Editor’s note: Saturday morning, a larger than usual crowd attended the second Great Bend Legislative Coffee of 2019, sponsored by the Great Bend Chamber of Commerce and Hutchinson Regional Healthcare System. They came for an opportunity to listen to and question “Big First” Congressman Roger Marshall, Kansas Senator Mary Jo Taylor of Dist. 33, and State Representative Tory Marie Arnberger of Dist. 112. The coffee started a half-hour early to accommodate Marshall who was expected later that day in Sterling. 

Today, we will focus on Marshall’s contribution to the coffee. Come back Tuesday we’ll report on what Taylor and Arnberger had to share about Medicaid expansion, education funding and more. 

Dressed in K-State purple, Congressman Roger Marshall greeted attendees to the second of two legislative coffees to be held in Great Bend during the 2019 Legislative Session. 

“It’s a great day for K-State, unseating another great team after 14 years in a row of championships,” he said. “Very proud of my Wildcats.”

He shared about his recent trip to the White House, to visit with President Donald Trump on Tuesday afternoon, to talk about health care and other issues. 

“For the first 20 minutes, President Trump started by asking me, ‘how are your farmers doing.’ We talked about trade and tariffs issues. He wanted me to tell everybody, he understands the burden that agriculture is bearing, that they are the tip of the spear, that they are hurt worse by these trade wars than anybody else, and he understands that,” Marshall said. He added that the president is committed to getting a good deal with China, and that he is optimistic about the progress being made. They also spoke about USMCA, otherwise referred to as NAFTA 2.0, and its importance to agriculture. 

“We export four times more to Mexico and Canada than we do to China at this point, and we have to get that shored up, and the president has given us that and now Congress needs to approve that. I can’t do it with Republicans only. It has to be a bipartisan vote. But it’s going to be good for agriculture and its good for manufacturing jobs, and its going to bring jobs back into Kansas and bring jobs back into this country. It’s certainly a testament to the president that he certainly understands the challenges going through agriculture right now.” 

Marshall then paused and opened the floor to questions. Health care was on the minds of many. 

Rose Kelly asked what Marshall was going to do about healthcare. 

“I think we have an awful lot of people right now who are uninsured and not able to have adequate healthcare, and I think that’s maybe a kind of sin,” she said.  

Sally O’Conner piggy-backed on the comment, noting that the United States is one of the few democracies where millions of people declare bankruptcies because of healthcare costs. She wondered how Marshall, as a doctor, could be okay with this. Pam Martin also wondered what Congress was doing to bring down the cost of pharmaceuticals.

“We’ve actually done quite a bit,” Marshall, who is the Chairman of the Health Care Task Force, said. “I’m not satisfied. And before I even started to tell President Trump what our plan was, he said ‘Whatever you do Roger, make sure you take care of people with pre-existing conditions,’ so our solution is going to embrace that.” 

Marshall’s attempt to open a philosophical conversation by describing the differences between Democrat and Republican approaches to the issue was met with resistance.

“What the Democrats would want to do is control you,” he said. “The Democrats think that they know what’s better for your health care than you do.” 

The comment raised objections, but others there demanded quiet so Marshall could speak. 

Marshall’s solution drives control of healthcare to the state, making it easier for states to innovate under the ACA state innovation waiver, he said. 

“My solution is to make patients into customers, and allow them to make their own decisions,” he said. 

He called the Affordable Care Act a failure, stating only 9 million people are on the exchange, and 28 million are without healthcare. 

“I’m afraid Medicaid is not the solution,” he added. He said Medicaid is not the same as access to care because nearly half the specialists do not accept Medicaid. He added hospitals actually lose money when they treat Medicaid patients. 

“My belief is a stronger economy, more people employed, more people getting their health care through their insurance, all of those things are good things,” he said. “Tell me one thing the government has done through federal mandates that actually works across the country.”

The Great Bend Tribune asked if, with increased involvement of the state, the federal government would still fund his plan or if it would be left to the states to fund. 

Marshall shared that the same dollars the federal government is currently funding exchanges with would instead be handed over to the states to innovate by setting up “high risk pools.”

 He explained further. 

“In this room here, five percent of people among us are going to eat up 50 percent of the healthcare dollars this year. I don’t know who its going to be, but we would allow them to move these folks into a high risk pool, so whoever is left, the cost of their healthcare should be 50 percent less. 

The Tribune asked if these high risk pools would be just like the state high risk pools that existed before the ACA became law.

“They are very similar, and their were many of them that were very successful,” he said. “There are about five states that are already doing it, and several with applications in, and I am trying to make that process easier simpler and allow states to do their own way because healthcare in Great Bend Kansas is different from healthcare in Wyandotte County is different than healthcare in Miami Florida.” 

In addition to allowing for state innovation, his plan also calls for more transparency surrounding the rampant kick-backs taken by pharmacy benefit managers when consumers purchase prescription drugs. The kick-backs, he said, amount to about one-third the cost of the drug. 

“They give kick-backs to insurance companies and big pharma as well,” Marshall said. “We’re working hard on transparency legislation in order to show where they’re going, from the direct fees and claw-back fees.”

Marshall then moved on to other topics. Robert Phelps, Great Bend, inquired about the leadership’s position on Deferred Action for Childhood Arrivals recipients and their parents. Marshall said leadership would like to come to an agreement, and two votes were taken in 2018, but Democrats were not in favor because border security funding hand been included in the bills. He added that he prioritizes border security. 

“Putting this issue in perspective, there are about 3,000 DACA recipients in Kansas, but there are about 70,000 jobs that are dependent on agricultural guest worker visas. I’ve worked hard for a fix to this problem, and I believe we have a fix, but we are having a hard time getting it approved.” 

Other topics covered included concerns over paying down federal debt, climate change, voting age, and tariffs and trade. Mark Mingenback commented on the importance of the federal government’s encouragement of opportunity zones, a program that has been implemented locally and which he feels is a great economic development tool. 

Marshall thanked the sponsors of the coffee, who then introduced State Senator Mary Jo Taylor and Rep. Tory Marie Arnberger to provide updates on their efforts in Topeka.