Exclusive: Tom Garrett to Vote ‘Yes’ on AHCA

In an exclusive interview with Bearing Drift at his Capitol Hill office on Tuesday, U.S. Representative Thomas Garrett (R-VA5) revealed that he will be a “positive yes” in voting for the latest iteration of a bill to repeal and replace Obamacare (a.k.a. ACA, or Affordable Care Act).

Garrett said that “unless there’s a dramatic shift” in the content of the bill, he will vote for the American Health Care Act, or AHCA, when it comes to the floor later this week or over the weekend.

Tom Garrett town hallWhen the AHCA was previously considered, Garrett was part of a coalition made up of the conservative Freedom Caucus and the centrist Tuesday Group that opposed the bill, which eventually did not come to a vote when the House leadership foresaw that it would fail.

According to a whip count by the Washington Post, if two or more additional Republicans vote “no” on the bill, it will fail. The House leadership – Speaker Paul Ryan and Majority Leader Kevin McCarthy – are working on narrow margins, which may be why they are meeting with individual Members to confirm their support. Congressman Garrett had just returned from meeting them when he spoke to Bearing Drift.

At approximately the same time, his constituents in Charlottesville were demonstrating outside his district office, demanding that he vote against the proposed legislation.

In our interview, Garrett said the latest version of the bill has federalist elements in it that appeal to him, because he likes to ”stand up and wax poetic about federalism all the time. They’ve sort of injected the federalist element into this. It would be a little bit hypocritical of me not to say ‘OK, this is something we can swallow.’”

At the same time, Garrett asked, “Is it everything I want?” Shaking his head, “no,” he explained that the bill is “not everything anybody wants but that’s the nature of 435 people on one side and 100 on the other” having to compromise, and then “the Executive has to sign it.”

Pre-existing conditions
The changes that caused Garrett to shift his position on the AHCA, he said, “essentially empower states to either stick with or opt out of … some of the Title I requirements that we found under the Affordable Care Act [that] were the real cost drivers.”

He added that the newer bill includes “funding for a pre-existing condition pool” and a provision that “mirrors the main concept for funding for care for folks with pre-existing conditions.”

That provision is “important,” he said, because “you’ve got three to five percent of the population driving 40 to 60 percent of health care costs.”

Ending and reversing an upward trajectory for health care costs was Garrett’s motivation as he considered alternatives to Obamacare, and the earlier version of the AHCA fell short of his goal.

“The reason we were a hard ‘no’ earlier,” he explained, “was we didn’t see circumstances that we were confident would drive down premiums and deductibles.”

With the changes in the bill now under consideration, he said, “I’m a ‘yes’ now because, while that might not happen everywhere, we’ve empowered states to make those decisions for themselves. I think where we see plans that work, you’ll get that ‘50 laboratories of democracy’ concept, where people migrate toward those plans” that work best.

Garrett described the economics of the bill that led him to change his position.

“The paradigm that we get on the ACA, is false. It’s not an ‘affordable care’ act, it’s an unaffordable coverage act.”

He pointed out that “there have been stories recently about two thirds of American households couldn’t find a thousand dollars in a financial crunch. Well, when the average deductible is five thousand dollars, [even when] you’ve got coverage, you don’t have care because you can’t pay your deductible.”

Driving down costs
“I just didn’t believe the original AHCA was going to drive down premiums and deductibles and that was for me the goal,” he repeated.

“We have to drive the costs down. We shouldn’t be focused on how many people lose coverage. We should be focused on how many people have access to care.”

With the new version of the AHCA, he said, “that’s what I think we’re moving towards here. I really, genuinely believe you’ll see the cost curve turn down.”

Somewhere, he said, he “saw a 38 percent” decline in costs predicted. “I’m not that optimistic but if it’s three percent it’s a move that’s in the right direction — as opposed in the last eight years, where we’ve seen a perpetual upward” cost trajectory.

Based on that reasoning, Garrett concluded, “I’m an absolute positive yes,” and he is willing to see it through even if, as the House leadership has indicated, Members will “be here all weekend if we have to” in order to pass the bill.