Rep. John Faso fields health care questions in Monticello

The future of healthcare was front and center for small business owners Tuesday morning, at a forum with Rep. John Faso held at the Miss Monticello Diner.

The $20-a-head event in Monticello for small business owners had limited seating and RSVP registration that began at 7:30 a.m. The event was broadcast live online and began at 8:30 a.m.

Faso, R-Kinderhook, is in his first term representing the 19th Congressional District, which includes Ulster and Sullivan counties.

After briefing those in the diner about his first few weeks of committee meetings, Faso took questions from the crowd.

Judy Balaban, CEO of Wellness Home Care in Goshen, said her concern was about the working poor. She said her son gets health insurance through the Affordable Care Act, or Obamacare. She told Faso that proposals by Republicans to change the structure of funding the program to health savings accounts or advanced tax credits wouldn’t help her son pay for the monthly premiums.

“I’m asking what the plan is for those millions and millions of people that are not going to be able to be insured,” Balaban asked.

Faso said he thinks people like her son won’t see much change.

“I think it would almost be imperceptible,” Faso said. “The concept of an advanced refundable tax credit to defray the cost of purchasing insurance is very, very comparable to the premium support.”

Lisa Lindsley, founder of KarmaKapital in Gardiner, worried that a repeal of the ACA would allow insurers to discriminate based on gender or age.

“I’m 52 – not getting any younger,” Lindsley said.

Faso said he supports the ACA’s ban on gender discrimination, but said the law is flawed by having an “age banding of three to one.” The ACA currently says that insurers can’t charge its oldest customers more than three times it charges its youngest.

The change was meant to curb costs for the elderly, who generally need more care. He said the impact is that insurance is too expensive for young people and they’re instead choosing to pay a fine instead of joining the market.¬†Faso said he’s listened to experts who say the ratio should be five to one to make the program “actuarially sound.”

“Age banding is something that critically needs to be adjusted,” Faso said.

Faso also addressed a concern about Republican efforts to change Medicaid into a block grant, which could reduce the amount of money the federal government spends on the program. Faso said if turned into a block grant the funding should be tied to medical inflation.

“I want to see a block grant that gives more flexibility to the state,” Faso said.

Faso said that through the ACA, the federal government began paying 90 percent of the premium costs for Medicaid recipients in New York instead of the 50 percent it had been paying. Faso argued that was never going to be sustainable.

“This is my ideal of how to transform this. That we have a base year based on where we are now, our spending now, that we try to move through tax credits and other efforts, move many of those Medicaid people to private insurance so they’re off Medicaid and at the same time recognize that the federal reimbursement was likely to come down to 50 percent,” Faso said.

But an audience member pushed back on that, saying that the federal government is required to stay at 90 percent coverage by law now and that Congress itself is the one who’s proposing lowering the amount of coverage. He also argued that Medicaid cost growth isn’t as big a problem as is being portrayed, saying its cost growth has the lowest rate of inflation of any health care sector. Faso disagreed.

“What I’m suggesting to you that the trend line in terms of those Medicaid expenditures was not sustainable,” Faso said.

Answering a question from an audience member, Faso earned some applause when he said he would support an investigation of Russia’s influence on the administration of President Donald Trump. Calling Russia’s attempts to influence the election “ham handed,” he said the intelligence committees of the House and Senate should look into the issues.

“Putin is attempting to play a very weak hand in a very aggressive fashion,” Faso said.

Faso was also urged by an audience member to host a town hall-style event that’s fully open to the public, as opposed to the limited paid event Tuesday. She said the town hall would allow him to hear from more than a select group of constituents.

Faso said he’s been holding smaller events and didn’t think the town hall model is good for gathering information. He also said there’s an “organized political effort” going on at town halls.

“I’ve seen around the country the ways the town halls have been conducted, they’re not productive and nobody believes they’re productive,” Faso said.

The full video of the forum can be found here:

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