One choice 12th Congressional District voters do not have is a candidate who promises to keep the Affordable Care Act, also known as “Obamacare,” as it is. But there are clear differences in the two candidates’ positions.
Rick Allen, the challenger, makes the common Republican vow to help repeal the entire act — but says Congress should do something afterward about coverage for pre-existing conditions and terminal illnesses. Meanwhile, John Barrow, the Democratic incumbent, reminds people that he voted against the bill’s actual passage, and although he has not joined Republican-sponsored bills to repeal it, he says he would repeal key parts.
“We need to repeal that act, OK?,” Allen said Thursday, “and then we need to deal with pre-existing conditions and we need to deal with those folks who have terminal illnesses and they are, say, fighting cancer and they don’t have the money to do it.”
He made an extended, late-afternoon campaign visit to Walker Pharmacy & Gifts on Brampton Avenue near East Georgia Regional Medical Center. Meanwhile, Barrow had just completed a two-hour shift behind a cash register, waiting on customers at the new Parker’s convenience store -- also on Brampton Avenue.
“First, I want to be clear about this,” Barrow said. “I voted against Obamacare all the way through, not because I didn’t think it was going to do some good for some people -- I could see that it was going to do some people a lot of good -- but because I could tell, from doing my homework on the bill, it was going to hurt a lot more people than it was going to help.”
Asked about alternatives, Allen talked about getting health professionals and organizations that pay for health care together to propose solutions. He said he has talked to thousands of health professionals, such as doctors and pharmacists.
“In fact, a lot of physicians, rather than put up with the regulatory environment with the federal government, they’d rather just give the care for free,” Allen said, in reference to severely ill people without the means to pay.
He spoke of private clinics that offer primary care with costs reduced based on ability to pay. Besides their being nongovernmental, his point is that such clinics offer regular checkups and preventive care. He mentioned Christ Community Health Services in Augusta as an example.
“It’s already saved like two-and-a-half million dollars a year in emergency room expenses at University Hospital,” Allen said.
He proposes preventive care as a key to controlling costs.
“We’re spending about 25 cents of every dollar on preventive care and about 75 cents of every dollar on critical care,” Allen said. “We could save a lot of money if we could get those closer together.”
The Affordable Care Act, in fact, requires that insurers cover certain kinds of preventive care.
In the candidates’ recent Statesboro debate and again Thursday, Barrow asserted that major parts of the ACA should be repealed, including the mandates requiring individuals to buy health insurance and employers to offer it.
“I think there are a whole bunch of ways in which we can make insurance affordable and available to folks who’ve been discriminated against in the past without mandating that everybody gets something that in many cases folks don’t want and in some cases don’t need,” Barrow said.

Medicaid expansion
One point the candidates differ on is whether Georgia’s Republican-majority government is acting appropriately in refusing federal funding to expand Medicaid coverage to more of the state’s residents.
Noting that Georgia’s constitution requires a balanced budget, Allen said he understands the governor’s and Legislature’s refusal to obligate the state to a federally controlled program.
“I certainly understand their position, and when the president won’t tell us what Obamacare is actually costing until after the election, you tell me we don’t have a problem?” Allen said.
There had been bipartisan support for Medicaid expansion, Barrow said. But he called the ACA’s approach to expansion “heavy-handed” and noted that it was originally a mandate, until the Supreme Court ruled that unconstitutional and gave the states the choice.
However, he said that participation would certainly be better than Georgia’s current situation.
“It makes no sense for those of us who are paying the full cost of our health insurance coverage, and then some, to provide for Medicaid expansion all over the country not to get any of the benefit of that in our state,” Barrow said.
The state’s refusal leaves Georgia hospitals with neither the federal funding that previously paid some of the cost of treating the indigent nor the Medicaid dollars that were intended to replace it.
“Now they don’t have the old safety net or the new one either,” Barrow said.
He also suggested that participation would give states more voice when Congress revisits the way the Medicaid expansion was written into law, something he and Allen agree should happen.
Al Hackle may be reached at (912) 489-9454.