HELENA — Sen. Jon Tester, D-Mont., isn’t backing down from his support of the Affordable Care Act, which he voted for in 2010 — but says he would like to see some changes.

He also says he supports the law’s mandate that everyone acquire health insurance by 2014, or face a federal tax penalty.

“The personal responsibility requirement stops freeloaders from getting free, emergency-room health care and driving up the cost of health-insurance rates for everybody else,” said Tester’s spokesman, Aaron Murphy.

The ACA, known by detractors as “Obamacare,” passed Congress and became law in March 2010, without any Republican support.

Rep. Denny Rehberg, R-Mont., who’s challenging Tester in this year’s election, and Rehberg’s supporters often criticize Tester’s vote in support of the ACA and denounce the law as costly, ineffective over-regulation.

The wide-ranging law not only requires Americans to have health insurance by 2014, but also reforms insurance law, offers tax credits to small businesses to buy insurance for employees, expands government coverage for poor people, and provides subsidies to help others buy insurance.

The law also gives the U.S. Health and Human Services secretary power to review health insurance rate increases. Tester said last week he wants to give the secretary power to block or modify those rates, too — a power not currently in the law.

He said he also wants the ACA to do more to push the health system toward electronic record-keeping, claims processing and other functions, to reduce the high administrative costs of health care in America.

Murphy also derided some health-reform ideas advanced by Rehberg as “truly unworkable” and not serious proposals.

Murphy noted that Rehberg, in recent months, has suggested people get federal tax deductions if they work out at a health club, say they don’t smoke, and drink in moderation.

“Congressman Rehberg is so out of touch with Montanans, that he has no plan to improve access to quality health care in Montana,” Murphy said. “(His) solution is to deny Montana families affordable health coverage (and) allow insurance companies to make harmful health care decisions for Montanans.”

Rehberg says he has proposed and supported plans to make health insurance and health care more affordable, such as interstate sales and restricting medical liability, that are widely supported by business and others.

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