Cramercare would look like what North Dakotans want, Congressman Kevin Cramer said Thursday, and would be the health care they’d have today, but for one vote in the Senate.
“It would look like Graham-Cassidy, which failed in the Senate by one vote last year,” Cramer suggested.
The bill he’s actually referring to was the skinny repeal of Obamacare. Graham Cassidy was never brought to an actual vote.
The late Sen. John McCain was in the spotlight for the skinny repeal, giving it a thumbs down on national television. But incumbent Sen. Heidi Heitkamp also voted “no” on the legislation, Cramer pointed out, and was a “no” on Graham-Cassidy, too.
He, himself, would have been a “yes,” and that’s why voters must choose him over Heitkamp for the Senate, he said. It’s also among reasons he decided to run for the Senate after all, leaving his House seat up for grabs.
Health care has become a focal point in the tight Senate campaign between Cramer and Heitkamp, with dueling claims by the candidates.
Cramer said Graham-Cassidy would put $700 million more health care dollars into North Dakota’s health care budget, based on figures from the Department of Health and Human Services.
Other reports, however, show Graham-Cassidy would be a net loss for several states, including North Dakota, once t federal funds provided to states for Medicaid expansion are included. An estimate published by Politico, prepared by Avalere Health, showed North Dakota losing up to $10 billion in funding from 2020 to 2026.
Cramer said Graham-Cassidy maintains protections for pre-existing conditions. The bill does require states to outline how they will maintain access to adequate and affordable insurance for those with pre-existing conditions.
But the bill also lets states get waivers to price premiums based on an individual’s health care status. That’s similar to the situation prior to the ACA, when premiums for those with pre-existing conditions were too expensive for most.
States would still have to provide essential health care under Lindsey Graham, such as coverage for cancer, maternity care and pediatrics, Cramer said. Both the ACA and Lindsey-Graham allowed waivers for these, but the ACA has stricter controls on actually getting them.
Another goal of Cramercare would be to return an incentive for the young and healthy to buy insurance.
“If you are 28, healthy as a horse, and the only thing to fear is an accident, but you can buy insurance after the accident at the same price as before, what is the incentive to buy insurance?” Cramer asked.
A dramatic jump in premiums under Obamacare was also another big disincentive, Cramer said.
“I know people whose insurance went from $400 a month to $1,500 a month with a $10,000 deductible,” Cramer said.
That individual has diabetes, Cramer added, and isn’t getting the medical care he needs now because his premium is too expensive, and said that the story is all too common.
“We’ve got to figure this out, and it’s not complicated,” he said. “We have to provide the money to the states, with more flexibility. The one (North Dakota) Senator who doesn’t agree is Heidi. Of course, she is smarter than all of us.”
Cramer has been critical of Heitkamp’s vote against Kavanaugh, as well as a recent ad featuring sexual assault victims. The Heitkamp ad criticized comments Cramer made about the Kavanaugh confirmation, but it turned out that some hadn’t agreed to appear in the ad.
“Here’s why I think she did that,” Cramer said. “She made a mistake, but I don’t think she did it accidentally. They miscalculated how the vast majority of people in North Dakota think and feel about things. They presume by talking to the same four people at a cocktail party that every woman wants to be part of this.”
Cramer said it’s time to stop lumping people into one big category. That’s his real issue with things like the #MeToo movement, which he has previously said makes women weak.
“I don’t like true victimhood being diminished by a mass movement that says women are all victims and men are all bad,” Cramer said. “They go too far, and the Kavanaugh fiasco was the greatest example of it yet.”
Real victims should be encouraged to come forward, Cramer said, but not on a national stage.
“No one should have to endure that,” he said. “Go to a pastor, a loved one, a police officer. These are the institutions that we have to deal with that, which are more open to and believing of people who have had something bad happen to them.”
He did not believe Kavanaugh’s accuser, he added, but pointed out that she’d asked for anonymity. Her name was leaked to the press, resulting in a very public dissection of her allegations.
What Cramer most wants is for women who have been victimized to be able to get help immediately. Among the first debates on the floor of the House of Representatives was the Violence against Women Act, which he voted for.
“Only 80 Republicans voted for it,” he said. “So it’s not like I don’t have a strong record on these issues.”
During his House tenure, most of Cramer’s efforts have centered around agriculture, he said. Among the top items is an amendment to the 2014 Farm bill limiting NRCS to 1 acre of mitigation for 1 acre of wetland.
“They had a grossly unfair formula,” Cramer said. “If a farmer wanted to drain a wetland they’d give it a value so a farmer would oftentimes have to give back five acres for one acre.”
Another bill allowed North Dakota to pilot a program consolidating permitting of various agencies under one roof.
“The way we were able to get Democrats on board — in fact they all voted for it — was by showing how we could condense the time frame and use the synergy of all the agencies together to provide greater oversight,” he said. “It was a classic win-win situation.”
He’s also proud of moving up political ranks quickly in the House, getting an assignment to the House Steering Committee. All the members have to go through that committee for their appointments.
“My position on that committee brings every member to me on a regular basis because I have something they want,” Cramer said. “It’s sort of a classic power politics, if you will, but to me that was a pretty major accomplishment.”
He’s also on the House Committee on Energy and Commerce.
From a political family
Cramer’s interest in politics began early. He remembers liking President Richard Nixon when he was a kid in grade school, as he’s the first president Cramer can remember. His mother, meanwhile, was a city commissioner in Kindred, where Cramer was born and raised, and his dad was a union steward at a rural electric cooperative.
“So at a very local level, I was exposed to this activism and liked it,” he said.
After college, he worked for the Scott Holby campaign for tax commissioner against Kent Conrad in 1984 and for Mark Andrews in 1985. He eventually became executive director and then chairman of the state Republican Party, though at that time, the party had been decimated.
“It didn’t seem that we could ever find our way back,” Cramer recalled. “It’s a constant reminder to me that none of us are entitled to these jobs.”
Goals in the Senate
His first aim, if elected Senator, are committee assignments that are relevant to North Dakota and complementary to Sen. John Hoeven’s. Cramer would like to get assigned to Environment and Public Works.
“When we take those two together, you have all the major environmental policies running through those committees,” he said.
Another goal, Cramer said, is getting the Senate back to work.
“I know that sounds like a grandiose sort of goal,” he said. “But I think we are close to getting that done.”
The game plan would be to join others in attacking “archaic rules” that have become a roadblock.
“I don’t mean blowing it all up with a hand grenade,” Cramer added. “But artfully and systematically, reviewing all the rules to see if there’s a way to restore majority rule of the Senate, rather than this crazy 60-vote rule.”
The filibuster is another “concoction,” he said, adding he doesn’t know who came up with it.
“It’s supposed to mean something, but it doesn’t now,” he said. “It’s just a tool for obstruction.”
These changes shouldn’t necessarily apply to everything, Cramer added. Appropriations is a good place to start.
He also wants to get closer to a balanced budget. “But, in the process, maintaining our highest priority,” Cramer added. “Making sure our military is as strong as it can be. We neglected it too long during the Obama years.”
Cramer’s approach would not focus on cuts, but “adjustments.”
While mandatory spending is the biggest driver, Cramer said that doesn’t necessarily mean cuts to Medicare and Social Security. He wants to deal with the revenue side, by lifting things like the cap on income and doing a little means testing for Medicare.
“I think we could ask people who are making a million or more a year to pay a little more,” he said.
Cramer added that he’s never said anything about slashing Social Security or Medicare.
“But in eight years, Medicare is insolvent,” he said. Small fixes today could change the picture dramatically.
“If you raise the $130,000 cap (on social security) now, it aggregates and compounds over the next 15 years,” Cramer said. “It’s a much smaller fix than if you wait.”
Farm Bill is better done right, than quickly
While it may have been disappointing the Farm Bill wasn’t done on time, Cramer said most programs do continue through the crop year, and it’s better to get the bill right than done quickly.
Cramer believes the new Farm Bill is going to include a provision allowing farmers to choose their safety net annually, rather than for a five-year period.
Cramer blamed Debbie Stabenow from Michigan for the Farm Bill’s lack of progress. She wants to cut the commodity title in favor of things like rooftop gardens in urban areas and other “crazy” stuff, he said.
“I don’t want to be hyper-critical either,” Cramer added. “I do believe that some progress is being made on several of these titles to get an agreement on them and come back.”
As far as base acres in North Dakota being directed to cotton growers in Texas, that’s not as bad as it sounds Cramer said.
“The base that would be taken wouldn’t be crop acres,” he said. “It’s not corn or anything grown in the last 10 years.”
That could strong advocates in Texas, who otherwise don’t necessarily like Farm Bills, Cramer said. But they could be convinced to like them if there’s something in it for constituents.
NAFTA 2.0 is a tremendous win, Cramer added. Not just for the elimination of grain grading and dairy issues, but also the reconciliation of phyto-sanitary standards with Mexico and Canada.
Republicans clear pick for energy
On energy, Cramer suggested Trump’s record and the Republican record is the clear winner.
“The greatest gift Donald Trump has given the American Energy sector is his commitment to energy dominance,” Cramer said. “He’s done a lot by rolling back many regulations that were barriers in cost. We just need to continue that while coming up with much more appropriate and efficient environmental protections. The biggest way to do that is by recognizing the state’s sovereignty and the state’s primary in environmental protections.”
Cramer said the changes have already made the country energy independent and secure.
“We can be energy dominant,” Cramer said. “We just need to get better at pipelines, export terminals and railroad terminals, shipping lanes and the things that provide us opportunities to sell our products to people around the world.”