Elizabeth Roberts ’78 is the 68th Lieutenant Governor of Rhode Island. Roberts became the first woman to hold the position when she was elected in 2006, first serving under Republican Governor Donald Carcieri, and now serving under Governor Chafee, an independent. Before a ten-year career in the Rhode Island Senate from 1996-2006, Roberts was a business consultant, policy analyst and health care manager.
Brown Political Review: You worked with Gov. Carceri before Gov. Chafee. What was it like working with a Republican Governor as a Democrat?
Elizabeth Roberts: It was very different working with Carcieri than it was with Gov. Chafee. Carcieri and I differed ideologically, but also had a difficult time working out a collaborative relationship. When Gov. Chafee came in, he really respected the work I had been doing on healthcare. He knew it was a huge issue for the state as we implement the national law, and turned to me and said, “Lets work together.”
I’m not sure party is the determining issue here. I talk with a lot of my colleagues from around the country. Sometimes they’re of the same party—even selected by their governor and not running in an election like I did—and they have difficulty working together. A lot of it is how you see your jobs as Lieutenant Governor and Governor, and how you can make that relationship work.
BPR: How have you made that relationship work? How do you see your job as Lieutenant Governor with respect to the Governor?
ER: With Gov. Chafee we’ve worked out a partnership—he’s clearly the Governor. Through executive order, he tasked me with implementation of health reform. He also gave me a role in the cabinet, coordinating a sub-cabinet group working on health reform inside government. I also frequently represent him publically, something that I never did with the prior Governor.
BPR: Is it easier to form that kind of relationship in state government as opposed to the federal government?
ER: Actually, I think with the past two Vice Presidents have had much stronger roles than we had seen for quite some time. Vice President Cheney, not someone I saw eye to eye with, you could see his influence in the administration and his role. Vice President Biden, I think, has a very strong role to play, particularly working across the executive-legislative divide because of his long experience in the US Senate.
BPR: The Affordable Care Act has been coming into effect over the past two years, and looking forward it’s set to gather pace. Have your constituents seen concrete benefits yet?
ER: Absolutely. Several things have already happened, things often people don’t know. Even I directly benefit: I have a 24-year-old daughter who is working. She’s back on my health insurance because she didn’t have that available to her. That’s a major benefit for her and for me, as her parent—as her mom. Last year was the first year in decades that the number of uninsured Americans declined, and that was because so many of our young adults came back onto their family’s coverage. It’s a very inexpensive way to insure people, and a very good way to protect them from any kind of catastrophic illness.
Despite politicians saying it was under siege, there have also been major improvements for Medicare. Closing the doughnut hole for people with catastrophic drug costs meant over $8 million back in seniors’ pockets in Rhode Island. They also see new preventative services that were never covered under Medicare. For small businesses, this is the second year they have a tax credit available to pay for employee insurance. It pays a third of the cost of health insurance and will go up to 50% next year.
So people are really starting to see the impact. And in many parts of the country you’re also seeing a change, where children can’t be denied coverage for pre-existing illness, or you can’t cap coverage. One of the tragedies of the American system is that you’re actually most vulnerable to healthcare costs when you’re seriously ill. People believe their coverage protects them, but in many states you could be terminated from your healthcare coverage.
BPR: A major criticism of Obamacare is that it taxes companies developing new technologies, who then cut down on R&D budgets and reduce medical innovation. What do you say to that?
ER: Well, they just voted to repeal the tax on the medical device manufacturers. There needs to be a balance. It’s very important that this program is paid for appropriately. And I think we need to support innovation, both in the drug industry and in the device industry. But I think we need to be careful that we aren’t supporting that innovation at too high a cost for the people that it’s ultimately supposed to benefit. So it’s important to have a balance, and I think that’s what they’re trying to strike.
BPR: Even its supporters say the ACA is only a first step in reducing costs. Yet you’ve spoken out against privatizing Medicare or the use of medical vouchers. Is there any room left for public policy to bend the cost curve?
ER: Absolutely. The main focus of the ACA is covering more people. There’s a great deal we need to do about cost. The government pays about 55 cents of every healthcare dollar across the country, and one of the challenges for us in government is how to maintain quality while we look at costs and sustainability. That’s where the healthcare exchange marketplace comes in focus. Even before Obamacare, we could not afford the system we had built. We need a system that focuses on outcomes rather than units of service, for example, and focuses on improved health, rather than just treating people at the most crucial stage of a serious illness.
BPR: Circling back to Governor Chafee, to what extent do you see your approval ratings as linked to the Governor’s?
ER: I have the blessing of not running for office again, and I’m not worrying very much about my approval ratings. But I think those of us in public office in these tough times, particularly in Rhode Island where we still haven’t got the economy going as well as it could, pay the price, as we should. We’re elected leaders and we bear some of the responsibility for the situation that our state is in. The Governor and I have really been pushing hard to try and make change—the Governor’s focus on improving our public education system, for example— things absolutely vital to our long term health as a state. All of us suffer with that to some extent. But if you live and die by your poll numbers, you don’t take on the tough issues.