Congresswoman Kuster On Guns & Medicare For All

Aug 17, 2019

Congresswoman Ann McLane Kuster, D-N.H., on NHPR's The Exchange on Aug. 20, 2019.
Credit Dan Tuohy / NHPR

U.S. Rep. Ann McLane Kuster joins The Exchange to discuss legislation and policies she's been working on in Washington, D.C., as well as recent state and national news. She serves on the House Committee on Energy and Commerce. 

This conversation airs live at 9 a.m. on Tuesday, August 20th, and again at 7 p.m. Audio and transcript of the discussion will be available shortly after the conclusion of the program. 


Highlights from the transcript:

 These hightlights are from a computer-generated transcript, and may contain errors. Find the full transcript of the conversation below. 

On background checks:

Upwards of 95 percent of background checks are completed within three days. But the small percentage that are not, it's because there's a question about criminal behavior in the background. We should switch the presumption that you do not get the gun, but that you can petition to get the gun. 

On limits on high-capacity weapons:

There are various bills that are looking at... limits to the capacity of the gun, the number of rounds that can be purchased. I think recently, one of the shooters that was thwarted in an attempt to commit violence had, I read, 10,000 rounds. And the point is, how does a person get access to that? That's a military level type of preparation. And so I think we need to give law enforcement the tools that they need to keep our communities safe. And right now, law enforcement is outgunned by these weapons...

There are buyback programs to encourage people, and to pay them the value. And that is one of the ideas that I heard that is just sort of a practical, New Hampshire type solution, because I know there are people who use these weapons for sport. They're not used for hunting. 

On Medicare for All:

Well, here's the problem with it. The way it's being presented, it will cost literally trillions of dollars. I think at least Bernie Sanders was upfront when he said, yes, of course, your taxes will go up. So I don't think a mandate that requires 70 percent of the people who currently get their health insurance from their employer to lose it is the way to go. But I do believe that an option, a public option, would create competition in the health care marketplace.

So my position is that we should create a public option. 

That is a choice where people could choose Medicare. They would pay a premium until they reached age 65, when they would be eligible for Medicare coverage for free. And what that would do is, first of all, reduce their costs, because there are advertising and marketing expenses. And the administrative expenses on Medicare are quite low, I believe, 3 percent.

Transcript:

This is a computer-generated transcript, and may contain errors.

Laura Knoy:
From New Hampshire Public Radio, I'm Laura Knoy and this is The Exchange.

Our guest today is New Hampshire Democratic Congresswoman Ann McLane Kuster. She was first elected to the U.S. House in 2012 by voters of the 2nd District, which covers the western and northern parts of the state. And this month, like most members of Congress, she's been spending the summer recess, traveling that district, meeting with constituents and hearing from them on issues ranging from health care to climate change. Today, Congresswoman Kuster is in our studios. And let's hear from you.

Laura Knoy:
And Congresswoman Kuster, welcome back. Nice to see you.

Congresswoman Kuster:
Great to see you, Laura. Thanks for having me.

Congresswoman Kuster:
Well, I'd like to start out with public safety, Congresswoman, and the mass shootings that seem to be hitting Americans as they go about their normal business school shopping worship going downtown. People, no matter what their politics, Congresswoman, want these to stop. What are two concrete steps that you think would help?

Congresswoman Kuster:
Sure. So the first the house has already taken, back in February, we passed two, what I call common sense, very reasonable gun reforms. And number one, the expanded background checks, 90 percent of the American people agree with that. And it should have been done long ago. But we've passed that now in the House.

Congresswoman Kuster:
And we passed a bill to close what we call the Charlestown loophole, which is the short version of that. It's a presumption that a person would get a gun if they wait longer than three days. We want to make the presumption that unless you pass the background check, which for 95 plus percent of the people happens within three days. Then if there's concern, you should not get the gun and have to fulfill the full background check.

Congresswoman Kuster:
But our big problem is Mitch McConnell in the Senate refused to take those bills up. And so if your listeners care on this issue, that's what we need to do. Put pressure on the Senate.

Congresswoman Kuster:
The other issue, Laura, is a little bit more complex, but I feel very strongly about it. We just had a very chilling conference call with the FBI and Homeland Security. And there is a convergence of white supremacy and domestic terrorism. These mass shootings, as you say, in every walk of life, from churches to schools to synagogues, et cetera.

Congresswoman Kuster:
What we need to do is recognize and put the emphasis on this threat to our country of domestic terrorism. We heard from the FBI and the Homeland Security that they have been pressuring the White House, this president, for two years to make this a higher priority. And the president was resisting wanting to focus on Islamist terrorism.

Laura Knoy:
The FBI said that to you.

Congresswoman Kuster: 

This was on a phone call, Christopher Ray explaining to members of Congress that they had this threat that they felt was more serious. So we said we will make this a priority in Congress. We talked about do you have the resources that you need? He made an interesting comment. Laura, and this is the conundrum. We live in a free society. We have constitutional protections for freedom of speech. And what he said was we do not spend time online as the thought police. But where it crosses the line to threats of violence, they can take action.

Laura Knoy:
Before the fact.

Congresswoman Kuster:
Correct.

Laura Knoy:
And that's been the concern.

Congresswoman Kuster: 

And 3 times in the last three days. Young white men threatening violence have been apprehended because of threats online. That's what we need to do to get ahead of this and to prevent this level of violence in our society, which is unacceptable.

Laura Knoy:
Well, I'm glad you clarified that, because a couple of weeks ago, the FBI director said the agency is focused on this issue of white supremacy, domestic terrorism. But he said and I'd love for you to clarify. Congresswoman, "we the FBI, don't investigate ideology. no matter how repugnant. But when it turns to violence, we're all over it."

Congresswoman Kuster:
That's exactly what I'm saying.

Laura Knoy:
When it turns to violent speech or violent acts? Cause violent acts are too late.

Congresswoman Kuster:
Threats of a violent act. And that's what these three were. This week, people saying, I am going to go kill these people. And many members of Congress have these threats. And the Capitol Hill Police and FBI investigated. But now. I think we need to focus and give the FBI the resources they need and frankly, the public needs to speak up. And my understanding is from the three that were stopped this week, it was public tips. If you see something online, say something. Contact the local police. Contact the FBI. And steps will be taken to protect our community.

Laura Knoy:
How do you assess, Congresswoman, the investigative capacities of federal, state and local police? Because sometimes this comes down to the local level to figure out the threat before it happens. We hear from New Hampshire police all the time that they are under severe labor shortage. I've heard from one police chief who said he's down four people. Others say they're down nine people.

Congresswoman Kuster:
Some of these towns literally will have two people, a chief and one other officer. And obviously, people need family time. They need holidays and vacations. So that's my point about making this a priority so that the resources will flow from the federal government to the states and local municipalities so that they will have the capacity to protect citizens from violent acts. We now know there's a Web site out there, 8chan that's been covered in the news quite extensively about these threats. But we need to be on top of each of these situations as they grow and mushroom. What the problem is that people are instigating violence and creating an environment. And frankly, part of this goes back to our elected officials. I think the president has been incendiary in his comments, and I believe he's divisive. And I think we need to tone down the rhetoric and work to bring people together in our communities. So I think New Hampshire's a very good example of that, where we have local community organizations talking across party lines, across ethnic lines, across religious lines. We've had incidents right here at home where we need to protect our brothers and sisters who have been threatened. And I think that's very important.

Laura Knoy:
I have a couple more questions for you, Congresswoman, on this. Getting back to background checks and the Charleston loophole. And you're gonna have to remind our listeners just very quickly what that Charleston loophole was, because some people aren't familiar with how the system works.

Congresswoman Kuster:
Right. So what that was about is this presumption that if the background check is not completed within three days, that the person would get the gun automatically. Our point is that upwards of 95 percent of background checks are completed within three days. But the small percentage that are not. It's because there's a question about criminal behavior in the background. We should switch the presumption that you do not get the gun, but that you can petition to get the gun. I see.

Laura Knoy:
And in the case of Charleston, just reminding people there were some questions that came up during the background check, but it took more than three days.

Laura Knoy:
So the shooter in that case got the gun and nine people were killed in an African-American church.

Congresswoman Kuster: 

Correct. The other thing that we believe should happen in the House of Representatives is this issue about it's called colloquial red flag. But what it really is, is a type of restraining order. If a family member or neighbor friend, minister, whoever knows the person well, has a concern about either violent threats or violent behavior and knows that that person has access to weapons, that they can go to the police and make this claim and say, we believe that this is a safety safety risk to our family or to the community. Again, I think we need to emphasize the community needs to get engaged and needs to if you see something, say something. Speak up if you have a concern.

Laura Knoy:
You said expanded background checks, Congresswoman.

Laura Knoy:
And many of these mass shooters, not all, but many do acquire their guns perfectly legally. They go through the check and so forth. They pass all the laws, waiting periods. Age restrictions, whatever. So how do proposed changes to gun laws? Help?

Congresswoman Kuster:
Well, because the point is they have such easy access. There are no background checks if you're buying it online or through a gun show, that type of thing. So we're talking about expanded background checks that every single purchase there would be a background check.

Laura Knoy:
Not just in an official gun show.

Congresswoman Kuster:
Right. Correct. Correct. And the other thing that is being talked about is the large capacity, you know, the number of people that are being killed in such a short burst of fire. And so there are various bills that are looking at that. Limits to the capacity of the gun, the number of rounds that can be purchased, I think recently one of the one of the shooters that was thwarted in an attempt to commit violence had I read 10000 rounds. And the point is, how does a person get access to that? That's a military level type of preparation. And so I think we need to give law enforcement the tools that they need to keep our communities safe. And right now, law enforcement is outgunned by these weapons.

Laura Knoy:
What can you do with those weapons? So, Congresswoman. I mean, there have been calls in the past for a ban on so-called assault weapons. And I say so-called because there's a lot of debate over how to label these guns and so forth. But even if you ban them, can you go into everybody's house and grab these weapons? I mean, how effective is a ban on so-called use our sales, future sales, not on confiscating guns.

Congresswoman Kuster:
There are buyback programs to encourage people and to pay them the value. And one of the ideas that I heard is just sort of a practical New Hampshire type solution, because I know there are people who use these weapons for sport. They're not used for hunting. There would be nothing left of the deer if you did, but that are used for sport in a gun arena that they could keep them there, keep them under lock and key there so that they can be used for that purpose, but not threaten the society and the community.

Laura Knoy:
I've got a question from a listener before the show. Congresswoman, I'd like to share it with you, Laura Rhoda. She says, Why do you consistently sponsor a ban on semi-automatic firearms? Laura says, I conceal carry. Why do you want to restrict my ability to protect myself? Thank you, Laura, for the question. Do you think?

Congresswoman Kuster:
The point is, we don't want to restrict your Second Amendment rights, but we are trying to keep our communities safe. And when nobody is safe, because they feel that a gunman might open fire. Kids are just going back to school right now. I talked to so many families. The fear of kindergarteners starting school and on the very first day of school. They're taught how to crawl under the desk or run to the closet. Our society needs to respond to the threat. And you sound like a responsible gun owner. You sound like somebody who's trying to protect yourself and your family. And I want to bring you into the conversation to protect our communities because people do not feel safe.

Laura Knoy:
I also want to ask you about a point that the president and others have made the argument that it is not the gun, it's the person who pulls the trigger. And that, as you know, Congressman, there are a number of ways to get guns illegally. You can buy them online. You can put together what's called a so-called ghost gun assembled from parts that can be ordered through the mail. Lots of ways to get a gun. So some people are saying don't focus on the weaponry. Focus on some type of understanding or outreach or ability to stop somebody before he does this. And I say he because the vast, vast, vast majority of mass shooters are men.

Congresswoman Kuster:
Absolutely, Laura. And, you know, it's not an either or it's a both. And. And I'm frustrated by the conversation because we make it either or and then we're talking past each other. But the point is that other countries that do not have these assault weapons do not have these mass shootings at this level. We are in a unique situation. And when there was a ban on these types of military grade weapons, there were fewer of these incidents. So you can't ignore that these weapons do kill. Now, obviously, there are people that are pulling the trigger. There's no doubt. And that's why I want the FBI, the Homeland Security, to focus in on this white supremacy and these hate groups that are organizing online that are triggering people literally to go out and commit mass shootings. There's discussions online about how to have the most fatalities. Our country is not safe.

Congresswoman Kuster:
While that is happening and we need to focus on both.

Laura Knoy:
When white supremacy is not involved. You're right. There has been an increase in these white supremacy fueled mass shootings.

Congresswoman Kuster:
Dramatic increase.

Laura Knoy:
But some have just been because someone is angry and wants to take a bunch of people out. We think that's much more so. What about those? Congresswoman, if committing a mass shooting or demonstrating the intent to commit one were considered domestic terrorism in all cases, what difference would that make?

Congresswoman Kuster:
It would give the FBI the resources to coordinate. Right now we don't have a federal violation for Domestic terrorism. They what they do when they go into these recent shootings in Dayton or El Paso, they rely upon local law enforcement. They may come in to coordinate the investigation, but they're relying upon state law, whether it's homicide, murder. There may be some coordination, some type of claim that they can bring against someone using the Internet to incite violence. That type of thing. What we're talking about is used the same tactics that we use against international terrorism for domestic terrorism. And that's what the president resisted.

Laura Knoy:
And would domestic terrorism, using that label for all kinds of mass shootings, not just those inspired by white supremacy, but all kinds. Would that create the situation where the FBI and law enforcement would have a better capacity to seek these people out before they commit because investigating you after the fact. Yeah. Isn't very sad.

Congresswoman Kuster:
Yes. The idea was prevention.

Laura Knoy:
Do you think that it'll be a good idea, Congresswoman, to label all of these acts as domestic terrorism?

Congresswoman Kuster:
Well, there would be a criteria. You said yourself that sometimes they're not, but that there would be criteria. And if they are related to hate crimes or seeking out particular people that you're trying to eliminate, then the answer would be yes.

Laura Knoy:
You mentioned earlier security in places of worship and half a dozen New Hampshire religious organizations were awarded federal grants last week to upgrade their security. I'm wondering, Congresswoman, how these were chosen, because some New Hampshire congregations who have been threatened and targeted in the past didn't get anything, and they're wondering why.

Congresswoman Kuster:
I think that would be a question for the state police and the decisions that were made by perhaps the governor's office. The federal funding came through, but it was and we were not involved in this decision making.

Laura Knoy:
Now, that's interesting.

Laura Knoy:
So the federal government says here the state of New Hampshire has one hundred and fifty thousand dollars, give it out to various religious organizations and the state decides how that money is going to be parceled out. Not the not you sitting in Congress.

Congresswoman Kuster:
Right.

Laura Knoy:
That's interesting. I don't think most people understand how that works. All right. Coming up, we will pivot to health care, but we will continue to take your calls and questions about public safety in the wake of mass shootings as we talk with Congresswoman Ann McLane Kuster. Laura, thank you for that comment. I got a bunch more comments here. Sure. Congresswoman, that I will share with you after a break. People wanna talk about politics.

Laura Knoy:
People definitely want to talk about health care.

Congresswoman Kuster:
And health care has been the number one issue since we've been home. That's what most of the questions have been about.

Laura Knoy:
That's what I understand from your staff at six out of eight questions I've received on the trail are about health care. So we'll talk about that after a break. But we do want to continue hearing from you. More with Congresswoman Ann McLane Kuster of the 2nd District in just a moment. This is The Exchange on NPR.

Laura Knoy:
This is The Exchange. I'm Laura Knoy today. New Hampshire Democratic Congresswoman Ann McLane Kuster. She represents New Hampshire's 2nd District, which covers the western and northern parts of the state, including the cities of Concord, Keene, Berlin and Lebanon.

Laura Knoy:
We are on Facebook live today. So you can also watch our interview as well as listen. And Congresswoman, let's go to our listeners right now. And joining us from Brookfield is Celia. Hi, Celia. You're on The Exchange. Welcome.

Caller:
Yes. Thank you for taking my call.

Laura Knoy:
Sure. Celia go ahead.

Caller:
A while back, Congresswoman Kuster made the statement that Mitch McConnell is blocking the bills for gun control. I know that's not the phrase we're supposed to use, but my frustration is that I have contacted my own senator for various reasons. But my understanding is I have no I have no way to contact Mitch McConnell. I'm not his constituent. So it seems to me that all we have is Kentucky constituents to pressure Mitch McConnell. And that is my frustration.

Laura Knoy:
You know, Celia, it's a great question. What do you think, Congresswoman?

Congresswoman Kuster:
Well, Celia, thank you for bringing it up. I think people are recognized in this all across the country and beginning to organize against not just Mitch McConnell, but the Republican leadership in the Senate for their refusal to take up legislation that they care about. I'll give you another example that was shocking to me. The Violence Against Women Act is something that has been bipartisan historically for years.

Congresswoman Kuster:
It passed handily in the House with bipartisan support. And again, Mitch McConnell on the Senate Republican leadership refused to even schedule it for a vote on the floor. That's grants to cities and towns all across our state, to our law enforcement to protect families from domestic violence and sexual assault. And it's an issue I feel very strongly about. So I think the point is to organize and there are many organizations online. This is getting more into the political realm.

Congresswoman Kuster:
And I'm here to talk from my official standpoint. So I need to be careful about how I talk about that. But happy to discuss it offline with you, Celia, that there is an opponent to Mitch McConnell in Kentucky and there's a lot of pressure being brought to bear. My understanding is his popularity in Kentucky is very low and maybe his time has come.

Laura Knoy:
Celia Thank you for the question. And let's take another one from Windham. Hi, Edward. You're on the air. Go ahead. Thanks for calling in today.

Caller:
Hi Congresswoman Kuster. I've been a big fan of yours. Thank you very much for everything that you do for us here in New Hampshire. My is back to the back of the gun control. As you know, here in New Hampshire, we could sell guns back and forth between our neighbors, our friends, our family without any control whatsoever. How can we implement some sort of waiting period? Where would we you know, who would we call? Would we do that online? And who's going to pay for that type of funding?

Laura Knoy:
Thanks a lot.

Congresswoman Kuster:
You make a really good point. That's why I talked about that expanded background check legislation that passed the House way back in February that is supported by nine out of 10 Americans. Feel this is urgent and we need to get this done. Is that there are some examples like the one you gave for sales that have no background check whatsoever at all, could be sold to a criminal, could be sold to someone with literally evil intent. I think the majority the vast majority of gun owners from New Hampshire are very responsible people. They keep their guns locked. They use them for hunting or for the safety of their own family. And they don't have any intention of letting their guns fall in the hands of someone who would do ill.

Congresswoman Kuster:
And I think the NRA has made a huge mistake. They seem to be focused more on the interests of the gun manufacturers than the responsible gun owners. I think we need to shift the whole discussion and debate to people like the people who are calling into the show, who say, I use this for sport, I enjoy this as a family tradition, or I use this to protect my own family. Let's work together. My interests are not contrary to the interests of responsible gun owners who want to keep their families safe as well.

Laura Knoy:
President Trump has said that we already have plenty of background checks. Others have said let's do a better job enforcing the background check laws that we already have on the books. What's missing in Europe?

Congresswoman Kuster:
We need to do both. Laura, we need to do a better job on the system that we have. Make sure it's up to date. Make sure it's quick and reliable for people. And then, as Edward points out, we need to close the loopholes that exist for this sale, literally guns that are purchased on the Internet. Many of these shooters, it's it's young people on the Internet putting together pieces into these violent weapons that are used for mass shootings, for mass destruction. That's. not What responsible gun ownership is about in New Hampshire at all.

Laura Knoy:
We got an e-mail from Chris in Bow who says, Fund the CDC to study gun violence, publish everything we know about these shooters. So we as parents, family and friends, know the warning signs. Chris says, allow lawsuits against firearms manufacturers and sellers for negligence, support background checks. But it's low hanging fruit, he says. And as far as I know, the recent shooters were legal. And that was the point I was trying to make with you before Congress. I mean, a lot of these shooters do acquire the guns either perfectly legally or they steal them. So all the background checks in the world aren't going to help that.

Congresswoman Kuster:
So Chris makes a really good point. Thank you, Chris, for bringing it up right now. And this is due to the influence of the NRA historically in Congress, although I think that is waning right now. There has been a prohibition on gun violence research. And I absolutely agree with you. The CDC should be empowered to protect America from a public health threat and that we should do research and that we should have a better understanding about the types of people that have been involved. There are definite trends.

Laura Knoy:
Well, and Chris, thank you for the e-mail. I want to let him and everyone else know that on September 9th, The Exchange is going to be having on the show one of the country's lead sort of analysts who has profiled these mass shooters. And that will give us a little bit more. I want to look at someone who's testified before Congress and has done all sorts of research. So, Chris, thank you very much for the e-mail.

Congresswoman Kuster:
Again, it said that the Judiciary committee in the House is returning from the work period early to start hearings. And I think they'll be probably hearing from this person as well. So you're right on on topic. So Congress is going back to Washington early from a dozen members of the House Judiciary Committee.

Laura Knoy:
To take up gun legislation?

Congresswoman Kuster:
Yes.

Laura Knoy:
Congresswoman, you said earlier that the majority of comments and questions you've gotten from constituents when you've been out in the district during August recess are about health care. You need me to tell you among your party's presidential candidates, there is quite a debate over Medicare for all. Whether this is the direction the country should go. What's your position, Congresswoman? Medicare for all. Yes or no?

Congresswoman Kuster:
Well, here's the problem with it. The way it's being presented, it will cause literally trillions of dollars. I think at least Bernie Sanders was upfront when people when he said, yes, of course, your taxes will go up. So I don't think a mandate that requires 70 percent of the people who currently get their health insurance from their employer to lose, that is the way to go. But I do believe that an option, a public option would create competition in the health care marketplace.

So my position is that we should create a public option. That is a choice where people could choose Medicare. They would pay a premium until they reached age 65, when they would be eligible for Medicare coverage for free. And what that would do is, first of all, reduce their costs because there are advertising and marketing expenses. And the administrative expenses on Medicare are quite low, I believe 3 percent.

Congresswoman Kuster:
So 97 cents on the dollar of their premium can go to their health care. Most people I meet who have Medicare coverage are quite satisfied with their coverage. Many have a supplemental that goes beyond the coverage. The basic coverage for Medicare. But you don't hear the stories about the very high deductibles or the co-pays or the out-of-pocket expenses that have become prohibitive. But the real issue for us right now, we need to make sure to protect the basic structure of the Affordable Care Act. The Trump administration has been working every single day to sabotage the Affordable Care Act and to limit access to health care. I'm excited to be working on the committee now that handles health care in the House. The House Energy and Commerce Committee. I'm on the health subcommittee and I carried the bill in the House that is covering preexisting conditions. We heard a lot about this during the Obama administration. In other countries, preexisting conditions are just called your health history.

Congresswoman Kuster:
And I believe that your health history should be covered for whatever illness you encounter. So that was not your option.

Laura Knoy:
We would stick with Obamacare, the Affordable Care Act, but include a so-called private option where any public option excuse me, public option where anybody could buy into the medical system, buy in regardless of age.

Congresswoman Kuster:
Right. And what this does is it would drive prices down across the board because insurance companies would have to compete with this flow of people. People would be essentially voting with their feet. Toward a different product. And then we would give us experience if that turned out to be successful. We would have experienced to know, can the hospitals bear that those Medicare rates?

Laura Knoy:
Are those ratings lower than what providers get with private insurance?

Congresswoman Kuster:
Yes, they are. And the question is, are they sufficient? They're higher than Medicaid.

Laura Knoy:
Yes.

Congresswoman Kuster:
The Medicaid rate is too low. It doesn't cover the costs and the expenses. But I have to make sure in a rural community like New Hampshire, with 26 hospitals, including in my district, a dozen critical access hospitals that they don't close because there's so many people coming into Medicare that they don't cover their costs.

Congresswoman Kuster:
So we have to find a balance where people have access to the physicians and the health care clinics and that they need as well as the hospitals that are in that system.

Laura Knoy:
Now, this public option idea was debated when the Affordable Care Act was debated by 2009. I think Nancy Pelosi wanted a public option.

Congresswoman Kuster:
A lot of people did.

Laura Knoy:
So what happened?

Congresswoman Kuster:
I Understand one person in the Senate blocked it. It was in the House version. And I think it's something that we need to revisit.

Laura Knoy:
And what was the fear back then about a public option?

Laura Knoy:
What was the supposed problem that that was going to create?

Congresswoman Kuster:
Knowing the state that this person was from, I'm guessing it was the competition to the insurance companies.

Laura Knoy:
Who was it?

Congresswoman Kuster:
Oh, I'm blanking.

Laura Knoy:
What was the state?

Congresswoman Kuster:
The Senator from Connecticut.

Laura Knoy:
OK, and Connecticut is a big insurance hub. So there were concerns from insurance companies that the reimbursement rates were gonna be so low.

Laura Knoy:
So a couple candidates, Elizabeth Warren, Bernie Sanders, say private insurance hasn't worked too expensive. Americans are getting nickeled and dimed to death by health care. We should just get rid of it. What do you think? With frustration on the left wing of your party, private insurance, overall.

Congresswoman Kuster:
No, no, no. And I agree. I agree. We had a town hall meeting down in Pelham the other night, and a woman, Cathy, said, I have to pay eight hundred dollars a month out of pocket and I have a six thousand dollar deductible.

Congresswoman Kuster:
She's self-insured. And that's what she's paying. That's not viable for her.

Congresswoman Kuster:
And she also has a disabled daughter that's in the same boat. So those types of premiums with those types of deductibles are not a viable option. But we don't have a switch in Washington, D.C., where we wake up in the morning and in Canada, you know, where suddenly there's health care for all. I think we need to transition our system to make sure that we have universal access to health care. I do believe in health care for all, but I believe that and this is as I said, Bernie Sanders was very honest with the American people. He said, yes, this would be a major tax increase, but everyone would have access to health insurance. And I want to find a middle ground. We have a tradition in America that started back at the Second World War where employers are involved in providing health care for their employees for the well-being of their employees.

Congresswoman Kuster:
You talked to people in the union community. They've negotiated over the past several decades for this health care benefit and they've made concessions on wages. I think that's part of the issue that we need to have higher wages. So they I hear from people who don't want to throw the whole thing out. That's a major negotiation that they've had and it's something that has value to them.

Laura Knoy:
I'm glad you mentioned Canada, because that's a perfect segue way to what I wanted to ask you about. Congresswoman, drug prices. Big concern. I'm sure you heard this as you've been out and about in the district and you've said you're in favor of President Trump's plan to allow for the importation of certain prescription drugs from Canada. But now there's questions about whether Canada can supply enough drugs to meet American demand. Some people have said, how about if we import from the EU, but let's just get back to the fundamentals, right? Why not just figure out a way to lower drug prices in this country? Why go through all the issues with importation?

Congresswoman Kuster:
I totally agree. And the only reason that you even talk about importation is that you begin to put pressure on American pharmaceutical companies to lower their prices because they don't want to lose that volume to another market.

Congresswoman Kuster:
But this is, again, where I'm very excited to be a part of this and a front row seat and be involved. Our committee held hearings on the high price of prescription medication. This is the number one issue in terms of access to health care, along with the high premiums that people are facing.

Congresswoman Kuster:
And we heard just heart wrenching testimony about drug spikes in insulin and in other lifesaving medications. So we passed a whole series of. Bills again passed out of the House and again not going anywhere in the Senate because of Mitch McConnell. But let me just give you a sense, there are two ways to tackle this. One is through generics and we had to close the loopholes. The generic system has been around for several decades and this is where you create competition with the pharmaceutical companies. As you know, a couple of pieces of legislation that write works. So we've passed those and closed those loopholes.

Congresswoman Kuster:
And then the other is the issue of a volume discount. And I think your listeners would understand this. When you whenever you buy more of something, you typically get a lower price.

Congresswoman Kuster:
But the federal government under the George Bush administration, and I believe because of the influence of the pharmaceutical companies, chose not to have a volume discount in Medicare Part D. We should replace that. And we should give both taxpayers and seniors the benefit of the bargain.

Laura Knoy:
Well, I got a lot of e-mails from listeners about health care, as you can imagine, Congresswoman, but since we're talking about generic drugs and your efforts to speed up the generic approval process and so forth, I got an e-mail from Diane in Durham who says recently I was sent a blood pressure medication, a generic prescribed by my doctor and a script distributed by Express Scripts. I learned by a news report that this medication contained a carcinogen. I contacted the distributor and learned it was correct and was informed regarding how to obtain untainted medication. I thought this was not a good way to learn about my daily medication. Will medications be safer and less expensive in the future? There's been some reporting recently, Congresswoman, that while generics often touted as a great way to lower drug costs, they're not always what they're cracked up to be.

Congresswoman Kuster:
Well, you need to talk to your physician and, you know, look at the Consumer Reports. Is this as this caller has. But the point is that they are approved by the FDA and they are the generic equivalent. That's where the expression comes from. They they may not be exactly the same, but they are the equivalent efficacy and they are approved by the FDA. And so that sounds like a exception to me. If there was a carcinogen, that shouldn't have been approved.

Congresswoman Kuster:
I'm happy to look into it. But in general, this is a way to create competition and bring down price.

Congresswoman Kuster:
And many people do find that they cost less and they have the same impact.

Laura Knoy:
Coming up, we will tackle opioids. Also, a quick question for you, Congresswoman, about energy. And then we'll talk a little bit about this year's Democratic presidential primary. Lots of candidates and I'd love to get your thoughts and we'll keep hearing from you.

Laura Knoy:
This is The Exchange. I'm Laura Knoy. We're talking with Democratic Congresswoman Ann McLane Kuster today. She's represented the 2nd District of New Hampshire since 2012. And Congresswoman, you are co-chair of the Bipartisan Opioid Task Force and recently led a talk about the threat of synthetic opioids such as fentanyl. I think you and others have called this the third wave of the opioid epidemic. Very powerful, very scary. New Hampshire received about 23 million last year to address the crisis. And at the time, you said. But our job is not done. What's left to be done? Congresswoman, I'm guessing there's a lot.

Congresswoman Kuster:
Sure. So what we have started doing and I've been going around and visiting all of the sites, getting the federal funding to the local communities to expand access to treatment, that's number one. We need focus on prevention and education, but expanding access to treatment, making sure people can get well from this disease of substance use disorder.

Congresswoman Kuster:
The other thing I'm excited about, Laura, is we had an incredible meeting up at Dartmouth Hitchcock with Dr. Barth, who's the leading researcher, frankly, in the whole country on reducing opioid prescribing. And this is where we've got to get ahead of the curve. We now know and it's very obvious if you follow online both the walls, The Washington Post and The New York Times had incredible maps of where the opioids were being prescribed at very high rates. And those maps follow exactly where the opioid deaths are. So we know we can see the cause and effect. Dr. Barth is leading the charge on convincing physicians, surgeons, et cetera, to reduce the prescribing rates so that they're not giving 30, 69. Is that still a problem?

Laura Knoy:
We've been talking about that for a decade now.

Congresswoman Kuster:
I can tell you, my son just had surgery a month ago.

Congresswoman Kuster:
It was out of state, but he was given a high number of opioids. And when I tried to return them to the pharmacy, at first, they said they refused to take them. And so we need. So what did you do? I threw a fit and he took them.

Laura Knoy:
You said "Do you know who I am?".

Congresswoman Kuster:
No, I don't say. Do you know who I am?

Congresswoman Kuster:
I said, people are dying. How can you how is that responsible for you to be prescribing this medication and not giving someone a way to dispose of the medication? I think in New Hampshire, we're doing a better job with that, with the bags that you can dispose of. But and then the third thing that I'm very involved in is to tackle the issue of the very high rates of recidivism in our prisons because of drug addiction.

Congresswoman Kuster:
It's because people are not getting the treatment that they need during incarceration, either mental health or substance use disorder. Ninety percent of our inmates have both co occurring illness. And what we're doing is legislation to have Medicaid cover those expenses for mental health treatment, for substance use disorder, inside the prisons, inside the prison, so that when they come out and they can get access to long term recovery care, they can get back to work, get back to their communities, care for their family, save taxpayers dollars. And because Medicaid is a heavy lift, but it's a big bill and I'm very excited.

Laura Knoy:
Well, we got an email from Sam about this who says, what can Congress do to address addiction treatment in correctional facilities? Sam says medical care in New Hampshire county jails is inadequate.

Laura Knoy:
So there's your answer, Sam.

Congresswoman Kuster:
Thank you, Sam. And what it's about is that 50 years ago, when Congress adopted Medicaid, there was an exclusion for people during incarceration. So you can understand what a big bill this is. When you consider all across this country 50 years, people have not had access to adequate mental health care or substance use care. And we live with these incredibly high recidivism rates. And New Hampshire is the best example. Sullivan County now Merrimack County dropped the recidivism from the 18th percentile to the 20th percentile. If you give treatment in-house and help with the recovery, OK? Because again, substance abuse is often a reason why people end up right. So we've created the worst system that is completely failing. I believe that New Hampshire can lead the country out of this opioid epidemic by demonstrating a better system. And using the tax dollars instead of incarceration for treatment.

Laura Knoy:
Again, Sam, thank you for that one. Congresswoman Kuster, you said earlier also that you've heard a lot from constituents about climate change. And I did want to ask you about that because you sit on the House Committee on Energy and Commerce with the defeat of Northern Pass and just opposition to this big scale hydro. Congresswoman, what renewable energy path do you think New Hampshire should emphasize from here on out?

Congresswoman Kuster:
Sure. What a great question. And we're going to be working on legislation. People have heard about the Green New Deal. I think we'll probably put together a clean new deal that will be a little bit broader than that. But basically, I've seen great success in New Hampshire with solar, and I'm very excited. I was just up in Plymouth and a community solar project where people of low income have access to the low to the low cost care, electricity from from solar.

Congresswoman Kuster:
Also wind projects, a new wind project over an anteroom, a successful wind project up in Groton and further north. So I think that's an option where it fits for the community. Hydro still is a big issue option over on the western part of the state. On the Connecticut River, I'd been visiting those dams. There's a licensing that's going on at the FAQ. The Federal Energy Regulatory Commission right now. And in New Hampshire, people may be surprised to know that 40 percent of the energy we produce is nuclear, which is, of course, no fossil fuels carbon free. I'm not a big fan of future nuclear, but I think that is part of the option for a fossil free footprint here in New Hampshire.

Laura Knoy:
So hang on. What do you mean by that, Congresswoman? Not a fan of the future of nuclear, but right now it's ok?

Congresswoman Kuster:
New nuclear.

Laura Knoy:
Don't build new nuclear power plants but support Seabrook?

Congresswoman Kuster:
But supporter have been support in any because of the issues around the waste and the transportation and the siting. Again, you mentioned about the big projects. Those are the biggest projects. And I think frankly, there it's difficult to get the financing to do a new project. But Seabrook has just been Reproved for another lengthy term, and that is part of our fossil free footprint here in New Hampshire.

Laura Knoy:
what about gas pipelines, Congresswoman, because a lot of business leaders and others say, look, we need this as a, quote, bridge fuel. So there are still lots of gas pipeline projects on the table.

Congresswoman Kuster:
Well, your listeners in the southern tier will recall my opposition with the communities to the Kinder Morgan project because they hadn't thought it through the siting was not thoughtful. There is an environmental impact and frankly, a community impact. The route was scheduled to go right between a middle school and a high school and one of the small towns. So if there are those types of projects, I think they need to be much, much more thoughtful in their siting. Use the current right of ways of other industrial zoning and energy projects maybe, but or highways. There may be other options to do that.

Congresswoman Kuster:
But I think both with Northern Pass and with Kinder Morgan, you saw communities rising up to say there are siting issues that we care about, the quality of life, the quality of environment, the quality of our communities. And we're not going to sit by. And I should say, Laura, I have legislation to have a community voice in the federal energy regulatory body damage to that process. And largely this is a state issue, a state and local issue. So I am curious what your role as a member of Congress is besides weighing in and saying, you know, this is a concern? No, it's definitely a federal issue because they're approved by the Federal Energy Regulatory Commission. And if they don't have approval, they don't go forward. But my concern has been we don't have a community process to bring up these concerns at the firm. And so I have legislation to make sure that local communities are heard on these siting issues.

Laura Knoy:
I've got a couple questions from listeners, Congresswoman, about immigration. Arnie wrote, Representative Kuster has traveled to the U.S. Mexico border and seem firsthand the cruelty of the Trump administration's current policy. This is Arnie talking. Since the administration is only able to implement its policies of family separation, border militarization, mass detention and deportation with funds appropriated by Congress. Arnie asks, what is she doing to cut off the supply of funding? So if you could just address the specifics of this question.

Congresswoman Kuster:
Yes. We just went through the appropriations process and did make changes to that and have very specific legislation about how children are housed, how they are protected, that they need to get medical assistance right away. The biggest issue here is that the length of time that people are being held and what I was pleased to see my second trip this year was that they had gone back to the process of releasing families or people coming across the border to their families here in the United States.

What I think people may not realize is that most of the people are coming to be with family here. And so the U.S. government doesn't need to house them. And most of the problems that we've seen have been in this detention housing situation. The kids in cages that the lack of medical care. The deaths that we've seen. So I was pleased to see a change in that policy and to have them released. There are private organizations that are helping to pay for bus tickets, helping to get them to the families around the country, and then they can go to their asylum hearing. And we've had a very high rate of people showing up for those hearings to determine if they'll be allowed to stay.

Laura Knoy:
So to Arnie's question, are you in Congress trying to use the appropriations process, power the purse to change policy? And has that been successful?

Congresswoman Kuster:
Yes. Successful in the House, but again, not in the Senate. The Senate has refused to take that up.

Laura Knoy:
Here's another question from Sebastian also about immigration, but more close to home. Sebastian says, What is your stance regarding Border Patrol checkpoints inside New Hampshire? CPB has authority over 100 miles from the border. That is the whole state of New Hampshire from any border east, west, north, south. We see checkpoints for immigration related issues and we end up arresting people for minor marijuana offenses. Sebastian asks, what can we do as constituents and yourself as a congresswoman and Sebastian. Thank you for the note.

Congresswoman Kuster:
Sebastian, thank you very much. I am not a fan. I was caught in one of those 100 miles from the border checkpoints myself. And I think it has a chilling effect. It's not the free and open America that we know. So I have sponsored legislation with my colleague Peter Welch from Vermont to reduce that to a 25 mile. Frankly, I don't think it's necessary at 100 miles. And when they put up these checkpoints on the busy holiday weekends, I think it has a chilling effect for people.

Congresswoman Kuster:
Look, I believe in strong borders. I believe in legal immigration. And I think that we can enforce that without having this impact on families that have come to New Hampshire to enjoy our lakes and our mountains in this wonderful region.

Laura Knoy:
Can you tell me that story? When were you stopped and what happened?

Congresswoman Kuster:
I was stuck. This was very early. One of the not the first one. And by the way, a shout out to the ACLU, because the issue about picking up people for marijuana was actually thrown out in court.

Congresswoman Kuster:
But, you know, I was going through just coming traveling my district the way I do. And we were coming back from an event in the north country and we were had to wait in a long line and then pulled over. And I think also it's the profiling that happens because, you know, they looked at me and the the person who was driving me happened to bright red hair. And we're both Caucasian. And they said, are you American citizens? And, you know, waved us right through. So it didn't take long. There were dogs, there were guns. There was a whole stakeout on the highway. And I just don't think it's the friendly environment that we want to convey to people visiting New Hampshire, although some people call that border security, congresswoman. But a hundred miles from the border do not go right in to take 100 photos from the border. It's not necessary. 25 miles from the border would be more than sufficient. And there's been no evidence presented to us that it's other than an intimidation tactic.

Laura Knoy:
Sebastian, thank you for the e-mail. And I did want to ask you, Congresswoman, while I have you here. We've seen as many as 23 Democratic candidates for president. I don't want to give an exact amount because it keeps changing. As a longtime Democratic official person who's been involved in the party and politics, just what do you make of the size of this field? How does it feel to you as a Democratic politician to sit down and watch these debates with ten people one night in ten people the next night?

Congresswoman Kuster:
Yeah. I mean, I think look, I'm very proud of our bench. I think it's really important the young people that we have coming up in the party. I don't think that at least half of them are serious about becoming president of the United States. And I think we'll see in the next few months people dropping out of the race as we've already seen people drop out of the race. What I do think is that we'll start to see a focus on the top tier of candidates and New Hampshire plays a very significant role.

Congresswoman Kuster:
This is one of the first that I can remember in a very long time where there's not an obvious nominee, where there will be competition, where we are looking at all different kinds of candidates. I was at dinner with friends last night and of the seven people at the table. They had seven different favorites. So that's rare. And I think we are well equipped. I'm so proud of my constituents here in New Hampshire for the quality of the questions, the level of engagement. I meet people who have met a dozen candidates and I've certainly had wonderful experiences with probably close to a dozen candidates, myself and my colleagues in Congress. Talk to me about it and tell me how much they appreciate the role that New Hampshire plays and how serious people are. They're very impressed.

Laura Knoy:
I got a couple questions from listeners about politics before the show. I can't share all of them, but I really appreciate everybody jumping in. But here's one from Rob who says, In this political culture, is it possible to work across the aisle or does the future lie in winning or losing our positions hardened. And boy, Rob. It's a great question. It's such a subject when a whole show. But thank you so much. Well, thank you, Rob.

Congresswoman Kuster:
And that's certainly my approach. If you know by background, you'll know I'm born bipartisan, raised in a Republican family. And I think my role in Congress has certainly been very bipartisan. The founder of the bipartisan opioid task force, I also am the founder of a bipartisan task force to end sexual violence. There are many, many issues where we can work together and we do on a regular basis. There are some issues that we've talked about today that are more challenging. I mean, the what's just happened to Planned Parenthood here in New Hampshire, losing Title 10, funding for low income women, issues around abortion, interest issues around gun violence.

Congresswoman Kuster:
I tried to seek opportunities and create relationships so that we can talk about even the toughest issues and find common ground.

Laura Knoy:
All right.

Laura Knoy:
Last quick question for you, Congresswoman. And it's the hardest one. It's August recess when you're not out shaking hands with constituents...

Congresswoman Kuster:
We like to call it the work period.

Laura Knoy:
I shouldn't call it recess. When you're not meeting with constituents, what do you do for fun?

Congresswoman Kuster:
Oh, we've had a lot of fun. The weather has been a ...

Laura Knoy:
Lakes? Mountains?

Congresswoman Kuster:
Both. We've been up on newfound lake voting and swimming, a lot of swimming, kayaking on the Contoocook River here in Hopkinton. And then we were up in the White Mountains and had a really nice time. I'm headed up there tomorrow for three days of events in the White Mountains. And we've got a town hall coming up. So check in on our Web site. We'd love to have you join us.

Laura Knoy:
OK, thank you very much for being here.

Congresswoman Kuster:
Thank you Laura always loved to come on your show.

Laura Knoy:
This is The Exchange on NH PR.

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