In 2009, Rep. Paul Tonko appeared before a raucous crowd of 1,500 in Bethlehem’s Elm Avenue Park to discuss the controversial Affordable Care Act, where he spent much of his time being shouted down by the audience.
The congressman held another, less contentious, chat on Wednesday, March 27, at the Voorheesville Public Library to discuss health insurance changes taking effect later this year as part of that law. The crowd of 45 or so shared concerns about the coming changes, while others were uncertain how the law would affect them.
“It was a hard fought battle and I see it, as many of our programs that we have come to know and respect over the years, as a work in progress,” Tonko said. “It is situations like this, dialogues that developed, that can further fine tune as we go forward, but I think it underpins the system in that it produces reforms that are long sought.”
Peter Dunning, of Voorheesville, said he didn’t like how the bill was passed and referred to Nancy Pelosi’s remark, “We have to pass the bill so that you can find out what is in it,” which Tonko said was taken out of context.
Tonko said she was talking about the forthcoming rules and regulations that needed to be fine-tuned before implementing the law.
“Was it clearly stated? I don’t know,” Tonko said. “In this business, what I learned is that once you say it, it is out there and people will interpret it and pass it along and perhaps even magnify the statement.”
Dunning also questioned how Congress was working to cut the deficit and asked if the Affordable Care Act would add to the nation’s debt. He said he couldn’t understand how the deficit is being reduced, as it appears to be growing.
Tonko said he is opposed to the continuing cuts in programs that benefit the masses while tax cuts that benefit the “most wealthy” are left in place. He said the federal government has reduced funds to programs helping the middle class.
Tonko said his mantra is “cut where we can, so that we invest where we must.” He added some money must be invested to “stop the bleeding.”
Another village resident, Steve Hensel, said he has two sons that “aged out” of his health insurance. One son lives in New York City and has insurance through his employer but struggles to make payments. His other son lives in Los Angeles and doesn’t have insurance through his employer.
“What will the act provide for in the way of availability and affordability of insurance for them?” asked Hensel.
Tonko said demands are placed on business owners with more than 50 employees, and if more than 9.5 percent of an employee’s take-home pay goes towards coverage, the employer would be penalized.
For someone who doesn’t receive insurance through an employer, Tonko said they would be able to obtain coverage through an insurance exchange. There would also be various subsidies paid out to people meeting certain income level requirements.
Another person questioned if the number of people obtaining insurance will increase as projected, with the Congressional Budget Office estimating around 30 million people gaining coverage.
Tonko said while the opt-out fee for an individual might be considered low at first, the fee would gradually increase every year and is based on people essentially doing what is right for the greater good. He added one of the main causes behind an individual filing for bankruptcy is unexpected health costs.
John Ives, of Guilderland, asked where the doctors would come from to address the large increase in insured patients.
Tonko said there are incentives in the bill, mostly for primary care doctors, to help build the “human infrastructure” needed.
Tonko referred attendees to the federal website detailing the law and changes (www.healthcare.gov) and said there is also state website providing information on the Health Insurance Exchange at healthbenefitexchange.ny.gov.