Sharp exchanges mark Neal's debut as Ways and Means chairman

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WASHINGTON — U.S. Rep. Richard E. Neal used his first full hearing as chairman of the House Ways and Means Committee to sell an existing law, a seemingly academic move that nonetheless brought fireworks.

With Democrats back in charge of the powerful committee, Neal honored a pledge he made after his party retook the House to "enshrine" the principle of requiring health insurers to cover people with pre-existing medical conditions.

Despite calls to work across party lines, the three-hour session appeared to close with some new bruises, with one Republican calling it "political theater." Hard feelings over efforts by Republicans to "repeal and replace" the Affordable Care Act colored some Democratic lawmakers' remarks.

Neal sat at the helm of it all, granting five minutes of speaking time to members. He sat, perched on the chairman's seat in the dead center of the dais, by design the chair with the tallest back. He conferred in whispered bursts with the committee's general counsel, glanced through paperwork and studied the witnesses.

Rising to the chairmanship of Ways and Means, after 26 years on the panel, fulfills a longtime ambition for the Springfield Democrat, who represents the 1st Congressional District, which includes all of Berkshire County.

"For me, this is a pinnacle of career achievement," Neal said the day after Democrats took control of the House. "And I fully intend to exercise the responsibilities of chairman of arguably the most important committee in Congress, and certainly within the House of Representatives."

Neal is the first Massachusetts politician to lead the panel since 1871.

In his opening comments Tuesday, Neal acknowledged the importance of the moment to him personally. "I take this position, and the history and prestige of this committee, very seriously."

Diving into the topic, Neal then gestured toward a group of people from across the country who had been invited to brief lawmakers.

"Our witnesses know that these safeguards can be the difference between getting needed medical assistance and forgoing necessary treatment," Neal said in his opening statement, referring to four of the five people sitting across from the dais in the ornate meeting room.

"These protections mean the world to people — and they're the law of the land," Neal said.

The provisions are part of the 2010 Affordable Care Act, also known as Obamacare.

Though Republican members insisted that they also back coverage of pre-existing conditions, Democrats weren't having it, pointing to years of attempts in a Republican-dominated Congress to unravel the landmark law.

U.S. Rep. John Lewis, the Georgia Democrat and civil rights leader, thanked Neal for making the issue a priority for the committee, which oversees health care, taxation, trade and other financial matters.

"I think this is the place to start," Lewis said.

U.S. Rep. Devin Nunes, the California Republican who, until this month, chaired the House Select Committee on Intelligence, was the second of his party's 17 members of the panel to cry foul. Everybody is for the coverage, Nunes said. "Always have, always will."

U.S. Rep. Kevin Brady, R-Texas, the panel's ranking member and its former chairman, used his opening remarks to argue that his party is on record backing the coverage but said rising costs of the ACA call for reforms.

"It's clear the status quo isn't working," said Brady, a key proponent of the 2017 tax cut bill. "We have to work together to make it affordable. It really is time for a fresh start, this time with both parties working together."

As the committee's former chairman, Brady opposed a move that Neal, his successor, has now put near the top of his list: requesting years' worth of President Donald Trump's federal tax returns.

Fault lines

The political fault lines opened an hour into the session, after four witnesses provided examples of how Obamacare provisions, particularly coverage on pre-existing conditions, help Americans.

One witness, Rob Robertson of the Nebraska Farm Bureau, was a guest of the Republican minority; he spoke about his group's creation of an association health plan that now enrolls 700 and is seen as an alternative to shopping for coverage in the individual marketplace.

"This is an issue of hardship, and we need to fix these individual markets," Robertson said.

Another witness, Andrew Blackshear, flew in from California to tell the story of two open-heart surgeries he underwent to save him from a life-threatening fungal infection he believes he picked up from spores while driving through the San Joaquin Valley. The well-documented malady is known as "Valley Fever."

After the first surgery, Blackshear's insurer challenged his claim.

"I owed nearly $200,000 in medical bills, but my insurer was doing everything it could to avoid paying," he told the committee. He told The Eagle he is healthy now, but the surgery removed the lining around his heart. "I will always be without a pericardium, so, having health insurance that covers pre-existing conditions remains a necessity for me."

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Another witness described Obamacare's impact in Oregon, where the law helped 340,000 residents obtain coverage and saved state hospitals "hundreds of millions of dollars."

Andrew Stolfi, the state's insurance commissioner, said that since Obamacare's debut, changes put through by Republicans in Congress and the White House have results in higher premiums — and growing concern.

"Unfortunately, uncertainty at the federal level has threatened our work," Stolfi said.

Karen Pollitz, a senior fellow with the Kaiser Family Foundation, called coverage of pre-existing conditions Obamacare's "defining feature."

Two hours in, as knots of House staffers stood along walls while working their cellphones, tempers rose another notch. U.S. Rep. Brian Higgins, a centrist Democrat from New York, said that, given actions the Republican Party has taken in regard to Obamacare, including 70 votes to repeal it, the party can't be trusted to safeguard coverage.

"Everybody up here does not support pre-existing condition protections," Higgins said, his voice rising.

"Will the gentleman yield?" a Republican demanded from the far side of the room.

"I will not yield," Higgins shouted back, pounding the dais.

Several Republicans, when granted time to speak, insisted that their party now accepts the popularity of coverage for pre-existing conditions, with one member terming that issue the "centerpiece" of the Democratic wave Nov. 6 that put the chamber back in Democratic hands.

"It's great politics, and we're doing nothing to crash the price," said U.S. Rep. David Schweikert, an Arizona Republican, referring to concerns about rising insurance premium costs.

One of the sharpest political arguments came from William Pascrell Jr., a New Jersey Democrat.

"You've got to be kidding me," he said with emotion after hearing pledges from the other side to protect the coverage.

"I hope you will write some of these things down, because it seems like a redo of the last six years," Pascrell said. He noted the party's repeated votes to strike down the law.

"Years of sabotaging the Affordable Care Act have left us with a lot of work to do to pick up the slack," Pascrell said.

"The sabotage that we've seen does not harken well," said U.S. Rep. Gwen Moore, a Wisconsin Democrat.

Like Lewis, Lloyd Doggett, a Texas Democrat, praised Neal for bringing attention to the insurance issue "in this new and much improved Congress" and after years in which, he said, Republicans persisted in trying to destroy the provision.

He said Republican claims of supporting coverage for pre-existing conditions can't be trusted. And he mocked the party for speaking of a goal to "repeal and replace" Obamacare, but never getting to "replace." On top of that, Doggett said, the Trump administration pulled out of litigation in Texas and declined to defend the federal law.

"They decided they would just lie down and play dead," Doggett said. "This was a total capitulation."

Fight ahead

In his opening comments, Neal made clear that he expects a fight, though the numbers now favor his party being able to advance legislation. Tuesday's witnesses were called in to brief the panel. No legislation has been filed yet to provide additional protections for pre-existing conditions coverage.

For Neal, the issue is key to protecting public well-being.

"Over 130 million Americans have a pre-existing condition, and protecting them goes to the core of safeguarding heath care for all Americans," Neal said.

"But my colleagues across the aisle have a different view. Despite their repeated claims to support protections for people with pre-existing conditions, their actions directly contradict those statements," he said. "They're leading ongoing efforts to undermine or eliminate the current law's protections for Americans with pre-existing conditions. This is the wrong course of action."

Neal said that 4 million Americans have lost health insurance coverage since Trump's election.

In January, the Trump administration took steps to cut tax credits available for the ACA by $900 million. At the same time, the out-of-pocket maximums that a family must pay rose by $400, shifting the cost of care toward average Americans.

Larry Parnass can be reached at lparnass@berkshireeagle.com, at @larryparnass on Twitter and 413-496-6214.


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