American Health Care Act Local NC Voting Record

However you feel about the American Health Care Act, here is how local representatives voted.

House of Representatives voting record (May 4, 2017) Burlington and Fayetteville, NC, representatives:

NC 6th Congressional District
Mark Walker voted for this bill

NC 8th Congressional District
Richard Hudson voted for this bill

NC 9th Congressional District
Robert Pittenger voted for this bill

It remains to be seen what will happen in the Senate with votes from Richard Burr and Thom Tillis.

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Some excerpts of the summary of the bill from the Congressional web site: (underlining added by me)

“(Sec. 111) The bill lowers, from 133% to 100% of the official poverty line, the minimum family-income threshold that a state may use to determine the Medicaid eligibility of children between the ages of 6 and 19. In addition, the bill reduces the Federal Medical Assistance Percentage (FMAP) for Medicaid home- and community-based attendant services and supports.”

“(Sec. 112)  Under current law, any alternative benefit plan offered by a state Medicaid program is required to provide specified essential health benefits. The bill eliminates this requirement beginning in 2020. (“Essential health benefits” include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services, and pediatric services.)”

“(Sec. 114)  The bill allows a state to delay or deny an individual’s initial eligibility for Medicaid benefits without providing a reasonable opportunity to submit evidence of a satisfactory immigration status or pending official verification of such status. A state that elects to provide a reasonable period for an individual to provide such evidence may not receive payment for amounts expended on the individual’s medical assistance during that period. ”

“(Sec. 115) With respect to states that did not expand Medicaid coverage under PPACA [ie, NC], the bill: (1) with specified limitations, provides for additional federal funding for certain health care services; and (2) through 2022, increases the applicable FMAP. A non-expansion state that subsequently expands Medicaid coverage under PPACA shall become ineligible for this funding.”

“(Sec. 132) The bill amends the SSAct to establish and make appropriations for the Patient and State Stability Fund to provide funding to states through 2026, including to: provide financial assistance to high-risk individuals so they may enroll in health insurance, stabilize health insurance premiums, promote participation and increase options in the health insurance market, pay providers for services, and provide financial assistance to enrollees to reduce out-of-pocket costs. Funding is allocated to states based on each state’s share of incurred claims and uninsured individuals below the poverty line. To receive funding, states must provide matching funds at a rate that grows from 7% in 2020 to 50% in 2026.”

“(Sec. 133) Health insurers must increase premiums by 30% for one year for enrollees in the individual or small group market who had a break in coverage of more than 62 days in the previous year.”

“(Sec. 134) Beginning in 2020, health insurance benefits no longer must conform to actuarial tiers.”

“(Sec. 135) The bill increases the ratio by which health insurance premiums may vary by age, from a three to one ratio to a five to one ratio. This ratio may be preempted by states.”

“(Sec. 206) This section repeals the penalties for certain large employers who do not offer full-time employees and their dependents minimum essential health coverage under an employer-sponsored health plan (commonly referred to as the employer mandate). The repeal is effective for months beginning after December 31, 2015.”

“(Sec. 207) This section delays the implementation of the excise tax on high cost employer-sponsored health coverage (commonly referred to as the Cadillac tax) until 2025. (Under current law, the tax goes into effect in 2020.)”

“(Sec. 241) The section repeals a provision that prohibits certain health insurance providers from deducting remuneration paid to an officer, director, or employee in excess of $500,000.”

“(Sec. 251) This section repeals the 3.8% tax on the net investment income of individuals, estates, and trusts with incomes above specified amounts.” The full text reads: “Subtitle A of the Internal Revenue Code of 1986 is amended by striking chapter 2A.” From the tax code section that would be struck, 2A, the “specified amounts” requiring a 3.8% Medicare tax on income from investments, estates, trusts is triggered when there is an adjusted gross income (ie, after deductions) above $250,000 for a joint return or above $200,000 for an individual return.

Always on the Route to Quaker House

I was always on this road, this road to Quaker House. I just did not know it. 

I was raised in a military family — birth to mid-high school.

One of my original majors in college was International Relations, but it was eventually switched out for English and a minor in biology, partly due to scheduling issues and time constraints, of all things.

When I applied to law school, both times (I transferred from Seattle University to the University of North Carolina), I specifically wrote in my essays that I wanted to practice law assisting nonprofit organizations. And, as a member of the first 1L class to get to choose an elective seminar at Seattle, I chose Introduction to International Law with Professor Chinen — because I wanted to know how to help nations and peoples live in harmony.

After I took the bar and felt like it was finally the right time for me to invest in regular volunteer work, I chose the Red Cross. I had no idea, at that time, that the Red Cross would show up several times in my reading of A service of love in war time: American Friends relief work in Europe, 1917 – 1919 as vital facilitators of the Quaker efforts during World War I. And, I think my high school friends would get a kick out of the fact that one of the key Quaker organizers of this humanitarian work was Rufus Jones. He was from Maine.

But, wait. How did the Religious Society of Friends suddenly start factoring into my story?

Turning right and going 2.5 miles brings you to Spring Friends. Continuing straight, off towards the horizon, another 72 miles brings you to Quaker House.

Well, one Sunday, I visited a Quaker meeting, partly because I wanted to learn more about their Peace Testimony. Many religions espouse peace, but I wanted to see what a longstanding core theological principle of intentionally promoting peace among nations, in addition to in our personal behaviors, looked like. I was fortunate in that I already had a strong religious faith upon which to build.

That Quaker Meeting was Spring Friends and, to get there, my best path included a 10-mile stretch of Route 87 South. That stretch of road became a regular journey for me. Little did I know, it would also become a section of my path to Quaker House, both figuratively and literally.

I got the call at about 9:00 Saturday night that I had been selected to be the next director of Quaker House, to follow in the footsteps of amazing directors before me and to work alongside wonderful experienced staff and a dedicated board of directors. They have a smooth transition planned. I will be learning from their expertise and experience all summer long, and Lynn and Steve Newsom, the current directors, will not be leaving their work at Quaker House until September.

Some of the Quaker House services:

  • Answering calls and providing assistance as a significant component of the GI Rights Hotline.
  • Educating about moral injury and its treatment.
  • Providing free and confidential in-person counseling for members of the military community, including for issues of domestic violence, sexual assault, and moral injury.
  • And, of course, advocating for a more peaceful world.

Quaker House assists our military members and families and works to promote world peace. It was established and is supported by a community of faith. My path brought me here. On one hand, it is not surprising.

On the other hand, it is humbling.

A = Burlington, B = Spring Friends Meeting, and C = Quaker House.