WASHINGTON — In a delegation packed with chairmen and some of the most bombastic members of Congress, one of the quieter Texas members this week took on one of the most daunting tasks ahead for House Republicans.
U.S. Rep. Michael Burgess, a Lewisville Republican, led his first hearings this week to unwind the Affordable Care Act, the Democrats' 2010 health care overhaul. But in an interview with the Tribune on Wednesday, Burgess suggested his aim was not so much to unwind the landmark bill but "to fix" the overall health care system.
The eight-term congressman is at this nexus of health care policy as chairman of the House Energy and Commerce Subcommittee on Health, a slot he earned through seniority and years of plugging away as one of dozens of members of Energy and Commerce.
Burgess also brings to the issue a unique background: He is the longest-serving doctor in Congress.
"Well, it’s what I asked for," he said regarding his centrality to the health care debate. "And in some ways, it’s what I asked for when I got here. It took me awhile to get here, as the chairman of the subcommittee on health."
"But when I just look at all of the things that have come together on this: the Affordable Care Act now being in the spotlight, long-recognized problems with our public health systems, this is where I need to be."
Burgess' reputation on Capitol Hill is that of an intense conservative, and in this new role, he is bursting with ideas on how to improve the country's unwieldy health care system. But as optimistic as he is, there is no clear Republican replacement plan. Issues like whether Obamacare's ban on insurance companies denying coverage to those with pre-existing conditions will survive under a Republican overhaul are the focus of intense interest. It will be Burgess sorting through much of that puzzle.
"My role is to get the policy in the best possible shape, where members can support it, where members can discuss it and where members can win arguments about it," he explained.
The congressman shied away from a suggestion that he will be the quarterback of the overhaul, pointing instead to House leadership.
“Nooooo ..." he said thoughtfully. "Waterboy?”
“More of an educator than a quarterback, let me put it that way, as far as educating subcommittee members, full committee members, House members and ultimately senators on what the right approach is."
While some members of Congress are politically wired, Burgess is a policy wonk who delights in the weeds of health care. As the ACA was implemented, Burgess enrolled himself in what he called the "unsubsidized bronze plan in the federal fallback exchange" rather than the plan most other members of Congress purchase.
"I think it was important for me as a member of Congress to go through what everyone else back home was going through," he said.
Burgess is a fan of health savings accounts, arguing they are a potential solution for younger people on catastrophic plans to tackle high deductibles.
“As long as you have the ability to buy that lower-cost, high-deductible plan, if you’re disciplined enough to put some of that money into a health savings account, then over time you’re actually going to grow that health care nest egg where you do have the ability to withstand some serious blows to health care and cover the spending that’s going to be required," he said.
He conceded the idea would not solve all the problems in the system.
"I recognize it's not for everybody," he said. "There are people that can’t or shouldn’t be in a health savings account environment, but why restrict it for the people who should be?"
Harkening back to his obstetrician background, Burgess frequently mentioned the bureaucratic burden on both patients and doctors.
"From the patient side, I've got to get something that is the least disruptive to people and the least disruptive to their lives," he said. "I want what we do to be helpful to patients across the board, so I have that role also."
That background is not lost on one fellow Texan, U.S. Rep. Gene Green, who is Burgess' Democratic counterpart at the subcommittee as its ranking member.
"I’ve worked with a lot of legislative doctors, and every doctor just wants to treat their patients, and I want them to be able to do that," Green said.
Green, a Houstonian, is as liberal as Burgess is conservative, but they share a passion for policy and frequently speak in esoteric policy jargon. Both men describe a friendly relationship.
"I’ve always found Gene Green to be someone who I can talk to, I might not always win the argument with him, but we understand where each other are coming from," Burgess said.
“We talk all the time,” Green concurred. “We know there are things we know we don't agree to."
But the two men are legislative adversaries on a controversial issue in the context of a Capitol that seems lately to be boiling over hourly with partisan rage. Green and fellow Democrats can be expected to fiercely fight to hold together as much of the Affordable Care Act as possible.
"I’ll work with them, but we’re not going to abolish ..." Green said, interrupting himself. "Access is the whole thing."
Yet access is also a sticking point for Burgess.
"I lost my individual policy with the health savings account because of the Affordable Care Act," he said. "The president told me I had junk insurance, and I couldn't have it anymore. So I have got to spend three or four times the amount on the premium, the deductibles doubled or tripled. And I’m supposed to be happy now?"
With months, if not years, of contentious hearings on the horizon, Burgess is ready to wield the gavel and become a C-SPAN star, of sorts.
It will also undoubtedly mean he will bear the brunt of liberal backlash.
His suburban North Texas district is safe Republican territory, but some constituents are already raising questions about the repeal effort. And it's likely inevitable that he will be confronted by voters who say he will be responsible for their lost health care coverage, as has happened to other Republican members.
Burgess insists he thrives on the constituent feedback.
"I would say to someone like that, 'This is great. You care about health policy just as much as I do. You carry that same burning passion that it ought to be right.'
“So, I’m willing to listen to what you have to say," he continued. "Really, that’s the way I look at our role in the subcommittee. We are the People’s House. People ought to interact with us. People ought to call their member of Congress."
And, he added, he's received plenty of calls from constituents pleading for a repeal of the Affordable Care Act without a replacement.
It took Democrats over a year to move their health care plan through Congress in the early days of the Obama administration, and they had a far greater majority on the Senate side than Republicans do now. The actual implementation of the Affordable Care Act took even longer.
In the here and now, Burgess has no illusions about the complex task ahead of him.
"That's going to be my life for the next two years."