Jill Schramm/MDN Congressman Kevin Cramer speaks with Matt Watne following a Rotary Club meeting in Minot Monday.

Congress has been getting the job done in easing regulations, addressing human trafficking, authorizing defense spending and imposing sanctions on rogue nations, Congressman Kevin Cramer told Minot Rotary members Monday.

What Rotarians wanted to talk about, though, were items Congress still is working on, particularly healthcare reform and re-authorization of the National Flood Insurance Program.

Regarding flood insurance, Cramer said it has been difficult to find a way to reform the system to make it actuarially sound while keeping premiums affordable. The current flood insurance program expires in September, so Congress is looking to write a replacement.

“What I think is going to happen is a pretty much straight up reauthorization,” Cramer said. “It avoids some of the problems of reform but it also doesn’t get us a lot farther down the road in terms of this fiscal soundness of the program.”

Cramer said the goal is to allow more private insurers to become eligible for NFIP so their solutions can be part of the mix.

On healthcare, the House passed a healthcare overhaul to replace the Affordable Care Act, otherwise known as Obamacare, but the Senate was unable to pass a bill or accomplish a repeal.

“I am all for anything that moves the bill in the right direction,” said Cramer, noting the Senate’s “skinny repeal” bill did that in eliminating insurance mandates and a medical device tax. “That bar was so low anybody could have crawled over it. And somehow 48 Democrats and three Republicans couldn’t make their way over it. And now they think that if we all work together, it will be better.”

Cramer said he is working to reduce rules and increase sustainability for critical access hospitals, which includes 36 small, rural hospitals in North Dakota. He said Obamacare’s slide into a single-payer, government healthcare system will spell the demise of rural hospitals.

“We have to restore the individual markets. That’s the only way to maintain rural healthcare as well as any other healthcare,” Cramer said.

“We need to be careful, on the one hand, that we keep our rural hospitals open but we also need our rural hospitals to evaluate what services they are able to offer in this changing environment,” he said. “We need to find what it is they have to do to take advantage of the growing, larger segment of healthcare.”

Medicaid Expansion benefits hospitals but has also cost taxpayers about a trillion dollars, he said. Republicans want to shore up traditional Medicaid, grandfather recipients of Medicaid Expansion and transition away from Medicaid Expansion to tax credits. Cramer also supports giving more leeway to states to operate their Medicaid program by giving them some form of federal block grants with annual inflation increases.

Cramer added he is working to eliminate a loophole that allows states to bar third parties, such as churches or foundations, from assisting in paying a person’s out-of-pocket medical expense. North Dakota is not among states barring that aid, he said.