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Published September 26 2010

Pomeroy, Berg are far apart on health care reform

About this series

On Nov. 2, North Dakota voters will decide the fate of the state’s only U.S. House seat.

In his bid for a 10th term, Democrat Earl Pomeroy faces a strong challenge by Fargo legislator Rick Berg – a Republican who’s consistently led Pomeroy in monthly polling.

The Forum asked Berg and Pomeroy where they stand on a host of issues, and each week leading up to Election Day, we’re highlighting their positions on topics including the economy, the federal budget, health care, Social Security, agriculture, energy and Red River Valley flood protection.

Last week, we analyzed the candidates’ positions on the economy and federal budget.

This week: a look at health care.

Health care reform has been at the forefront of American politics for more than a year, and it continues to be a controversial issue, influencing the 2010 mid-term elections.

Six months after President Barack Obama signed the legislation into law, Republicans and Democrats continue debating its potential effects on the nation’s health care delivery system – how it could change the types of services provided and at what cost to individuals and the federal government.

Democrats generally defend the Affordable Care Act and praise its benefits, while Republicans clamor for repeal and condemn higher costs they say will result from the bill.

Democratic incumbent Earl Pomeroy and Republican challenger Rick Berg hold positions mostly akin to their party colleagues.

Pomeroy said he read the 2,400-page bill and was “very involved” with it as a member of the House Ways and Means Committee, which helped craft it.

Berg said he read only some of it but has studied its contents through analyses done this year by the state Legislature. He said he stopped reading “when I reached the point that I clearly understood this needs to be repealed.”

Drawing fire

Pomeroy voted to advance the Affordable Care Act as it made its way through Congress, and he also voted in favor of its final passage in March.

His position, in part, contributes to his vulnerability this fall. North Dakota Republicans accuse him of betraying the position held by most of his constituents.

Pomeroy said again recently that he believes his vote was the right decision because the bill addressed major problems with the health care system.

“I felt we needed to do something about that, and the core achievements of this controversial bill is to make sure that even if you have a health condition you get coverage,” and can afford it, Pomeroy said. “It’s not a perfect bill. Improvements need to be made.”

Regardless, Pomeroy’s votes drew almost relentless fire from Republicans and conservative interest groups during the months of congressional debate in 2009 and early 2010.

In the months since, their offensive hasn’t faded.

A prominent platform for Berg this year is his pledge to repeal “Obamacare.”

Various statements from his campaign have singled out Pomeroy’s vote – an act they say “went against the wishes of 73 percent of North Dakotans who didn’t support (it).”

The figure Berg’s campaign cites comes from a November 2009 survey by Zogby International. The query provided North Dakota participants with summaries of supporters’ and opponents’ arguments of the bill, and then asked where they stood based on those arguments.

In responding, 54.7 percent strongly opposed the bill, 11.3 percent somewhat opposed it and 6.9 percent were not sure. Taken in total, it’s the figure Republicans continue to cite.

The accuracy of the 10-month-old figure is unknown, but Pomeroy doesn’t dispute there is still some level of dissatisfaction among North Dakotans.

The intricacy and controversial nature of the health care reform package led to its unpopularity – despite the various benefits it would provide, he said.

In North Dakota, where TV ads come relatively cheap, Pomeroy said public opinion was tainted by the influx of negative ads paid for by special interests that perpetuated misinformation about the bill.

“The complexity of this bill and the bad things said about it made people think that it was going to get worse,” Pomeroy said.

Facts and figures

Like national politicians, Berg and Pomeroy continually reference the bill’s costs and benefits, but the figures are contradictory.

Berg said the health care reform package adds $1 trillion to an already massive national deficit. He also uses GOP rhetoric in saying the bill cuts Medicare by at least $500 billion, “hurting seniors,” and created at least $525 billion worth of new taxes, penalties and fees.

Pomeroy said Berg’s claims are not accurate.

The nonpartisan, independent Congressional Budget Office said the health care reform bill would reduce the deficit by $1 trillion over the next 20 years, Pomeroy said.

Additionally, Pomeroy said, “Medicare benefits are not cut one cent. … In fact, benefits have been expanded, so that there’s full coverage of preventive services.”

In agreement

There is one instance, though, where Pomeroy and Berg are on the same page. Both support an amendment that will bring better Medicare reimbursements for medical providers in North Dakota.

The state’s all-Democratic congressional delegation advocated for the provision to ensure rural states that were historically underpaid by Medicare would now receive fair payment.

The so-called Frontier Amendment will bring $650 million worth of increased Medicare payments to North Dakota providers during the next 10 years.

“I believe if we hadn’t taken the step to pass the Frontier Amendment – making sure that Medicare paid fairly in North Dakota – the health care system that we have would suffer inevitably in the years ahead,” Pomeroy said.

While Berg supports the provision, he views it as a distinctly separate piece of the bill he wholly opposes.

“It was an amendment to the bill; it wasn’t in the bill,” Berg said. “So, again, if you want to split hairs, are there amendments to that bill that I’d support? Yeah. But I think that the core bill should be removed.”

Berg said the provision didn’t need to be tied to health care reform.

“That’s a piece that should’ve been done 15 years ago,” he said.

Going forward

Both Pomeroy and Berg would like to see improvements made to the health care overhaul. Berg calls for repealing the bill in its entirety, while Pomeroy said only adjustments need to be made.

Specifically, Pomeroy said he would like to see a provision lifted that requires employers to file a 1099 tax form not only when they pay employees but also when they make purchases.

“To me, that’s overly burdensome and needs to be repealed,” he said.

Pomeroy also said Congress needs to make sure the bill is implemented carefully so as to avoid unintentional consequences – such as increased insurance premiums for consumers or fewer health insurance companies operating in a competitive market.

“I don’t think either one of those is going to happen if the bill is implemented in a correct and careful way,” Pomeroy said, adding that improvements to the law “would be best done on a bipartisan basis, and I look forward to being part of that effort.”

Berg said he would like to see a replacement to the Affordable Care Act that reduces costs, increases competition and funds health care services based on outcomes, instead of the number of procedures.

“You kind of go the opposite direction of this health care bill,” Berg said.

With Republicans poised to take control of Congress after the November election, repealing the bill is an option. But if Congress pursues it, Obama would likely veto the effort.

Berg said he’d like to see Republicans wait to repeal health care reform until they have a bill to replace it with – but he said Republicans need a majority in the House of Representatives before they can start crafting such a substitute.

“That’s the law of the land,” he said. “If Congress doesn’t change, nothing’s going to change.”

Readers can reach Forum reporter Kristen Daum at (701) 241-5541

In focus: health care

Six months ago, President Barack Obama signed into law sweeping reforms of America’s health care system that were passed by Congress following months of divisive debate.

The most substantial changes from the Affordable Care Act won’t be implemented until 2014, but some elements – such as a new Patient’s Bill of Rights – have already taken effect.

Due to the complex and varied provisions detailed in 2,400 pages of legislation, many Americans still don’t understand how health care reform will affect them.