Rep. Matt Cartwright (D-Pa.) is a freshman lawmaker and a staunch defender of the Affordable Care Act. A story in today's Washington Post details Cartwright's advocacy for the law and how he defended it in front of a skeptical crowd over the weekend.
Before his information town hall session, Cartwright spoke last week about why he's defending the law, why he thinks it will work, and how House Democratic leaders prepared the rank-and-file for the inevitable political attacks from Republicans. A transcript of the interview, edited for length and clarity, appears below:
Question: After about three weeks of implementation, how do you think the rollout of the Affordable Care Act has gone?
Cartwright: "First off, I think people appreciate honesty, and there are a couple of things we have to surrender, throw up the white flag about. Obviously the Web site -- which I have personally been touting a lot for the last six months -- doesn’t work. That’s an embarrassment. It’s an embarrassment that one of the president’s talking points includes that you won’t have to lose your coverage. When the truth is, there’s an asterisk on that statement, and the asterisk is that normal market forces still apply, and normal insurance policies still apply, and they changed their coverages, so it’s hard to grandfather in a policy that’s going to be changing as part of the normal course anyway.
“So that was unfortunate, maybe a bit of puffing salesmanship so I may get some flack over that. But my approach is going to be this: Look at the big picture, and take the long view. The big picture is this is a wonderful thing for this country, and it’s a wonderful thing for the people in the 17th District of Pennsylvania, because the truth is uninsured care happens, and it’s been happening for a long time.
"I campaigned [last year during his election campaign] on my own experience as a board member of a hospital. Every month we would look at the amount of uninsured care that we were doling out and absorb it. And you can absorb, and absorb, and absorb, until you can’t anymore, and you go out of business. But even before that, you absorb that free care. It eats into your bottom line. It eats into your cash flow, and so you have to cut. As they’re circling the drain, they cut variable expenses, and what’s the biggest variable expense in hospitals? People. Nurses. So that the more we expect hospitals to shoulder this burden of uninsured care, the more the people in the hospitals suffer, and the fewer nurses they can afford to employ, and pretty soon you get to a situation where you have a med surge nurse covering 24 beds. So what happens when two people code at the same time among those 24 beds? You better hope one of them isn’t your aunt."
Question: What’s been the reaction from constituents?
Cartwright: “We get the full spectrum. We get people calling in thanking me for taking a stand for the ACA. Then of course on the other end of the spectrum, we get some of the less-informed folks. There are people who are working double-time to spin the ACA the wrong way. They’re the people who like to tell you about death panels, and they’re the people who like to talk about how you will lose your doctor, and so a lot of what we do on our staff is to dispel misinformation."
Question: How does this frustration and embarrassment with the law and the adverse reaction at home affect your psyche as a Democrat and as an ACA advocate?
Cartwright: “I started off by telling you that I take the big picture. The big picture is that ACA is a great thing, and that in the long run, it’s going to be one of the greatest things. History will smile on the ACA. That’s the long view. I look back at the rollout of the Medicare Part D prescription drug benefit, and there were glitches, and there were headaches and complaints, and people didn’t understand, and you know, my wife’s grandmother was alive at that time, and I couldn’t. She was hardly disappointed in me, because they had to sign up, they had to choose one of four plans at the time. It was difficult to understand, and seniors had a hard time with it. Eight years later, nobody even remembers that. There are growing pains involved in any kind of change."
Question: House Democrats have spent most of this year prepping members like yourself for the law's implementation and new Republican attacks on it. Do you attend these meetings? Are they helpful?
Cartwright. “Yeah, a lot. I go to a lot of caucus meetings. They’ve done a nice job getting folks from all over."
“You asked me about what the Democratic leadership has been doing. They’ve just been doing a phenomenal job of keeping members apprised of the Affordable Care Act and that includes the night [House Minority Whip] Steny Hoyer invited me to dinner with Kathleen Sebelius, and we had about 12 other freshmen Democratic representatives.
"Secretary Sebelius also had dinner with us at the Capitol Grille about three months ago."
Question: What did she tell you?
Cartwright: "She fielded questions. We didn’t really get marching orders. I like her, and I hope she stays around. She’s obviously going through a pretty good maelstrom right now. She’s got some grit, I think she’ll weather it."
Question: What were the closed-door meetings hosted by the House Democratic Caucus like?
Cartwright: “Informative. I can’t comment on what other people were feeling or what their motivations were, but I found them to be helpful, to be informative. Several times we had folks from the White House over helping explain things. But frankly, look, I am one of 50 Democratic freshmen in the U.S. House of Representatives. If you think any of us got elected not in ignorance of what’s in the ACA, that would be incorrect. Speaking for myself, I was a defender of the ACA in my election campaign. I have candidly said from day one, as a politician that I fully expect there to be plenty of kinks in that law that probably during the balance of my political career we will be sorting out."