Pressed on “Medicare for all” Kilmer says loss of private insurance would threaten rural hospitals

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Ballots for the Nov. 5, 2019, general election will be mailed Oct. 16. Your ballot includes only candidates for districts in which you vote.
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Ballots for the Nov. 5, 2019, general election will be mailed Oct. 16. Your ballot includes only candidates for districts in which you vote.

U.S. Rep. Derek Kilmer told a town-hall audience in Gig Harbor last week that he favors a “public option” for health insurance because it would increase competition and lower costs.

But Kilmer, a Democrat, said he does not support the “Medicare-for-all” bill popular with many in the party —a stance which drew sometimes rancorous criticism from a contingent of red-shirted democratic socialists who showed up for the town meeting.

Kilmer, who resides in Gig Harbor, represents Washington’s 6th District, which encompasses the Olympic and Kitsap Peninsulas, as well as the Grays Harbor area.

He spoke to about 50 people at Peninsula High School last Monday, Sept. 2.

Kilmer said he can’t support HB 1384, the current “Medicare-for-all” bill because it would eliminate employer-provided and other private health plans on which 165 million Americans have come to depend — and, for the most part, like.

“There is no certainty I can look you in the eye and say, ‘We will replace your employer-provided health care with something better,” Kilmer said.

The concept of “Medicare for all” has been endorsed by presidential candidates, including Bernie Sanders and Elizabeth Warren, and HB-1384 has 119 house co-sponsors, including Rep. Adam Smith, D-Tacoma.

But Kilmer argued that the current bill would imperil rural hospitals in his district that are being effectively subsidized by private health plans.

He noted that many rural hospitals are reimbursed only about 70 or 80 cents on the dollar from Medicaid and Medicare, but $1.20 on the dollar from private medical plans.

“They lose money on public pay,” he said. “Private pay is the difference that allows them to keep the lights on.”

He noted that, “In many of the counties I represent, hospitals are not only the largest employer, but often the only health care provider.”

“They’re also your largest donors,” shouted a man in the audience. He later identified himself as Hillel Samlan, 33, of Tacoma, one of about a dozen self-identified “democratic socialists,” some wearing red shirts and carrying signs, in the auditorium.

“I’m not taking that bait, but I do resent the implication,” Kilmer replied, before diving deep into a long explanation of the Affordable Care Act. — the thrust of which was that it would be better to improve the ACA than replace it with an untested new system.

(According to the Center for Responsive politics, of about $2.3 million Kilmer raised in the 2017-18 election cycle, he received slightly more than $200,000 from health-related donors, including health-care providers, pharmaceutical companies and medical insurance companies, or their political action committees.)

In questions to Kilmer, some of the red-shirted visitors took issue with his conclusions, a few with passion.

When the interests of “the one percent” are threatened, said Isaac Wagnitz, 30, of Olympia, “it is always people like you, who are supposed to represent us, tell us that it’s too hard, too complicated, and nothing can be done.”

“Medicare for all would cost less than the system we have now,” he continued. “It would be very easy to pay for if there were the political will to tax the rich.”

The statement drew applause, which Kilmer acknowledged, saying the present system is not perfect and need improvement. He cited the need to “unravel the sabotage the Republicans have done to the Affordable Care Act,” and to make it more accessible.

“If you get sick, you should not have to go broke,” he said.

Kilmer said he would support a public option to “introduce more competition, which would lower health care costs, while allowing people who are happy with their private-pay plans to keep them.”

There are several variations of the public-option proposal, but most would create a government program that would compete in the insurance exchanges created under the Affordable Care Act. Some variants would allow people to “buy in” to existing state Medicaid programs.

Kilmer has been holding town-hall style meetings throughout his district during the Congressional recess. He was scheduled to return to Washington, D.C. when Congress reconvenes this week.

CORRECTION: An earlier version of this story reported erroneously that Mason General Hospital in Shelton is among those that receive only 70 to 80 cents on the dollar from public-pay systems like Medicare and Medicaid. Mason General is a critical-care facility which receives 99 cents on the dollar.