PORT ANGELES — A day after President Donald J. Trump signed a single-page executive order aimed at scaling back the Affordable Care Act, U.S. Rep. Derek Kilmer told Port Angeles Downtown Association members the fate of health insurance in the United States remains uncertain.

“On one side you have folks who treat [the ACA] as if it’s been handed down from God on stone tablets never to be adjusted in any way,” Kilmer, D-Gig Harbor, told downtown association members Saturday. “On the other hand you have folks that say scrap it, repeal the whole thing.

“Frankly, both of those approaches are misguided.”

He has yet to hear any proposals to replace the ACA, Kilmer said.

When asked about what is being done to help small businesses provide affordable health insurance to their employees, Kilmer said there is legislation that would provide tax support for small businesses trying to provide insurance.

“Most of the employers I’ve met with provided insurance to their employees,” the Port Angeles native said. “Those that didn’t, it wasn’t because they didn’t want to, it was because they couldn’t afford to.”

Kilmer was unavailable for an interview following the meeting.

“You’ve got small business people who pay huge premiums — $800 and up — and still have to wade through a $3,000 of $5,000 deductible,” said Young Johnson, PADA president. “Unless it’s a major medical issue, you still can’t afford to go to the doctor.”

Kilmer told business owners the ACA is far from perfect, but that it has been a boon for Olympic Medical Center and thousands of people who were previously uninsured.

About 10,000 people in Clallam County gained health insurance after the ACA passed, allowing many to get preventive care that kept them out of emergency rooms, he said.

“It’s a good thing for every woman I represent who can’t be charged more simply because they are a woman,” he said. “Things like preventive care — mammograms and cancer screenings and annual physicals — can now be covered without copay.”

The problem locally and in other rural communities, he said, is that it’s difficult to find a primary care provider.

“Unfortunately while there was a lot of thought put into having people develop medical homes, there wasn’t enough effort to ensure you’re producing enough primary care providers in rural communities,” Kilmer said.

If Kilmer had it his way, Congress would keep some parts of the ACA and fix its problems, instead of replacing the whole thing.

“Let’s fix the things that need fixed,” he said.

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Reporter Jesse Major can be reached at 360-452-2345, ext. 56250, or at jmajor@peninsuladailynews.com.