Community Health Leader Weighs In On National Health Reform Debate: An Interview

Jul 26, 2017



After failing to pass a full repeal of the Affordable Care Act, Republican leaders are working to garner support for a more scaled down version dubbed the 'skinny repeal.' 

That option could mean slashing key elements of the Affordable Care Act like the individual and large employer mandates and abolishing a tax on medical devices. 


Chuck Duarte is the CEO of Reno-based Community Health Alliance. It’s the largest primary health care provider to low-income individuals in Northern Nevada. Prior to that, he served as the Nevada Medicaid administrator for a dozen years.


Duarte is concerned that rolling back the individual mandate could destabilize the insurance market. “It would allow people to not have to buy insurance," Duarte explains. "Not having to buy insurance, a lot of healthy people are going to make the decision not to buy insurance and that will leave sick people to make the decision as to whether or not they need to buy it.” Duarte says insurance premiums could skyrocket with fewer people in the risk pool to help offset the overall cost of healthcare.


Senator Dean Heller voted against a full repeal on Wednesday, but in comments to POLITICO, he said he’s thinking of supporting the skinny repeal. 


Democratic leaders are skeptical of the scaled down version and are concerned that if it passes, it could open up the door to more extensive changes later on as the legislation moves to a committee conference including members from the Senate and House of Representatives.



Duarte says amendments to a skinny repeal could make even more drastic cuts to healthcare than the provisions in the Senate Republican health bill that failed to get enough support.


“The big thing that people are concerned about is if a [skinny repeal] bill gets passed in the senate and goes to conference committee with the house, it would then have to force compromising between the Senate and the House. A compromise between those two chambers is going to result in something that’s worse than the senate version and leave millions more out.”


On Wednesday afternoon, Governor Brian Sandoval joined a bipartisan group of governors urging the GOP to reject the skinny repeal.