By Congressman Chris Van Hollen
I respectfully disagree [that HR 3590 is a disasterous health care bill] . After careful consideration of the provisions in this bill, I came to the conclusion that the changes would ultimately benefit health care consumers in our community. I voted for the Patient Protection and Affordable Care Act (HR 3590) which passed the House of Representatives through the traditional voting process by a count of 219-212. President Obama signed this bill into law on March 23, 2010. I also voted for the Health Care and Education Reconciliation Act (HR 4872), which contained important changes to the Senate bill and passed the House by a vote of 220-207.
Let me be clear, this bill does not entail a government takeover of health care. This health reform builds on the current system of private health insurance. Every American will still be able to choose his or her own doctor and private health insurance plan - and make care decisions with that doctor. In fact, according to the nonpartisan Congressional Budget Office, private insurance coverage will expand by 16 million under this bill.
This legislation includes ideas from across the political spectrum, incorporating hundreds of amendments from Republican members of Congress as it moved through committees. It has been endorsed by hundreds of non-partisan health care groups, including the American Medical Association, the American Nurses Association, the American Hospital Association, the AARP, the American College of Physicians, the National Association of Community Health Centers, and the American Cancer Society Cancer Action Network. A full list of the organizations who have endorsed the bill is available here: http://www.speaker.gov/newsroom/reports?id=0323.
In the next six months, Americans will begin to see the benefits of a health care system that works for them and not the insurance industry. Children with pre-existing conditions will no longer be denied coverage and young people will be able to remain on their parents' insurance up to their 26th birthday. Health plans will be banned from placing lifetime caps on coverage, small businesses will be given tax credits so that they can provide affordable health coverage, and we will begin to close the Medicare Part D doughnut hole and help seniors pay for their high prescription drug costs.
Over time, we will prohibit insurance companies from denying coverage to any customer based on pre-existing conditions, create health insurance exchanges so that Americans have the same choices as Members of Congress, extend health care coverage to an additional 32 million Americans, ensure middle class families can afford insurance by providing the biggest tax cut for health care in U.S. history, and reduce the deficit by over a trillion dollars in the next two decades.
Health care reform expands the number of trained doctors in our country to ensure that access to doctors is not a problem. These provisions include providing new scholarships, loans, and loan repayment help to help recruit new doctors and nurses into the profession, especially primary care providers. The bill will make sure we are training the right kinds of doctors to meet our needs and provide incentives for them to better coordinate health care.
Because small businesses are our engines of economic growth and our number one job creators, this legislation provides $40 billion in tax credits for small businesses to help them offer employee health insurance coverage - if they choose to do so. This year qualified small business employers will be eligible for a sliding-scale tax credit, worth up to 35 percent of a small business's premium costs. In 2014, Health Insurance Exchanges, competitive marketplaces of private insurers, will enable small businesses and their employees to purchase affordable coverage and pool their buying power through access to the same quality plans only available to large firms today.
Finally, the legislation makes significant strides towards reducing the deficit. According to the Kaiser Family Foundation, health care costs have been rising for several years, surpassing $2.3 trillion in 2008 and accounting for 16.2% of the nation's gross domestic product. Health care expenditures have outpaced inflation and income growth. And the cost growth was straining the systems used to finance health care, including private employer-sponsored insurance, Medicare, and Medicaid. This growth was simply not sustainable for families or the government.
According to the non-partisan Congressional Budget Office, the health care reform signed by the President cuts the deficit by $143 billion in the first ten years and $1.2 trillion in the second ten years. Half of the bill is paid for by ending overpayments to private insurance companies in the Medicare Advantage Program as well as cracking down on fraud, waste, and abuse. Currently, Medicare Advantage plans cost the government an average of 14% more (and in some regions of the country 20% more) without providing better service than traditional plans. The remaining cost of the bill is offset by targeted fees on health insurance providers, pharmaceutical companies and medical device manufacturers who will be benefitting from reform, phased-in revenue increases on so-called "Super Cadillac" plans that fail to bring their costs under control, and a modest Medicare surcharge on the top 2% of American households. Beginning in 2013, individual filers with income above $200,000 and joint filers with income above $250,000 will begin to pay Medicare taxes on unearned income above those limits, as well as an additional 0.9 percentage points on wages and self-employment above those limits. In addition to paying for reform and reducing the deficit, these revenue enhancements will extend the solvency of Medicare by an additional nine years.
But the bill helps rein in health care costs, as well. In the health insurance exchanges, consumers will be empowered to choose the best private insurer, based on public ratings, premium costs, and quality of care, which should lead to companies competing to offer the best rates. And, because of the individual mandate, they will be selling to a larger pool, spreading out risk.
This was not a perfect bill, and there will be more work to do to manage health care costs. But I believe it is a good approach, building on what works in our current system, expanding private insurance markets, and establishing important consumer protections, especially for those with pre-existing conditions.
Chris Van Hollen
Member of Congress
For a physician's point of view about the Democratic Health Care Disaster, CLICK HERE .