Though he views the nation's health care architecture as disjointed and flawed, U.S. Rep. Charlie Dent, R-15th District, says his goal is to enhance that infrastructure. 

            "There is no perfect system," Dent said last week following an Upper 

Perkiomen Valley Chamber of Commerce event. "We have to make it better."

            During the organization's August Legislative Series Breakfast last week, Dent and two congressional colleagues spoke to approximately 60 chambers members about their efforts to improve the Affordable Care Act through the Problem Solvers Caucus, a bi-partisan collection of members of the House of Representatives. The caucus is an off-shoot of No Labels, a bi-partisan political organization.

            U.S. Rep. Ryan Costello, R-6th District, described the 43-member caucus, which comprises a near-equal number of Republicans and Democrats, as a collection of reasonable legislators trying to get things done.

            Members of the caucus combine ideological independence and common sense with a willingness to reach across the aisle to get things done and put country ahead of party, according to U.S. Rep. Brian Fitzpatrick, R-8th District. A former FBI agent, Fitzpatrick said the group's decisions are based on facts and evidence, and issues are examined with a laser-like focus.

            Its bylaws allow the members to vote as a block in the House, according to Fitzpatrick, whose district includes Marlborough and parts of Upper Hanover townships, as well as Green Lane Borough. 

            "It's a way to get closer to yes," he said during the chamber event, held at the Schwenkfelder Library & Heritage Center in Pennsburg.

            The caucus has taken on an added significance in Washington, D.C., because "some things are not getting done and some stuff needs to be done," according to Costello, whose district includes Douglass, New Hanover and an area of Upper Hanover townships as well as Bally, East Greenville, Pennsburg and Red Hill boroughs.

            He said the debate to improve the Affordable Care Act gained recent relevance after Congress failed to repeal the law. None of the three members at the breakfast voted for the House bill that would have taken health care away from at least 22 million people.

            "We needed to pick up the pieces, find consensus and move forward," Costello said.

            In late July, the caucus – co-chaired by U.S. Reps. Tom Reed, R-New York, and Josh Gottheimer, D-New Jersey – announced that it reached consensus on a bipartisan set of solutions to stabilize health insurance markets and provide relief to individuals, families and small businesses.

            The proposals include bringing cost-sharing reduction (CSR) payments under the Congressional oversight and appropriations process while ensuring they have mandatory funding; creating a dedicated stability fund that states can use to reduce premiums and limit losses for providing coverage, especially for those with pre-existing conditions; adjusting the employer mandate by raising the threshold on the requirement for employers to provide insurance under the employer mandate to businesses from 50 to 500 employees or more; repealing the 2.3 percent medical device tax and providing technical changes and clear guidelines for states that want to innovate on the exchange or enter into regional compacts to improve coverage and create more options for consumers.

            Trump has threatened to withhold the cost-sharing reduction payments. Without them, premiums on the Silver plans offered through the ACA's marketplaces would increase by an average of 20 percent in 2018, according to a projection prepared by the Congressional Budget Office, a nonpartisan agency that has produced independent analyses of budgetary and economic issues to support the Congressional budget process since 1975. 

            "Hopefully we can take the hardest edges off," said Dent, who represents a portion of Hereford Township.

            Costello and Dent could not guarantee that House Speaker Paul Ryan would permit the entire membership to consider the legislation. However, the lawmakers expressed hope that that the body's leadership will embrace certain segments, including the employer mandate adjustment and the elimination of the medical device tax. 

            "I'm hoping that the leadership could embrace this," Dent said after the meeting. "They have not yet come out against it, which I take as a positive."

            All three House members said they expect the caucus to play a significant role in non-health care-related issues in the coming weeks, as well. Costello told the group that he expects the caucus to weigh in on the budget, tax reform and the plan to raise the debt ceiling by Sept. 30, which is required to avoid a default on the nation's debt.

            Costello also decried Trump's Aug. 15 comments – in which Trump drew a moral equivalency between white supremacists and the counter protesters who descended on the Virginia community – as a failure of presidential leadership. 

            "We should disavow hate and all its forms," Costello said.

            According to Costello, Trump's comments should have focused solely on the supremacists marching near the University of Virginia to protest the removal of a statue of Robert E. Lee, the commanding general of the Confederate army in the Civil War.

            "We don't want to give oxygen to a toxic conversation," Costello said. "Hate has such a pernicious effect on so many things." 

            White supremacy must be identified as evil, according to Fitzpatrick. He said there can't be a hint of moral equivalency.

            "We knew September would be very difficult even before the president's response to the incident in Charlottesville," Dent said after the presentation. "Now it's going to be even harder."