Statement of Support of HR 3962, Affordable Health Care For America Act

Nov 7, 2009
Press Release
Last Sunday, 42,000 people gathered in my hometown of  New York City to run the NYC marathon while 2 million more people watched, cheered, and marveled at those who accepted the challenge of running 26.2 miles.  It is likely that each participant had a different reason for running, but the ultimate goal was the same:  to finish, to succeed, and to accomplish a goal.  As Greek legend explains, the concept of the marathon comes from the long distance a messenger ran to deliver the important news that the battle had been won.  Madam Speaker, as we stand here today to debate a historical bill that will substantially improve the delivery of health care in America, we are the runners at mile 25.  The cheers are the loudest, the anticipation is the greatest, and the end, while near, seems very far away.  Despite all of the noise, the message is clear: now is the time for health care reform, now is the time to take care of all Americans, now is the time to make sure that families are not forced to see loved ones die because they did not get the care they need and deserve. I’d like to thank and commend the leadership of Speaker Pelosi, Majority Leader Hoyer, Chairmen Waxman, Miller and Rangel and of course, Chairman Emeritus Dingell who has been working on health care reform since he first came to Congress.  HR 3962, the Affordable Health Care for America Act, is a significant and important step toward securing affordable, accessible, and quality health care for all Americans.  Our current health care system is broken. Costs continue to increase at unsustainable rates and too many families and businesses are feeling the debilitating burdens brought on by these expenses.  Too many Americans have inadequate coverage or lack coverage entirely and are suffering or dying as a result.

§    HR 3962 is critical to the health of our families, to the health of our economy and to the health of our nation;

§    HR 3962 lowers costs for every patient, reins in premiums, co-pays, and deductibles, limits out of pocket costs, and lifts the cap on the amount that insurance companies cover each year;

§    HR 3962 strengthens Medicare, securing the financial stability and solvency of Medicare for years to come, and provides seniors with better benefits and guaranteed access to their doctors;

§    HR 3962 reduces the deficit by over $100 billion in the first 10 years, and likely by even more in the following decade, according to the Congressional Budget Office;

§    HR 3962 provides affordable coverage to those who cannot get health insurance because of pre-existing conditions, including domestic violence and pregnancy, and protects consumers from higher rates due to gender or other factors;

§    And, very importantly, I am proud that HR 3962 includes a public health insurance option that will increase competition and reform our current system.  I am grateful to Speaker Pelosi for her steadfast support of this important provision and am confident that it will expand access to care to the many people in need.  When 14,000 Americans are losing their health care coverage each day, it is clear that a public option is needed.  It will bring down costs, increase access, and improve care for all Americans.  The richest country in the world should not have people who go without the basic necessity of health care.  The public option will hold health insurance companies accountable for the practices that price people out of the health care they need and deserve.

Health care is the most important public policy issue of our generation that will affect generations to come.  I am grateful for the opportunity to be a part of this momentous reform and would like to take the time to highlight some areas of the bill that specifically impact my Congressional district. 

HR 3962 will improve employer-based coverage for 440,000 residents in my district and will provide credits to help pay for coverage for up to 120,000 households.  It will also improve Medicare for 88,000 beneficiaries, including closing the prescription drug donut hole for 8,100 seniors.  HR 3962 will allow 33,300 small businesses to obtain affordable health care coverage and provide tax credits to help reduce health insurance costs for up to 31,300 small businesses and will cover 26,000 uninsured residents.  In short, HR 3962 will make health care affordable for the middle class, provide security for seniors, and will guarantee access to health insurance coverage for the uninsured while reducing the federal deficit over the next ten years and beyond.

In addition to representing the residents of the 14th Congressional District of New York, I am proud to represent 14 hospitals.  Many of these are the jewels of American medicine, training our nations’ doctors, and facilitating cutting edge research that identifies cures and gives hope to millions of Americans and their families.  I am pleased that HR 3962 recognizes the importance of teaching hospitals and preserves Graduate Medical Education.  New York’s teaching hospitals, while training our future physicians, are treating the sickest of the sick and poorest of the poor.  These payments, including Direct Medical Education and Indirect Medical Education are critical to the survival of these hospitals and to the greater good of medicine.

HR 3962 takes into account diverse patient populations, the cost of goods and services, and the higher costs incurred by teaching hospitals.  Teaching hospitals tend to treat the most complex cases and are the first to adopt innovative technologies and techniques that advance patient outcomes, so their costs are often higher than average. A policy that reduces spending arbitrarily runs the risk of stifling innovation which is why I am pleased that the bill is sensible on how it addresses geographic variation.  This bill recognizes the pitfalls of a blanket overhaul.  It requires the Secretary of HHS to contract with the Institute of Medicine to conduct two studies.  The first is a study of wage levels which will look at the hospital wage index and the physician geographic practice cost index and will recommend changes to the methodologies, if necessary.  The second study looks at the geographic variation associated with volume and intensity of services in Medicare, Medicaid, and private sector spending per capita.  The IOM is encouraged to understand and separate out higher-than-average spending due to unavoidable or desirable factors (e.g., patient demographic and clinical risk factors and wage levels) from higher-than-average spending due to avoidable or undesirable factors (e.g., excessive medical errors, and practice patterns differing from best practices).  The bill wisely includes specific prohibitions against recommendations to reduce graduate medical education, disproportionate share, and health information technology payments. 

While I am pleased with the bulk of the bill, I am concerned that HR 3962 does not extend the 340B discounts to drugs purchased for inpatient use, a provision that was included in an earlier version of the bill.  Currently, the 340B Drug Pricing Program requires pharmaceutical manufacturers that participate in Medicaid to sell outpatient drugs at discounted prices to disproportionate share hospitals (DSH) that serve a high threshold of low-income, uninsured and underinsured patients.  Under current law, DSH hospitals participating in the 340B Drug Pricing Program pay approximately thirty percent more for their inpatient drugs than their outpatient drugs, although the drugs are frequently the same. The inpatient and outpatient settings serve the same low-income population that the 340B Drug Pricing Program was designed to assist.  These discounts lower costs for patients and taxpayers.  At a minimum, extending the 340B Drug Pricing Program to inpatient drugs would reduce inpatient drug costs by fifteen percent.  These new resources could be better used to provide direct patient care.  I am hopeful that during Conference, the House will cede to the Senate language and extend the 340B drug pricing to inpatient drugs.  After all, now is not the time to deprive safety net hospitals from millions of dollars in savings needed to treat the most vulnerable in our communities.

Madam Speaker, the task is huge and the rewards even bigger.  Today we will vote to cover 96 percent of Americans without adding a dime to the deficit.  We will be doing what’s right for our families, what’s right for our economy, and what’s right for our future.  I urge my colleagues to look at the larger picture and remember that today we will make a lasting difference in people’s lives.