Helping Those in Need

As a still somewhat-new Member of Congress, I’m still growing accustomed to people asking me how I’m doing as though I’ve been diagnosed with a terminal illness. It goes without saying that Congress remains a fixer-upper.

Despite the dysfunction and lack of legislative progress on many fronts, I’m pleased to report that there are still ways to make positive changes for folks in our region. Oftentimes, that starts with conversations I have with you.

A couple of years ago, I sat down with a group of young veterans at the University of Washington-Tacoma. During our discussion, a few of the vets  mentioned that they knew veterans who were struggling with mental health issues related to their experiences on the battlefield. In many of these cases those who needed help the most were being denied access to the medical care they needed to help them heal. Specifically, they described a situation in which servicemembers who had received an other-than-honorable discharge because of relatively minor forms of misconduct were being blocked from receiving care within the VA system.   

As I looked into the issue, I found that many of these misconduct incidents arose from mental health issues related to their experiences at war. 

Last year the New York Times reported on the experiences of servicemembers like Kristofer Goldsmith, discharged from the Army for missing a plane to Baghdad because he was in the hospital after attempting suicide – issues resulting from post-traumatic stress disorder. A Marine veteran, Thomas Burke, was charged with misconduct and received an other-than-honorable discharge following a drug charge and an attempted suicide. He was never evaluated for post-traumatic stress disorder (PTSD). In fact, since 2009, the Army has separated at least 22,000 combat veterans diagnosed with mental health disabilities or TBI for alleged misconduct. Too often, “bad paper” veterans were never screened for PTSD.

From Tacoma to Colorado to Georgia this is a problem. I decided to do something about it and went to work with my Republican colleague, Representative Mike Coffman, to change this policy. We introduced a bill that would direct the VA to provide initial mental health assessments and urgent mental healthcare services to veterans at risk of suicide or harming others -- even if they have an other-than-honorable discharge.

It’s really simple. If you serve your country we should have your back.

Last week VA Secretary David Shulkin committed that the VA would move in the next couple of months to provide these services to veterans who had received an other-than-honorable discharge. During his announcement, the Secretary explicitly mentioned our bill. He also acknowledged that veterans receiving mental health assistance through the VA were much less likely to attempt suicide.

This is a good first step and demonstrates how your input can end up leading to changes for the better. We are going to keep pushing our bill so we can make these changes permanent. No veteran should face these mental health challenges on their own.

You can read more about the news in the Seattle Times here.

As always, if you are a veteran grappling with VA issues, please don’t hesitate to contact my office. And if you are a veteran facing mental health challenges, you can reach the Veterans Crisis Line at 800-273-8255.

It’s been a jam-packed two weeks so read on for more of what I’ve been up to.   

Speaking of hearing from you….

For those of you who attended my town hall meetings in Tacoma, Bremerton, Hoquiam, or Sequim, let me say a giant THANK YOU! 

And for the several thousand of you who participated in last week’s telephone town hall, please know how much I appreciated you taking the time. It’s always fun to take questions from back home when I’m working in the other Washington. Whether on the phone or in an auditorium, I was inspired that so many of you came together to participate and make your voice heard.

Our democracy needs people-power. Seeing so many of you join in our back and forth was heartening, and I appreciate you staying engaged on the issues that matter to you.

If you live around Hoquiam and missed out on our town hall, you can see some of the action here.

Likewise, if you were unable to make it to Sequim check out the write-up in the Peninsula Daily News!

As always, if you have other thoughts or questions please don’t hesitate to reach out to my office. Remember, I work for you!

Moving our healthcare system forward, not backward

As many of you know, I wasn’t in Congress when the Affordable Care Act was passed. There are parts of the law that represent real progress for the folks I represent. That said, there are also improvements that I believe ought to be made. In fact, I’ve sponsored several bills to try to reduce health care costs for small businesses, improve access to primary care, and strengthen care in rural areas. I’ve said that if there are reasonable proposals to improve the law, I’d be open to supporting such improvements.

Unfortunately, what we’re seeing in Congress is heading in the wrong direction. This past week, we saw the release of a proposal by Republicans in Congress that would effectively dismantle some of the progress made under the Affordable Care Act. This new plan (known as the American Health Care Act or the AHCA for short) doesn’t pass the test of improving the system. As written, it is expected to cover fewer people and cost taxpayers and those purchasing insurance more.

You’re going to be hearing a lot about this in the next few weeks, and I want to take a few minutes to share some of my concerns.

First, the Republican plan does real damage to the Medicaid system. Medicaid provides healthcare to lower-income Americans and their families, people with disabilities, nursing home residents, children, and others. And it’s a difference-maker. In Washington state alone 20,000 people got cancer treatment because of the healthcare they received through the Medicaid expansion. Unfortunately, the AHCA proposal would cut off funds for states to add new enrollees, reduce the amount of Medicaid dollars states receive for current enrollees, and would lock out those who have a gap in coverage. The Brookings Institution reported that “at least 15 million people will lose coverage” under the AHCA.

Second, the AHCA negatively impacts women’s health services. Millions of women rely on Planned Parenthood for primary care visits, cancer screenings and other health services. Despite the fact that federal law currently prohibits tax dollars being used to fund abortions, the Republican proposal includes a provision prohibiting Planned Parenthood from receiving Medicaid reimbursements for any of the care it provides – including mammograms, cervical cancer screenings, family planning assistance, and other care. This impacts a lot of people, especially lower-income women. One in five women in our country have visited Planned Parenthood, with over three-fourths having incomes of 150 percent or less of the federal poverty level.

Third, this bill eliminates the Affordable Care Act’s Prevention and Public Health Fund. This important fund supports approximately 12 percent of the CDC’s entire budget and helps ensure that Americans are protected from communicable diseases such as Ebola, Zika, measles, and mumps. We all know the CDC is at the frontlines of stopping epidemics before they spread. What’s more, our state gets $14 million from this fund, with those dollars covering roughly 50 percent of our state’s immunization program. The Republican plan would zero this prevention fund out entirely.

Fourth, this bill would impede the progress we’ve been making in the fight against the opioid epidemic and mental health challenges. Currently, as a result of the Medicaid expansion, nearly 1.3 million people receive treatment for mental-health and substance abuse disorders, including 30,000 people in Washington state who got treatment for substance abuse disorders through the Medicaid expansion. Unfortunately, as mentioned, the bill pulls the plug on the Medicaid expansion. Beyond that, though, the bill proposes eliminating the requirement that Medicaid cover basic mental health and addiction services. That’s why the American Psychiatric Association and mental health advocates have raised concerns about the bill.

Fifth, the bill cuts health care for working people and those living paycheck to paycheck in order to give nearly $600 billion in tax breaks to special interests and the super-wealthy. The AHCA proposes two tax cuts specifically for the wealthiest Americans. These proposed changes would not save $1 – not $1 – for folks earning less than $200,000 per year. In contrast, if you’re a millionaire, you’ll get – on average – a $50,000 tax cut. In fact, according to the Center for Budget and Policy Priorities, our nation’s 400 highest income taxpayers (who earn, on average, over $300 million/year) would see an annual tax cut of roughly $7 million. If that wasn’t enough, the Republican plan would allow insurance companies to get a tax deduction for pay and bonuses they provide to their executives over $500,000. For the life of me, I can’t figure out the problem that provision is trying to solve.

And finally, this bill would hurt seniors. Changes in the bill would shorten the solvency of the Medicare program, hastening the exhaustion of the Medicare trust fund by four years. In addition, the Republican proposal changes the law to allow insurance companies to charge seniors five timesmore than young people for healthcare coverage. That’s why groups like the AARP have come out against it.

Sadly, this proposal was voted out of two Congressional committees last week in the dark of night.  In neither Committee did the bill even get a hearing. In addition, usually a bill would be analyzed by the Congressional Budget Office to determine the impact this bill would make on the deficit and to lay out how many people would lose their health insurance. Not this time, folks. It’s befuddling to me that my colleagues would vote for a bill without being able to tell their constituents what the impacts would be on insurance premiums, on the number of people insured, on the deficit, and on taxpayers.

We’ve heard from the American Hospital Association, the American Medical Association, and others involved in healthcare that this bill goes in the wrong direction.

We’ve also heard from many of you. A lot of you have shared stories with me in the past month about healthcare. Folks like Robert in Kitsap who runs a small business and saw lower rate increases and better coverage through the Affordable Care Act. Or Pamela in Gig Harbor, a cancer survivor who no longer has to worry about being turned away from insurance because of her pre-existing condition.

Folks who have read this newsletter for a while know that I’m willing to work with anyone – regardless of party – to try to make progress for the folks I represent. But I’m really struck by how damaging this proposal is. In my view, the focus needs to be on improving our healthcare system. Not going backward. That will continue to be my priority as this discussion continues in the weeks ahead.

Don’t slash Puget Sound investments

Around this time of year we would generally see a budget from the President that Congress could begin debating. So far we’ve only seen draft proposals floating around about what the administration is thinking of doing. On one in particular move, I joined the co-founder of the Puget Sound Recovery Caucus, Representative Denny Heck, in raising strong objections.

Puget Sound is an iconic body of water that is vital to our economy. It’s part of who we are as Washingtonians. But the Trump Administration proposed cutting funding to restore the Sound by 93%. On the heels of a speech in which President Trump committed to working for clean water and good jobs, this proposal would devastate efforts to restore shellfish beds, revitalize salmon runs, and recover the Sound for future generations. The federal government should be a partner in making the Sound healthy again, and as Vice Ranking Member of the House Appropriations Committee I will fight back against this completely irresponsible proposal. Read more from theSeattle Times here.

The importance of citizen advocates

I’m enormously impressed with tremendous advocacy done by folks in our region. So many of you get involved with causes you believe in and share your priorities with me.

A couple of weeks ago, I had the honor of meeting with Mark and Jan Fischer, who flew all the way from Port Angeles to D.C. to advocate for their granddaughter who has cystic fibrosis. This disease has hurt far too many families, and I was moved by the Fischer's story and their powerful role as citizen advocates. They are a prime example of people-power in action.

I'll continue to fight for investments in research and funding that will help us make progress beating back cystic fibrosis and other diseases.

If you are advocating for a particular cause or if there’s an issue about which you’d like to chat with me, please reach out to my office—and consider me a partner on essential work that assists our communities.

Working for You 

I had a great meeting at Olympic Medical Center in Port Angeles talking with Eric Lewis and the OMC team about supporting rural healthcare and how we can continue to improve our healthcare system. As part of our conversation I talked about a recent bipartisan bill I introduced to boost Accountable Care Organizations so folks can have better access to primary care providers.

While in Aberdeen and Hoquiam, I visited Grays Harbor Community Hospital with CEO Tom Jensen, discussing local healthcare related issues and how rural communities are likely to be impacted by decisions in our nation's capital.

I had a terrific visit with folks at the Hoquiam Senior Center. We got to talk about initiatives I'm working on to create new opportunities on the Peninsula and my commitment to protecting two of the most successful public policy programs in our nation's history, Social Security and Medicare.

OK. That’s it for this time. Please don’t hesitate to holler if I can be of assistance. As always, it’s an honor to represent you.

Derek Kilmer