Democratic Congresswoman Annie Kuster says if she is re-elected, her proposals for healthcare in New Hampshire, including a plan for Medicare expansion, will increase access and stabilize health insurance markets.
All Things Considered Host Peter Biello spoke with Kuster, incumbent in the 2nd Congressional District, on healthcare policy. All Things Considered is speaking with all Congressional candidates this week.
(This transcript has been edited lightly for clarity.)
Health insurance is getting more expensive. More employer plans now have deductibles, which on average are growing. According to the Kaiser Family Foundation, premiums are rising three times faster than inflation and twice as fast as wages. What would you do in Congress to help bring the cost of health insurance down?
I've voted 53 times not to repeal the Affordable Care Act because I care a lot about people having coverage and particularly having coverage for pre-existing conditions. But what we do need to do is fix it and I've got a plan that I've been working on with members of Congress to bring forward that would stabilize these insurance markets and would increase access, particularly for small businesses here in New Hampshire. 90 percent of our jobs are small businesses and it can be expensive to offer health insurance.
Some would argue that the Affordable Care Act did expand access but in fact it has not slowed down the growth in costs. So how can you argue that increasing access would in fact keep costs down?
Well that's the idea behind the Medicare expansion, is that part of the reason that we haven't been able to contain costs is we need more competition. We need to have an option, some people call it a public option, the Medicare option, so that everyone knew that they could go into a lower cost option for them and that would create more competition with the private insurers.
You said in NHPR’s forum last week that we need to recognize that substance use disorder is a chronic illness. How does this inform the way you approach the opioid crisis?
I created this bipartisan task force bringing people together, we've got 105 members, half Republican, half Democrat, and part of my goal was to educate my colleagues, just as we've been educated here in New Hampshire. It's not a 28 day one-and-done type thing. It's a chronic illness. There's a high rate of relapse and what it means is that we need to increase access to treatment. But more importantly we need to increase access to long term recovery, so supports in the community. Intensive outpatient treatment is one option. Increasing access to medically assisted treatment is another option. I'm very interested in the alternatives for recovery housing and giving people the stability in their life, job access, job training, transportation, child care, and then of course the co-occurring mental health issues.
With respect to VA health care, the trend is to allow vets to find more options in the local community, the private sector. You supported the Mission Act which is sort of like the follow up to the Veterans Choice Act. Veterans Choice had a lot of problems stemming in part from the third-party contractor, the private company that was sort of managing it. How can you and Congress ensure that the problems that existed with the Choice Act won't exist with the Mission Act?
That's the whole point of the VA Mission Act, it's to solve the problems in the Choice Act. Most importantly the third party administrator did a terrible job. So we eliminated that. They'll be able to work directly with the VA to get access to care and to make sure that their medical records will follow them to the community care and back to the VA so that their physician at the VA will have a full record of their care and just better coordination.
How are you covered? How do you get your health insurance?
I'm on the exchange. All members of Congress are on the exchange. And I've been so far pleased with the coverage that we have. We pay a premium just like everyone else and we have access to care and we're very fortunate here in Concord to have excellent physicians. I feel very fortunate. So I want to make sure that everyone else has that same coverage and that's why I am a firm believer in universal access to affordable health care.