The U.S. Chamber of Commerce currently has the ad below running in Kentucky, starring Lexington business owner Patty Breeze, who says that the Affordable Care Act is “stifling business” in Kentucky and Sen. Mitch McConnell will fight it and Washington:
The Herald Leader’s #YoungSwagger did a story on Breeze a few days after the ad started running, which oddly focused on what a celebrity she is now, instead of asking her specifics on what problems she has with the Affordable Care Act and what she thinks needs to be done with it. Or maybe #YoungSwagger asked her but decided that wasn’t worth printing, who knows.
Curious as to what Breeze specifically thinks about the Affordable Care Act, I decided to call her, and had a long phone conversation with her where she aired her many problems with the law. Breeze has run a financial service practice in Lexington since the 1980s, which partly consists of helping businesses and individuals shop the marketplace for healthcare insurance. She went through the certification process to be an insurance agent for clients through Kynect, and since last fall helped roughly 25 individuals and one small business sign up for coverage through the website.
While Breeze talked at length about problems with the ACA state exchange in Kentucky (Kynect) — mostly involving a difficult to use website and insufficient staffing and training for Kynect staff and insurance agents — she also told me that there are many good parts of the law that she thinks we should keep, and we should improve the law through legislative fixes instead of repealing the law in its entirety and going back to the healthcare system we had before it.
If you’re paying attention to the Senate race here in Kentucky, the general election will soon have one candidate who favors repealing the law “root and branch” because the law cannot be “fixed,” and there’s another candidate who says that she has problems with the law, but we should keep the ACA because of its good parts and fix what isn’t working, instead of repealing the law and going back to our old broken system. While Breeze will strongly criticize parts of the law and its implementation here in Kentucky, she seems to identify with the “keep and fix” strategy of Alison Lundergan Grimes more than the “repeal it root and branch” strategy of the man she cut the Chamber ad to promote, Mitch McConnell.
Breeze’s criticisms of Kynect were long, detailing the many frustrations she and her clients had logging on and navigating Kynect’s website initially, and the many hours of waiting on hold when they tried to contact Kynect staff to answer questions. She partly blamed the insufficient training that registered insurance agents like herself were initially given, saying that a more detailed training on how to use the website was not offered until mid-March, near the end of the enrollment deadline. She also said that when she was finally able to get through and talk to Kynect staff over the phone, often the staff did not know enough information to be able to answer her questions.
Breeze said that a large majority of her clients were not happy with their Kynect experience, noting that two faced bureaucratic nightmares after they were signed up, saying they were told they were not covered by the insurance they signed up for and had to go back to Kynect to solve the issue. She said most people she signed up for insurance were already covered, though she was able to help two or three people sign up who were not covered beforehand.
I asked Breeze if Kynect would have worked if they had hired more staff — with better training — to answer questions, and if the website had been more functional, to which she answered affirmatively.
“Yes, I think so, if people could have answered their questions,” said Breeze. “That was the biggest thing that we were having problems with, getting people to answer questions. We kept getting sent from one person to one person to another. It was frustrating. And it was extremely time consuming, a lot of wasted time… We spent so much time waiting on the phone for people, trying to get answers to questions, helping clients. It slows down production.”
Despite these criticisms of staffing, training and efficiency, Breeze told me that there are actually parts of the Affordable Care Act that she supports and wants to keep.
“There are some good parts to that federal act,” said Breeze, “that people aren’t denied (coverage for) pre-existing conditions, and children can stay on their parents health insurance for longer to age 26, and that we’ve got free preventative services that promote wellness. There are good pieces to that.”
Asked whether lawmakers should go back and fix the parts of the Affordable Care Act that arent’ running smoothly, or repeal the law and start over from scratch, Breeze answered that she favors the “keep and fix” approach:
“I don’t think we need to go back to the way it was,” said Breeze. “Something needed to be done. But the plan that they have come up with is so cumbersome that it really needs some major changes. I’ve already told you about the parts I thought were good. I think the more bureaucracy you throw into the mix, it just muddies the water. And most business owners will tell you, just keep it simple and understandable.”
Asked what she thought of politicians who favor repealing the law “root and branch,” Breeze answered, ” I don’t know… I’ve already told you I think it needs revision. I think they need to keep the good parts of it, and they need to revise the way they’re delivering it. They need to encourage the free market (to participate), and I think they’re discouraging it.”
Breeze also conveyed other problems she has with the ACA, including lifetime caps and forcing small businesses to go through the exchange in order to receive tax credits. While not condemning it outright, Breeze said she is doubtful that Medicaid expansion in Kentucky will be as affordable as Gov. Steve Besehar and the accounting firms he hired to study the expansion said it would be, expressing concern that the state won’t be able to afford covering new people once the federal government starts paying for 90 percent of their Medicaid, instead of paying 100 percent, which the federal government currently pays for.
Breeze also wondered why Kentucky couldn’t have kept its state high risk pool — Kentucky Access — an idea that McConnell himself floated a month ago. As we noted then, Kentucky Access was not very popular when it existed, as its premiums were expensive, whereas these people can now be covered on Kynect with subsidies to lower costs and new consumer protections. Asked why Kentucky Access had so few people sign up for it when it existed, Breeze answered, “I have no idea. I guess they chose not to be on it. Maybe they couldn’t afford it.”
So while Breeze is highly critical of the Affordable Care Act, her approach to what should be done with it — fix what’s wrong with it instead of repealing it — appears to stand in stark contrast to McConnell, who says it must be repealed “root and branch,” the healthcare system was better before than it is now, and it cannot be “fixed” — even though McConnell has occasionally slipped and referred to a “fix,” quickly getting jumped on by Matt Bevin. Oddly enough, Breeze is actually more in line with the Chamber of Commerce who produced this ad, who have changed their rhetoric over the past few months to talk about “fixing” the law instead of repealing it. Hell, the Chamber even used that message for their pro-McConnell ad they aired in Kentucky in February, even if McConnell goes out of his way to avoid such language.
It will be interesting to see if McConnell’s stance and language on the ACA changes after his primary win over Matt Bevin next Tuesday, when he no longer has to worry about being attacked as an enabler of the dreaded “Obamacare” from the right-wing Tea Party crowd in Kentucky. If he thinks that Kynect is popular enough among general election voters this fall that they won’t want to see healthcare stripped from over 400,000 Kentuckians — and the evidence is strong that this might be the case — we might start to see McConnell transition into “keep and fix” rhetoric while criticizing the law, sounding much more like Patty Breeze than the Tea Party zealot he’s sounded like in recent years.