FAYETTEVILLE, ARKANSAS—Tom Cotton, the Republican candidate for Arkansas’ U.S. Senate seat, has repeatedly denounced the Affordable Care Act as a failure and vowed to help repeal it if elected. But in his second and final debate Tuesday night against Democratic incumbent Mark Pryor, he went further, claiming the high-risk insurance pools that many states ran before Obamacare’s passage were better for people with pre-existing conditions than the current exchanges.
“Many people were happy with their coverage under the high-risk pool, before it was eliminated,” Cotton said. “They should have been allowed to keep that choice.”
Pryor shot back, saying his personal experience proved otherwise. “I am a cancer survivor,” he said. “I have been in the high-risk pool. I have lived there. It is no place for any Arkansan to be. If we go back to the high-risk pool, it’s like throwing sick people to the wolves.”
Many of the high risk pools Cotton praised were known for their sky-high costs, exclusion of many applicants, and strict limits on what care is covered. In Arkansas, out of pocket costs for patients in such pools could be as high as $20,000 and those with pre-existing conditions had an average 6 month waiting period for care.
Americans who could not afford or qualify for the program and lacked an offer of employer-based coverage, were forced to turn to the individual health care market, where they were routinely denied coverage. Common disqualifications included diabetes, hepatitis C, multiple sclerosis, schizophrenia, quadriplegia, Parkinson’s disease and AIDS/HIV or even relatively mild health issues like acne.
As Pryor noted in the debate, before the Affordable Care Act went into effect, “people in Arkansas with pre-existing conditions were routinely denied access to coverage. They were one medical emergency away from bankruptcy. The insurance companies had all the power. I think that it would be a mistake to go back to those days.” He then accused Cotton of having “no answer” for what would happen to such people were the nation to “start over” on health care reform—as Cotton has repeatedly advocated.
During the debate at the University of Arkansas in Fayetteville, the back-and-forth on health care all stemmed from a question about Walmart—the most powerful employer in the state and, arguably, the world—cutting the health insurance of tens of thousands of its part-time workers.
Cotton began by brushing off his opponent’s point that the workers now have the subsidized exchange market to turn to when they lose their employer insurance, an option that did not exist before the Affordable Care Act.
“Those people at Walmart or other companies do not want an option. They want their health insurance,” he said. “They are feeling the pain and stress of losing their insurance and trying to find a better option when they have an exact plan that suited their needs.”
But whether the Walmart plan ever suited the needs of its workers is up for debate. Most plans available to part-time workers at the company were prohibitively expensive and came with high deductibles that would make it difficult to pay for a major illness or surgery. And according to a study by consulting firm PricewaterhouseCoopers earlier this year, the workers will likely be able to find more comprehensive and cheaper plans on the private exchange market. The low wages Walmart pays would almost certainly qualify them for a federal subsidy or Medicaid coverage.
Pryor did say he would make some changes to the Affordable Care Act, such as scrapping its medical device tax. But in a race where he has struggled to counter a barrage of ads tying him to President Obama, Pryor defended the president’s signature law and his vote in its favor.