The United States has the most expensive health care system in the world in terms of absolute costs, per capita costs, and percentage of gross domestic product. Yet despite the fact that we spend more on health care than any other industrialized nation, too many of our citizens cannot access the very medical care that America has long been a leader in providing.
Today, approximately 46 million Americans lack health insurance coverage - leaving one in six Americans without access to proper medical care. In Rhode Island, a state that has a strong record of providing health insurance through public and private partnerships, over 100,000 individuals are uninsured, of which 16,000 are children. As the cost of health care continues to rise, it imposes an increasing burden on our families, places American employers at a competitive disadvantage and creates significant fiscal challenges to balancing our federal and state budgets.
One of my top priorities as a Member of Congress has been to create a system of universal health care that increases quality, affordability, efficiency and choice for families and businesses across America. I have also been a strong advocate of strengthening our public health and safety net programs, including the State Children's Health Insurance Program (SCHIP), Medicare, Medicaid and veterans' programs; as well as promoting a strong and sustainable health care workforce; and encouraging investment into innovative research and technology.
On March 21st, I was proud to join my Congressional colleagues in taking an historic vote to pass comprehensive health reform legislation. The Patient Protection and Affordable Care Act (Public Law 111-148) will begin to institute the changes we need to provide more security and stability to Americans who have health insurance, guarantee insurance to the millions who don't, and lower health care costs for our families, businesses and the government. It will expand coverage to 32 million Americans, promote a strong health care workforce, reduce the deficit by $139 billion over 10 years and protect Medicare for our seniors.
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The American Health Benefits Program
I have been a longtime advocate of establishing a system of universal health care that guarantees every American access to quality, affordable health insurance regardless of income, age, employment or health status.
Prior to Congressional efforts focusing on comprehensive health reform, I introduced legislation representing my own vision to achieve universal health care, the American Health Benefits Program Act (H.R. 2399), a proposal designed to guarantee every American access to the same coverage as members of Congress. Now that Congress has successfully passed a comprehensive health reform bill, I will work to ensure that the legislation is properly implemented and works to the benefit of every Rhode Islander.
Children's Health Care
Our children are our most precious resources, and it is crucial that we provide them with the health care services they both require and deserve. Since 1997, the State Children's Health Insurance Program (SCHIP) has successfully provided health coverage to millions of low income children across the country who would not otherwise be able to access these services. However, too many children and their families remain without access to proper health services.
To address this, I was pleased to support H.R. 2, the Children's Health Insurance Program Reauthorization Act (CHIPRA), which was signed into law by President Obama on February 4, 2009. This bill expands coverage to 11 million children by reauthorizing SCHIP for four and a half years and providing coverage for an additional 4 million uninsured children who are currently eligible for, but not enrolled in, SCHIP and Medicaid. It also improves SCHIP by ensuring dental coverage for children, mental health services on par with medical and surgical benefits, as well as improved access to private coverage options through premium assistance subsidies.
The recently enacted health reform law also extends federal funding for the Children's Health Insurance Program (CHIP) for two additional years, to September 30, 2015, and provides states with additional funding to ensure children have access to this proven successful program. Additionally, it provides young adults the opportunity to remain on their parent's health plans until the age of 26, so they do not lose coverage as they transition from college into the workforce.
COBRA Health Coverage
During this difficult economic time, it is important that people who lose their jobs can continue to receive health coverage.Under current law, workers who become unemployed can temporarily continue the health coverage previously provided by their employers by paying the full cost of the insurance premiums, under a program known as COBRA.
To ease the financial burdens of health coverage for those who were laid off during the recession, the American Recovery and Reinvestment Act (Public Law 111-5) provided for a 65% subsidy for health premiums under COBRA for up to nine months for workers who have been involuntarily terminated. This program was set to expire at the end of 2009; however, I was pleased to support legislation that extended this assistance until May 31, 2010. As this deadline has passed and Rhode Islanders continue to look for jobs, I am working diligently with my colleagues to pass another extension that will prevent people from losing their health coverage assistance at a time when they need it the most.
The Medicare system was established in 1965 because the private health care industry was unable to provide adequate health coverage for the elderly and disabled citizens of our nation. The virtue of the current Medicare system is that it guarantees health care to the most vulnerable members of our society.
We must take meaningful action to ensure a strong and sustainable Medicare program that provides our seniors with the health care they deserve. The recently enacted health reform bill begins to achieve this by closing the Medicare Part D prescription drug gap, also known as the donut hole, in order to make drugs more affordable for seniors. This includes an immediate rebate of $250 for those who reach the donut hole in 2010. It also eliminates co-pays for preventive care to promote wellness and ease cost burdens, gets rid of billions of dollars in fraud, waste and abuse and protects Medicare by extending trust fund solvency by nine years.
Additionally, on November 19, 2009, the House passed a companion bill to health reform, H.R. 3961, which would provide a permanent fix for the flawed Medicare physician reimbursement formula, known as the Sustainable Growth Rate (SGR) formula, which is threatening access to care for our seniors. Since the Senate has not acted on a full repeal, Congress passed multiple temporary measures to delay the expected 21 percent reduction in doctor reimbursements, including a recent bill to delay the cuts through November 30, 2010, and a corresponding increase in reimbursements of 2.2 percent. I continue to believe we must find a permanent solution so that Medicare physician reimbursements more accurately reflect the costs of providing care in the current market.
Making Prescription Drugs Safe and Affordable
Americans pay 30 to 300 percent more for prescriptions than citizens of other industrialized countries. The main reason is that other countries engage in cost-control measures, such as the use of bulk purchasing power, to keep drug prices down. The high cost has taken a heavy toll, primarily on American seniors.
I have been a strong supporter of legislation to allow Medicare to use its bulk purchasing power to negotiate fair prices for prescription drugs on behalf of beneficiaries. Price negotiation is already practiced by the Veterans Administration and the Medicaid program. Medicare price negotiation could result in tremendous savings for consumers and the government, allowing Medicare money to be used more efficiently. The reinvestment of these savings could help strengthen the Medicare prescription drug benefit by reducing or eliminating the doughnut hole.
I also support the reimportantion of life-saving medications at significantly reduced costs from certain industrialized nations. Since consumer safety is of paramount concern, any prescription reimportation policy must also include strict oversight by the Food & Drug Administration (FDA) and be restricted to FDA-approved drugs from FDA-approved facilities.
As prescription drugs are one of the fastest growing components of health care spending, we cannot address the health care crisis without addressing the reasons behind these cost increases. I will continue to fight for reduced prescription drug costs for all Americans, as well as increased safety and oversight of new and existing medications in the market.
Supporting Innovative Health Research
The National Institutes of Health (NIH) is the primary agency charged with conducting and supporting medical research. Projects funded by NIH represent opportunities to understand diseases, improve health, and open the way for future progress in medical research. They provide us with the knowledge needed to understand - and ultimately to control or defeat - cancer, Parkinson's, diabetes, and many other ailments, diseases and conditions. This research also plays a key role in preparing the nation for incidents of bioterrorism. During my time in Congress, I have been proud to advocate strongly for funding increases at NIH. Furthermore, I support efforts to invest in pioneering research in the Veterans Administration's Office of Research and Development, which plays a key role in advancing knowledge and promoting innovations that improve the health and care of veterans and the nation.