“I think sometimes it’s easy for this to seem like a distant policy debate,” said Rep. Derek Kilmer by phone from his office, nearly 3,000 miles away, in Washington, D.C.
“I think it’s important to talk about what this is really about,” the congressman from Gig Harbor continued.
“And it’s about people.”
Our topic of conversation was a familiar and timely one: Obamacare, otherwise known as the Affordable Care Act.
It’s an unavoidable topic now that Republicans control the Senate and the House of Representatives, and Donald Trump will back his gold-plated moving trucks up to the White House this week.
It appears the ACA (at least as we know it) will soon be a thing of the past. The members of the new Republican majority seem intent on repealing or dismantling the national health care law. What they’ll replace it with is yet to be determined.
For many, including Democratic lawmakers at the state and national level, this uncertain prospect is cause for considerable concern.
In a letter to Auburn Republican Dave Reichert, urging the congressman from Washington’s 8th Congressional District to not vote to repeal the ACA, Gov. Jay Inslee and state Insurance Commissioner Mike Kreidler laid out some of them.
They cited the more than 750,000 people in our state who have secured medical coverage though the ACA, and the state’s uninsured rate, which the 2010 health care law has helped to lower from 14 percent to just 5.8 percent. The letter also notes that the ACA has helped Washington add 51,000 jobs.
Statistics like these — while powerful — aren’t new. For its shortcomings — and, yes, the ACA is far from perfect — the work the law has done to help the previously uninsured gain coverage, lower the costs at hospitals associated with providing care for the uninsured, and stabilize and stimulate the health care industry as a whole is well-documented.
It’s all out there, for anyone interested in seeing it.
But rehashing these bullet points is not why Kilmer and I chatted Thursday.
Instead, we spoke in more local terms, about what scrapping the ACA without a plan to preserve the very real positives it’s achieved could mean here in Tacoma.
And, specifically, on Hilltop.
It’s here, on the corner of Martin Luther King Jr. Way and South 12th Street, where a three-story building — Community Health Care’s Hilltop Family Medical Clinic — stands as a shining example of some of the under-appreciated gains the ACA has made.
“I think they’re kind of front and center, both in terms as just an institution having benefit from the law, but also serving a large population of people who had previously been uninsured,” Kilmer explained of the Community Health Care facility.
It’s for this reason that the congressman was part of a roundtable conversation Saturday morning at the clinic, intended to “voice opposition to a congressional plan to dismantle the Affordable Care Act,” according to a press release from his office.
“Through the ACA (Community Health Care was) able to make substantial investments in that facility,” Kilmer continued. “And they literally serve thousands of patients on Hilltop.
“I think it’s important to understand the local dynamics.”
David Flentge, Community Health Care’s CEO, is certainly familiar with those dynamics. When asked about how the ACA has helped Community Health Care serve Tacoma’s community and primarily lower-income residents, he first points to a $12 million grant, part of the original ACA law, that made the new building possible.
“That building would not exist except for the ACA,” he said bluntly.
But the benefits of the ACA on Hilltop aren’t just seen in the new facility. Flentge also pointed to the staff Community Health Care was able to bring on specifically to help more people from the area sign up for health insurance and a new residency program that trains physicians out of the Hilltop location.
In June, the first class of six physicians trained on the Hilltop will graduate, thanks to the ACA. Flentge expects a majority of the new doctors will stay in Pierce County.
But, as Kilmer said, more than anything, the ACA is about people.
And, for many people on Hilltop, it’s unquestionably made life better.
Since the law took effect, Flentge says, it has helped Community Health Care increase the number of patients served in a year by just over 15,000 — a 51 percent increase — and the number of patient visits in a year by over 51,000 — a 47 percent increase. He attributes these gains to an overall increase in the number of patients with insurance, and evidence that shows people with insurance are far more likely to seek medical care when they need it instead of delaying care due to financial concerns.
Flentge described this as “an enormous increase in services” that would not have been possible without the ACA.
All of this brings us to the present and the reality that a national health care law that has helped so many people in Tacoma might soon disappear or be rendered unrecognizable.
“I think what most people embrace is that there are really important parts of this law that have positive impacts on real people,” Kilmer said, “What most people say is, ‘Why would we throw out all of it? Let’s fix the parts that need fixing.’ ”
Asked whether that’s a realistic possibility, given the rhetoric and Republican momentum behind scrapping Obamacare, Kilmer responded optimistically.
“I think that’s in the realm of the possible,” he told me.
I hope he’s right.