As the 115th Congress begins, I am honored to assume a new role as Interim Chair of the House Budget Committee.
It is an exciting opportunity, particularly as the first woman to fill the position, but more than any title before my name, I’m still most proud of the two letters that follow: “R.N.”
I graduated from nursing school in 1971 and still keep my license today. Those years on the front lines of patient care, primarily in emergency room settings, inform much of the work I do in Congress – especially when it comes to ObamaCare.
It’s no secret that Congressional Republicans aren’t keen on former President Obama’s health care law (of course, recent polling shows that a majority of Americans still aren’t either) but, for me, the debate has never been about politics. It’s personal.
As a nurse, I saw the impact of health care decisions in Washington play out every day on my patients’ faces and in their billing statements.
I understand the need for healthcare reform as well as anyone, but ObamaCare wasn’t the way to do it – and nowhere is that more deeply felt than in my home state of Tennessee.
In 2013, 28,000 Tennesseans lost their insurance coverage in a single day when a state program called “CoverTN” lapsed after the Obama administration decreed that it ran afoul of the health care law’s top-down requirements.
Two years later, our state’s ObamaCare co-op would follow suit, leaving thousands in a scramble for coverage.
Our state insurance commissioner didn’t mince words last year when she described the marketplace as “very near collapse” but even that characterization is generous. When three-fourths of your state lacks any choice among insurers, it’s no longer a marketplace at all – it’s a monopoly.
Sadly, Tennessee has seen this movie before, and we know exactly how it ends. A similar government-run program, called TennCare, failed in our state less than 15 years ago.
First enacted in 1994, this program dramatically expanded Medicaid eligibility to just about anyone that wanted it, including healthy, insurable adults who simply lacked employer-sponsored coverage.
Costs for TennCare quickly exploded, rising 146 percent over a ten-year window with little to show in the way of improved health outcomes.
In 2001, BlueCross Blue Shield, which covered half of all TennCare patients, threatened to pull out of the program because of massive losses and, by 2004, an independent audit revealed TennCare was on track to bankrupt Tennessee.
Like ObamaCare, TennCare couldn’t deliver on its promises. Both programs found themselves mired in court cases, unable to attract healthy adults, struggling to keep insurers, crippled by a lack of proper verification for eligibility, and ultimately failing to bend the health care cost curve.
It was ultimately a Democrat Governor, Phil Bredesen, who scaled back TennCare to a traditional Medicaid model, admitting “Our experience with trying to do universal coverage ended up being a disaster."
Now, Tennesseans are experiencing a bad case of déjà vu.
Following the clear mandate from American voters last fall – and keeping the lessons of TennCare in mind – Congressional Republicans recently took the first steps towards the repeal of ObamaCare.
The debate on the House floor over the legislation was spirited, with Democrats claiming that supporters of repeal are pulling the rug out from millions of Americans, but their argument falls short.
For every person that ObamaCare loyalists claim has been helped by this law, another has opted out of the law altogether. Indeed, between the number of people who claimed an exemption from ObamaCare penalties and those who paid the fines – some 20 million Americans are rejecting ObamaCare outright.
Washington types fail to understand that by repealing and replacing ObamaCare, we are not disrupting a system that is working, we are offering a rescue plan to stop the bleeding and transition away from a law that already failed by every measure. That also means offering a stable transition period, so that no one falls through the cracks, and then offering a path to something better.
If President Obama’s infamous pledge that “If you like your plan, you can keep it” was the greatest lie surrounding ObamaCare, then a close second is the claim that Republicans have no alternative.
For example, Speaker Paul Ryan filed the Patients Choice Act during the same session of Congress ObamaCare was passed. Unsurprisingly, the Democratic majority wouldn’t give the bill consideration.
More recently, my Tennessee colleague, Congressman Phil Roe, a physician by trade, offered the American Health Care Reform Act and Congressman Tom Price, an orthopedic surgeon, introduced the Empowering Patients First Act.
While the exact details of these bills vary, they all center on solutions that expand choice, force insurers to compete for patients’ business, protect our most vulnerable, and work to drive down the cost of care.
Last summer, House Republicans put many of these solutions together in a detailed, 37-page policy blueprint called “A Better Way” for health care reform.
The House will legislate on an ObamaCare replacement bill that meets the contours of that plan this year.
Nearly seven years after ObamaCare became law on a party line vote, we can say with certainty that we’ve tried health care reform the Washington way and it didn’t work.
Now, it’s time to try a better way – with solutions that trust patients over politicians and that offer Americans the care they want without forcing them to buy into a product they don’t need.
This nurse is ready to roll up her sleeves and get to work.
Republican Diane Black represents Tennessee's 6th Congressional District in the U.S. House of Representatives. She has been a registered nurse for more than 40 years and serves on the House Ways and Means and Budget Committees.