With premiums high and coverage options limited, health care reform is among the most important issues in the Nov. 6 election.
Congressional candidates in Illinois' 6th and 14th Districts have been divided about matters such as how big of a role government should play in health care and whether the Affordable Care Act should be fully dismantled.
U.S. Rep. Randy Hultgren, 14th Congressional District
Hultgren, R-Plano, said one of the differences between his beliefs and those of his Democratic opponent, Lauren Underwood of Naperville, is the role of government in health care.
Hultgren said individuals should be free to make their own health care decisions and not rely on insurance companies or the government. He said he would be open to keeping portions of the Affordable Care Act that have benefited families, but overall, former President Barack Obama's flagship bill has not been working.
"I still see a lot of families who are struggling with lack of choices, lack of ability to be able to see the doctor that they want to see, very big increases in deductibles and out-of-pocket costs and premium increases, and so what was passed a few years ago really isn't providing help and relief to our families," Hultgren said.
To alleviate this, Hultgren said, the marketplace should be opened up to give residents multiple options for health care providers while protecting coverage for people with pre-existing conditions and encouraging innovation.
"Honestly, I want what is going to be good for the families of this district, and having patient-focused care where people truly can get the care and afford it in a quick way, while we still are pushing for the highest quality in the world, so I don't want to give that up," he said. "But I also want to make sure that we're encouraging innovation and again, when government is running things, it doesn't encourage innovation, and it doesn't encourage cost savings."
Underwood has said during numerous campaign events that her decision to run for office was motivated by a promise from Hultgren to only support a version of Affordable Care Act repeal that kept health care coverage for people with pre-existing conditions, which she felt was broken when Hultgren voted for the American Health Care Act.
To fix the nation's broken health care system, Underwood – who believes health care is a human right – said the nation needs to get a handle on prescription drug prices.
In speaking with residents of the 14th Congressional District, Underwood said, she met one father who has to pay $2,000 a month for his diabetic daughter's insulin. Unlike EpiPens, which also have experienced significant price spikes, Underwood said insulin has multiple brands and a whole class of drugs.
"And so to me, this speaks to a systems-level problem where we need to have creative solutions, including allowing the federal government to negotiate drug prices," Underwood said.
Underwood also proposes creating or restoring incentive plans that insurance providers would have to offer through the risk-corridor program, a provision of the ACA that was meant to cover insurer losses in the first three years of health insurance exchanges.
Although the program has resulted in billions of dollars in outstanding risk-corridor payments, a U.S. Court of Appeals ruling earlier this year stated that the federal government doesn't owe health insurers more than $12 billion in unpaid payments under this program.
U.S. Rep. Peter Roskam, 6th Congressional District
Roskam, R-Wheaton, has called the Affordable Care Act a failure and voted to repeal it, which has made him the target of attacks from his Democratic opponent, Sean Casten, for casting votes that would deny coverage to individuals with pre-existing conditions.
Roskam, however, said any ACA replacement would have to protect pre-existing condition coverage; protect employers' ability to offer health benefits to employees; protect Medicaid for the disabled, elderly and impoverished; and provide tax credits to people who don't get coverage at work or have access to Medicaid or Medicare.
As a member of the U.S. House Ways and Means Subcommittee on Health, Roskam also is fighting for patient-centered alternatives designed to increase access to affordable health insurance and spur competition among providers to bring down costs, according to his campaign website.
Businessman Sean Casten of Downers Grove supports universal health care, and he said the ACA is a step in the right direction, so he is against attempts to repeal it.
To help transition to a universal plan, Casten has suggested the creation of a taxpayer-funded health care plan to fill the gaps where individuals not currently eligible for employer or existing government programs are served, possibly through the expansion of existing Medicare networks.
True universal health care, however, may come with a hefty price.
A study from George Mason University’s Mercatus Center released in July determined that federal spending would increase by about $33 trillion by 2031 under former presidential candidate Bernie Sanders’ universal health care plan, the Medicare for All Act. However, the study also indicated that Americans’ total health care spending would drop by more than $2 trillion by 2031.
Casten does support universal coverage through the creation of a public option but has not committed to a single payer health care system such as the one Sanders has touted.
Casten has also said Medicare should be allowed to negotiate drug prices and thinks the program should be protected.
Editor's Note: The story has been updated to reflect why Underwood ran for office.