February 04, 2019

Kilmer discusses hospital reimbursement in Port Angeles town hall meeting

Shutdown, Snake River dams, changes needed in Congress also examined

PORT ANGELES — U.S. Rep. Derek Kilmer fielded several questions about his stand on the Snake River dams and discussed Olympic Medical Center reimbursement, changes needed in Congress and ways to avoid another government shutdown during a town hall meeting in Port Angeles.

“It’s a mistake to shut down government on any policy issue,” Kilmer, a Gig Harbor Democrat who grew up in Port Angeles, told about 90 people who arrived for the meeting on the Peninsula College campus on Saturday morning.

He said the shutdown that ended for at least three weeks Jan. 25 after 35 days — the longest in the nation’s history — was unique in that it happened over an impasse on policy and not a disagreement between the House and Senate on spending priorities.

During the partial government shutdown, paychecks were withheld from 800,000 federal workers nationwide including 531 on the North Olympic Peninsula of which some 300 are Coast Guard personnel.

The shutdown was due to an impasse between President Donald Trump and Congress. Trump demanded that the spending bill include $5.7 billion for a wall on the country’s southern border with Mexico and Democrats refused to approve the money.

Trump signed a bill to fund government through Feb. 15 — and has not ruled out another shutdown beginning then.

Kilmer said the cost of the shutdown to the U.S. economy was $1 billion a day and described it as “incredibly damaging,” especially in his 6th Congressional District, which includes the North Olympic Peninsula.

For the first time in history, the nation’s Coast Guard wasn’t paid, a fact Kilmer called “unacceptable.” He also told of a Quinault Nation timber sale frustrated only by the lack of a signature of a federal employee who wasn’t at work for five weeks — and said that cost the tribe $1.4 million.

He spoke in favor of the USA Act, introduced in Congress in January 2018, saying it would require that each mile of the border be assessed for the best way to control it — whether through technology or fencing. It also would provide certainty for Dreamers and direct the State Department to investigate problems in Central America that give rise to mass migration from there to the U.S.

He said that the way to stop future shutdowns is to “stop linking policy bills to government funding,” reform the budget process and require that if Congress does not pass a budget, it has no recesses and no pay.

“You shouldn’t get paid if you don’t do the job,” Kilmer said.

Olympic Medical Center

Legislation in 2016 exempted existing facilities from the provisions of legislation to reduce Medicare reimbursement to sites located 250 yards or more away from the hospital campus to create “site-neutral payments.”

Yet, said Kilmer, Centers for Medicare & Medicaid Services (CMS) “says it plans to ignore that law and substantially reduce payments” to such hospitals as Olympic Medical Center in Port Angeles and Sequim.

The change would mean a 60 percent cut to OMC in practice expense reimbursement for patient visits more than 250 yards from the Port Angeles hospital. Reimbursement to OMC will be cut by about $1.7 million in 2019 and another $1.7 million in 2020, officials have said, with the cost over 10 years at about $47 million.

“The proposed changes are particularly detrimental to rural facilities,” Kilmer said.

Site-neutral payments “may make sense in a municipal area. It makes zero sense in a rural setting,” he said.

The hospital is one of four plaintiffs in an American Hospital Association lawsuit against the federal Department of Health and Human Services over the cuts, filed last fall.

“This direction that CMS is taking is incredibly wrong-headed and extremely dangerous for the residents of Clallam County,” Kilmer said.

The congressman also decried “very intentional sabotage” of the Affordable Care Act, saying that has resulted in the enrollment period being cut in half, no budget for marketing plans and cuts in payments to mitigate the expense of coverage of pre-existing conditions.

Of the latter, he said, “The president has said we aren’t going to do that. That has had a big impact on increasing premiums in Washington state.”

Kilmer said he wants to work to reverse some of the effects of recent changes in the health care law.

Snake River dams

Several residents spoke of their support for breaching four lower Snake River dams in southern Washington state to allow a free-flowing river and more chinook salmon for endangered Southern Residents orcas, which now number only 74 individuals.

They asked Kilmer why he favored continuing study instead of acting now.

“You want actions to be based on the best available science,” Kilmer said. “It’s not a fast process.”

He said “that wasn’t to suggest that the federal government shouldn’t be taking action” just that “it’s important to allow the process to be driven by science, not politics.”

Congress, economy

Kilmer said that his primary objectives are to get the government back on track and get the economy back on track.

To help the economy — which he said is not creating higher income for the middle class — he supports investment in education and infrastructure, especially broadband.

He recently was named chairman of the Select Committee on Modernization of Congress and also is chairman of a bipartisan work group that meets, he said, to discuss issues and seek common ground.

“We need to do a whole lot more of that as a country,” Kilmer said.

Quilcene event

Kilmer also held a town hall meeting Friday at the Quilcene School.

There Kilmer said he disagrees with the administration and Republicans about people seeking asylum. He said the Senate recently pushed for a cap on the number of people granted asylum in the United Sates, something he disagrees with.

“To me that is not consistent with our values as Americans,” he said.

Kilmer recalled when he spoke to 22 women who were held at the Northwest Detention Center in Tacoma who had their children taken away from them.

One of the women, he said, was fleeing from her town in Guatemala that had been overrun by cartels and gangs. He said the woman mostly walked to the southern border and presented herself as an asylum seeker.


By:  Leah Leach
Source: Peninsula Daily News