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Election 2020 Fact Check: Perry and DePasquale on healthcare

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10th Congressional District race

Eugene DePasquale vs. Scott Perry

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The candidates for Pennsylvania’s hotly contested 10th Congressional District — incumbent Republican Congressman Scott Perry, and current Democratic state Auditor General Eugene DePasquale — are scheduled to be featured in a second debate on WGAL on Oct. 19, following their first debate Oct. 8 on ABC27.

The 10th Congressional District encompasses all of Dauphin County as well as parts of Cumberland County and York County, and polling indicates the seat is a toss-up.

In anticipation of DePasquale and Perry’s next head-to-head appearance, The Sentinel presents a series of fact-checks on the critical issues from the first debate.

DePasquale: “[Perry] literally voted to end Medicare as a guaranteed benefit and opposed Medicaid expansion, which is critical to giving so many people access to health care. ... Scott Perry is supporting a lawsuit that would throw tens of thousands of people off their health insurance.”

This has been Democrats’ bludgeon against a number of GOP incumbents, and that didn’t change during last week’s debate.

The statement is generally true, with a few caveats. Perry voted multiple times during the Obama administration to repeal the Affordable Care Act, commonly known as Obamacare, without a replacement, which would have stripped states of funding for Obamacare’s expanded Medicaid eligibility for low-income workers. That funding would’ve also been phased out under the GOP’s 2017 Obamacare replacement bill, the American Health Care Act, which passed the House but failed in the Senate.

Perry has also voted in favor of budget resolutions that included former GOP House Speaker Paul Ryan’s plan to convert Medicare into a system where beneficiaries would receive a set amount of money via a voucher to support private health insurance premiums, as opposed to the current system where the federal government makes direct fee-for-service payments. The plan was intended to drastically cut social services spending ahead of the GOP’s tax cut legislation, although only the latter was fully implemented.

Finally, the Trump administration is supporting a lawsuit from Republican states’ attorneys general, currently before the Supreme Court, that seeks to overturn the ACA on constitutional grounds. This would eliminate the Medicaid expansion, mandates for insurers to cover pre-existing conditions, and federal support for states’ public insurance exchanges under the ACA.

Perry has been a vocal supporter in the past of court arguments to overturn elements of the ACA — praising, for instance, the dissenting opinion in the 2015 Supreme Court case King v. Burwell. The plaintiffs in the case argued that, based on their reading of the ACA, only insurance plans purchased off state-run exchanges, and not off the federally run exchange, should be eligible for premium assistance. The court ruled against this interpretation, but had Perry’s preferred outcome prevailed, Pennsylvanians would’ve lost their ACA funding, given that that Pennsylvania only began to run it’s own exchange this year.

Perry: “My opponent would tell you that the only way to handle pre-existing conditions or health care is to have a federal government top-down approach. … That’s why I co-sponsored the MAGIC Act and worked with Democratic Rep. [Lauren] Underwood from Illinois to reduce the cost of insulin for everybody across the country.”

Republicans’ retort to Democratic attacks on their health care record has been that Americans are better served by fewer regulations, including the requirements of the ACA.

Perry did co-sponsor the Market Access for Generic Insulin Competition Act, which works under this concept, fast-tracking the approval of certain generic insulins with the idea that fewer delays for the drug manufacturers will result in lower prices for insulin consumers. Underwood’s Lower Insulin Costs Now Act, which became law last year with bipartisan support, operates on the same principle.

Likewise, Perry did vote against House Democrats’ legislation that would have capped out-of-pocket prescription drug costs for Medicare enrollees, restricted certain drug price increases to the inflation rate, and created a price index to be used by the federal government in negotiating pharmaceutical prices.

House Republicans said the legislation would amount to price-fixing and would stifle innovation by pharmaceutical companies; the GOP caucus introduced their own bill that was limited to just the first item on the Democratic list, reforming the patient cost cap in Medicare Part D.

Perry: “When Speaker Ryan came with the repeal bill for the ACA and it didn’t include protections for pre-existing conditions, that’s why I was a no vote. … Not until we got that coverage for preexisting conditions through blind risk pools would I vote for the bill.”

Perry’s other retort on the health care issue is less clear-cut. Perry voted against the first version of Ryan’s AHCA, as did the rest of the Freedom Caucus, the group of conservative legislators of which Perry is a member.

Perry and the Freedom Caucus did support the second version of the AHCA, which introduced separate risk pools for patients with pre-existing conditions, where insurance companies would receive federal financial assistance for accepting these patient pools.

However, Perry’s statement lacks one critical piece of context — the risk pools were introduced because the second version of the AHCA allowed states to eliminate the ACA’s primary means of protecting patients with pre-existing conditions, something the first version of Ryan’s bill did not permit.

The second version of the bill allowed states to opt-out of the ACA’s “essential health benefits” clause, which requires all insurance plans to cover a list of common pre-existing conditions, thus spreading out the cost among all enrollees.

The Freedom Caucus vocally lobbied for this change, preferring the risk pool model to the essential health benefits model; the risk pool system, according to multiple analyses from sources such as the Kaiser Family Foundation, would cost those with pre-existing conditions more and require significantly more financial support than the AHCA offered.

Thus, while Perry’s statement about blind risk pools is technically true, the pools were introduced only because Perry successfully pushed to have stronger protections for pre-existing conditions eliminated.

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