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Issue Position: Health Care

Issue Position

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Health care reform is one of the greatest and most important legislative decisions of our lifetime.

In March 2009, President Barack Obama invited Members of Congress and national health care leaders to the White House for an open, broad-ranging discussion on how to expand access, improve quality and lower the costs of health care for all Americans. House and Senate Democrats took an open and transparent approach to the debate on health insurance reform, with nearly 200 bipartisan hearings and countless health care events across the country.

I received thousands of letters and telephone calls from constituents who both opposed and supported comprehensive health care reform.

With each of those letters and calls in mind, on March 21, 2010, I cast the most important vote in my career, in favor of H.R. 3590, the Senate version of the Patient Protection and Affordable Care Act [PL 111-148].

The American people waited for over 100 years for this legislation that provides quality, affordable health care coverage and fights waste, fraud and abuse. These are just a few of the benefits that took effect immediately:

* Tax credits for small businesses to make employee coverage more affordable;

* $250 provided to Medicare beneficiaries who hit the "donut hole" in 2010;

* Americans who are uninsured because of a pre-existing condition are able to obtain insurance through a temporary high-risk pool;

* Insurance companies are prohibited from denying coverage to children with pre-existing conditions;

* Health plans are required to allow young people up to their 26th birthday to remain on their parents' insurance policy;

* Health plans are prohibited from dropping people from coverage when they get sick;

* Health plans are prohibited from placing lifetime caps on coverage; and
* Beginning January 2011, preventive services under Medicare will be free.

Most importantly, this reform will accomplish these objectives while paying for itself. The non-partisan Congressional Budget Office estimates that the law will reduce the deficit by $143 billion over the next 10 years and by $1.2 trillion in the following decade.

Half of the cost of the bill is paid for by targeting waste, fraud and inefficiency in Medicare and Medicaid. The other half of the cost is paid for by asking the wealthiest two percent of Americans to contribute, imposing fees on certain health care industries and closing two tax loopholes.

By enacting this legislation into law, Congress and President Barack Obama have put the American people first. We have ensured that the United States remains a leader among industrialized nations, and we have ensured that the American people can now take comfort in knowing that an illness will no longer wipeout their life savings and lead to bankruptcy.

In addition to providing access to health care coverage, H.R. 3590 does a great deal to address health care disparities in our nation's minority communities. Specifically, it includes language that I introduced with Representative Jesse Jackson, Jr. (D-Ill.) H.R. 2778, the Health Equity and Accountability Through Research Act.

This legislation sought to elevate the National Center on Minority Health and Health Disparities (NCMHD) to the level of Institute, giving it the authority to better address the appalling health disparities that are plaguing our nation's minority communities.

NCMHD was created to promote minority health and to lead, coordinate, and assess the efforts of the National Institutes of Health (NIH) to ultimately eliminate health disparities. Unfortunately, the previous structure of NCMHD created confusion regarding who has the responsibility for the coordinated minority health disparities research conducted or supported by NIH.

Additionally, NCMHD lacked real input into and authority over all NIH-supported health disparities activities and funds. H.R. 3590 addressed these concerns by elevating the Center to the level of Institute, and clarifies the role of the Director as coordinator and manager of the NIH-wide minority health and health disparities portfolio.

The bill also provides the new Institute with professional judgment over NIH-wide minority health and health disparities budgets as well as management over NIH-wide minority health and health disparities allocations. However, this is not the only improvement that minority and underserved communities will see.

This comprehensive healthcare package also includes $11 billion for community health centers, which offer comprehensive primary care and mental health services to underserved populations. These health centers are a critical stopgap, allowing better care for chronic conditions, while preventing unnecessary trips to the emergency room.

Last but certainly not least, H.R. 3590 honors the life of Deamonte Driver--a 12 year old boy from Maryland whose life was cut drastically short three years ago when an untreated tooth infection spread to his brain. Deamonte's tragic death haunts me to this day. Eighty dollars worth of dental care might have saved his life, but he never got that care because he lacked access to a dentist.

The enacted health care legislation will prevent others from dying in such a tragic fashion. Under the new law:

* Pediatric dentistry is covered as an essential health benefit;

* Funds will be provided to launch a dental campaign to new parents and traditionally underserved areas;

* Workforce Training Grants will be available to provide technical assistance to pediatric training programs in developing and implementing instruction regarding the oral health status, dental care needs, and risk-based clinical disease management of all pediatric populations with an emphasis on underserved children; and

* There is a loan repayment program with preference given to qualified applicants who have a record of training individuals who are from a rural or disadvantaged background.

However, minorities and underserved communities will not be the only populations that will benefit from our actions. Millions will be touched by healthcare reform in their daily lives in marked, measurable way.

Just in Maryland's 7th District:

* 28,000 uninsured resident will now have insurance coverage;

* 403,000 people will have better coverage;

* 90,000 seniors will benefit from improvements to Medicare; and

* 147,000 families and 14,000 small businesses will receive tax credits to help cover the cost of health insurance.

By enacting healthcare reform, the government has met its moral obligation to the people and it will make this nation stronger.

The Republican Attack On Medicare and Medicaid:

I refuse to accept the Republican attack on our national commitment to Medicaid and Medicare.

Republicans would slash federal Medicaid spending by $771 billion over the next 10 years -- demanding, in effect, that seniors and the disabled pay for most of that $1 trillion in additional Republican tax breaks for the most affluent.

Fully 42 percent of all long-term nursing and in-home care for America's senior citizens is paid for by Medicaid. When Medicaid's care for individuals with disabilities is included, the percentage increases to two-thirds.

Republican cuts to Medicaid would be catastrophic. Facing serious budget constraints, state governments would be unable to effectively cover a $771 billion Republican cut in federal funding.

Our seniors, along with their middle-aged children, would then be left with the bills, bulldozing them into a financial landfill.

The Republicans' demand to cut Medicare benefits would be just as damaging.

Republicans would immediately raise our current seniors' healthcare costs by taking away the free preventive care benefit and reinstituting the prescription drug "donut hole."

Even more pernicious, for those Americans under 55 -- who paid into the Medicare Trust Fund for all of their working lives -- Medicare's guaranteed benefits would be taken away.

Under the Republicans' Medicare proposal, future seniors would receive a voucher from the government each year and be forced to shop for their own private health insurance. Private insurance company bureaucrats would be placed in charge of their healthcare.

The projected additional cost for those seniors would be substantial. In Maryland, seniors' out-of-pocket annual expenses would more than double by 2022 under the Republican proposal, reaching an individual budget-busting burden of $13,368 each year.

I am committed to finding an equitable path to national solvency, as we demonstrated by the measures in our Affordable Care Act that extended the solvency of the Medicare Trust Fund by eight years. I will not accept misguided efforts to balance our national budget solely on the backs of America's working families.

Prostate Cancer:

In March of 2009, I was joined by eleven of my colleagues, including Energy and Commerce Committee Chairman Henry A. Waxman (D-Calif.), in sending a letter to the National Institutes of Health (NIH) and the National Cancer Institute urging the agency to utilize a portion of $8.2 million in biomedical research funding received from the American Recovery and Reinvestment Act to improve prostate-specific imaging technology.

Every eighteen minutes, another man dies of prostate cancer, and yet, despite its prevalence, we still lack adequate diagnostic tools to provide for early detection, accurate biopsies, and appropriate treatment. By using a portion of these additional research funds on prostate-specific imaging technology, we can move one step closer to ensuring that our commitment to prostate cancer research matches its impact in our lives.

Despite prostate cancer having a higher prevalence than breast cancer, advanced diagnostic imaging technologies comparable to life-saving mammograms still remain unavailable for men.

A study funded by the National Cancer Institute, published in the March 26 issue of the New England Journal of Medicine, shows no evidence of a survival benefit associated with aggressive screening for prostate cancer using the prostate specific antigen (PSA) test. Because of the lack of an effective diagnostic tool, more than 1 million men undergo unnecessary and traumatic biopsies each year, with side effects such as impotence and incontinence.

The leadership of NIH in the advancement of breast imaging technologies resulted in the transformation of diagnosis and minimally-invasive treatments of breast cancer, and I firmly believe that NIH and the National Cancer Institute can lead the way in bringing this same transformation to prostate cancer.

Signatories of the letter included myself, Henry A. Waxman (D-Calif.), Dan Burton (R-Ind.), Donna M. Christensen (D-V.I.), Danny K. Davis (D-Ill.), Jesse L. Jackson, Jr. (D-Ill.), Keith Ellison (D-Minn.), Michael E. Capuano (D-Mass.), Dennis Moore (D-Kan.), Jim Marshall (D-Ga.), Tim Holden (D-Penn.) and Robert Wexler (D-Fla.)

Men's health is of particular importance to me. Significant numbers of male-related health problems, such as prostate cancer, testicular cancer, infertility, and colon cancer, could be detected and treated if men's awareness of these problems was more pervasive.

With this in mind, I authored H.Con. Resolution 142, a resolution supporting National Men's Health Week. I am proud to support efforts to keep men in my community healthy, and to ensure that proper screening helps save their lives.

Testicular cancer is one of the most common cancers in men between the ages of 15 and 34, and when detected early, has a 95 percent survival rate. Cases of colon cancer among men numbered almost 54,000 in 2008, and almost half of such men died from the disease. A man in America has a 1 in 6 chance of developing prostate cancer, with more than 186,000 cases in 2008. African-American men have the highest incidence in the world of prostate cancer.

Access to Healthcare for Medicare Patients:

On July 15, 2008, I joined my House colleagues to pass H.R.6331, the Medicare Improvements for Patients and Providers Act of 2008 over President Bush's veto.

We sent America and those who would hold our Seniors' health hostage a strong message that improving and expanding care for our Seniors - and ensuring fair payment for providers - are national priorities.

I remain steadfast in that conviction.

I also am confident that the current Congress will defer the 23% cut in Medicare reimbursement - currently scheduled for December 1 - because we already have done so four times this year.

I would prefer a multi-year "doc fix," but we have been blocked by Senate Republicans.

Assuring that our seniors and other Medicare participants receive the care that they need is a top priority for me -- and a major budgetary issue. The Congressional Budget Office estimates that the cost of keeping Medicare reimbursement payments consistent with inflation from 2011 through 2020 would cost $330 billion.

Congress must meet this challenge. Medicare is a sacred trust.


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