Congressman Frank Guinta is running for re-election to New Hampshire’s first district, but he faces a tough primary fight with defense industry executive Republican Rich Ashooh. Guinta spoke with NHPR’s All Things Considered host Peter Biello about his policy ideas.
Let’s start with the state’s opioid crisis. More than four hundred overdose deaths in New Hampshire last year. That number may exceed 500 this year. What would you do to reverse this trend?
Well, I’m serving as the chairman of the Congressional Task Force to Combat Heroin and Opioid Use. It’s a bipartisan task force. I named [New Hampshire Democrat] Anne Kuster my co-chair. I thought it was important for us to work collaboratively to find solutions at every level. We’ve got 80 members of Congress who are on the committee.
We were very pleased to have hearings in New Hampshire as well as Washington D.C. We learned a lot about this crisis nationwide and we were able to spearhead through the committee process the CARA legislation that we passed and thankfully the President signed into law earlier this summer.
[CARA] does several things. It provides more treatment and recovery services. Secondly it provides educational dollars so we can communicate to the youth of New Hampshire the significant problems with opioids and heroin. Third it focuses money on veterans who are in pain management clinics. Fourth, it provides resources for women who happen to be pregnant and have the illness of addiction.
This is a very strong first step. It’s $192 million per year for the next five years. I’d like to see that utilized in a way where we can expand drug courts in the state of New Hampshire, try to get somebody from the illness of addiction into a long term treatment facility so we can provide them a second opportunity at life.
So I’m looking forward to the implementation of that legislation. And then we’ll assess what additional requirements we will need here in the state of New Hampshire.
So if I’m hearing you correctly, you’re saying the specific things you’d do would be to use CARA funding to expand drug courts and increase options for long term treatment?
Yeah, I think the two primary needs are expanding treatment alternatives, making sure we have enough beds in the state, getting people through the drug court process and into long term recovery. That has the highest likelihood of success for somebody who has the illness of addiction.
Moving on to a different subject: what would you do, if anything, about the national debt?
The national debt is at $19 trillion. It’s a significant problem and it’s growing. We have to, in my view, reform the budget process. It hasn’t been updated since 1974. We have to have a balanced budget, an annual balanced budget. Right now it’s about $430 billion out of balance. We’ve got to be able to balance the budget first and then, with I think a reform of the tax code and a reduction of the $2 trillion regulations that impact the nation and having pro-growth public policy initiatives that will move GDP into the four to five percent growth, then we can start to pay down that long term debt. Those are the steps that need to be taken immediately.
You mentioned tax reform. What specifically would you do to reform the tax code?
There’s been a great bipartisan discussion of the need for an overhaul of the corporate tax rate. We’re now seeing both sides of the aisle, Republican and Democrat, agreeing that the 35 percent rate at the corporate level is just not competitive internationally.
We have among the highest corporate tax rate around the world and we’re losing companies to Europe and other parts of the world. So to be more competitive, we’ve got to reduce it. I would think somewhere around 15 percent would make us much more competitive. That way we would encourage businesses not to leave the country but to stay here in the US and reinvest their profits, both in their R&D and employment growth, and obviously that would be an increased revenue source to the treasury and we could utilize that money as well—not just to balance the budget but reduce the long term debt that we have.
What about tax reforms for individuals?
I do think we need to simplify the tax code right now. Currently there are seven rates. I’d like to see that dramatically reduced. There’s a lot of discussion about one single rate. I think the likely outcome of tax reform is going to be somewhere in the neighborhood of three to four rates, but they would be significantly reduced, so hard-working families can keep more of their resources.
That means we’ve got to get more efficient with the tax dollars that are spent in Washington. One of the frustrations I have is that the GAO reports show significant waste, fraud, [and] abuse in all aspects of the agencies. I mean, the most I think frustrating one to people is the $140 million dollars in bonuses that was provided by the VA when those resources could have been better utilized for direct and high-quality care for our veterans around the country.
I’m glad you mentioned that because I spoke with your opponent in the race, Rich Ashooh, about this very legislation and he actually thought that good work should be rewarded when it is good work. Is that something you agree with?
Well, I think for federal employees it’s important that we have proper pay scales but to just provide bonus money to individuals for doing their job I don’t think is the right way to go.
A lot of that money was utilized for things like moving expenses. I don’t know if you recall the story of the person who moved to Philadelphia. There was $200,000 provided for relocation services. That’s not what I think is a good and effective use of taxpayer money.
Look, we’ve got to make priorities in the budget. We’ve got to make choices. We want to hire the best people capable of doing an exceptional job for our veterans, but I just don’t believe that $140 million in bonus and other money was the most effective way to use those resources.
While we’re talking about veterans’ issues, let’s talk about the Veterans Choice program, which allows veterans to get care at civilian hospitals in the community. If you are re-elected, what would you do to reform and fix the Veterans Choice program.
I was very pleased that the Veterans Choice card was passed and signed into law by the President, and then several months later, in the next budget, he zeroed out the program. I was very disappointed with that, so I worked with Anne Kuster in creating legislation that not just fully funded the Veterans Choice card but also made it permanent. So we’re working on that piece of legislation, we’ve got it funded currently.
But there are problems with the administrative aspect of the Choice card. I hear this from veterans in New Hampshire as well as employees of the VA. So we’re working with the VA here in New Hampshire to address the backlog, to ensure that additional providers are added to the Choice card so veterans can truly utilize physicians and medical facilities in their communities. I think that that makes sense. I think it’s far more effective than sending a New Hampshire veteran to either Vermont or Massachusetts for care.
Beyond that, I just don’t feel that veterans should have to beg for the benefits that they’ve earned. High-quality health care for our veterans should be a top priority of this nation. We’re talking with people who defended our freedom and liberty and are willing to put their life on the line. So it’s an area where I think there’s widespread agreement that the Veterans Choice card has to be better administered and has to provide better access to our veterans.
One of the administrative issues with the Veterans Choice program is that the third party contractors—HealthNet on this coast—have been really slow in paying their civilian doctors, and that’s caused some doctors to actually re-think whether they want to accept Veterans Choice patients. That has to do with the administration of the program, which you mentioned needs to be reformed. What specifically would you do to reform the procedures that the VA uses when administering Veterans Choice?
Well, the VA has got to get much better in how they administer the program. I’ve heard the same concerns that you just expressed and, you know, first, I think if you audit the program, put goals and objectives and metrics into the program to make sure they’re meeting their weekly goals and far greater oversight, that’s supposed to be done by the VA. You know, I would expect the VA to complete that.
I am working with the VA in Manchester on a regular basis to make sure they are doing a better job. But I have heard from medical providers that because their payments are either late or significantly late, it’s sometimes difficult for them to provide this service.
So we’ve got to get a better system in place where they’re paid on time, that the claims are properly administered, and that’s something I think the local VA here in Manchester, New Hampshire is trying to do a better job of.
Productivity of Congress has been lower than what many people would want. If you were re-elected, how would you ensure that more of the legislation you introduce actually gets passed?
Part of that is working with your colleagues on both sides of the aisle to get things accomplished. That’s why I wanted to set a very strong tone regarding the Bipartisan Task Force to Combat Heroin and Opioid Use. We’ve got an equal number of Republicans and Democrats. We work together. We were able to take a bill that started in the Senate three years ago and in less than a year we were able to revive it, get it reviewed by the House members and the Senate members and get it passed and get it signed into law.
In addition to that, there are several other pieces of legislation that I have been able to get signed into law. The Cadillac Tax repeal bill that I filed, something that’s incredibly important to eliminate, it’s a 40 percent tax on healthcare plans. I was able to convince the President of the United States that it was not good public policy. He signed into law a two-year delay.
I was also able to work on behalf of the Portsmouth Naval Shipyard to make sure they weren’t part of the BRAC process. (Base Realignment and Closure.) I think it’s one of the critical shipyards in the country. I think it’s the best one. They typically work rather quickly and under budget. They’re growing at a rapid pace and they have a significant importance to the economy on the Seacoast. We were able to get that signed into law. Protecting our fishermen from over-regulation from the federal level. We were able to work across both sides of the aisle to get legislation passed to support them.
Look, I think it’s important not just how you vote, but getting things accomplished, and we’ve been able to do that in this term.
On Social Security: you said in a debate with NH1 last week that it needs to be preserved and protected. How specifically would you propose to do that?
I support preserving and protecting Social Security. The first thing we need to make sure is that seniors who currently receive Social Security would see no change, and individuals near retirement would see no change. I think it’s important to inform the country that that’s the direction we’d like to go in. But for future beneficiaries that are just entering the workforce, for example, are going to be living longer, working longer than when Social Security was first started. They have more investment vehicles at their disposal than people were able to access fifty years ago. That should be taken into consideration as we modify the program for those future recipients.
If we do that, not only can we save resources now but also in the long term. If we don’t do anything, by 2034, there would be an immediate and across-the-board cut to existing recipients. That’s not something I want to see. I don’t think it’s fair, I don’t think it’s right. This next Congress is going to have to make sure that it tackles this issue with the next President.
You mentioned other investment vehicles, and I want to be clear about what you mean by that. Are you saying that, for those citizens who would be drawing on Social Security in the future, they should prepare now to be able to draw less than what current recipients draw, even when adjusted for inflation, and plan now to take advantage of current investment vehicles, or are you saying that part of Social Security would be privatized in the future?
I’m not talking about privatization. I’m saying there are investment vehicles that people can access today outside of Social Security that were not available to individuals when Social Security first began. As a result of that, I think people are utilizing those private investment opportunities as a main portion of their retirement portfolio. Then anything from Social Security would supplement that.
So you would ask people to depend more on their 401(k) or their Roth IRA?
It also depends on what you’re capable of placing into your own personal retirement. Social Security should remain as a safety net for those who don’t have the long term capability of acquiring the necessary retirement resources. So as we look to the future, we want to make sure that if there is a need for somebody to have Social Security, they’re going to have it.
On the Affordable Care Act, you’ve said it’s important to focus on repeal and you said “a free market approach” would replace it. What would a free market approach in your view look like?
What we have with the Affordable Care Act after five years is a top-down federal government mandated approach. It cost over $1 trillion. The idea at the time, we were told by the President, was to create greater access and greater affordability.
I have talked with Minuteman Health, for example, one of the companies that runs an exchange here in New Hampshire. They just cannot compete. As a result of that, they are increasing their rates this summer by about 40 percent.
What they communicated to me is, unfortunately, for a family of four, that’s about $1,200 a month for someone who is receiving benefits under Obamacare. That’s not what I would consider an affordable plan. So I think the most important thing is to bring—when I say “market-based approach,” you’ve got to have competition in the marketplace.
Look, we’re down to essentially two: Anthem and Cigna. We could be down to one in New Hampshire. That’s not giving any employer or employee choice or competitiveness. I had to deal with this when I was mayor of Manchester and having essentially two choices for carriers was not in the best interest of taxpayers or the employees of the city.
So we want to create an environment where more carriers are going to come into the state and fight for your business, whether you’re an employee or and employer. That requires a very different approach, not a mandated approach from the federal government, but a less restrictive approach.
That requires us to erase those state lines where we can purchase anywhere. That would immediately bring greater options to employers and employees in the state. And I also think that there has to be greater transparency. You should know what the cost is within your plan for a particular medical need that you have, whether it’s a surgery or whether it’s an MRI. You should know what the cost of that is. You should be able to price it and go to the place of your choosing. That transparency we’ve started to implement as mayor of Manchester, and that was able to allow us to reduce the cost to both the employer, the employee and the taxpayer.
If the ACA is reapealed, what would happen to the provision of the law that prevents people from being denied coverage because of pre-existing conditions?
Well, you’d have a bridge to make sure that people would not lose coverage over a period of time, whether it’s a twelve to…to be determined what that time is, but it would be long enough for people to make sure that they can find alternative coverage.
You would see the return of what states had, like New Hampshire, prior to the Affordable Care Act, where there is a risk pool for those who can’t afford insurance and that was available prior to the Affordable Care Act. Unfortunately it no longer is because of the Affordable Care Act.
So you’re saying—I’m not quite clear on this yet—are you saying that people would still be able to get coverage, even if they had a pre-existing condition?
Well, that would be likely designed by the states, but under a high risk pool, that typically is the case, yes.
Because it was not the case before Obamacare, so presumably, that would return to being the case if the Affordable Care Act were repealed.
I think it depends on what states, each state decides. But I think most states would recognize that they would want to provide care to individuals. So we’d have to see what each state would suggest in terms of their particular state plan.
And another provision of the ACA, people under the age of 26 staying on their parents’ plans. Would that also cease to be the case if you repeal the ACA?
Again, that would be up to the states, what states would like, and what kind of alternatives are being presented by carriers. I think the greater level of competition, the greater opportunity and choice that an individual has. I’d like an idea, a scenario where you can pick and choose the kind of plan that fits you personally and your family. And I think that a market-driven approach could provide those options.
Lastly, on the issue of immigration: what do you think should be done with people who are here illegally?
I think it’s important to secure our border. I think if you secure our border, it’s a humane border. Unfortunately, you see young children, families sending their young children across the border without their parents, without any guardianship. I don’t think that’s a way to treat a young child and unfortunately we saw that happen over the last several years.
So I think it’s important that we secure the border, not just to stop illegal immigration, but to ensure that the heroin coming into our country is stopped.
Secondly, I think we’ve got to enforce the existing laws. That’s not happening right now under this attorney general. If someone is overstaying their visa or caught and identified in the commission of a crime and they happen to be someone who is here illegally, then there is a law that should be followed where they are returned to their country of origin. But that’s not occurring at this moment and I think that’s the first step toward stopping future illegal immigration and then to ensure that people here are here legally.
So two separate issues, then, with respect to immigration: the first is border security, the second is dealing with people who are here. The laws on the books say people here illegally need to be deported. Would you step up efforts to deport all those people?
What I would like to see is an enforcement of current law.
Is that what that means? Deporting all those people?
I want to see an enforcement of current law. The attorney general should enforce current law, existing law.
Well, existing law is that if you’re here illegally, if for example you overstay a visa or are caught in the commission of a crime, you would go through the process of being returned to your country of origin.
I would enforce existing law.
On the issue of border security: Donald Trump, the Republican presidential nominee, says he wants to build a wall. Is that something you would support with legislation?
I visited the southern border back in April as the chairman of the Congressional Task Force to Combat Heroin and Opioid Use. There are parts of the wall, the fence, that are 18 feet high with steel structure, video surveillance, sensors in the ground and border agents properly secure that fence. In those areas, the fence is essentially impenetrable.
However, there are, of the 2,000 miles along the border, there are only about 700 of those miles that have a fence. Portions of that area—the fence is barbed wire with two stakes that you can buy at Home Depot. It’s not what I would call a proper security measure. So I think we need to, in the areas that…there are certain areas that you have to build a proper fence. There are certain areas where you can use proper technology. We have to continue to increase the number of border agents to properly secure the border, but I think it’s an important and critical thing to do, not only to ensure that we reduce illegal immigration, but that we stop the heroin from crossing the border, which virtually, 100 percent of that heroin is reaching the streets of New Hampshire.