My Opposition to US Representative Don Young's Position on Health Care Reform

Our lone representative in the U.S. House has chosen once again to ignore the concerns of his constituency. He recently sent me a letter expressing his views on national health care reform stating in no uncertain terms that he does not support H.R. 3200, America's Affordable Health Choices Act of 2009. Mr. Young cited as his reason the following:

The President's proposed program will create a public option that functions very similarly to the current Medicare program, and for us Alaskans that spells disaster. As it stands today, most doctors are not taking new Medicare patients in Anchorage because even though we have a standardized reimbursement rate, the cost of practicing medicine is higher in this state than in the Lower 48. Doctors are finding that taking on too many Medicare patients will bankrupt their practices. Implementing a public option modeled on Medicare will actually decrease Alaskans' access to health care.

This statement by Mr. Young simply is not true. H.R. 3200 seeks to impose regulations on the private health insurance industry that would vastly improve coverage for Americans. Without it health insurance companies will continue to raise insurance premiums, and cut or limit what medical treatment.

For a summary of H.R. 3200, please see below:

SUMMARY AS OF: 7/14/2009--Introduced. America's Affordable Health Choices Act of 2009 - Sets forth provisions governing health insurance plans and issuers, including: (1) exempting grandfathered health insurance coverage from requirements of this Act; (2) prohibiting preexisting condition exclusions; (3) providing for guaranteed coverage to all individuals and employers and automatic renewal of coverage; (4) prohibiting premium variances, except for reasons of age, area, or family enrollment; and (5) prohibiting rescission of health insurance coverage without clear and convincing evidence of fraud. Requires qualified health benefits plans to provide essential benefits. Prohibits an essential benefits package from imposing any annual or lifetime coverage limits. Lists required covered services, including hospitalization, prescription drugs, mental health services, preventive services, maternity care, and children's dental, vision, and hearing services and equipment. Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family. Establishes the Health Choices Administration as an independent agency to be headed by a Health Choices Commissioner. Establishes the Health Insurance Exchange within the Health Choices Administration in order to provide individuals and employers access to health insurance coverage choices, including a public health insurance option. Requires the Commissioner to: (1) contract with entities to offer health benefit plans through the Exchange to eligible individuals; and (2) establish a risk-pooling mechanism for Exchange-participating health plans. Provides for an affordability premium credit and an affordability cost-sharing credit for low-income individuals and families participating in the Exchange. Requires employers to offer health benefits coverage to employees and make specified contributions towards such coverage or make contributions to the Exchange for employees obtaining coverage through the Exchange. Exempts businesses with payrolls below $250,000 from such requirement. Amends the Internal Revenue Code to impose a tax on: (1) an individual without coverage under a health benefits plan; and (2) an employer that fails to satisfy health coverage participation requirements for an employee. Imposes a surtax on individual modified adjusted gross income exceeding $350,000. Amends title XVIII (Medicare) of the Social Security Act to revise provisions relating to payment, coverage, and access, including to: (1) reduce payments to hospitals to account for excess readmissions; (2) limit cost-sharing for Medicare Advantage beneficiaries; (3) reduce the coverage gap under Medicare Part D (Voluntary Prescription Drug Benefit Program); (4) provide for increased payment for primary health care services; and (5) prohibit cost-sharing for covered preventive services. Requires the Secretary of Health and Human Services (HHS) to provide for the development of quality measures for the delivery of health care services in the United States. Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality, financed by a tax on accident and health insurance policies, to conduct and support health care services effectiveness research. Sets forth provisions to reduce health care fraud. Amends title XIX (Medicaid) of the Social Security Act to: (1) expand Medicaid eligibility for low-income individuals and families; (2) require coverage of additional preventive services; and (3) increase payments for primary care services. Sets forth provisions relating to the health workforce, including: (1) addressing health care workforce needs through loan repayment and training; (2) establishing the Public Health Workforce Corps; (3) addressing health care workforce diversity; and (4) establishing the Advisory Committee on Health Workforce Evaluation and Assessment. Sets forth provisions to: (1) provide for prevention and wellness activities; (2) establish the Center for Quality Improvement; (3) establish the position of the Assistant Secretary for Health Information; (4) revise the 340B drug discount program (a program limiting the cost of covered outpatient drugs to certain federal grantees); (5) establish a school-based health care program; and (6) establish a national medical device registry.

Mr. Young futher states in his letter:

H.R. 3200, the mainframe for the health care bill, creates 53 new government boards, bureaucracies, commissions, and programs and adds $1.2 trillion in new federal spending over the next ten years. Nearly five million jobs could be lost as a result of increased taxes with small businesses being particularly hit hard. Unemployment is already at 9.5%; how much higher will it go when small businesses are forced to choose between paying new government fines and keeping an employee on the payroll? This legislation misses the mark completely.

Figures posted by the Congressional Budget Office (CBO) refute this statement. The link to the CBO report follows:

http://cboblog.cbo.gov/?p=332

H.R. 3200 will cost taxpayers money, but the percentages and figures Mr. Young states in his letter are not factual, and he provides no references to back them up. Yes, new government position will be created, but the wording of the legislation provides concise governance for their actions. Those actions will serve to protect Americans from the unscrupulous dealings of "for profit" health insurance companies. They will serve to protect our medical providers from the burden of unreasonable premiums for malpractice insurance.

At the end of his letter, Mr. Young asked me to support two other pieces of legislation before the House that he consponsored, H.R. 2516 (Medical Rights Act of 2009) and H.R. 3218 (Improving Health Care in America Act of 2009). I read both bills through and through. It wasn't hard, because neither bill is very lengthly. Mr. Young accuses H.R. 3200 of being a poor attempt at placing a band aid on a deep wound. If that is true, then the effect of his two bills could be likened to your mother kissing your boo boo.

H.R. 3218 does little more than provide a small tax credit to insurance policy holders. The maximum credit is $2,500 for individuals and $5,000 to couples filing jointly. That is it. No reform. It will not cost the tax payers much, but then neither will it provide much benefit. I pay $3200 in premiums each year. I might be grateful for the return, but then there is the $2500 deductible and the 50% of ten thousand that I have to pay before I am reimbursed 100% for medical expenses. I will probably appreciate it even less when I can't get reimbursed for a medical procedure, and the insurance company keeps me jumping through hoops until I am bankrupt or dead.

While H.R. 3218 can be considered a pathetic attempt to convince Americans that compassionate conservatives have our best interests at heart, H.R. 2516 is a blatant attempt to outright forestall any attempt by the Federal government to reform health care. Here is a excerpt from the bill:

(a) In General- Subject to subsection (b), no Federal funds shall be used to permit any Federal officer or employee to exercise any supervision or control over-- (1) the practice of medicine, the practice of other health care professions, or the manner in which health care services are provided; (2) the provision, by a physician or a health care practitioner, of advice to a patient about the patient's health status or recommended treatment for a condition or disease; (3) the selection, tenure, or compensation of any officer, employee, or contractor of any institution, business, non-Federal agency, or individual providing health care services; or (4) the administration or operation of any such institution, business, non-Federal agency, or individual, with respect to the provision of health care services to a patient.

Because such a bill would absolutely hamstring the government in administering current government run programs, section (c) of the bill sets forth a provision exempting existing programs such as the VA, DOD, Indian Health, and Public Health.

If H.R. 2516 were to pass, the government have no authority to regulate private health in any way, shape, form or fashion. The link to the full text of this bill is below:

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.2516:

Representative Young's alternate to H.R. 3200 is unacceptable. H.R. 3218 does absolutely nothing to reform private, "for profit" health insurance, while H.R. 2516 is an outright to hamper if not outright block government from regulating the health insurance industry.

I wish to express my condolences to Mr. Young on the loss of his wife. His loss makes it very difficult for me to post this blog out of respect for his grief, but I cannot let Mr. Young's letter go uncontested. Please write, call and email Mr. Young and demand that he support true reform for health care in Alaska.