Public gusto not his remedy
Gardner has low-key approach to reform
washington» Three years after running on a pledge to repeal the Affordable Care Act, U.S. Sen. Cory Gardner of Colorado has a chance to do just that — having been named to a 13-member team of Senate Republicans tasked with dismantling the massive health care law.
But Gardner isn’t approaching the assignment with the same kind of public gusto seen in lawmakers such as U.S. Sen. Ted Cruz of Texas, who has advocated for a strategy that would pull out all the stops to repeal Obamacare. Instead, Gardner has kept a lower profile — a reflection of both his policy goals and the political peril that comes with undoing President Barack Obama’s signature law.
After House Republicans narrowly passed their own version of an Obamacare repeal bill, Gardner said little about the hard-line measure itself — other than to note that he looked forward to working on a Senate version. Nor has he joined with Cruz and U.S. Sen. Rand Paul, R-Ky., in calling on Senate leaders to bend parliamentary rules to get a full repeal bill done. He said he’s focused more of his time on taking meetings with stakeholders and fellow senators, including a few Democrats.
“It’s important that we can find something that can pass,” Gardner said. But “for people to stand around Congress and say the status quo is acceptable — shame on them.”
Democrats and Republicans, he added, “have to work and find a solution and put in place of the Affordable Care Act something that reduces the cost of care and increases the quality of care.”
The anchor on his approach is the way that Colorado policymakers have welcomed the Affordable Care Act. Unlike
some of his Republican colleagues — whose home states have kept the law at arm’s length — Colorado fully embraced the health care law by launching a program for residents to buy coverage through a state exchange and vastly increasing the number of residents covered by Medicaid.
It’s the Medicaid piece that Gardner likely will have the most say on as a member of the 13member panel, which was picked by Senate Majority Leader Mitch McConnell and initially included only male Republicans. That composition drew fire for its lack of inclusiveness, and McConnell later invited every Senate Republican to participate, including the caucus’ female lawmakers.
The Trump administration wants the Senate to vote on a bill before lawmakers leave for their annual August recess, though senators have been in less of a rush than their House counterparts.
The House-passed version of the repeal bill would begin rolling back Obamacare’s expansion of Medicaid starting in 2020. Patients covered by Medicaid expansion in 2020 could remain on the program so long as they kept their eligibility, though it’s expected the group would dwindle to nothing within five years of the deadline.
The change could have a significant impact on Colorado, which added an estimated 407,000 residents to Medicaid under the Affordable Care Act — growing the rolls to 1.3 million Coloradans, nearly a quarter of the state. The Medicaid expansion was the main reason the number of Coloradans without health insurance dropped from nearly 15.8 percent in 2011 to 6.7 percent in 2015, according to the Colorado Health Institute.
But Republicans have raised concerns about its cost. “Medicaid was never designed to be a standardized, standard-issue insurance policy for everyone,” Gardner said. “This was designed to be a safety net for the American people and we need to make sure that safety net is sustainable.”
The goal of Republican law- makers is to shift patients, such as those added to Medicaid, to health insurance covered by the private sector. But Gardner said he wants to provide as much time as possible for these Medicaid patients to find new insurance — though he wouldn’t commit to a specific deadline when asked whether the 2020 date in the House bill was appropriate.
“We need to have a glide path that works for the states,” Gardner said.
Garner has said he likes how the Affordable Care Act allows children to remain on their parents’ insurance until they turn 26 and also protections for patients with pre-existing conditions; a shield the House bill would lower by allowing states to get a waiver from that requirement for the individual market.
“We need to make sure the people with pre-existing conditions continue to have coverage and continue to have access to affordable coverage,” Gardner said.
The issue of pre-existing conditions was the reason U.S. Rep. Mike Coffman, another Colorado Republican, said he voted against the House version.
The challenge for the Republican-controlled Congress is to craft a bill that can appease hardline conservatives in the Freedom Caucus — who pushed the House bill to the right — and lawmakers such as Coffman and Gardner.
But make no mistake. Gardner wants to repeal the 2010 health care law — including its fines on citizens who don’t buy insurance and penalties on large businesses that don’t provide coverage.
One motivation is Colorado’s experience with the individual health care market, which provides insurance options for residents who don’t get it through Medicaid or their employer. Only a fraction of state residents get their health insurance this way — and even fewer, about 184,000, chose their plan through Connect for Health Colorado, an exchange created by the Colorado legislature in response to the Affordable Care Act.
But Republicans have raised concerns about the state of the individual market, including its cost to consumers and lack of choices.
“We have to save the American people from a collapsing Obamacare law,” Gardner said.
Coloradans who buy their own health insurance were expected to see their rates increase 20.4 percent for 2017 over last year — although many of these consumers would qualify for subsidies under the health care law, according to the Colorado Division of Insurance.
Any change to the system, however, has the potential to ripple across the landscape, said one health care expert.
“I like to think of the health care system like a Rubik’s Cube,” said Kyle Legleiter, a senior policy director with the Colorado Health Foundation. “Tinkering with individual pieces of health care policy or health care insurance affect all the others. You can’t change Medicaid policy without having an impact on the individual market or employer-based coverage.”
How the Senate address health care could have long-range political repercussions for Gardner, who faces voters again in 2020.
For months, Gardner has been the target of liberal activists in Colorado who are angry about his push to repeal the Affordable Care Act. There’s been a steady presence of protesters at Gardner’s office in Denver, and health care was a major sticking point for activists who gathered earlier this year at a pseudo town hall meeting — complete with a cutout of the Colorado lawmaker.
Katie Farnan, a Gunbarrel librarian and leader of the antiTrump group Indivisible Front Range Resistance, said she remains concerned about the process — given how the Senate started with the male-only team.
“Unless they’ve been a woman at some point in their life, I doubt they will know what it’s like to have a failure to latch (with a baby during breast-feeding) or a bad Pap smear,” said Farnan, who added that the Affordable Care Act helped her access pump supplies for her babies and preventative care for women’s health.
“Male health care is just not the same as female health care,” she said
But the left isn’t Gardner’s only worry. In two separate Colorado polls, a majority of respondents said they wanted to keep or fix the act, and not just start over. Notably, 38 percent of Republicans in one survey by Magellan Strategies — run by David Flaherty, who previously worked at the Republican National Committee — held that view.
While more Republicans, at 58 percent, wanted to start over or simply undo the Affordable Care Act, those backing a fix were a key reason why a total of 60 percent of Coloradans who were against a health care repeal.
One looming issue is whether the Senate delays a vote on its proposal until it learns from government budget hawks how much its plan costs.
The House was criticized for voting on its plan before getting a price tag from the Congressional Budget Office; Gardner said it was important but didn’t commit entirely to getting a CBO score before a vote.
“Obviously we want to turn it around quickly, and there are going to be other scores out there that will show us what the bill will do and it’s important to not just look at the CBO score. There will be other experts out there and other analysts out there will show their opinions as well,” he said.
No matter what happens, however, health care is likely to remain at the forefront of issues for Gardner and his constituents.
“It is safe to say that the politics of health care will continue to impact Colorado’s political environment heading into 2018, especially if congressional Republicans enact a solution that is not popular with a majority of Colorado voters,” noted a memo that accompanied the Magellan Strategies poll.