Local Congressional representatives are either condemning the Republican proposal to replace Obamacare or reviewing it with high hopes that a different national health care system could work. Not surprisingly, their views depend on their party affiliation.
Democrats ripped the bill as taking away benefits of the Affordable Care Act, while local Republicans -- who have repeatedly criticized the current health care law widely known as Obamacare -- were looking for answers and for constituent responses, as they prepared for discussion at the House committee level as early as Wednesday.
U.S. Rep. Paul Tonko, D-Amsterdam, whose 20th Congressional District covers the heart of the Capital Region, said the Republican bill is being rushed through, in contrast to the weeks of review the Affordable Care Act received before it was enacted in 2009.
As a member of the Energy & Commerce Committee, Tonko will be involved in the House review of the bill. He said he'll try to get the bill amended, though he can't say how his proposals to protect existing benefits will be received. The Republicans could have sat down with Democrats to negotiate fixes for the ACA, he said, but GOP leaders chose to draft an entirely new bill -- one he thinks doesn't have the right priorities.
"The (Republican proposal) cuts taxes for the rich and would cut access for the poor and raise premiums for the elderly," Tonko said.
The American Health Care Act, as as the Republican bill is formally known, would eliminate the current mandate that individuals buy insurance, replacing it with a system of tax credits to partially offset insurance premiums. Young people could still remain on their parents' plans until age 26, as called for in the Affordable Care Act. But the GOP bill would roll back the Obamacare expansion of Medicaid coverage for the poor, which Tonko said could deprive 15 million to 20 million people of coverage they have now.
"What basically has happened here is shifting the burden onto the middle class and working families," Tonko said.
Tonko predicted a quick committee review of the bill and a House floor vote within two weeks.
"This is a fundamental right that the American public should enjoy. It needs to be protected," Tonko said. "This is a cut-and-run being done in the middle of the night."
While President Donald Trump has enthusiastically endorsed the bill, some conservative Republicans think it gives the government too much control -- and one local Republican said he needs to know more before endorsing the bill.
19th Congressional District Rep. John Faso, R-Kinderhook, said he likes what he's read so far, but he will need satisfactory answers to questions before he will agree to support it. He's a member of the House Budget Committee, which is expected to review the bill next week.
Faso said he wants to assure himself that insurers will be able to offer products to people who rely on the prescribed advance refundable tax credits, that the high-risk reinsurance pools for those with high medical costs will have sufficient funding, and that the Medicaid block grants to states that will replace the current Medicaid system will be adequate.
"What I'm seeing so far, I like, but there are aspects that, like President Reagan said, I want to trust but verify," Faso said.
The ACA has disrupted insurance markets, Faso said, causing many insurance companies to withdraw from the health insurance exchanges. Because group premiums have gone up for employers, he said, it has also affected the creation of new full-time jobs.
He said the premium formula in the Republican bill should mean lower premiums for young and healthy people, giving them more reasons to buy insurance. While premiums would rise for older people, he said, "it will not have the same impact in raising premiums for older people, because more young people will come into the pool."
North Country 21st Congressional District U.S. Rep. Elise Stefanik, R-Willsboro, has been a strong critic of the Affordable Care Act. She posted a link to the House legislation on her Facebook page and emailed it to constituents, asking them to react to it.
"I am working with my colleagues to ensure that the package includes reforms that will help lower costs for families and businesses in our district, protect coverage for those on their parents' plan and those with preexisting conditions, help job creators, as well as protect the needs of rural communities like ours," Stefanik wrote in her message.
Any bill that passes the House will still need to pass the U.S. Senate, where most analysts expect it to run into obstacles.
U.S. Sen. Kirsten Gillibrand, D-N.Y., issued a statement criticizing the bill and linking it to Trump, who polls show is unpopular in New York.
"I will do everything I can to stop this assault on the health and economic security of middle-class families and seniors," she said.
"I believe health care is a human right and that Americans should never be denied access to quality, affordable health care," Gillibrand said. "President Trump's health care proposal would force middle-class families and seniors to pay more money for less care and leave more people uninsured, all while giving huge tax breaks to insurance companies and the highest wage earners."
The National Association of Health Underwriters, an insurance industry group, praised the law as potentially beneficial to the insurance markets.
“We look forward to continuing our dialogue with members of Congress and the administration on the implementation of health reforms that reduce costs and encourage competition," said NAHU CEO Janet Trautwein. "Our goal is to help all Americans receive the coverage they deserve at a price they can afford. By working together, we can ensure this happens.”