Virginia’s 1st congressional district (from here)

Am I a big fan of Rob Wittman? No. The guy talks like a Conservative, but he votes like a moderate. In fairness, however, a large chunk of his district is in Northern Virginia. Conventional wisdom does not favor the election of Conservatives here.  So if he voted as a Conservatively as he talks, I suppose he thinks a Democrat Liberal would soon replace him. Yet he also has a bunch of Conservatives in his district.  So he tries to please everyone. Not possible, of course.

Anyway, here is Wittman’s rationale for voting for the American Health Care Act. It is the text of an email he sent out today.


This week, the House of Representatives passed H.R. 1628, the American Health Care Act, with my support. It is clear the Affordable Care Act is failing and must be fixed. Having reviewed the text of the bill and the Upton and MacArthur Amendments, I believe this legislation does what is necessary to protect individuals with pre-existing conditions, meets the principles for health care reform I laid out several months ago, and puts in place policies that will expand health care choices, increase access to care, and reduce costs.

This is the first step in a multi-step legislative and administrative process that will give individuals and families more control and choice over their health care decisions while increasing flexibility for states to deliver quality, affordable health care options to their residents.

I wanted to further explain my support of the bill by highlighting key parts of the American Health Care Act. Throughout the year, I conducted a Healthcare Listening Tour, where I heard from hospital administrators, doctors, nurses, patient advocates, people affected by the failing Affordable Care Act, and other stakeholders. These conversations reiterated how the failing Affordable Care Act is negatively affecting the constituents of the First District and furthered my resolve to work to make healthcare better for everyone. I remain committed to the constituents of the First District and will continue working to on behalf of their best interests.

 The Case for the American Health Care Act

1. The Affordable Care Act (ACA) is failing

The Affordable Care Act promised to lower costs, increase access to care, and expand health care choices. It has failed on all three.

Costs: According to the Washington Post, “Insurers are raising the 2017 premiums for a popular and significant group of health plans sold through HealthCare.gov by an average of 25 percent, more than triple the increase for this year, according to new government figures. The spike in average rates for the 38 states that rely on the federal marketplace created under the Affordable Care Act was announced by federal health officials on Monday.”

Access: According to Bloomberg, “Failing insurers. Rising premiums. Financial losses. The deteriorating Obamacare market that the health insurance industry feared is here. As concerns about the survival of the Affordable Care Act’s markets intensify, the role of nonprofit “co-op” health insurers — meant to broaden choices under the law — has gained prominence. Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years.”

Choice: According to Time, “According to a new analysis from the nonpartisan Kaiser Family Foundation, almost a third of counties will have just one insurer participating in the exchanges by 2017, significantly more than the 7% of counties who had one option this year. That equates to 19% of all enrollees facing just one insurance option.”

And just recently we heard that Aetna was leaving the insurance exchanges in Virginia, meaning that Virginians in 50 of our 95 counties where Aetna operates will have one fewer insurance option. In 24 counties where it operates, there is just one other insurer selling Obamacare plans. This means Virginians have fewer choices and will face increased costs.

2. The Republicans plan to repeal the ACA will replace it with a bill that expands choice, increases access, and reduces costs

That plan is H.R. 1628, the American Health Care Act. The bill is the first step in a multi-step legislative and administrative process that will give individuals and families more control and choice over their health care decisions while increasing flexibility for states to deliver quality, affordable health care options to their residents.

The American Health Care Act repeals the ACA’s individual and employer mandates and tax increases while phasing out the ACA’s health insurance subsidies and Medicaid expansion, replacing them with refundable tax credits and a more effective Medicaid funding model.

3. American Health Care Act Questions Answered

Will the AHCA kick 24 million people off of their health insurance?

No. AHCA will ensure everyone has access to affordable, quality health care, but not by forcing them to buy insurance or penalizing them if they don’t purchase insurance. Instead, the AHCA provides refundable tax credits to low and middle income individuals so they have an incentive to purchase insurance.

Moreover, the original Congressional Budget Office (CBO) estimate failed to take into account other planned legislative and administrative actions, which will help bring down costs and expand coverage. The CBO has a spotty track record when it comes to projecting health insurance coverage.  When CBO originally scored Obamacare, they projected that 21 million Americans would have coverage in 2016. The reality was half that number, about 10.4 million gained coverage.

Our plan provides every American with access to affordable coverage. Low-income individuals not on Medicaid will receive a refundable tax credit to purchase insurance (meaning they get assistance even if they do not pay income tax). States can also further help low-income Americans through a new Patient and State Stability Fund.

I have a pre-existing condition. How does this bill affect me?

Under the AHCA, insurance companies cannot deny you coverage based on pre-existing conditions. And your health status cannot affect your premiums, unless your state asks for and receives a waiver—a condition of which is the state having other protections in place for those with pre-existing conditions. Even if your state does obtain a waiver, so long as you’ve been continuously covered, you still cannot be charged more. The bill provides added resources to help people in waiver states who have not been continuously covered to gain coverage. Bottom line, there are many levels of protection for those with pre-existing conditions in the legislation.

I heard about the MacArthur amendment allowing states to waive protections for pre-existing conditions. If this happens, will I lose all my benefits?

No. This amendment preserves protections for people with pre-existing conditions while giving states greater flexibility to lower premiums and stabilize the insurance market. To obtain a waiver, states will have to establish programs to serve people with pre-existing conditions. And no matter what, insurance companies cannot deny you coverage based on pre-existing conditions.

The MacArthur amendment only applies to the individual insurance market, where roughly 7 percent of the country purchase coverage. This means that the MacArthur amendment does NOT apply to 93 percent of Americans with employer-provided coverage or government coverage (Medicare, Medicaid, Tricare, VA benefits, and others).

Does the MacArthur amendment allow states to waive certain coverages, therefore raising costs?

Although it gives states an option to tailor coverage limitations, the process is very strict. A state must explain how a waiver will reach the goals of lowering premiums, increasing enrollment, stabilizing the market/premiums, and/or increasing choice. States must lay out the benefits they would provide. And most importantly, states may only apply for a waiver if they have their own risk pool in place. Again, the coverage of people with pre-existing conditions will be protected.

Even if a state asks for and is granted a waiver, no one’s premium may be priced based on health status if they have maintained continuous coverage. In addition to these protections, the AHCA provides significant resources at the federal and state level for risk-sharing programs that lower premiums for all people.

And what about the Upton amendment?

This $8 billion is on top of the $130 billion available to states through the AHCA’s Patient and State Stability Fund, which helps states repair their health markets damaged by Obamacare.

States can use the funds to:

  • cut out-of-pocket costs, like premiums and deductibles
  • promote access to preventive services, like getting an annual checkup, as well as dental and vision care
  • promote participation in private health insurance or to increase the number of options available through the market

How will the AHCA affect seniors?

We know that seniors require and deserve more robust health insurance coverage. But under the ACA, the cost of the most generous plan for older Americans is limited to three times the cost of the least generous plan for younger Americans. Many health economists say the true cost of care is 4.8-to-one. So Section 135 of the American Health Care Act changes what is known as the “permissible age variation” to a five-to-one ratio in insurance premium rates so that seniors have coverage that works for them. Simply put, seniors will be able to purchase a plan that covers their true cost of care.

Are Members of Congress and their staff bound to the same rules as everyone else?

Yes. The House passed, with Rep. Wittman’s support, H.R. 1292, a bill that ensures Members of Congress and their staff are treated the same way as everyone else under the American Health Care Act. What many people don’t know is that the Affordable Care Act included the exemption for Members of Congress and staff. Rep. Wittman opposed that language in the ACA, worked to get the exemption removed, and does not accept the stipend provided to Members of Congress under the Affordable Care Act to pay for his insurance premiums.

Personally, I am not happy with this bill, but it is a start, and we have to start someplace.

Elections have consequences. When we elected all those Democrat Liberals —  Socialists — and we asked them to give us other people’s money, that permitted our government to rob us.  Fortunately, we have started electing people who are more willing to let us run our own lives. That may not sound as wonderful as electing a clown who makes promises only God could keep, but it is considerably less costly, both in fortune and in blood.

Remember these words.

The journey will be difficult. The road will be long. I face this challenge with profound humility, and knowledge of my own limitations. But I also face it with limitless faith in the capacity of the American people. Because if we are willing to work for it, and fight for it, and believe in it, then I am absolutely certain that generations from now, we will be able to look back and tell our children that this was the moment when we began to provide care for the sick and good jobs to the jobless; this was the moment when the rise of the oceans began to slow and our planet began to heal; this was the moment when we ended a war and secured our nation and restored our image as the last, best hope on earth. This was the moment – this was the time – when we came together to remake this great nation so that it may always reflect our very best selves, and our highest ideals.

Supposedly smart people gave the man the Nobel Peace Prize just for uttering pretty words and getting elected. How crazy is that! Obama had almost no experience managing anything, much less a peace process. Just because someone can confidently spout pretty prose, does mean he can or even intends to deliver? Yet we elected him twice.

Republicans are not promising the sun and the moon or suggesting they have control over the rise of the oceans. They are not trying to pass their bill before we know what is in it. So please ignore our biased news media and give them a fair hearing.


  1. The reason so many doctors are imported is because in countries like India, it costs the same to educate an engineer as a doctor.

    Now if you can answer why the USA cannot do the same, We now seduce young men into the armed services by paying a young man to join the army to obtain a college degree and then have to serve four or more years. in return.

    Instead to receive a doctors degree in the USA, the potential doctors have either rich parents or they incur loans that they have to pay off banks for the rest of their careers, and of course charge higher fees.

    Wise or foolish, you decide.

    Regards and goodwill blogiging.

    1. Why is it government’s job to make certain we have a enough people in this or that profession? What would make anyone think that our elected official either have or would properly hire people with that sort of expertise?

      Consider. Our military wastes gobs of money getting those people with four-year degrees they NEVER use. And still we don’t have enough engineers, supposedly.

      1. Tom,

        In ancient times in Israel, the Priests warned against having a King because they knew taxes and power problems would result in time.

        Then because Israel was invaded over and over, the people decided they need a King to unite against invaders and King Saul was anointed.
        Anointed meaning a King was believed to be God’s choice to rule over them. In other cultures, Kings were to be Gods on Earth and their decisions were oracles.

        The USA Government has three branches of “Kingdoms” and instead of oracles, we have laws. We cannot stomach call the leaders Kings, so we allow them to be our Big Brothers and protect us from invaders and bullies. .

        However, some Big Brothers believe they get first “div.” of all “goodies” in the household.

        In other words, the only difference over time is the name of leaders who get first div.

        We are beholden to government by our own choice and must pay tribute. We vote ‘em out when they get too greedy same as we overthrew Kings.

        Only problem nowadays is our leaders no longer are anointed leaders meaning the choices are made by a lot of people who no longer believe in the concept of anointing.

        In the USA, lots of people believe they no longer need either a King or a God anymore, only Big Brothers for guidance and have been “conditioned” to allow Big Brothers to make all their decisions so they won’t get beaten up by bullies or invaders.

        When you say why Government get involved in everything, you are warning against having a King same as in ancient Israel.

        “Nothing is new under the sun.”

        Notice that President Trump has issued an executive order to allow Priests to no longer be stifled by Big Brothers from speaking out again to “anoint” Big Brothers.

        The pendulum may be beginning to swing back to the original way to choose input from God to vote to hopefully choose better Big Brothers in time?

        Regards and goodwill blogging.

  2. The details are too steep for me. All I know is my children and their families now have $5000 deductibles from their employers. I had $250 for my family before Obamacare.

    Whether it was higher medical costs or Obamacare, I frankly do not know.

    Regards and goodwill blogging.

    1. The higher medical costs are generally driven by the government. Government literally pours money into our health care system. Look at the Federal Budget (=> http://www.usfederalbudget.us/health_care_budget_2017_1.html). With so much money pouring into the system, we have an artificially huge demand. So the prices skyrocket.

      Now you might think that the prices would eventually stabilize. So why don’t they? Here are just a couple of examples. Healthcare has intense regulation. That’s a a costly barrier to entry. Small players have a difficult time dealing with so many administrative headaches. Only so many doctors and nurses get trained every year. These people have licensing requirements. Nobody can just walk in off the street. What happens instead is doctors come here from other parts of the world so that they can earn some of that money.

      My bottom line is that the vast majority of that spending has no constitutional authorization, none whatsoever. The reason we cannot effectively control it is that we should not be doing it at all. Most of that spending is just legalized theft. We are just robbing our own treasury. We cannot control it because we refuse to stop stealing. We refuse to admit we are stealing.

  3. I second the comment above. Under Obamacare I had no hope. Now I have some hope.

    Many people have no idea how absolutely awful the ACA has been, so like, no access to healthcare, huge fines,massive medical bills, insurance that covers nothing, outright fraud, businesses forced to shut down, the misery just goes on and on.

    It’s so bad, congress can’t help but improve it. They certainly couldn’t do anything to make it worse. That’s saying something too, because congress is notorious for finding new and inventive ways to make everything worse. 🙂

    1. Reminds me of one of my favorite quotes.

      The most terrifying words in the English language are: I’m from the government and I’m here to help. — Ronald Reagan

      I suspect it will be a pleasure if I ever meet that man in heaven.

  4. Thank you for this detailed account! It gives great hope, something I didn’t have under Obamacare!

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