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During the week of November 16th, a number of us received a semi-personalized, e-mailed constituent letter that reinforced Rep. Betty McCollum’s argument for her affirmative health care reform vote in the U.S. House; her “last word” on this subject. Her letter and our rebuttal to her arguments follow:
November 20, 2009
Thank you for contacting my office regarding Congressional action on health reform. In addition to you, my office was contacted by thousands of constituents over the past months - supporters and opponents - of proposed health reform legislation. I appreciate the opportunity to share my perspective on this important issue.
On November 7, 2009, the U.S. House of Representatives passed the Affordable Health Care for America Act (H.R. 3962) by a vote of 220 to 215. I voted in favor of this historic legislation to increase access, reduce costs and improve care for all Americans. My views are further detailed in my attached statement for the Congressional Record. In summary, this bill:
- Extends health insurance coverage to 36 million Americans – The percentage of insured Minnesotans is 92%. The objective of H.R. 3962 is an insured percentage of 94% from a current National average of 83%. In its analysis, the Congressional Budget Office (CBO) estimates that “by 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 24 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent.” (http://cboblog.cbo.gov/?p=426)
So the net gain for Betty’s Minnesota constituency is an additional 2% insured at what cost? On a National basis, by 2019, 24 million will STILL be uninsured and that INCLUDES 8 million unauthorized immigrants whose health care needs are being met by EXISTING programs, such as non-emergency E.R. care.
If health care insurance companies were allowed to compete across State lines, as automobile insurers do, State legislatures could mandate a health care “assigned risk” pool, now done for poor automobile insurances risks, as a condition for doing business. Those with pre-existing conditions may not be receive the most competitive rate, but they would be able to purchase health care insurance.
- Creates a competitive public insurance option – Health care is a question of access, cost and quality. Which of the three does a public insurance option address? (Hint: It’s not access or quality.)
- Protects families from medical bankruptcy by eliminating insurance payment limits – Medical cost was the leading cause of bankruptcy according to a Harvard University study of randomly selected pre-mortgage meltdown filings in 2007. In an ATLANTIC MONTHLY column, author Megan McArdle pointed out that although the proportion of medical cost as a major contributor to bankruptcy appeared to be climbing from 2001 – 2007, the total number of U.S. family bankruptcies actually fell by about half during that time period. So the number of medical bankruptcies would have decreased from about 667,000 in 2001 to 451,000 in 2007. (http://www.scientificamerican.com/blog/60-second-science/post.cfm?id=are-medical-costs-the-leading-cause-2009-06-05)
It can be argued that even one medical cost bankruptcy is one too many and the Government should intervene. But one mortgage-related bankruptcy is one too many also and the Government intervened. See “TARP.” How many mortgages assets have been rescued by this $700 billion program?
- Fixes the geographic disparities in Medicare payments that currently penalize Minnesotans – This is Betty’s signature contribution to Obama Care. Medicare payments to providers in states such as Florida are higher than Minnesota, penalizing Minnesotans in Betty’s world. But this legislation does not REWARD Minnesota providers for their efficiency, it PENALIZES those high-charge providers. So there is no real or tangible benefit to her Minnesota constituency.
- Allows young adults to stay on their parents' insurance plans until age 27 – Why just to 27? What’s magic about that age? Why not 30 or 35? Children are now eligible for care until the age of 25 under SCHIP. And they’re the healthiest American population group. Catastrophic health insurance policies – now available - accomplish the same end for much less cost.
- Reduces the federal budget deficit over 10 years – Technically true when the cost of H.R. 3962 is analyzed alone. HOWEVER, the House companion bill (H.R. 3961) which changes Medicare’s payments to physicians AND H.R. 3962 will ADD $89 billion to the deficit in the 2010 – 2019 period (http://cboblog.cbo.gov/?p=427). Recall that the Senate unsuccessfully tried to decouple these two issues in their version of reform. Finally, the cost of Medicare is 9X higher than Congress forecast when it was enacted in 1965. So who trusts Congress’ estimates of the cost of any health care legislation?
Another very important element of the Affordable Health Care for America Act is that for those Americans who are happy with their doctor and insurance plan, nothing changes - nothing. Under this bill, you can keep exactly what you have right now. Well, the name may stay the same, but the substance for those of us placed on Medicare will change. Cost, access and quality. With $400 billion of Medicare “savings” forecast by Congress, will cost, access and quality be improved? Or will cost be controlled with corresponding declines in quality and access?
If $400 billion of Medicare savings is a realistic and responsible outcome, why does health care insurance have to be reformed to realize it?
Finally, regarding the Stupak-Pitts Amendment, Betty wrote: “During debate on this bill, the House voted 240-194 to include the Stupak-Pitts amendment, which bans legal reproductive health care services for women who pay for their own health insurance. I voted against this amendment because it violates the first tenant of the entire reform effort, which is to ensure that no one loses coverage they currently have.”
This simply is not true; the Amendment did not ban legal reproductive health services for women who pay for their own health insurance. The Stupak-Pitts Amendment prohibited abortion funding by the public option and through affordability credits which would be given to consumers to pay for health care plans that fund abortions. (http://www.lifenews.com/nat5629.html)
So regardless of how Betty spins it, her vote AGAINST the Amendment WAS a vote FOR taxpayer-sponsored, Government infanticide.
Reforming our broken health care system is a national priority. As the U.S. Senate now takes up its reform legislation, I will work to ensure the strongest possible final bill emerges so that America remains healthy, strong and economically competitive.
For those of you keeping score, here’s a list of new taxes provided by the House Bill needed for “reforming our broken health care system.” The grand total is $700 billion. (http://blog.heritage.org/2009/10/29/the-house-health-care-bill-a-700-billion-tax-hike/)
1. Health Savings Account Tax: Increases tax on health savings account funds not used for medical purposes from 10% to 20%. ($1.3 billion)
2. Flexible Spending Arrangement Cap: Caps contributions to flexible spending accounts at $2,500. ($13.3 billion/ ten years)
3. Medical Devices Excise Tax: Imposes 2.5% excise tax on sale of medical devices. ($20 billion/ ten years)
4. Self-Insured Health Fee: Imposes fee on insured and self insured health plans.
5. Itemized Deductions Definition: Conforms the definitions of medical expenses from employer-provide health insurance, merging flexible spending arrangements, health reimbursement arrangements, health savings accounts and archer MSAs to the definition of itemized deduction. ($5 billion/ ten years)
6. Medicare Part D: Eliminates deduction for expenses that can be allocated to the Medicare Part D subsidy. ($3 billion/ ten years)
7. Payments to Corporations: “Requires information reporting on payments to Corporations” ($17.1 billion/ ten years)
8. Worldwide Interest Allocation: Delays implementation of interest allocation. ($26.1 billion/ ten years)
9. Treaty Benefits Limit: Limits the treaty benefits for some deductible payments. ($7.5 billion/ ten years)
10. Economic Substance Payments: Codifies economic substance doctrine and imposes penalties for underpayments. ($5.7 billion/ ten years)
Sincerely,
Betty McCollum
Member of Congress
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