Congressional candidates weigh in on health care

Healthcare has proven to be a contentious issue in the race for New York’s 21st Congressional District, with all three candidates voicing displeasure with the Affordable Care Act, even as its provisions, once advanced as theoretical solutions, solidify into reality.

But the three candidates — Republican and Conservative nominee Elise M. Stefanik, Democrat and Working Families Party nominee Aaron G. Woolf and Green Party candidate Matthew J. Funiciello — have very different takes on how to fix the nation’s healthcare system.

For Ms. Stefanik, it’s a full repeal of President Barack Obama’s signature healthcare legislation, though the candidate, a former White House aide who lives in Willsboro, also acknowledged she would be willing to look at “immediate fixes” to the law in the meantime.

“I’ve made very clear since the beginning of the campaign that I would have voted no on Obamacare,” Ms. Stefanik said, using the term favored by Republicans. “I support the repeal but I feel that it is important to put forth what a comprehensive health care package would look like and, in the meantime, talk about those immediate fixes.”

To that end, Ms. Stefanik put forward a series of proposals last week to replace the law or at least temporarily fix the parts of it she said aren’t working well.

In contrast to Ms. Stefanik’s position, Mr. Woolf’s refusal to say whether he would have voted for the law have become a mini-theme on the campaign trail lately, cropping up at events centered on entirely different topics, as during a news conference on women’s issues last week in Watertown.

But from Mr. Woolf’s perspective, it is a “hypothetical” question that doesn’t pertain to his plans to fix certain parts of the law.

“Everyone knows where I stand on this piece of legislation,” Mr. Woolf, a documentary filmmaker with a home in Elizabethtown said. “This is what we have before us. And I think one of the things that characterizes a lot of the way I approach the world politically is fixing what we have before us.”

For his part, Mr. Funiciello, a bakery and cafe owner from Glens Falls, railed against the Affordable Care Act, calling it “anti-worker.” He advocated for a single-payer healthcare system in which the government would pay for all medical services.

“I think the ACA, to put it mildly, is the most anti-worker bill that has been passed in the United States since NAFTA and GATT were railroaded through by the corporate parties,” Mr. Funiciello said, referring to the North American Free Trade Agreement and the General Agreement on Tariffs and Trade. “That one destroying our manufacturing base and this one forcing the working poor to buy for-profit health insurance. And the injustice and the brutality of that is that we are already supporting the healthcare infrastructure to the tune of 60 percent.”

Citing an article titled “Paying for National Health Insurance — And Not Getting It” published in Health Affairs by Steffie Woolhandler and David U. Himmelstein in 2002, Mr. Funiciello said that moving to a single-payer model would not be as onerous on taxpayers as previously thought.

The three candidates are running to replace Rep. William L. Owens, D-Plattsburgh, who is not seeking re-election. As one of his first acts in office, Mr. Owens voted for the Affordable Care Act — a position he spent the following two election cycles defending.

Ms. Stefanik and Mr. Woolf both agreed on repealing the medical device tax but differed on most every other point.

For instance, Ms. Stefanik said she would look to protect those with pre-existing conditions by continuing to allow states to fund the “high risk pools” that provide insurance coverage for some individuals who do not qualify for other plans. The Woolf campaign attacked this idea as one that would return the health insurance marketplace to a system where working families suffer under high deductibles.

On purchasing health care across state lines:

“It would expand choices and lower costs. Right now in this district, especially in the Clinton County, Essex County area, even Franklin County, there are limited options. But if you go across to Vermont, there are many more options in the Burlington area, so again, I think it’s rethinking how we focus on a 21st century economy,” Ms. Stefanik said.

“I also think its reflective of people of our age group who move around more frequently as opposed to our parents’s or grandparents’s generation. It allows healthcare coverage to be portable in a way it hasn’t before but ultimately that will help lower costs for everyone because you’re allowing the free market to thrive,” said Ms. Stefanik, who recently turned 30.

In a statement, the Woolf campaign said that Ms. Stefanik’s proposal would hobble states with strong patient and consumer protections in favor of states with weaker protections, ignores the varying rates of healthcare costs by geography and fails to take into account the fact that the Affordable Care Act allows for regulated cooperation over interstate purchasing.

On addressing tort reform and reducing so-called “frivolous lawsuits”:

“The cost of medical malpractice liabilities are rising so high, it’s forcing the practice of defensive medicine at the physician base but also for hospitals, and it’s ultimately driving the cost up for consumers. I think the way you can address tort reform is having a cap on what those lawsuits, basically more protection for our physicians, I think, so they’re avoiding driving up those costs and practicing defensive medicine,” Ms. Stefanik said.

“I’m all too aware how easy it is to sue a physician and the pressures our physicians are facing, seeing patients for 7 to 15 minutes, it’s all that much easier for somebody to find an error,” Mr. Woolf said. “I think it’s facile to say ‘tort reform’ as just kind of a blanket statement. We need to cut down on frivolous lawsuits but we need to make sure we have a system of justice when things go wrong.”

The employer mandate:

“Basically it incentivizes businesses to not hire above the 50 employee number… I think we should be encouraging companies to grow. I’ve heard from a number of companies who are at the cusp who are not hiring those additional three or four people because they don’t want to be above the line,” Ms. Stefanik said.

According to Yianni Varonis, Mr. Woolf’s spokesman, Mr. Woolf wants to give businesses enough time to meet the employer mandate and would be open to delaying the implementation of the rule further.

Mr. Woolf would also like to extend tax credits offered to businesses with 25 or fewer employees who offer health insurance to those who employ between 25 and 50 people, Mr. Varonis said in an email.

Mr. Woolf also proposed creating another, more affordable category for individuals who are purchasing health insurance on a state marketplace — something that would, for instance, fall below the “Bronze” plan on the New York state exchange.

On the Affordable Care Act

“I believe that everyone should have access to affordable healthcare and Obamacare is not moving us in that direction. I think that’s become pretty clear to any candidate you speak to… That’s an important vote, it’s not a hypothetical. It’s a vote that actually came up in Congress and it’s a vote that our current member of Congress voted the day after he was sworn into Congress. It’s one of the top issues in this election cycle. I think it’s an important issue to stake where you are,” Ms. Stefanik said.

“I absolutely agree that people have a right to healthcare. I feel like, when you’re sick you should be able to go to a doctor. I think what we have to do is continually tweak and improve a system that allows that to happen. I think there are particular challenges with rural healthcare delivery, I think this district has particular challenges but I think what we have is a significant number of residents who were previously uninsured that now have quality affordable healthcare and that’s an important step,” Mr. Woolf said.

By Daniel Flatley, Times Staff Writer