Questions about Republicans’ efforts to repeal the Affordable Care Act once again dominated the first half of Rep. Jaime Herrera Beutler’s live telephone hall event on Tuesday night.

After a brief update on her legislative efforts in Congress, including work on a number of bipartisan bills, the fourth-term Republican congresswoman representing Washington’s 3rd District opened up the phone lines to constituents and health care-related questions poured in.

It was Herrera Beutler’s second telephone town hall since becoming one of 20 Republicans to vote against the House Republicans’ Obamacare repeal bill in May.

The first question, from a caller named Thomas in Vancouver, focused on tax cuts in both the House and Senate versions of bills to repeal President Barack Obama’s signature achievement.

“What I just can’t get my arms around is why we need to make this large tax cut for wealthy people part of the health care bill, especially when it seems to be a quid pro quo,” Thomas said. “I just don’t understand the rationale for that.”

Herrera Beutler maintained that there isn’t a tax cut “per se in the health care bill,” unless Thomas was referencing repeal of the ACA’s individual mandate requiring everyone to purchase health insurance or pay a tax penalty.

However, both the House and Senate bills would repeal the Affordable Care Act’s taxes on households earning above $250,000 per year. Those taxes on high earners are used to give premium subsidies to low-income people purchasing coverage through federal and state-run exchanges on the individual health insurance market.

Herrera Beutler went on to say she voted against the House bill because she didn’t feel the legislation did enough to lower costs and did too much to cut the social safety net.

“I felt like it left people vulnerable,” Herrera Beutler said. “That’s why I voted against it and I agree that you shouldn’t take from the most vulnerable and redistribute to other folks.”

On Monday, the Congressional Budget Office released a report estimating that 22 million people would lose health insurance under the Senate bill — 2 million fewer than the House-passed bill.

The CBO also said the bill would cut more than $770 billion from Medicaid and could increase premiums, especially for those buying individual health insurance through exchanges.

Another caller, named Ron, expressed concern that the House and Senate bills don’t permit insurers to sell policies across state lines or address medical malpractice reform.

“That’s a competition-stopper when the insurance company can’t cross state lines,” he said.

Herrera Beutler agreed, telling the caller “you should have the right to purchase health insurance across state lines just like you do with auto insurance.”

Allowing insurance companies to sell across state lines has been a tenet of Republican health care reform policy throughout the Obamacare repeal debate. Five states currently have laws permitting insurers to sell out-of-state policies — but so far no insurers have chosen to offer those types of policies in any of the states.

Asked by a caller named Brandon about whether she would fight against the Senate bill if senators tried to pass the legislation after the July 4 recess, Herrera Beutler said she supports repealing the Affordable Care Act but that Republicans “have to do better.”

The congresswoman said Medicaid — which was originally designed to be a program that served the disabled, elderly and children — needs to be reformed in order to remain sustainable.

“Right now, if we leave it as is, it will break on everybody,” she said.

Roughly 660,000 Washington residents became newly eligible for health coverage through Medicaid under the Affordable Care Act, according to the Washington Department of Health. About 30,600 Cowlitz County residents received health coverage through Medicaid last year.

Herrera Beutler also highlighted her work on legislation to fight ocean acidification and on a bipartisan bill co-sponsored by Oregon Democrat Kurt Schrader that would allow a small number of sea lions to be killed in order to protect local salmon.

She also discussed the Trump administration’s recent budget proposal to privatize Bonneville Power Administration, a public utility that provides Cowlitz County with relatively cheap power. Herrera Beutler assured callers that she had voiced her opposition to that measure to Energy Secretary Rick Perry and received his assurance that “it was just a proposal.”

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