WASHINGTON — Alaska Sen. Lisa Murkowski isn't on board with the legislation to repeal and replace the Affordable Care Act that's moving through the U.S. House, and she plans to focus on getting less expensive coverage for more Alaskans, she said Thursday.
Murkowski held a Facebook Live "town hall" on health care Thursday, taking questions from constituents online. Murkowski held her town hall not long after word circulated on Capitol Hill that the House would postpone a vote on its repeal and replace plan.
The senator detailed an array of concerns with the bill, but said she remained "committed to repealing the Affordable Care Act."
Murkowski cited three main problems in Alaska: There's only one provider left on the state's market; the state had to infuse the market with major funding to stabilize it; and premiums nevertheless continue to rise.
But Murkowski said she is not happy with much in the House health care plan.
There were quite a few major policy measures drawn from the ACA that Murkowski wants to keep in place, she said, including:
• Prohibiting insurance companies from discriminating against people with pre-existing conditions.
• Allowing young people to stay on their parents' health care plans until they turn 26 years old.
• No lifetime or annual limits on coverage spending.
• "I don't support pulling the rug out from those who have received coverage" under Medicaid expansion, she said.
• No repeal of the Indian Health Insurance Act, which was passed as part of the ACA.
• Murkowski said she doesn't think funding for Planned Parenthood should "even be part of the debate."
Aiming for those ends, Murkowski said the House bill — the American Health Care Act — is deeply "flawed."
"As the bill stands right now in the House, I cannot support it," Murkowski said Thursday on the Facebook Live event.
The bill does not take Alaska's high premiums into account. And "the ramp down of Medicaid expansion and the Medicaid reforms do not take Alaska's unique needs or complex system of care into consideration."
Alaska Rep. Don Young remained undecided on his vote Thursday night, according to his spokesman Matt Shuckerow.
The congressman said he was still working to extract concessions for Alaska-specific issues that would keep him from voting "yes" on the bill.
The Washington Post reported that House Speaker Paul Ryan got down on a knee to plead with Young to support the bill.
Meanwhile, Alaska Gov. Bill Walker said Thursday 45,000 Alaskans could lose health care coverage under the AHCA.
That includes 30,000 Alaskans covered under Medicaid and 13,000 of the 19,000 Alaskans who have purchased plans on the state insurance exchange, because the plans would become unaffordable.
"For the past two years, my team and I have heard from Alaskans statewide who received lifesaving procedures, critical care for loved ones, and peace of mind knowing they had health care coverage," Walker said in a statement.
Walker and Murkowski both noted the mental health and addiction treatment options ACA offers to Alaskans during a time of an opioid epidemic.
In the end, Murkowski is hoping to see increased access to health care in Alaska, and "a tax credit schedule that better reflects the needs of Alaskans," she said.
Murkowski would also like everyone to slow down.
"I cannot and will not support a reckless repeal process," the senator said Thursday. "I have urged caution and a thoughtful, considered process."
Earlier in the week, a reporter asked her about indications Senate Majority Leader Mitch McConnell, R-Ky., wanted to move legislation in less than two weeks. Murkowski said she thought the plan was overly ambitious.
Here are some of the questions Murkowski answered online Thursday. (Questions are paraphrased):
What about the 24 million Americans that the Congressional Budget Office (CBO) said would lose coverage under the House bill?
"No, I don't think it's acceptable for 24 million people to lose coverage," Murkowski said. The senator said she wants to reduce costs and increase access, and the House bill "takes us backwards."
Murkowski noted she was still awaiting the second CBO analysis of the House bill. It actually came out while she was speaking.
The new estimate, taking changes into account, said the same number of people would lose coverage, but it would reduce the deficit by $150 billion over 10 years, down from $337 billion as predicted for the original legislation.
What about Planned Parenthood?
Murkowski made it clear throughout her live chat she does not support cutting federal funding for Planned Parenthood.
On how to aid her cause, Murkowski told supporters to "remind other lawmakers that women's access to care" is important and "Planned Parenthood plays a vital role."
What about allowing the purchase of insurance across state lines, since Alaska is stuck with just one health insurance provider on the exchange?
Murkowski said she is in favor of provisions to encourage insurance purchases across state lines.
But Alaska is an expensive state, and after some research on the issue, "I don't want people to believe that this is the end-all, be-all," she said. Lower prices on premiums in other states won't necessarily translate to Alaska, she said.
What about the 'Cadillac Tax'?
Murkowski, like most Republicans, is dead set against the so-called "Cadillac Tax," which was supposed to help fund the ACA by taxing higher-cost health care plans. So far Congress has put off the tax year by year.
But Murkowski said her reasons are Alaska-specific. The tax would have a "significant impact on so many plans in Alaska," not because they are so fancy and generous, but just because health insurance is very costly in Alaska, she said. "Most of our plans would be considered 'Cadillac,' " she said.
The House bill pushes the tax back to 2020.
Correction: This story initially misstated the change in deficit reduction reflected in the new Congressional Budget Office "score" of the House bill. It is $150 billion, not $150 million.