town hall meeting. Comer said the bill coming out of the committee will look a lot like the 2014 farmbill, but may have 'a lot' of amendments on the House floor.
He said most of the bill covers Supplemental Nutrition Assistance Program - or SNAP benefits. He said SNAP is the only reason why some members of Congress will vote for the farm bill and said there will likely be little, if any, cuts to the program.
President Trump's proposed budget, however, called for dramatic cuts to the program, of $193 billion over 10 years, or 25% and would shift some of the costs to states.
In the ag policy meeting, Comer also praised Murray State's Hutson School of Agriculture and answered questions from students about hemp industry potential. Murray State's ag department is invested in hemp. Congressman Comer was instrumental in the hemp pilot project in Kentucky as the state ag commissioner and has filed legislation reducing regulations on the crop.
OTHER TOPICS
Other topics brought up by members of the audience involved drug testing and opioid recovery programs. Comer said he's a proponent of faith-based programs. He said the Graham-Cassidy bill includes increased funding for opioids. The bill notes "responding to urgent health care needs within states," but doesn't appear to specifically mention opioids, drugs or recovery programs with the exception of an exemption from work requirements. It does, however, according to an assessment by Avalere, significantly reduce federal funding to some of the states with the highest rate of opioid addiction, including Kentucky.
A member of the audience wants the justice system to hold members of the Obama administration 'accountable' for 'abusing the law,' namely former National Security Adviser Susan Rice, who reportedly requested unmasking people in the Trump campaign who were caught up in surveillance of foreign officials. Comer said he's on the Oversight Committee and said they will "probably investigate a lot of different things" including the Trump administration and Russia. He suggested investigations into the previous administration may follow.
A woman in the audience said her son is in the military and conditions have been bad under the Obama administration. She asked if he would support more funding for the military. Military spending in recent years is a complicated issue. Comer said "continuing resolution" spending, as opposed to a budget, has hampered the military. Comer said he has voted for an increase in spending for the military. "We do need an increased spending bill with respect to the military," he said.
Comer's next town hall is in Logan County.
