Mike Levin, a Democrat running for the House, had his first teleconference with voters from his district this week and it seemed clear from the questions that health care may be the crucial issue in the race.

Levin took questions from eight callers Thursday night, and with one exception, all were related to health care, particularly about the potential for single-payer insurance — which Levin supports — and funding for public medical programs.

The questions came after Republicans in the Senate failed to get enough support for their latest effort to repeal the Affordable Care Act, and as Democrats backed a bill that would create a federally-run health care program that would cover all Americans.

In the 49th District, where Levin is running, the candidates are split on party lines on health care. Levin and other Democrats, Doug Applegate and Paul Kerr, all support a government financed, single-payer system, while incumbent Rep. Darrell Issa, R-Vista, does not.


Issa wants to replace the Affordable Care Act with a system that allows people to buy health insurance plans across state lines and allows them to buy the same policies the federal government provides its employees and their families.

Issa, who introduced his plan in a bill, does not explicitly maintain the subsidies that currently defray health insurance premiums by significant amounts for millions of Americans. It also does not explicitly continue the flow of federal cash that has allowed expansion of Medicaid programs in many states, including California.

Premiums to all policy holders would also be the same regardless of age, gender, pre-existing condition or other statuses, Issa has said.

Levin, in the 45-minute teleconference, opened with his support for single-payer health insurance.


“When you think of the 49th District, it’s thought of as a fairly affluent place,” he said. “However, there are also many that are struggling to make ends meet, and they are one health care emergency away from being able to pay their bills.”

His comments, while not only expressing his support for a single-payer system, also lacked older caveats where he called single-payer health care inevitable, but only a long-term goal.

Besides providing universal access to health care, all but 5 percent of households would save money under this type of plan, and government would be able to eliminate overlapping health care program expenses. But there would be a need to adjust marginal tax rates, capital gains taxes, dividends and deductions for the wealthiest Americans and their estates, Levin said.

“I think a lot of times we hear about the costs, but we also need to talk about the savings,” he said.


Among the candidates, Applegate has been the earliest and strongest supporter of a single-payer system in the district, and made the issue a part of his platform when he ran against Issa last year. The ACA helped get more people coverage, but Medicare needs to be expanded to cover everyone, not just people who are 65 or older, he said.

He has also endorsed bills in Sacramento that would create a single-payer system.

“A lot of folks have jumped on the single-payer train, and that’s great, but most are for single-payer in theory, at a later date, somewhere over the rainbow. I’m for Single Payer now,” Applegate said.

Kerr’s backing is the most subdued, and limited to a brief statement on his website.


“We need a solution that will ensure every American has quality, affordable health care. Medicare is a proven, cost-effective solution that has worked well for over 50 years — and it’s time to improve and expand Medicare to cover all Americans,” he said.

In an email he said that healthcare is a basic human right, and resounded how his own family came close to bankruptcy after his mother was diagnosed with a neurodegenerative disease.

While Levin and Applegate have called the Affordable Care Act a success that could still use improvements, Issa has said it’s not working. His assessment, and his vote to repeal former President Barack Obama’s signature piece of domestic policy in May, have helped fuel ongoing protests outside of his district office in Vista.

The 49th District in northern San Diego County and southern Orange County is one of the most watched races in the country. Last year Applegate lost to Issa by 1,621 votes, the tightest margin of any federal race.


Twitter: @jptstewart


joshua.stewart@sduniontribune.com

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