The Republican challenger seeking to oust first-term U.S. Rep. Lauren Underwood, D-Naperville, said the U.S. needs a better health care system, something Underwood agrees with although she had very different ideas on how to get there.

“I'm not going to get into a partisan argument of do we have to repeal and replace [the Affordable Care Act] or can we fix it," Republican candidate Jim Oberweis said. "We need a better system. Either way, we gotta get there."

Oberweis is running to unseat Underwood, the Democratic incumbent, to represent Illinois' District 14, which spans from Harvard to Waukegan along the Illinois-Wisconsin border and down to McHenry, Marengo and parts of Crystal Lake. The district also includes portions of Kane, DeKalb, Kendall, DuPage and Will counties, stretching south to Yorkville.

About 80% of Americans listed "taking steps to lower the cost of health care" as being "extremely" or "very important" to them when they go to the ballot box in November, according to a recent study by Politico and the Harvard T.H. Chan School of Public Health. About 75% said the same about lowering the price of prescription drugs.

The study was conducted on voters of both parties at the end of January, before the COVID-19 pandemic brought health and health care to the forefront of many voters' minds.

Oberweis has pitched a market-oriented approach and has also backed a plan that would replace the ACA, a proposal that fellow Republican Jeanne Ives running in the neighboring congressional district has previously expressed support as well.

Underwood, on the other hand, signed on as a sponsor to legislation that seeks to limit how much families pay for health insurance bought through ACA marketplaces. This bill, which also was sponsored by Ives' Democratic opponent U.S. Rep. Sean Casten, D-Downers Grove, would also allow Medicare to negotiate prescription drug prices.

“When I think about the challenges in our health care system right now, we know there's a big problem with affordability, whether it's premium prices, prescription drug prices or whether it's people being able to pay for their co-payments,” Underwood said in an interview Friday.

The Oberweis Way

In an interview last week, Oberweis summed up his views on health care reform in two words: transparency and competition.

He said he feels strongly about using tax incentives to bring large drug manufacturers back to the U.S. The best way to lower prescription drug prices for Americans is by creating new market pressures in the private sector rather than "adding barriers" through governmental regulations, he said.

This can be done by allowing Americans to re-import drugs directly from Canada, where the Canadian government negotiates lower drug prices with American pharmaceutical manufacturing companies by excluding research and development costs, Oberweis said.

Allowing for the re-importation of drugs at Canadian prices would create downward pressure on the market and force U.S. drug companies to lower their prices to remain competitive, Oberweis said.

Countries that import American drugs should also have to contribute to the research and development costs associated with them so that the burden does not fall entirely on consumers in the U.S., he said.

"We're going to have to charge higher prices to Canadians or they can't have these drugs," Oberweis said. “That should begin to, over a period of time, equalize the costs between our country and other countries.”

Oberweis is supportive of the health care plan proposed by the Republican Study Committee, which was introduced in October 2019 as a replacement for the ACA, also known as Obamacare.

The plan would roll back the ACA's federal protections for people with preexisting conditions, instead asking states to design their own high-risk pools to help people with expensive plans afford the cost, according to a summary of the Republican Study Committee plan. States would be empowered to operate high-risk pools through federal grants but would not be required to do so.

Oberweis said he wants to expand the use of health care savings accounts and increase the ease at which Americans are able to take their health insurance with them when they change jobs, two points which also are proposed in the Republican Study Committee plan.

Last year, as a state representative, Oberweis filed the Right to Shop for Health Care Act, which would have required insurance companies to make the average in-network costs of common treatments and procedures available on their websites, increasing transparency and empowering consumers, he said.

The bill would have allowed patients to use an out-of-network provider if it were cheaper to do so and proposed that any savings be split between the patient and their insurance provider, Oberweis said.

Giving people the freedom to buy health insurance plans across state lines would also allow for more flexibility and patient choice, he said.

While Oberweis supports continuing expanded unemployment benefits, including health insurance, as the country recovers from the economic effects of COVID-19, he said those benefits should not be extended too far into the future.

The Underwood Way

Underwood is a registered nurse, has master's degrees in nursing and public health and lives with a preexisting heart condition. She said her background informs her approach to health care.

She said she supports the Patient Protection and Affordable Care Enhancement Act, which the U.S. House of Representatives passed in late June on a mostly party line vote. The U.S. Senate still needs to consider it.

One portion of the bill, which Underwood first introduced as the Health Care Affordability Act, would limit how much consumers in ACA marketplaces would have to pay for certain plans to a percentage of their income, she said.

“Right now in the 14th District, it's not uncommon for families to be spending 20% or 25% of their income on premiums,” Underwood said.

The legislation would bring that percentage down to 8.5% for those buying a benchmark silver plan off the marketplace. The bill also seeks to provide incentives to states to expand their Medicaid programs and to primary care providers so more accept Medicaid, according to a fact sheet on the plan.

The plan aims to save money by giving Medicare the ability to negotiate prescription drug prices and would once again require all health care plans to cover certain medications and treatments, according to the fact sheet.

During her first term in Congress, Underwood authored the Lower Insulin Costs Now Act, which lowered the cost of insulin by allowing cheaper, generic brands of insulin to be made available sooner. The bill was signed into law by President Donald Trump in December.

Underwood criticized Oberweis for supporting the Republican Study Committee's plan, saying it would roll back protections for people with preexisting conditions. She also criticized statements that Oberweis has made about outlawing abortion.

At the start of the pandemic, she said she joined her Democratic colleagues in calling on the president to provide a special enrollment period for the ACA to accommodate those who saw their pay cut drastically.

The COVID-19 pandemic has also underscored the need for more equitable access in the system, Underwood said.

For this reason, Underwood said she has been especially active on the Black Maternal Health Caucus in understanding why Black women in Illinois are six times more likely than white women to die during childbirth.

She introduced a bill at the beginning of March which would, in part, require the Department of Health and Human Services to make collaborative efforts to look into social determinants of health, especially when it comes to maternal, mental and behavioral health.

“Disparity has got to be central to the health care work that we do moving forward ... making sure that different segments of our community are not dying more than other people and understanding the root causes of those disparities and then taking aggressive action to stop them,” she said.