Direct Supply
Milwaukee, Wisconsin

THE VICE PRESIDENT:  Well, first and foremost, would you join me again in thanking our host Bob Hillis and Direct Supply for having this conversation and hosting us today?  (Applause.) 
 
Thank you very much.  It is an honor to be with you.  Great to be back in Wisconsin.  And quite honestly with all of my Hoosier biases notwithstanding, I will just tell you, you have like one of the greatest governors in the history of this country in Scott Walker.  I truly believe it.  (Applause.)  I truly believe it.
 
If we weren’t such good friends, I would still say that.  And, Governor, I’m grateful for your leadership on healthcare.  And in so many areas, Wisconsin really sets the pace for the country.  And I’m grateful that you would take time to be with us today.
 
Thank you all for taking time on a beautiful Saturday afternoon to come in.  I’m also very appreciative of being joined by two members of Congress.  Representative Jim Sensenbrenner I had the privilege of serving with for 12 years, one of the great, great conservative voices on Capitol Hill.  (Applause.)  And Representative Glenn Grothman, who is a great, great friend and a great champion for Wisconsin in Washington, D.C.  Glenn, good to see you.
 
I’m here today really to listen more than to talk, and we’re grateful for members of the media to be here to have the opportunity to hear from all of you.  They’ll hear from all of you.  They’ll hear from us in a little bit as we make some formal remarks later. 
 
But as I’ve traveled the country on behalf of the President talking about healthcare, we’ve been taking the opportunity to listen to families that have been impacted by the failed policies of Obamacare.  But the business leaders gathered around this table have your own story to tell.  I’ve heard it around the country. 
 
And here in Wisconsin, I don’t really need to tell you about the failure that is Obamacare.  In Wisconsin, we’ve been in a recent study — issued by the administration, we’ve seen that premiums in this state have nearly doubled since 2013. 
 
Everybody remembers when Obamacare was passed that we heard if you like your doctor, you can keep it.  If you like your health insurance, you can keep it.  And, Jim, you remember those promises.  Chief among them was that the cost of health insurance would go down.  Every single one of those promises have been broken.  And here in Wisconsin, a 93 percent increase in premiums.
 
And in some states around the country it’s been twice that.  It really is extraordinary.  President Obama actually promised that you’d save up to $2,500 in annual premiums.  The average cost of premiums now is $3,000 or more for families in this state.  Insurance providers are pulling out of Obamacare left and right.  One-third of the counties in this country have only one insurer available for purchase in the individual market.  And next year tens of thousands of Americans will have no Obamacare coverage available at all.
 
So we’ll talk about solutions here in a little bit.  But I’m very anxious with members of the media and others gathered listening on, I’d like to have you slip your hand in the air and answer the question:  How has Obamacare impacted you, your business, your employees?  And if you can share a couple of minutes, I’d really, really be grateful to hear from you.
 
Also just share with who you are and your business.  And the first person ready to talk.  Mary, you ready to go?
 
A PARTICIPANT:  I’m ready.  I’m Mary Springer (ph).  My brother and I, Steve Wyberg (ph) — we own and operate a business in Waukesha called Thermtec (ph).  We currently employ 117 people.  A few years ago we were up to about 165.  Some of that is due to this — the general downturn of the economy, and some of it is partially due to healthcare and us not wanting to expand our payroll because we can’t afford to expand our payroll.
 
Our health insurance costs per employee have gone up 100 percent —
 
THE VICE PRESIDENT:  Since Obamacare?
 
A PARTICIPANT:  Correct, since 2013.  So we’re typical I think of many employers.  We have opportunity to expand, but finding good people and wanting to insure them makes us pause.
 
One thing on our minds about the cost of insurance is how is the government — if they’re going to continue to be involved in insuring, how do we do that when only 50 percent of us pay taxes?  How is that ever going to work?  Because the pool of money coming in is just never going to be great enough to support the ever-expanding cost of healthcare. 
 
And furthermore, the Republican Party — I know Obama promised to have costs go down.  That’s totally unrealistic given the advances made in medicine today.  We have an employee who was getting a treatment for Hep C that costs $22,000 per dose.  And you needed six doses in order to be cured.  So those are wonderful advances, and everybody wants to take advantage of them.  But when we only have half of the country paying anything into the tax system, and costs go up like they do, how are we going to guarantee — as the Republican Party to say they can lower the cost.  I think we have to be cautious and maybe say, we can reduce the amount of the increase.  When we’re getting double-digit increases every year, maybe the wiser strategy would say, let’s bring it down to single-digit increases.  
 
But if we say there won’t be increases, we’re going to lose.
 
THE VICE PRESIDENT:  Thank you, so much, Mary.
 
A PARTICIPANT:  Hi, my name is Sri Vasudevan.  I’m chairman of the Republican Party of Ozaukee County.  But I’m a physician by background.  And for 40 years I’ve practiced in rehabilitation medicine and mostly taking care of people with pains.  So my practice was pain rehabilitation.  And I ran multi-discipline pain programs at four different facilities, including a medical college and for the communities here.
 
The way it directly affected me, if you mean, is that the benefits have substantially decreased.  Even though more people got insurance, they got insurance for going to emergency room visits.  But for taking care of issues like chronic pain, which requires physical therapy, psychological treatment, and some medications, which are excellent for it, those are not covered by most insurance companies.  And especially Obamacare did not cover that.  And so people then resorted to opioids.  
 
That led to many of the opioid problems, which I identified.  I wrote about it in 2010 before the so-called crisis began.  And it continues to be such a problem.  The last three years of my practice, basically I couldn’t see anyone who needed to be seen.  They needed a program.  But we hook or crook, we tried to find a little bit of care for them, eventually forcing me to retire last year after 40 years.
 
So if you come up with a new plan, I may go back into practice again.  But for now, I’m serving the Governor.  And I served on the medical examining board, on his appointment, and on the injured patient compensation board, which I serve right now.
 
But most importantly, the second thing I want to point out is our Governor has been very good in creating Medicaid for all and not taking the Obamacare — and it still worked.  And it’s not helped the pain field, but people with chronic pain don’t get the care and services they should.  And in my opinion, that is so important if you want to ever decrease the opioid crisis in this country.  
 
And I thank you very much.
 
THE VICE PRESIDENT:  Doctor, thank you.  And I just really appreciate the Governor’s focus and your focus —
 
A PARTICIPANT:  Thank you very much.
 
THE VICE PRESIDENT:  — on the opioid crisis in Wisconsin which is impacting families across.
 
A PARTICIPANT:  Yes, Chris Hanson (ph).  I’m a small-business owner in the Fox Cities and Appleton, and I am involved in health insurance.  I actually work in three different markets.  I work in small business — so I have over 100 small-business clients.  So I’m kind of your boots on the, per se.  I am in the weeds.  I live there.  
 
I also deal in the individual market, the under 65.  So I’m certified on the marketplace, and I deal with Medicare.
 
So what I’ve seen — I also, as a little background beyond that is I worked in healthcare delivery for most my career before that.  So I have seen two sides — both the delivery and the health insurance. 
 
Health insurance is very different than healthcare delivery.  Healthcare delivery is on the forefront, health insurance is always behind trying to catch up on how do we cover those services.  So they’re always far behind in that.
 
I also sat on the HIRSP board when it was here in Wisconsin, and we had a — the high-risk pool.   We had a very good program.  We could be the poster child for the rest of the United States when it comes to how can you take what the federal government is doing today, bring it back to the states.  It ran very, very efficiently here.
 
THE VICE PRESIDENT:  And that was done away with?
 
A PARTICIPANT:  Yes, in 2014, that expired when Obamacare came into business.
 
What I see — a couple of things that have impacted small business is those employers that have less than 50 employees, when this came into an action in 2014, they all — and there might be some that say yes — we’re not going to expand.  We’re not going to get over 50 employees, then we don’t have to offer health insurance.
 
THE VICE PRESIDENT:  How many people have heard that?
 
A PARTICIPANT:  Everyone.  So where was the incentive to expand, grow businesses?  I don’t want to offer benefits.  I don’t want to be forced to, therefore I won’t.
 
And even those in companies over 50 employees, when they really looked pay-or-play — pay the penalty or actually offer benefits, cheaper to just pay the penalty.  So again, you’ve dis-incentivized business for expansion.  
 
Also when it comes to small business, 75 percent — I noticed in my own block of businesses I work with, and it’s been confirmed by the commissioner’s office in Wisconsin that 75 percent of all small businesses that have health insurance are still pre-ACA, pre-the Affordable Care Act, meaning at the 11th hour, if you like your plan, you can keep it.  Yes, they did.  All the insurance companies said, well, we will transition you.  We will grandfather you in so that they were able to keep their pre-ACA plans.  If those small businesses are forced — and at least at this point, transitional relief goes to the end of 2018, if that continues indefinitely that would be good for small business because otherwise, if they are forced to be rolling into the Affordable Care Act, their premium increases will be anywhere from 20 percent to 40 percent, if not more.
 
So that’s what I see in the small business.
 
THE VICE PRESIDENT:  Thank you so much — the impact of Obamacare — your business.
 
A PARTICIPANT:  For me, I’m a financial planner, and I work with a lot of people.  Personally on my own, my premiums have gone up over 80 percent — 48 percent last year. 
 
THE VICE PRESIDENT:  Since 2013?
 
A PARTICIPANT:  Since 2014.  I got cancelled midway.  The amount of my deductible went from $2,700 to — we both pay $6,500 apiece.  
 
THE VICE PRESIDENT:  Deductible?
 
A PARTICIPANT:  Just the deductible.  And right now here if I break a leg, I have no coverage.  I can only get coverage in my little HMO market up there.  I can’t go see my son without worrying that if I get hurt, I have to fly back with a broken arm or broken leg if I’m helping him on something. 
 
Just there’s no coverage for us.  We have to stay in our little corner of the world to be covered.
 
I work with a lot of people who are looking at retiring.  The very first thing I ask — and they want to retire before 65 — is have you looked into your health insurance?  Do you understand what the premiums are?  Most of them have had group insurance through their employer.  The second they see what the premiums are, I have them go on the website to figure it out, they’re like, we can’t retire.  They just cannot.  There’s no way to pay for it.
 
It’s either they have enough money that they can pay for it, or they’re so — they don’t have enough, and we try to use games to make their income low, so they can get subsidized.  And they have to stay that way until they’re 65.  It’s really, really tough for them to retire these days. 
 
A lot of them are just deciding that they have to work longer.
 
A PARTICIPANT:  And our premiums since 2013 — well, beginning of ’14, our premiums have went up — how much, just for the two of us?  You have the number.
 
A PARTICIPANT:  I said it was 80 percent.  We paid a little less than $10,000 for the two of us, and that included our HSA contribution.  Now with our HSA contribution, we’re going to spend $21,000 this year. 
 
An associate of mine, he was going to retire at 61 — 
 
THE VICE PRESIDENT:  And that’s a direct result of Obamacare?
 
A PARTICIPANT:  Oh, 100 percent, 100 percent. 
 
And he was going to retire at 61, but his premiums came in with his HSA contribution at $29,000.  He is now going to have to work until 65.  His wife had quit her job at the hospital, and she had had the health benefits all along.  They can’t retire.   So they have to continue working.
 
THE VICE PRESIDENT:  And you’re talking about your premiums — and I share this with people that are looking on — your premiums went from $10,000 to $21,000, right?  And yet not only did that double your cost, but your deductible went from $2,700 to $6,500 — each.
 
A PARTICIPANT:  Each.  
 
THE VICE PRESIDENT:  This is the story you hear about Obamacare everywhere across the country is that premiums have doubled, in some cases in some states have gone up by 200 percent.  And at the same time the coverage that you have to pay that exorbitant price for now has such a high deductible that it’s essentially impractical for people to take advantage — making a choice that you said they’re making simply to opt out of the system and pay the fine (inaudible). 
 
A PARTICIPANT:  Well, thank you very much for having me.  It’s an honor to be here.  Governor Walker toured Monarch (ph), a few years back, and we had the honor of having him there.  So thank you very much for touring us.
 
I’m currently president of Ector Technologies (ph), which is just down the road.  But my experience with Obamacare started at Monarch Corporation, which I ran for 15 years, so I saw the transition pre-Obamacare or pre-ACA and heading into ACA.
 
And our rates actually went up over 80 percent, and it wasn’t 100 percent only because we moved carriers in order to keep those costs down.
 
THE VICE PRESIDENT:  Just to stay on our language here.  The premiums went up — 
 
A PARTICIPANT:  Well, our premiums for our employees, we were between 50 to 100 employees — went up 80 percent between 2013 and 2016.
 
Now the reason it didn’t double is because we changed providers in there several times in order to keep the cost down.  But we also had to go from plans that were $2,500 deductible to $7,500 deductible plans.
 
Now, keep in mind we were tied to mining at that time, so we couldn’t give guys raises.  We couldn’t give individuals bonuses.  And I wasn’t raising or bonusing myself either.  But to have their rates go up like that, and then to have the deductibles go up by triple, they can’t afford it.  They just literally can’t afford it.  
 
So we literally had guys opting out of insurance altogether because it didn’t make sense to them.
 
THE VICE PRESIDENT:  Well, I want to be sensitive to everybody’s time.  Bob?  
 
A PARTICIPANT:  Well, I want to talk about the other side of the coin, which is the America Health Care Act that just passed the House.
 
Direct Supply serves over 3 million seniors and 1 million of those are on Medicaid.  And the American Health Care Act did an excellent job of taking care of the disabled and the elderly that are an average age of 87 years old who have nowhere else to turn.  And I want to congratulate Governor Walker and Speaker Ryan and your, Mr. Vice President, on the fact that you helped defend the people who really need help most of all under Medicaid.  
 
And the American Health Care Act preserves that, and it’s very important to our company and our partners.  
 
THE VICE PRESIDENT:  Thank you.  Well, let me just say to the others who are here, I know I can speak for the Governor and I can speak for the two congressmen who are here that just very grateful for your testimonials about this.  They were powerful and eloquent, and I think are going to be very helpful.
 
Thank you also for — and I want to give a lion’s share of credit to Wisconsin’s Paul Ryan and to these great congressmen that the no good deed goes unpunished in Washington, D.C.  (Laughter.)  But I think as time goes on — and I thought, Mary, this was reflected as you look at what Speaker Ryan and these legislators moved out of the House, it was precisely a stair-step approach.  And it represents I think meaningful progress in rescuing the country from Obamacare and heading us on a path of being able to tackle exactly those issues that the both of you raise, and all of you did.
 
But, Bob, thank you.  So thank you for that shout out.
 
END