Health care, regulations among top concerns

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I recently had the opportunity to visit with more than 5,220 constituents during a telephone town hall meeting. With one of the largest congressional districts in the country — 29 counties spanning nearly half the state of Colorado — I make a point to visit as many communities as I can throughout the year to hear from groups and hold public meetings. I typically hold my public meetings in the spring and summer months, which I will continue to do in the 115th Congress. In the winter and throughout the year, I use telephone town hall meetings as one platform for keeping in touch with constituents and sharing updates on my work.

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Courtesy photo

Scott Tipton

I heard from constituents on a variety of topics during my hour-long telephone town hall, but the most frequently asked questions were about health care, regulations and public lands.

Many families in Colorado are facing an average deductible of more than $6,000 under Obamacare, and in some cases, their premiums have exceeded their mortgage payments each month. I consistently hear from people that they can say they are insured, but they can’t afford to use their health insurance or find providers in their communities who will accept additional Medicare or Medicaid patients.

This is unacceptable and unsustainable, and it is why I am working to repeal and replace Obamacare with a health care system that gives Coloradans and Americans in every corner of the country access to affordable health care services.

House Republicans recently released the American Health Care Act, the draft reconciliation bill that makes up the first part of our three-part strategy for repealing and replacing Obamacare. Reconciliation is an important tool for getting our health care system back on track, however, it has limitations in terms of what changes can be made. Reconciliation prohibits provisions that have no budgetary effect, which is why there are a number of Obamacare provisions that are not addressed within the AHCA. These provisions will be addressed in the second and third pieces of our repeal and replace strategy.

The second part of the strategy involves Health and Human Services Secretary Tom Price using the administrative authority granted to him in the law to determine whether certain provisions need to continue to be enforced, as well as whether to repeal and/or replace additional rules and regulations. This process has already started.

The final part of our repeal and replace strategy will require Congress to pull from existing replacement proposals to develop a bill that addresses the components of Obamacare that will remain, following reconciliation and the actions taken by the HHS secretary.

In its current form, the AHCA is not perfect, and I intend to continue to carefully review the details of this plan during the coming days and weeks. At this point, I have concerns about some of the provisions, but I am confident we can work through an open amendment process and deliver a final product that takes a strong step in the right direction for Americans.

During the telephone town hall meeting, I also heard from constituents who had questions about some of the resolutions Congress has passed to roll back the regulatory overreach of the Obama Administration.

Congress has a tool called the Congressional Review Act, which gives the House and Senate the authority to consider resolutions of disapproval that would void regulations that have been finalized by the executive branch. So far this year, Congress has used the CRA to void two of the previous administration’s midnight regulations, and there are several other resolutions of disapproval that are in the process of being considered by the House and Senate.

One regulation that was voided was the Department of the Interior’s stream buffer rule. Prior to proposing the rule, the DOI conducted its own investigative report, which showed that nearly all coal mines around the country have no off-site impacts. Yet, the department finalized 1,640 pages of mandates that would apply to every coal mine in the country. The rule would have had little environmental benefit, given the protections that are already in place under the Clean Water Act, and would have only served to regulate away good-paying jobs and our most reliable energy source in use today.

When it comes to public lands, I have and always will fight to protect Colorado’s pristine areas and cultural treasures. In 2014, I worked to designate more than 70,000 acres of the San Juan National Forest as the Hermosa Creek Special Management Area, and I carried legislation through the House to designate Chimney Rock as a national monument. Earlier this year, I joined my Colorado colleague, U.S. Rep. Jared Polis, in introducing a bill that expands the boundary of the Arapaho National Forest.

If you are interested in listening to the complete telephone town hall, you can do so on my YouTube channel or by downloading the link from my recent news release: Tipton Talks Health Care, Regulations, and Public Lands During Telephone Town Hall.

Rep. Scott Tipton represents Colorado's 3rd Congressional District.

Comments

George Fargo 2 weeks, 2 days ago

Come out from behind your telephone. Under Trumpcare those people will have infinite deductible, $0 premium and no health insurance

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Gaylan Hellyer 2 weeks, 1 day ago

Something needs to change in Healthcare. They are pricing themselves out and we are running out of options.

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Scott Wedel 2 weeks, 1 day ago

Healthcare is about 17% of the US economy, you don't just try anything.

The British movie Breaking the Sound Barrier had a British pilot as the first to break the sound barrier. A key moment is where the pilot decides to fly as if controls are reversed to break the sound barrier. Chuck Yeager, the person that did first break the sound barrier, was once asked about that scene. He said anyone that would have attempted that would be a dead man.

Ideas to fixing or improving the healthcare system should be limited to what can work, not randomly trying something. Or proposing to spend less money and hoping for better medical care. I note today that Republicans are talking about the cost of long distance phone calls. Well, at the time that long distance became unregulated it was the objective of the regulations to charge much more than costs for long distance to subsidize local phone service. So for the Republicans analogy to make sense then they should be able to describe what part of medical care costs far less than is being charged to provide that regulations is making expensive.

That they are using that analogy suggests to me that these Republicans don't have a clue and are just trying to deceive the public that more for less will magically occur for health care. Rest of developed countries have structural reasons for lower costs, but they are also facing rising costs. So more for less is not to be expected unless we want to embark on the structural changes of other developed countries (doctors education heavily subsidized and so doctor pay much lower, etc).

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j mcginnis 2 weeks, 1 day ago

One of the most frequent topics from your constituents is health care, not surprisingly. You state that many families are facing deductibles greater than $6,000. You “hear from people that they can say they are insured, but they can’t afford to use their health insurance or find providers in their communities who will accept additional Medicare or Medicaid patients”.

These are anecdotes, not data.
It would be helpful if you could provide facts about our congressional district. What is the average deductible now? How has it changed in recent years? How is the proposed plan going to address this concern about deductibles? How will reducing the number of people covered by insurance in Colorado reduce anyone’s deductible?

Here are some actual facts.
-The ACA created two taxes to help fund the program. The people who are subject to these taxes have income in the top 5% of US households. Repealing these two taxes is a $275 BILLION benefit to the richest Americans over the next 10 years. In your district there are 284,000 households and at most about 10,000 are subject to these taxes. Of the over 700,000 people in the district, over 300,000 have public health coverage. How many of those people are going to lose access to medical care because the AHCA will roll back Medicaid in states like Colorado? How much more will it ultimately cost because these people do not get preventative medicine?
- The ACA limits premiums on seniors to no more than 3 times the lowest premium for the young. AHCA permits insurers to charge seniors 5 times as much. There are 106,972 people in your district (14.5%) between the ages of 55- 64. This will affect them. - There are 737,812 people in your district. Some have a high insurance subsidy (14,932 ) or medicaid expansion ( 76,939) for a total of 91,872 or 12.5% who will probably lose coverage.

The ACA was not perfect, and as you said, “In its current form, the AHCA is not perfect.” The independent Congressional Budget Office has not yet evaluated the cost of the AHCA. Before you repeal, your constituents deserve a clear understanding of what a replacement means for them. If, as has been suggested, the most immediate consequence of repeal and replace is that thousands of people go back to being uninsured, and the ultimate burden of caring for those who become ill falls on emergency rooms and over-burdened local hospitals, no one will be better off.

When can we expect you will provide a clearer evaluation of the consequences to the people of your district?

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Carl Steidtmann 1 week, 3 days ago

The ACA created dozens of new taxes not just two. Here is a partial list:

2.3% Tax on Medical Device Manufacturers began in 2014

• 10% Tax on Indoor Tanning Services began in 2014

• Blue Cross/Blue Shield Tax Hike

• Excise Tax on Charitable Hospitals that fail to comply with the requirements of ObamaCare

• Tax on Brand Name Drugs

• Tax on Health Insurers

• $500,000 Annual Executive Compensation Limit for Health Insurance Executives

• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D

• Employer Mandate on business with over 50 full-time equivalent employees to provide health insurance to full-time employees. $2,000 per employee – $3,000 if an employee uses tax credits to buy insurance on the exchange (AKA the marketplace). (starting 2015 for employers with 100 or more FTE and 2016 for those with 50 or more.)

• Medicare Tax on Investment Income. 3.8% over $200k/$250k

• Medicare Part A Tax increase of .9% over $200k/$250k

Even with all those taxes, it still added substantially to the deficit despite promises that it would be revenue neutral.

The ACA was a full time job killer. Many service businesses cut back full time employees to under 30 hours so as to avoid having to pay for health care coverage.

ACA was a rip-off of younger people. Having a 3 to 1 price differential between young and old meant that young people paid substantially more for insurance that most of them never needed and did not want.

ACA was a rip-off of men. Since women consume roughly 50% more health care over their life time and ACA did not allow for price differentials between men and women for insurance, men had to pay more.

In 2010 the Obama Administration estimated that by 2014 13 million Americans would be covered through the exchanges. In reality fewer than 6 million were covered. They estimated 16 million would be covered by the extension of Medicaid by 2014. Only 8 million were covered. That is far from 'not perfect'. Oh, and 75% of those receiving Medicaid coverage could have done so under the pre-ACA rules.

And I haven't even touched on the millions of Americans who lost coverage under the ACA rules and lost their doctors despite repeated promises to the contrary.

Less than perfect would have been a huge improvement for the ACA. At it was, it was a complete and total failure.

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Lock McShane 2 weeks, 1 day ago

Congressman Tipton,

Regulations are NOT killing coal; fracking and natural gas are. The markets are picking the better option which should make the conservatives happy. How about some money for training our workforce to do the current and future jobs that will improve the middle class? How about eliminating tax loopholes so that we can't dodge our tax obligations that fund our civilized society?

The AHCA will not give us more affordable, better, more available health care. The for-profit health insurance industry only worked after WW2 because health care was offered by companies instead of frozen wages. The system worked because large companies with large union participation enrolled many young, healthy workers along with some sick ones. The risks were easier to calculate, and money could be made. The insurance pools left out most of the population who had no communal cost-sharing until MediCare and Medicaid came along. The For-Profit Health Care Industry (FPHCI) has succeeded only when it could pick who they insured and denied payments for services. If you want health care for all, promised by our President, at lower cost, then the FPHCI must go. If you believe that health care should only be for those that can afford it, then the FPHCI can do that.

Our current system has too many prices for the same service for anyone to reasonably shop for health care. Can we, at least, get one price for everyone, no matter who pays, for the same service at the same facility?

About your telephone town hall, I got the call halfway through, and didn't get to actively participate. Next time, call us ahead of time, and let us know when it is happening. I also tried to leave you a message after the meeting and got a beep that lasted minutes before it hung up on me. An on-line town hall meeting would allow more interaction between you and those who you serve.

You have to remember that you are working for ALL the people in your district, and if you don't have the time to communicate with your constituents, then you are not succeeding in your job and should let someone who listens to all of us do the work.

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Nancy Spillane 2 weeks ago

These telephone "town halls" are a joke that are being done by Tipton and Gardner. No interaction. Just ask a question and get a party line answer.

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Scott Wedel 2 weeks, 1 day ago

Slightly off topic, but on the topic of where regulations are killing jobs is

https://www.brookings.edu/blog/up-front/2015/01/27/nearly-30-percent-of-workers-in-the-u-s-need-a-license-to-perform-their-job-it-is-time-to-examine-occupational-licensing-practices/

When 30% of jobs require a state license, up from 5%, then it becomes far harder for people to find a new job. Michigan requires over 1,400 days to become an athletic trainer. That means a middle aged person will spend a big portion of remaining work years to become licensed.

Also, some states allow very restrictive noncompete employment contracts so that if you work in one summer camp in Massachusetts then you cannot work in any other summer camp. Or cannot work for another hairdresser and so on.

We do have too many rules that do make it too hard to work. It is ironic that state licensing occurs for jobs that remain the same and can easily be defined by lawmakers, while high growth tech jobs change too much for government imposed licensing. In tech, certifications are by private companies (such as Microsoft Certified Professional) and businesses can decide if that means anything in their hiring process.

The state licensing is typically a protection racket for the current employees in a field. The licensing requirements often are not online tests showing needed knowledge, but require costly classes and substantial experience as added barriers for new employees in a field.

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Dan Shores 2 weeks ago

What happened to tort reform and selling insurance across state lines? We were told ad nauseum that this was all that was needed to fix health insurance.

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Ken Mauldin 2 weeks ago

Tort reform and selling across state lines can't be included in the current Reconciliation Bill because those aspects don't directly impact the Federal budget. Passing a Bill of complete repeal, outside of the reconciliation process, would be better than trying to re-word such a convoluted disaster.

Here's my proposed Bill: "The Patient Protection and Affordable Care Act is hereby repealed, effective January 1, 2018" (or some reasonable time in the near future.)

This would keep all current coverage in place and give time for all stakeholders to adjust and provide time for Congress to pass tort-reform and pre-existing condition regulations. I think selling across state lines would become legal upon the complete repeal of the ACA, as it's the ACA that expressly forbids sales across state lines.

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Lock McShane 2 weeks ago

Since insurance companies are regulated by the states, selling across state lines would require Federal regulation. If there is selling across state lines, which state regulations apply, those of the seller or those of the buyer? There are states that allow insurance sales across state lines, like Mass and Maine, yet no insurance companies have tried to do it, since establishing networks of providers out-of-state is difficult. How about having all providers being a part of all networks; that will help.

None of the so-called reforms are addressing the real issue, reductions of the cost of health care. Companies can charge whatever they want, since there is no direct competition with the opaque pricing structures that we have.

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Scott Wedel 2 weeks ago

Lock,

Nor is there any indication that state's regulation of health insurance adds significant costs in many states. In most states, the health insurance is a much more powerful lobby than anything else so they have gotten what they want.

One of the reasons that health care has such opaque pricing is because healthcare providers negotiate reduced prices with their in network providers. So whether a provider joins a network depends on whether they agree to those negotiated prices.

As can be seen from much of the healthcare debate, a big problem is that too many people are too insulated from actual costs. Many people don't realize how much their employer is paying for their portion of health insurance.

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Ken Mauldin 2 weeks ago

Hi Lock - We have BCBS of GA through our employer and have never had trouble with providers in Florida or Colorado. So, I'm not sure it's difficult to establish networks of providers out of state. At least, it hasn't ever been a problem for us.

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Scott Wedel 2 weeks ago

I believe that selling across state lines could matter in the highly populated Northeast where many people live near a state border and there are big cities near state lines. So it wouldn't be a matter of setting up a network in another state, but being able to sell health insurance to use a network in another state.

Right now, in Colorado you cannot even buy health insurance to use a network in another part of the state. So all of the health insurance options in this part of the state have to have negotiated prices for procedures with YVMC. State insurance regulations prevent providers from doing what the VA does which is to say go to the Grand Junction hospital for ongoing health issues.

The whole thing is so inconsistent.

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Anne Barounos 2 weeks ago

Dear Rep Tipton -

According to the new report by the Congressional Budget Office, 14 million people will lose their health care in the first year of Trumpcare with another 10 million losing health care by 2026, for a total of 24 million losing health care under Trump.

Additionally, according to the CBO, Trumpcare would cut taxes dedicated to finance Medicare by at least $117 billion and cut Medicaid by $370 billion, in order to give a huge tax cut to the wealthy, including a $7 million annual tax break to the wealthiest 400 U.S. households.

And by the way, "telephone town halls" are not meetings with your constituents - they are cynically stage-managed events where only the people you want to allow to speak are able to get through and ask questions -- they are infomercials.

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Scott Wedel 2 weeks ago

Anne,

You think Rep Tipton, unwilling to hold a public town hall, is reading this blog?

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Nancy Spillane 1 week, 6 days ago

Anne, you are right. The telephone town halls are NOT town halls, they are infomercials. That's why we all write/call Mr. Tipton daily to ask for a real town hall meeting in Routt County.

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Ken Mauldin 1 week, 6 days ago

I don't think it's wrong or bad that a representative would hold both in-person and telephone meetings throughout the year, especially in a District as large and prone to winter weather impacts as Colorado's 3rd Congressional District. According to the article, Rep. Tipton's spring and summer public meetings will provide the opportunity to speak directly with him and ask questions in person.

I would encourage Rep. Tipton to vote in favor of a complete repeal of the ACA. The GOP shouldn't try to alter or modify it; the ACA should be completely repealed.

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Lock McShane 1 week, 5 days ago

Can we all agree that the most obnoxious regulations are those that try to "idiot-proof" the country? Like the notice on the cup that coffee is hot. My new car stereo has a notice '"Do Not Watch Videos While Driving" that takes 10 seconds of bootup time. My truck locks the doors when I put it in gear. These are the regulations we need to get rid of, not those that protect our air and water.

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Jeff Kibler 1 week, 4 days ago

EPA's "Waters of the United States" looks good on paper, but the enforcement overreach is egregious. Watch out for that snow melt on your land. The EPA will declare it a seasonal stream and fine you thousands with no due process. These are the regulations we need to get rid of.

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Lock McShane 1 week, 4 days ago

I do have a seasonal stream. But I try to make sure that I don't put anything in that stream that affects the purity of the water downstream. So I won't get fined thousands of dollars if I don't pollute it.

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rhys jones 1 week, 4 days ago

Lock -- The things you name aren't regulations, they are attempts to avoid liability, voluntarily undertaken at the instruction of an attorney. So your displeasure is misplaced, and should be with the legal fraternity. I'm not saying there aren't too many laws -- I'm saying the sharks make a feast out of the ones there are. Hence driving up everybody's cost of living, even those fortunate enough to not need them.

"Less regulation" is a joke. We pay the pols to make the laws, then we pay the lawyers to squabble over them. It's a self-perpetuating situation. There's money in laws. Our money.

I hope somebody keeps score: How many laws Trump negates, and how many he signs.

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Lock McShane 1 week, 4 days ago

Then I should be able to voluntarily bypass the idiot-proofing, thereby releasing the company from any liability.

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