Just as House Democrats announced their health care bill, BlogHers spoke with Republican Congresswoman Cynthia Lummis. There was no shortage of personal health care stories as well as policy questions.

You can listen to audio of the call here on BlogHer:

You can also read the transcript of the call here on BlogHer:

**start transcript**

Nancy Watzman: Hi, welcome, everyone. I’m Nancy Watzman of the Sunlight Foundation representing BlogHer today and their community generalism initiative on healthcare policy.

The Sunlight Foundation is a non-partisan, non-profit dedicated to using the power of the Internet to catalyze greater government openness and transparency.

As CEO Lisa Stone announced, BlogHer has been sponsoring a bipartisan series of telephone conference calls to connect women bloggers directly with their legislators.

Today on the call we have Representative Cynthia Lummis from Wyoming and I’m going to turn it over to her to give a brief introduction and then we’ll do questions.

Cynthia Lummis: Thank you, Nancy. I appreciate the time you’re spending with me today and looking forward to your questions and your feedback about healthcare reform. I’m a Republican and I want you to know from the outset, Republicans are in favor of healthcare reform but we would do it differently than the Speaker of the House and the Democratic majority.

Among the things that we would like to do is take some of our 53-plus bills and borrow the best of the best ideas from them and individually debate them over time so we can come up with responses to some of the really targeted problems we have with healthcare including addressing pre-existing conditions, addressing how to protect the doctor-patient relationship, and how to deal with people who that truly are in need - people who are not well-served by our current healthcare system - while preserving the rights of people who like their insurance, like their hospitals, like their doctors and want to keep the programs they have.

Just a few minutes ago, the Speaker of the House Nancy Pelosi rolled-out the latest bill on healthcare reform that she will be advocating in the next week. It is almost 2000 pages long. The word “shall” nearly 3500 times, that we know from just a quick word search of the bill.

What’s called the “Doc Fix” which is about $200 billion to adequately compensate doctors is not in this bill so that’s how they got it under a trillion dollars. If you add “Doc Fix” it is over a trillion dollars and it shifts many costs to states in the form of unfunded mandates meaning states will be required to provide services and come up with the money to do so.

An example of that is expanding Medicare to include more low-income people so it’s essentially shifting costs onto states who don’t have the ability to print money like the federal government does so I’m terribly concerned about the proposal and I’m an advocate of a number of Republicans alternatives.

Among the things that I like better are a bill that would fund high-risk pools in states and that would be to serve people who have pre-existing conditions now. Also I favor the ability of employers to receive a tax deduction to contribute to an individual’s health savings account.

That way the individual can go out and shop for the insurance they want and then when they leave that employer and go to another employer, it is portable so that addresses another significant problem with our current healthcare system that we can address without throwing out the baby with the bath water so to speak and producing a brand new system that is government run.

I am very concerned about the financial stability long-term of our Medicare program which of course serves people over the age of 65 so to have another government-run system that in the long run is financially unsustainable to me is very problematic.

One of the Democratic Governors in the United States - the Governor of Tennessee where they have something called “Ten Care” which is a state-run healthcare program - has called this bill the mother unfunded mandates.

So Governors, state legislators and people in states should be I believe very concerned about some of the shifts in obligations to fund healthcare that are in the Speaker’s bill.

And I’ll tell you that we just got the bill so we’re just beginning to analyze the Speaker’s bill. We will be given 72 hours then a big amendment will be added to the bill and we will be given another 72 hours to look at it.

And then we could be voting on the Speaker’s bill next Thursday, Friday or Saturday so this is a very short timeframe to digest a 2000-page bill. I’m not sure what the rush is to reform a healthcare system that serves about 85% of Americans very well.

I wish instead we were targeting on the 15% that is not well-served and addressing their specific issues. Now with that introduction, I would like to open it up for questions.

Nancy Watzman: Yes, let’s go to the first caller.

Operator: Thank you. Ladies and gentlemen, if you would like to register for a question, please press the 1 followed by the 4. If your question has been answered and you would like to withdraw your registration, please press 1-3.

If you are using a speakerphone, we ask you to please pick-up the handset before placing your request. One moment, please, for the first question. And the first question is coming from line 492-L. Please proceed.

(Loralee): Hi. I actually would like you to expound a little bit more on your ideas for - you touched briefly on high-risk pools and pre-existing insurance conditions with the states.

I’m currently enrolled in a high-risk pool and it costs us a huge amount of money every month and they - it’s kind of a well-publicized fact that my pregnancy even though I had just come from a group insurance policy was considered a high-risk condition by the state.

I’m just curious as to what your - I’d like you to go into that a little more in detail as to what you were referring to as to things you would like to see.

Cynthia Lummis: High-risk pools we authorized by Congress a number of years ago to the states. What one of the bills that I’m co-sponsoring does and it is HR 3400 is provide more funding to states for those high-risk pools.

So the obligation on you to come up with a lot of money to pay for your own pre-existing condition will be somewhat relieved and the source of the money to fund those high-risk pools in the states comes from taking monies that no longer will be spent on stimulus and converting them to monies for the high-risk pools.

In other words, we found a way to do it without increasing the deficit and without increasing the debt by taking unspent stimulus monies and sending them to states for the high-risk pools. Did that adequately answer your question?

(Loralee): Pretty much. I just kind of - my husband is - I’m more - I’m a moderate Republican. My husband is very conservative and we have been going at it like cats and dogs about healthcare reform. I’m very for healthcare reform and I tend to be much, much more liberal about it.

And he keeps telling over and over again that it won’t help our particular situation so I just wanted some clarification and thank you.

Nancy Watzman: And (Lora Lea), could you just quickly say who you are and where you’re from since I don’t think we got that when you...

(Lorlee): Oh, sure. They said it was anonymous and that I was not to say that. Yes, (Loralee) and I am actually from Utah.

Nancy Watzman: Okay, great. Thanks.

Cynthia Lummis: And thank you for your question.

(LoraLee): Thank you.

Nancy Watzman: Okay, next caller?

Operator: Thank you, and...

Nancy Watzman: Oh, and I just wanted to clarify, you can definitely identify yourself and please do if you’re willing to.

Operator: Thank you. Ladies and gentlemen as a reminder, if you have a question, please press the 1 followed by the 4, and the next question coming from Line 462-L. Please proceed.

(Jaelithe Judy) Hi, Representative Lummis. Thank you for participating in this call today with BlogHer. We really appreciate it. My name is (Jaelithe Judy). I live in Saint Louis, Missouri and I’m a blogger at (momocrats.com) and I actually also have a slightly more specific question regarding pre-existing conditions.

I am the parent of a child with special needs. I have several family members with pre-existing conditions including both my mother and stepfather and actually I heard you say you’re not sure what the rush is. Well, my stepfather has diabetes and is a small business owner.

He owns a rural farm in rural Washington State and he actually because of his pre-existing condition of diabetes has not been able to afford private health insurance and is not getting the insulin treatment that he currently needs so he could actually die from this current situation with the healthcare system so for me, there is a bit of a rush.

What I wanted to ask you about specifically was I read on your Website that you support Senator Mike Enzi’s bill that was introduced in the Senate in July 2007, Senator Enzi’s 10 steps to transform healthcare.

And I read his bill and in the entire bill there is one mention of patients with pre-existing conditions and it basically says that healthcare plans would be eligible - consumers - would be eligible for tax breaks, you know, tax credits for purchasing specific healthcare plans.

And the only healthcare plans that would be qualified for those tax cuts would be ones that impose no pre-existing condition limitations, but what I’m wondering is, you know, I didn’t see anything in that bill and frankly I’ve also read HR 3400 and I did not see anything in that bill that explicitly prohibits insurance companies in general from discriminating against people with pre-existing conditions.

And I’m just wondering, you know, I mean, right now people with pre-existing conditions can buy into high-risk pools in their states but the cost is very, very high and I heard what you said to (Lora Lea) about trying to control costs by redirecting some stimulus funding to states.

But I’m just wondering, you know, in terms of controlling costs in the private market, what’s the Republican position on that? How do you intend to stop the insurance companies from charging people with pre-existing conditions exorbitant rates that they can’t afford?

Cynthia Lummis: Well, thank you for your question. People with current pre-existing conditions such as the stepfather with diabetes who is in a position right now to find insulin unaffordable could go to their state high-risk insurance pool and find adequate funding there if the Republican bill HR 3400 passed because the monies would be taken out of unspent stimulus monies and transferred over to state high-risk pools to provide more money to help essentially buy-down the stepfather’s insulin cost.

So for people in that kind of dire and immediate need, that bill does address the specific instances of people who are currently finding themselves in an untenable situation so that would address the immediate need that you specified.

Nancy Watzman: Okay. Well, I would like to ask a question. I’m from the Sunlight Foundation as I said and we work very hard to bring transparency to government and I noticed you mentioned, you were talking - when you were talking about the process for the bill, that it would be available for 72 hours and then 72 hours again - I’m wondering what your position is on transparency in this debate but also generally for other debates.

There’s legislation - H Resolution 554 - that would require all legislation be made available for 72 hours before debate begins and I’m wondering if you have a position on that and on transparency in general.

Cynthia Lummis: I’m a big advocate for transparency. I do support the bill that would require that bills be available for 72 hours before voting on them. I also support Representative Reichert’s bill which would require bills being reported out of committee to be available online and those types of votes to be available to the public.

Right now only 12 of Congress’ 21 standing committees requires that bills coming out of committee have votes recorded available to the public and those bills to be posted online so those are some of the transparency provisions that I support.

I also support transparency with regard to earmarks so that if someone requests an earmark, they would have to post it with the Clerk of the House in which they serve and that would be available to the public so people know what members of Congress are asking for.

I support legislation being available online. I support one subject per bill so we don’t have these nearly 2000-page-long bills and that we can break things down and have legitimate debates about them.

I oppose the what’s called “air dropping” amendments into bills which means bills that have already passed committee should come to the floor in the form in which the committee passed them and not allow the leadership of the party in charge of Congress to drop massive game-changing amendments into a bill just hours before it is brought to the floor of the House.

And I believe these kind of transparency measures would involve the American people more in our representative democracy at a time when communications and electronic media allows us to have a more participatory democracy.

Nancy Watzman: Okay, thanks. Let’s go on to the next question.

Operator: Thank you. And the next question coming from the line of 455-L. Please proceed.

(Danine): My name is (Danine) and I am calling from (assumption). I have a complicated medical history and I currently on - I’m so sorry - on Medicaid and I want to get off of those programs, be kind of quite frankly, Medicaid and disability are demonized and treated, you know, every time you talk about an entitlement program, you know, well, they’re demonized.

But I absolutely have to have health insurance. I have a condition called (hydrocephalus) and I have a shunt in my head that relieves the pressure from my brain and every single day of my life, I have to be able to afford health insurance and healthcare.

And I - in order to get off of SSI and Medicaid, I need to be able to - I’m working towards self-employment - and I need to be able to afford health insurance.

And with all due respect and I mean this incredibly, the reality is is that our greatest chance for - I don’t - I can’t - the reality is is that I probably won’t be able to afford private insurance in the current environment and my best option is probably - I’m sorry - but it’s probably in with this healthcare reform as the Democrats are proposing it.

Is there any possible way that you can support their policies or get on-board with healthcare reform in 2009? I need healthcare reform. I need something because the day that I don’t have health insurance, that could be the day that my shunt breaks and I need emergency brain surgery.

It’s a life - I think it was literally started - no, I’m sorry. I don’t remember which person said it. That’s the day that I could - that’s the day that - it’s a life and death thing and I’m sorry, but it’s very, very personal for me.

And I need my legislative Congress people to help. I’m not trying to put you on the spot, but...

Cynthia Lummis: No, you’re not putting me on the spot and I appreciate your dilemma. I want you to know how proud I am of America that Medicaid is there for you and you should not feel the least bit apologetic about the fact that Medicaid is serving you to help you with a condition that is highly debilitating and that really affects your quality of life.

That’s why it’s there so please take advantage of it. You are exactly the person that it was meant for. In the case that your condition were to improve to the extent that you could leave the availability of Medicaid, there would be tax credits in Republican plans for low-income people.

Of course the high-risk pools if you still can’t get coverage would be available to you. There is in Republican bills the opportunity for insurance to be purchased across state lines so in states like my state of Wyoming which has a very small population and health insurance cannot be pooled across state lines, bills would allow for Wyoming to participate in much bigger pools.

And the people of Wyoming could band together either through their church or their trade associations or states themselves to provide larger pools of people who can share the burden and lower the cost of health insurance, especially for those of us as I said that are in areas of very small populations.

So by all means, keep your Medicaid, keep healthy to the extent that those medications are helping you have a higher quality of life and don’t be the least apologetic about participating in Medicaid. That’ what it’s there for.

Now the problem I have with the bill that the Speaker rolled-out today is that it forces on states unfunded mandates to expand Medicaid. Where are the states going to get the money to do that?

In California, there would estimates that it could cost California $8 billion a year to expand Medicaid according to the Speaker’s bill. California is already awash in debt. They can’t add $8 billion to the state’s debts in order to cover programs that Congress mandates on them that they can’t afford to pay for.

So the problem I have with the Speaker’s bill and with these government-run programs that Democrats are advocating is that they are not paid for so it will just create a situation just like we’re going to face with Medicare down the road and that is that Medicare will eventually go broke because it is going to be paying out more in benefits than people are paying in.

And with those kinds of unsustainable government programs that promise a lot but are unpaid for, we are burdening our children and grandchildren with paying for us and for our needs without regard to what our children and grandchildren will face in the future.

And I’m opposed to saddling my child and her children with debts that I incur. I need to make sure that while I’m here in Congress, I am being responsible to the next generation and doing the best job I can for us in this generation.

That’s why I encourage you to stay on Medicaid to the extent that you are able to and when your situation improves to the extent that you are able to afford insurance, take advantage of the tax credits. Take advantage of state high-risk pools and thank you and, you know, I hope your condition improves and thank you for your question.

(Danine): I have one quick question. How is Medicare and Medicaid more - how is Medicaid more financially solvent and this is - I’m not being just (cold), I actually want to know?

Cynthia Lummis: What was your question again?

(Danine): Is Medicaid more financially solvent than Medicare?

Cynthia Lummis: Well, Medicaid is - they’re both in trouble. They’re both in trouble in the long run because they’re paying out more in benefits than they take in and every year more of the federal budget is going to pay for entitlement programs, Social Security, Medicare, Medicaid and the states are responsible for of course picking-up a share of Medicaid so it’s also having a big impact on state budgets.

(Danine ): Okay. Thank you.

Nancy Watzman: Let’s - I think we have time for one more quick question so let’s go to it.

Operator: Thank you, and our last question comes from line 396-L. Please proceed.

Erin Kotecki Vest: Good morning, Congresswoman. My name is Erin Kotecki Vest. I am actually the political director over at BlogHer and since you were just so positive about Medicaid and Medicare which kind of astounds me coming from a Republican.

I’d love to talk a little bit more about that and if you would be strengthening something like Medicare and Medicaid over the public option that we’re seeing or something along that lines to get all of these millions without insurance because I am taking a look at a House bill in April that called for replacing the traditional Medicare program with subsidies to help retirees enroll in private healthcare plans.

Essentially abolishing or killing Medicare that came out of the House Budget Committee, Representative Paul Ryan that had 137 Republicans voting for it, so I’d love to hear you talk about the differences there between how you support Medicaid and Medicare and you feel it needs to continue, but also some of these votes that clearly seem to not support it.

Cynthia Lummis: Well, I support the ability of people who need that safety net like the last caller to be able to access that safety net and Medicaid is that safety net for low-income Americans.

So to say I support the program unchanged would be completely inaccurate. Those programs need revision too to be more sustainable but I’m glad that Medicaid is there right now as a safety net for the last caller. I do support reforms in entitlement programs including Medicare and I am anxious to learn more about your proposals to reform Medicare.

Among the things I think that my generation - I’m a baby boomer who has not yet retired - but I know that 10 years from now when I’m eligible for Medicare that I come in with an enormous bubble of Americans who are going to be on that program unless we change it in a way that makes it more sustainable.

So I am advocating reform of Medicare. Furthermore, right now rural hospitals and rural doctors are reimbursed for providing Medicare services at lower rates than urban doctors and urban hospitals.

In fact it’s so bad in my home state of Wyoming that Wyoming Medical Center in Casper, Wyoming is reimbursed for providing hospitalization services to Medicare patients at roughly one-third of the cost to provide them care.

And that is in my view the federal government shirking its responsibility to adequately fund a program that it has set in place, so we have to make sure that doctors and hospitals are reimbursed for the actual cost of providing care to Medicare patients.

At the same time, we must ferret out the waste, fraud and abuse from Medicare and Medicaid. Now I’ve met with federal agencies whose responsibility it is to do that and there have been reductions of over the years from about 17% waste, fraud and abuse to about 10% waste, fraud and abuse so we’re heading in the right direction but we need to continue to ramp-up efforts to ferret out waste, fraud and abuse.

At the same time, I would be delighted to hear your ideas about reforming Medicare so it is more sustainable so as I said my child and her children and the other participants in this call will not be shirking our responsibilities and loading on our children and grandchildren debts and deficits that they cannot...

Nancy Watzman: Excuse me, Congresswoman. We were told by your staff that you have to go, so I would love to urge people who are on the call to leave their comments in the comment section on the blog post at BlogHer and we will be posting the audio and transcript from this event and so people can follow-up that way.

Cynthia Lummis: And I also have a healthcare blog I encourage all the callers to visit. It is www.cynthialummis.tumbler.com and thank you all for participating today.

Nancy Watzman: And thank you Congresswoman. That wraps-up today’s call with Congresswoman Lummis and BlogHer. Thank you for participating and thank you bloggers for joining us. Please keep an eye on blogher.com for the audio and transcript and for the announcement of any new calls where we’ll give you another opportunity to talk with legislators. Thanks.

Operator intro and outro have been deleted

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