VOICES | Call and Response: Letters to Congress, Part 2

quotation-marksWe call attention to this letter to demonstrate how our representative (OH-7), Bob Gibbs, has responded to constituents’ concerns—in this case, the Affordable Care Act. Fellow Knox Countian Ed Schortman has written to Rep. Gibbs a couple of times, only to receive the same form letter in response. It doesn’t surprise us that the Congressman sends form letters to us, but it does remind us how little care is given to constituent voices. It speaks volumes about the state of our democracy.

Dear Representative Gibbs,

Thank you for your response to my letter concerning Congress’ efforts to repeal the Affordable Care Act (ACA).  Unfortunately, there seems to have been an error in that this letter is the same one you sent me in response to my first comments about the ACA.  I realize that you and your staff are very busy and that such mistakes are inevitable.  Nonetheless, I am still interested to hear what you think of some of my earlier remarks when you have the time to send them along.

The more I read about the possible repeal of the ACA the more concerned I become.  Beyond the real humanitarian crisis the repeal would precipitate there are considerable, and negative, economic implications for all parts of the country should the ACA be repealed in part or in its entirety.  For example, the 29.8 million people who will lose their health insurance will either be forced to pay high premiums to private insurers in order to have some semblance of coverage or to go without insurance entirely if they cannot cover these high costs.  Money that the former spend on health insurance will be money that they cannot use to pay for goods and services in their communities.  Businesses, especially small businesses, will therefore see a downturn in customers and profits.  Given that many of these enterprises are operating close to the margin as it is, such a loss of business will prove dire for them.  Those among the newly uninsured who cannot afford these high premiums will be forced to use emergency rooms as their main source of medical care.  States and municipalities will have to pick up these costs, placing an unfair burden on their already limited resources.  Increased taxes to cover the inevitable budget shortfalls will take more money out of the pockets of consumers.  In short, repealing the ACA will blight local economies as the high costs of insurance will drain resources from the pockets of consumers.  I have seen estimates that Ohio alone is expected to lose 50,343 jobs with the repeal of the ACA, the country as a whole losing about 1.2 million jobs.  We can argue about the numbers but that there will be a net loss in employment is inevitable.

Mr. Ryan has proposed that one way of meeting these problems is through block grants.  Allocating federal funds to states in fixed amounts may be a good way of looking like the government cares about those who will lose their insurance with the ACA’s repeal but:

  • block grants are not flexible enough to cope with new diseases that are costly to treat (and insure against) and increases in drug prices (caused, in part, by the inability of government to negotiate these prices with drug companies)—the rise in the cost of epi-pens is but one tragic example of that last, all-too-common tendency;
  • block grants put the burden on states and municipalities to cover such shortfalls which will result in people losing their eligibility for benefits (block grants thus constitute an unfunded federal mandate burdening hard-pressed states and towns while forcing local functionaries to make hard decisions concerning who gets health care and who doesn’t—talk about death panels);
  • block grant programs that I am familiar with do not come with safeguards that ensure that states cover all those whose medical needs are currently met by Medicaid; in short, states are free to kick off the ‘undeserving,’ however they choose to define undeserving (single mothers? transgender individuals? and so forth).

As I mentioned earlier, you and I disagree on a great deal.  These are complex issues with which you and your colleagues in Congress are dealing and the solutions will not be simple.  There is much to disagree about in these cases.  I like to think, however, that we are both interested in the greater good.  The difference is that you have the power, and terrible responsibility that comes with that power, to do something about achieving that greater good.  If even one-tenth of my fears about the ACA’s repeal are justified, curtailment of that law will cause tremendous misery.  It will not serve the common good.  If for whatever reason you feel it necessary to support the ACA’s repeal, I urge you to replace that law with one that does not leave our fellow citizens and the communities in which they live bereft and despairing.  You have heard the stories of those whose very lives depend on the ACA.  Please remember them when you vote on these issues.

Ed Schortman


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