Our reporters spent several weeks calling and emailing all of NC’s Congressional candidates to ask the same three questions on health policy.We asked about the Affordable Care Act, women’s health issues and Medicare.

Our goal was to talk to candidates and get their stated thoughts on issues, not just reprint canned answers about these important issues from their websites or press handlers, so if we could not speak to the candidate, we did not print their response.

Their answers are here.

By Saja Hindi, Rose Hoban, Ben McNeeley, Brenda Porter-Rockwell

District 1

Congressman G.K. Butterfield
G.K. Butterfield

G.K. Butterfield (D – incumbent)  http://www.gkbutterfield.com/

Your stance on the Affordable Care Act. If part of the answer is to “repeal and replace” please be specific about what you would replace it with.

I am in unequivocal supporter of the ACA. It will be transformational in my district and as one of the members who helped author the bill I’m pleased we were able to pass it.  I represent a low income district in Eastern North Carolina and I have more than 100,000 people who are uninsured living there. This legislation is going to make health insurance available to them.

Your stance on women’s health issues, including abortion and birth control.

I support woman’s right to choose.  I think that it’s up to a woman and her doctor and her god and government should not have a role in that decision. On birth control, it has been a hot issue and that’s unfortunate, because contraceptives should be available to every woman who has health insurance, they all  need to have the option of contraception, no matter their employer. That’s the president’s stance and that of most Democrats.

Your stance on how to keep Medicare solvent into the future.

That is a complex question it can be done, but not by one political party acting in a vacuum. There will have to be a bipartisan approach to containing the costs of Medicare, it will need bipartisan ideas, I could support some ideas from the other side of the aisle as long as it’s a bipartisan approach.

I recognize that the cost of Medicare is exploding and unless there is some change, it’s gong to consume the national debt and I understand that, but I don’t have a singular approach to Medicare reform, it’s gong to have to be multiple things, for example, age modification, means testing, increased taxes for high earners, but I’m not in a position to give a single approach, it’s too complicated.

Some ideas for solutions include increasing earnings that are taxable for Medicare beneficiaries, I don’t like that but if it’s part of a deal that includes other sacrifices, I could agree to it. But we can’t do it alone. It’s such a complicated issue that it will require bipartisan compromise.

But it’s very expensive, and it’s clear that if we don’t contain the costs, it’ll strangle the federal budget.

Peter DiLauro
Peter DiLauro

Peter DiLauro (R)  http://www.petedilauro.com/

Mr. DiLauro responded that he did not want to be interviewed.

District 2

Congresswoman Renee Ellmers
Renee Ellmers

Renee Ellmers (R – incumbent) http://www.reneeforcongress.com/

Congresswoman Ellmer’s campaign declined interview requests citing lack of time.

Brian Irving
Brian Irving

Brian Irving (L)  http://irving4congress.libertypoint.org/

Your stance on the Affordable Care Act. If part of the answer is to “repeal and replace” please be specific about what you would replace it with.

My answer is that I think it needs to be repealed and despite what the Supreme Court says I still think it’s unconstitutional.

I believe the solution to the health care problem is a truly free market.  I would not replace the Affordable Care Act with anything other than the free market.  The problem we have is not health care but health insurance and part of that problem is government regulation and meddling in the health care industry had driven up costs. And so the way to drive down costs is to get rid of government regulation and meddling.

Three aspects of reform would be to allow people to put money into health savings accounts that would be nontaxable and they would be able to draw on those accounts and pay for their medical expenses. If they didn’t have means to put money into a health savings account, then they should be able to deduct the cost of health insurance and the costs of healthcare itself from their income taxes.

If insurance companies would be able to sell whatever policies they want, there would be more competition and better prices. Insurance companies are in a business where they see the ability to make a profit, it has to be profitable for even for people who find it difficult to get insurance. And for those who can’t afford it, there would be charities, not-for-profits, churches and the like that could also step in and help people that needed it.

Your stance on women’s health issues, including abortion and birth control.

The same thing would apply, any kinds of issues are best handled by the free market.

I consider myself pro-life and pro-choice. Those two terms have a lot of baggage. I believe that a woman should have the right to decide matters of her own health, but i also believe in the sanctity of life. I’m not of a position where I want to use the force of government to force a woman to do what she doesn’t want to do.  That’s what some people who consider themselves pro-life are. I think life should be protected in all ways, you don’t protect life by using force, you protect it by using persuasion.

Your stance on how to keep Medicare solvent into the future.

That’s a difficult one. It’s a federal program, but there’s nothing in the constitution that gave the government authorization to create it. On the other hand, it’s a contract that has been extended to people so we need to honor it.

The first thing we need to do is stop forcing people to become part of the system, it’s unsustainable. It takes more and more people paying into it to provide the care for fewer and fewer. I’m in that category, I was in the military and my wife is on Medicare now. But with Medicare reform that involves making lesser payments, retracting services that are provided… that’s not sustainable.

So, the ultimate goal is to phase it out completely, to end the program. But in the meantime, we have to make good on the promise to the people who have paid into it. So, people will ask the next question .. how to pay for it, similar to Social Security. Well, the federal government has assets it can sell off to make money to handle things like Medicare, things that are no longer needed, in particular land. Like in some of the western states, some of the actual territory is owned by the federal government, places like old military installations, national parks, buildings, national forests. The government could sell then off and use proceeds to pay for Medicare. And when people who have paid into it now are gone, the program should be ended.

Too often Libertarians are accused of being uncaring… that’s not the case. Instead of Medicare, we’ve always had strong charities and we could return to that mode and people would help others, help their neighbors, help their fellow church members through bad times.

Steve Wilkins
Steve Wilkins

Steve Wilkins (D)  http://www.wilkinsforcongress.org/

Your stance on the Affordable Care Act. If part of the answer is to “repeal and replace” please be specific about what you would replace it with.

I support the ACA.  I think it’s going be good for North Carolina and the people in the Second District. To me the most important part of the law is providing greater access and by insuring more people, so it’ll drive down the cost for all of us… or at least it should.  But we don’t know what’s going to transpire.

We’re making a significant business model shift, we need to do something bold and comprehensive, and the idea of repealing it and then bringing it back piecemeal does not make sense to me. Many of the politicians who’ve been against it seem to have moderated their position a lot lately. My opponent is this way, saying we like this part of it and that part of it. But those are the things that are the major components of it anyway, so I don’t understand the concept of dumping it and starting over.

We need to continue and complete implementation and work in a bipartisan fashion and make changes that will inevitably be made as we go down the road. That’s how I intend to behave in Congress. I will be openminded and attempt to be as bipartisan as anyone can be, and fix things in the future. We don’t know what people’s habits will be like, what health issues that will arise, things that might have a low impact now may now may have a greater impact later on the system. We don’t know what trends will be in people’s health and what industry trends will be as a new business model is implemented.

In North Carolina, there are parts in this district that have 11 percent-plus unemployment. About 20 percent of North Carolinians who have health care coverage experience disruptions to that coverage in a given year – job loss, increased costs – and these are mostly families. I can’t imagine what it’s like to not be able to provide health care to your children, it’s inexcusable for us to move forward and not try to do better.

Your stance on women’s health issues, including abortion and birth control.

I am pro choice, I think all women ought have access to birth control on their own. Men have unique health care issues as well, for example, prostate cancer, I don’t want women trying to control what we do about that. It’s not that everyone shouldn’t be involved in healthcare decisions, like if you’re married couples make those decisions jointly. But both men and women have unique concerns and problems and I don’t think it’s a group of men in the legislature who should dictate what women can and can’t do.

For me birth control is not a moral issue, it’s a pragmatic issue and one in which women have to be able to decide. There may be women who think they have enough children, some women have health reasons why they should not get pregnant. They should have access to birth control, no matter who’s their employer.

I struggle with why men should dictate these things to women.

Your stance on how to keep Medicare solvent into the future.

I think there are some aspects of the Affordable Care Act that are going do that. In the president’s budget, there is 700 billion dollars of savings because of taking care of Medicare Advantage and with elimination of payments that are too high.

One way to keep Medicare healthy is not to privatize it at all, I’m totally against that idea. Medicare is essential to a lot of our population and we have to make sure that system stays healthy, robust and is accessible to the people who need it. The program has a low overhead compared to other insurance programs.  And we have a responsibility to keep the system solvent.

These are big issues, they’re complicated, it’s difficult to get too specific with some of these things in a short interview.

District 3

Walter B. Jones
Walter B. Jones

Walter B. Jones Jr (R – incumbent)   http://www.walterjonescommittee.com/

Congressman Jones’ campaign did not respond to multiple emails and calls requesting an interview.

Erik Anderson
Erik Anderson

Erik Anderson (D)   http://electerikanderson.com/

Mr. Anderson’s campaign did not respond to multiple email and calls requesting an interview.

District 4

David Price
David Price

David Price (D-Incumbent)

Your stance on the Affordable Care Act. If part of the answer is to “repeal and replace” please be specific about what you would replace it with.

I support the ACA, I think we need to implement it very carefully and look for ways that it can be improved.

I have one specific idea for improvement. You know that the provisions regarding the high risk pool are somewhat problematic.  The federal high risk pool is the more affordable than the state high risk pools, but in order to be eligible for the federal high risk pool you have to be uninsured for 6 months. That makes no sense.

We need to repeal that requirement in the law, because now the effect is to force people to stay in the state high risk pools even though they’re less affordable. There are things like that in the Affordable Care Act that will need tweaking.

But the Republican approach has been to do nothing to improve the law. It’s hard to get co-sponsors for a bill to make changes, to get real bipartisan support for even common sense changes like the one I describe.

Legislation as complicated as this needs monitoring, it will need follow up and adjustments will need to be made along the way. But I do support the act. I want to see it implemented.

Your stance on women’s health issues, including abortion and birth control.

I’ll say a couple of things… I support Roe v. Wade, the idea of leaving the decisions about abortion to the woman and her doctor in the early months of pregnancy.  I support contraceptive coverage, the provisions in the Affordable Care Act, and with certain narrow exceptions, employers should not be able to deny that coverage in their companies insurance policies. There are explicit exceptions for religious institutions, but they need to be narrow, they shouldn’t include things like hospitals and other large social service organizations.

Your stance on how to keep Medicare solvent into the future.

The Affordable Care Act does extend Medicare solvency. One way that it does that is cut some Medicare costs, it cuts overpayments to private insurance companies and we get a better deal. The Affordable Care Act gets a better deal from pharmaceutical providers and hospitals. Those are the kinds of savings that we’ll need to achieve and not a dime is cut from benefits. So, Medicare solvency is extended something like 10 years by the Affordable Care Act and Medicare is improved – the donut hole is closed, and preventive care is enhanced.

This is helpful, it doesn’t entirely solve the long term problem of Medicare financing, so that will need to be taken up hopefully in the context of bipartisan budget talks that get past the Republican rigidity on the revenue side.

Tim D'Annunzio
Tim D’Annunzio
Tim D’Annunzio

Tim D’Annunzio (R)

Your stance on the Affordable Care Act. If part of the answer is to “repeal and replace” please be specific about what you would replace it with.

My position is repeal and not replace.

I do not believe the federal gov’t has any place in providing health insurance and not on the scale of Obamacare. Beyond that, if the object is to make health care more affordable there are a lot of common sense ways to do that without resorting to government control. I’m a business guy and I know there are a lot of free market ways to make prices go down. The whole idea of the free market is that it increases the quality of the product and decreases the price and it would do the same if we let the healthcare marketplace really operate in the free market. It would work the same with healthcare as in other markets… if it were allowed to.

The only thing I’d add is that a federal level program like nothing that was ever intended by the founders when they formed our government.  i’m not saying that states can’t take it up.

Your stance on women’s health issues, including abortion and birth control.

I’m against killing unborn children for any reason whatsoever. There’s no need to elaborate on it. I’m against it 100 percent because they’re human beings and all humans under our constitution have certain guarantees. They’re living humans and not just a mass of cells.

On birth control: it’s been framed by the media as something other than abortion… but it’s another reason why the fed government shouldn’t be providing healthcare. If you want to have birth control, don’t force me to pay for it if I don’t believe in it. Once it (birth control) becomes part of national health care, the government manipulates us into not having our right to oppose it if we don’t want to take part in it or subsidize it.  We become demonized for voicing opposition and for not wanting to subsidize it.

If they want to use it, feel free, but I don’t think the federal government has any right to tell you not to do it, but don’t take away my right to not agree to accept it.

Your stance on how to keep Medicare solvent into the future.

My stance is one of the only realistic stances out there. Right now, people talk about the federal debt and everyone is astounded by the magnitude of it, but we don’t talk about our unfunded obligations, which is a liability to the countries long term viability.

The greatest of those liabilities is Medicare. The unfunded obligations of Medicare are 88 trillion, while our total obligations are about 110 trillion. So, Medicare is close to 75 percent of those and there’s no way in the world we can pay that.

So what’s going to happen when it’s lumped together with Obamacare? Once we can’t afford these things the one option is to cut back on the amount of services we offer and that’s the only way to cut the costs.

A lot of people talk about people like me who face these things realistically, that we’re not caring. But the only truly caring way to deal with this?  We’re covering everyone, but then all of a sudden, if it operates unchanged, it collapses and those same people who are dependent on it, and that’s their only means of receiving health care, they’re the same people who are the most vulnerable.  So I believe that Medicare needs to be cut up and returned to the states so that they can decide how to proceed on their own.

It should be a state’s decision how to handle people who can’t afford insurance. Once you have 50 different states operating programs, you see what works and what doesn’t, instead of being locked into one system that’s take it or leave it.

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...