5th District Candidates on the Issues: Part Three - The Affordable Healthcare Act

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With Election Day less than a week away, we're bringing you a three-part series looking at what the 5th District candidates for United States Congress say they would do on a variety of issues.

In the first installment of our "On The Issues" series, NBC29's Nora Neus asked candidates Jane Dittmar (D) and Tom Garrett (R) about their positions on the economy. The topic of the second part of our series was on national security.  

Now, in this final segment, both candidates discuss the Affordable Care Act (ACA). The candidates have discussed the ACA in almost every debate and are running campaign advertisements centered on the issue. 

Garrett’s dislike of the Affordable Care Act is no secret: 

“It has to be repealed! It absolutely, positively, have to repeal it,” he said. “We’ve taken premiums, we’ve driven them up where it’s routine that a family of four might pay $1200, $1,500 a month.”

Instead of the ACA, he supports Health Savings Accounts which allow people to save tax-free money for healthcare expenses, and then spend it on other things once they reach a certain savings level.

“The Affordable Care Act has literally been so unaffordable that members of the Affordable Care Act, who are paying the full premiums with the raised deductibles, could have a health savings account instead with greater services where they had control over their own health care.”

Democrat Jane Dittmar agrees that the Affordable Care Act needs work:

“I’d like to also understand the competitive disadvantage that some of the insurance providers are experiencing and causing them to pull out completely from markets. So we want to look at all those things.  And we want to do it sooner than later or else I think the Affordable Care Act will collapse on itself.”

But Dittmar advocates a piecemeal approach to fixing problems, rather than repealing the entire law:

“It hasn’t been worked on at all and that’s why we are where we are today.  If we can save the benefits and work on the challenges, we really will have a health care system in this country to be proud of.”

Dittmar underlines what the ACA has done right:

“It’s worth mentioning what we’ve gained. Right now we have over 20 million people that are insured that weren’t. Right now we have students, who used to have to get off their parents plans, now can stay on until 26 if they need to.”

This last point is an area of agreement for the candidates. Garrett states:

“There are good provisions, OK? Extended coverage for young people that makes some sense, portability across state lines makes some sense, pre-existing conditions makes some sense.”

Despite that common ground, Dittmar and Garrett hold divergent positions on one provision of the Affordable Care Act: Medicaid expansion. Virginia chose not to accept federal dollars to expand Medicaid after the Supreme Court ruled in 2012 that the decision was optional on a state-by-state basis.

Dittmar points to the so-called “donut hole” gap in coverage that the decision created, leaving thousands of Virginians without access to either Medicaid or ACA marketplace coverage:

“It’s just amazing to me that we’d do that to people.”

Garrett has long opposed Medicaid expansion in Virginia. In a 2014 op-ed in the Richmond Times Dispatch, Garrett called Medicaid expansion crazy. When asked if he still thinks that, he stated:

“Absolutely! Absolutely. In one year we uncovered over $1 billion in Medicaid fraud in Virginia. It’s like throwing people into a sinking lifeboat to suggest that more money’s gonna solve this problem.”

If you missed the previous installments of this series, you can find them here: 5th District Candidates on the Issues: Part One - The Economy and 5th District Candidates on the Issues: Part Two - National Security.