An onslaught of bewildering television ads have so far dominated the pivotal struggle for the congressional seat that includes Rim Country.
Flagstaff dentist and Republican Paul Gosar has drawn an avalanche of private and party money, which he has funneled into ads that have focused on sideshow issues in his effort to unseat freshman Democratic lawmaker Ann Kirkpatrick.
Few of the ads have dealt with one of the most crucial divisions — the candidates’ stances on the federal health care reforms.
Kirkpatrick, a former prosecutor and state lawmaker, has staked out one of the most independent voting records among House Democrats. However, she also supported the Obama Administration’s health care reforms.
Gosar has repeatedly called for the repeal of the entire health care reform package and said that if he’s elected he’ll vote against any money to implement those reforms. At a candidate forum in Payson, Gosar said even if the Republicans take charge of the House, as some observers predict, they won’t be able to fully repeal the reforms unless an “act of God” removes President Barack Obama and his veto.
Kirkpatrick, defended her vote for the health care reform package. “I think it was the right thing for the district,” she said. “I’m proud of my vote.”
She said, for instance, that Native Americans comprise a quarter of the population in the vast First Congressional District, which extends from Four Corners to Casa Grande. She said she worked to make sure that reforms restored previous deep cuts in the Indian Health Services budget.
Gosar, on the other hand, stressed the cost of the provisions in the bill that provide coverage for an additional 32 million Americans, but also fine individuals and businesses that don’t get health insurance.
“Ann Kirkpatrick’s vote for Obamacare will cost Arizona taxpayers $1 billion a year. Every voter in Congressional District One should remember her vote when they cast their ballot,” said Gosar.
The biggest expansion of health care coverage since the establishment of Medicare relied heavily on the existing private insurance system, rather than setting up a new public system. Already, early provisions barring insurance companies from dropping coverage for people after they get sick, imposing lifetime limits on coverage and refusing to cover children with pre-existing conditions have gone into effect.
Other reforms will phase in gradually over the next three years, including insurance pools, a system of fines levied on those without insurance and subsidies to lower the cost of insurance for businesses and individuals. The reforms also include a series of reductions in the rate of increase in Medicare spending.
Already, some insurance plans and employers have balked at the reforms. For instance, McDonald’s has threatened to drop coverage for its workers unless the federal government grants a waiver so it can continue to offer what amounts to a catastrophic health care plan with sharp limits on coverage.
Moreover, many health care plans have promised sharp increases in premiums if they have to repeal lifetime limits on coverage and lose the ability to exclude pre-existing conditions and drop people from their plans after they become sick. Other insurance plans have said they will pull out of certain markets if the federal government enforces a proposal limiting insurance overhead costs to 15 percent of the premium dollar. Some insurance plans have stopped offering child-only plans.
The reforms could also have a substantial impact on Arizona’s deficit-plagued budget, mostly because voters previously expanded the state’s Medicaid-based AHCCCS program, which provides medical care mostly to low-income children and medically bankrupt nursing home residents.
Voters had previously expanded eligibility for AHCCCS to about 130 percent of the poverty line. The Legislature tried to repeal that expansion, but the federal government threatened to withhold all the state’s AHCCCS money. The federal government currently pays about 95 percent of the cost of the program.
Gosar’s ads have accused Kirkpatrick of supporting cuts in Medicare, although the health care reform package also includes money to reduce the cost of prescription drugs for people on Medicare. The bulk of the Medicare reductions involve cuts in subsidies to private Medicare Advantage plans, health maintenance organizations that have long enjoyed extra subsidies.
Few voters have yet seen any personal benefit from the changes, most of which won’t take effect until 2014.
Nationally, an estimated 45,000 Americans die each year as a result of a lack of medical insurance that prompts them to delay care for medical problems, according to studies. The U.S. remains the only advanced, industrialized nation without universal health care, but spends far more per person.
Federal estimates suggest that eventually about 1.3 million uninsured Arizona residents will benefit from the reforms — especially in Gila County where 30 percent of the population gets coverage through AHCCCS.
The House Commerce Committee prepared estimates of the ultimate impact of health care reforms locally, including the following projected impacts in the First Congressional District.
• Extend coverage to 118,000 people without insurance.
• Allow 66,000 young adults to get coverage through parents.
• Provide funding for 30 community health centers.
• Reduce uncompensated care for local hospitals by $54 million.
• Provide broader coverage for 331,000 residents.
• Reduce prescription drug costs for 127,000 Medicare recipients.
• Provide help paying insurance premiums to 203,000 families and 14,800 small businesses.
• Provide coverage for an estimated 20,000 people with pre-existing conditions.