Republican congressional candidate Matt Doheny is looking beyond the "repeal and replace" mantra that has dominated much of the discussion about the Affordable Care Act in recent weeks.
The Watertown businessman, who is challenging U.S. Rep. Bill Owens, D-Plattsburgh, in this fall's election, has consistently supported repeal of the health care law, which is often referred to as Obamacare. Owens helped pass the bill almost immediately after taking office in November 2009.
Up until recently, Doheny hadn't offered many specifics on what he would do to replace the health care law. In an interview with the Enterprise last week, the candidate outlined some of his proposals, although Owens dismissed many of them for lacking substance and mirroring provisions of the current health care law.
(Enterprise file photo)
Doheny has stated repeatedly he favors an incremental approach to replacing Obamacare. So what would that look like?
Doheny said he'd support medical malpractice reform, letting people cross state lines to buy health insurance, making it easier for people to transfer health insurance policies when they switch jobs, and letting young adults stay on their parents' health insurance plans longer.
Doheny said allowing people to purchase health insurance policies in other states would open up a "vibrant national market.
"I've said this many times: You can go online and buy something through Amazon, Google or any other e-commerce around the world or the country and that's not allowed for health care," he said. "(It) makes no sense."
States' varying insurance laws stand in the way. For example, Owens pointed out that currently, the New York State Department of Financial Services requires insurance companies to maintain enough resources to pay out claims. He said letting people cross state lines to purchase their policy would put the customer at risk.
Young adults, Doheny said, often switch jobs multiple times, or they may consider starting their own businesses. He said giving those people the option of portable health insurance plans can make those transitions easier.
Doheny said employer-based health insurance has been a good thing, but it may be time to consider plans that are tailored more to the individual. Owens said the Health Insurance Portability and Accountability Act already permits portability of insurance plans for up to 18 months.
"The other avenue that's available under the bill is the state exchanges, which are not tied to employer coverage," Owens said. "So there's a couple vehicles, either already in existence or which are available under the ACA, that would get that done."
Doheny said he also supports letting people up to age 26 stay on their parents' health care plan. The current health care law includes the same provision.
"Those are four common-sense ways that I think can get bipartisan support that I think will continue to make a difference in reducing health care costs," Doheny said, "because right now, with Obamacare, health care costs are not going to go down."
One of the major criticisms of the health care law has been its size. Doheny said passing bills targeted at specific solutions would make more sense, and they're more likely to garner bipartisan support.
Doheny said he also supports the use of health savings accounts, improving doctor recruitment in rural areas and the expansion of telemedicine programs. He said telemedicine means less time and fewer hospital stays for patients and reduces costs for health care providers. Telemedicine can also lead to more customers for providers, which means additional revenue, Doheny said.
Citing the Journal of Telemedicine and e-Health, Doheny said there are three impediments to expanding telemedicine: licensing, credentialing and reimbursement. He said there should be a "national telemedical license, instead of requiring providers to obtain licenses for each state in which they operate."
Owens countered that telemedicine is a common practice at North Country hospitals. He said it's "alive, well and functioning."
Owens said a national telemedical license would amount to more federal bureaucracy.
"It's another layer of government becoming involved in something the states already do quite successfully," he said. "I think if you talked to any medical provider and you talked about telemedicine, they'd tell you that they're doing it quite well. The real difficulty is that they'd like to do more of it, but it's not because they have impediments as a result of licensing."
Grants to expand telemedicine programs have been made available through the Affordable Care Act, and some local hospitals, like Adirondack Medical Center in Saranac Lake, have been on the receiving end of those grants.
Doheny said he was surprised the Supreme Court upheld the heath care law as constitutional. In a close vote, the court ruled June 28 that the individual mandate in the law amounted to a tax.
"So my opponent, one of his very first votes in Congress was to raise taxes, and obviously has continued to reaffirm that as recently as last week, when he reaffirmed his vote on Obamacare," Doheny said.
The House has voted 31 times to repeal Obamacare. Owens has called those votes "messaging bills" because they stand little chance of passing in the Senate, and President Barack Obama has stated he wouldn't sign the legislation anyway.
Doheny said the path to repeal will require majorities in the House and Senate and a Republican president, all of which are possible in this fall's election. He said voters will have a chance to send a message on the health care law.
"I think that that's the way it's supposed to be," Doheny said. "I think it's a clear signal, and we'll have a clear result through the electoral process and ballot box on November 6th."
Contact Chris Morris at 518-891-2600 ext. 25 or firstname.lastname@example.org.