Editorial: Quiz candidates on health access and coverage

By The Herald Editorial Board

Have your questions ready; the candidates are coming.

With about two months remaining before the Nov. 6 general election, expect to be blasted with a fire-hose-stream of information about candidates running for Congress and the state Legislature.

Not all of it will be particularly helpful, especially that coming from negative campaign ads on television, radio and in your mailbox. More useful can be the statements coming directly from candidates themselves in news coverage, at public forums and even at your doorstep as they look to talk personally with voters.

A little preparation on the part of voters can help make certain you get the responses you need as you consider who to support. And even if you can’t question a candidate directly, a little background can help you gauge candidates’ responses as to what they support, what they don’t and how well they understand the issues and your concerns.

Voters will have their own priorities they’ll want to see candidates address, but questions over health care are already top of mind for many voters. A poll by NBC and the Wall Street Journal in June found that 22 percent of voters counted health care as their top issue when considering candidates, followed by the economy and jobs (19 percent), firearms (13 percent) taxes and spending (11 percent) and immigration (10 percent).

Another June poll, by the Kaiser Family Foundation, asked more specifically about the Affordable Care Act’s provisions protecting coverage for people with pre-existing conditions; 63 percent said continuing coverage of pre-existing conditions was either the most important or very important in their consideration of which candidates to support.

There’s good reason for that concern.

With Republicans unable last year to repeal and replace the ACA, also known as Obamacare, the Trump administration and Republicans at the state and national level have instead sought to force its collapse.

Texas and 19 other states have filed suit, claiming that the ACA’s individual mandate requiring people to obtain health insurance is now unconstitutional, following Congress’ decision to end the tax penalty for those who do not have health insurance. If the lawsuit is successful, the court decision would likely render unconstitutional the ACA’s provision on pre-existing conditions along with others.

At the same time, the Trump administration has sought to allow lower-cost short-term insurance policies that were originally intended to provide stop-gap coverage, for example, between jobs. The policies, seen as an alternative to Obamacare, are less costly, but many don’t offer coverage of pre-existing conditions or even medications.

Trump’s decision to halt billions of dollars in annual payments to insurers to pool risk and help stabilize the markets is also expected to result in higher premium costs for millions of individuals and small business owners, increases that insurance companies are expected to announce shortly before the election.

Whether the ACA is ultimately repealed and replaced; is kept and reformed; or more sweeping legislation such as Medicare for All is to be considered, the nation and individual states will need to make decisions soon on the accessibility, affordability and sustainability of health care.

Last year, U.S. citizens, employers and state and federal governments spent more than $3.5 trillion in personal and corporate income and taxpayer dollars on health care, accounting for 18 percent of Gross Domestic Product, according to figures from the Committee for a Responsible Federal Budget and the Concerned Actuaries Group.

The annual cost of health care per average household, the groups said, is estimated at $28,000, the largest household expenditure. And that cost is expected to grow by $5,000 between now and 2027.

The costs incurred by Medicare are a concern for state lawmakers as much as members of Congress. Medicaid, the CRFB said, consumes about 67 percent of every federal dollar going to state and local governments, up from 55 percent just eight years ago.

Congressional candidates can also be quizzed on their support for funding for community health centers as demand increases for general health care, dental and behavioral health care.

Candidates for state Legislature, which will be writing a two-year budget next session, can be asked about funding for mental health and addiction treatment facilities in communities and better support of public health agencies, such as the Snohomish Health District.

Candidates may not have all the answers to how these issues are resolved, but you can hold them to providing an answer that convinces you they have done their homework and are paying attention to your concerns.

Correction: An earlier version of this editorial gave the wrong date for the Nov. 6 general election.