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Public Statements

Protecting Access to Healthcare Act

Floor Speech

By:
Date:
Location: Washington, DC

The House in Committee of the Whole House on the state of the Union had under consideration the bill (H.R. 5) to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system:

Ms. HIRONO. Mr. Chair, this week we celebrate the 2nd anniversary of the Affordable Care Act.
The Affordable Care Act is designed to fix so many of the things that ail our health care system and burden everyday families. The new law has already had a major impact on families in Hawaii.

Senior citizens in Hawaii now have some relief from the high cost of prescription drugs. In 2010, over 24,000 people with Medicare in Hawaii received tax rebates to cover prescription drug costs.

One senior from Waimea on Hawaii Island told me her $250 Medicare rebate check was ``a blessing'' in these tough economic times. She was able to use that money to pay for her other medical bills.

In 2011, more than 21,000 people in Hawaii with Medicare saved close to $7 million on prescription drugs. The ``donut hole'' gap in coverage will be closed by 2020.

A mother in Kailua told me that because of the Affordable Care Act, she could now add her 21 year-old son and 24 year-old daughter to her work-sponsored insurance plan.

These are just two of the over 5,000 Hawaii young adults who can now stay on their parents' plan until age 26. This Kailua family is now using the thousands of dollars saved on health insurance each year for other household needs, including paying down past medical debt.

The old saying is true, that ``an ounce of prevention is worth a pound of cure.'' Preventive services like mammograms, colonoscopies, and wellness visits can detect problems early and prevent higher costs later.

Thanks to the Affordable Care Act, nearly all 210,000 Hawaii people with Medicare can now get preventive services without a co-pay or deductible. In addition, 240,000 people in Hawaii with private insurance are now eligible for preventive services--including women's health services such as domestic violence screenings and contraception--without a co-pay or deductible.

The Hawaii Prepaid Health Care Act already covers employees who work for more than 20 hours per week. As a result, a large percentage of our people can get the healthcare they need to stay healthy. We have a low rate of uninsured. And that saves all of us money.

This is why I fought hard to preserve the Hawaii Prepaid Health Care Act in the House bill. I offered an amendment to preserve Hawaii's law and defended my amendment in committee, convincing my colleagues to support my amendment. Then, all of us in the delegation worked together to make sure the final Affordable Care Act law maintained Hawaii's law.

Because of Hawaii's Prepaid Health Care Act, most employers in Hawaii already provide health coverage. The Affordable Care Act makes it easier for Hawaii small businesses by providing tax rebates to help pay for health care costs. Nearly 29,000 Hawaii businesses are eligible for tax credits under the law.

Today I also met with leaders from eight of Hawaii's Community Health Centers. The Affordable Care Act helps fund these 73 health center sites that serve our highest-need rural and underserved communities, especially on the Neighbor Islands and rural Oahu. These health centers care for over 130,000 people and provide nearly 1,300 jobs throughout the state. The message these health leaders shared with me today is that the Affordable Care Act has made a positive difference in the lives of so many.

Given how much the Affordable Care Act is already helping Hawaii, it is unfortunate that some in Congress want to repeal it. Because they can't repeal the law all at once, they have continued to try to de-fund the law or repeal one piece at a time.

Today we're seeing another example of this, with H.R. 5. This bill would repeal the law's Independent Payment Advisory Board, also known as the IPAB.

This board is a panel of experts that will make recommendations so taxpayers aren't paying for unnecessary Medicare procedures. This will save taxpayers billions of dollars, while protecting Medicare patients. The board would not be allowed to recommend any cuts to reimbursement rates that ration or harm patient care. Congress would vote on the board's recommendations, or come up with an alternative that reduces cost growth by more.

In fact, because the Affordable Care Act has already reduced the growth in Medicare costs, the Board's recommendations wouldn't even be triggered until 2022 at the earliest.

I have heard from some medical providers in Hawaii who are worried the IPAB will recommend cuts to their specialty. These providers say they might choose not to see Medicare patients. I can understand their concerns, but here's the thing: Medicare costs are going up partly because of expensive and sometimes unnecessary procedures. Most members of Congress aren't scientists or health care researchers, so a panel of experts would be better suited to use the best research to recommend reforms. I will vote against a bill to repeal IPAB that doesn't put a better system in its place.

Unfortunately, this week the House Majority released a budget plan (the Ryan Budget) that would end the Medicare guarantee for our seniors. The Ryan Budget would again turn Medicare into a voucher system where seniors would have to purchase private plans. Private plans could deny and delay coverage, without Medicare's consumer protections our seniors get today. Last year's House budget tried this same plan, and the Congressional Budget Office said it would increase costs to people on Medicare by $6,000 per person starting in 2022.

The bill we're voting on today, H.R. 5, also recycles an old misguided proposal for medical negligence reform. Someone who is harmed by misconduct by a health professional should not be barred from appropriate compensation for a permanent disability or loss of a loved one.

The reality is that most medical providers are doing the right thing. A small percentage of doctors are responsible for over half the medical malpractice cases. We shouldn't be protecting this minority of providers over the rights of patients injured through these providers' negligence. Today's bill would deny justice to those who have been harmed by a small number of medical providers.

Today's bill, H.R. 5, would also hurt states' rights by preempting state medical malpractice laws. A cap on damages for physical impairment, pain, suffering, and even death could not exceed $250,000, regardless of individual states' existing limits.

Today's bill also extends far beyond medical malpractice. It would also apply to limit patients' rights in all ``health care lawsuits,'' which could include cases against pharmaceutical and medical device manufacturers, nursing homes, HMOs, insurance companies, and hospitals.

While proponents of medical malpractice reform argue that frivolous lawsuits are driving up insurance premiums, the fact is, economic studies have shown that medical malpractice payouts are not the cause of higher premiums for consumers. Instead, premium increases are caused by other factors, such as too little competition in the private insurance market.

I urge my colleagues to reject H.R. 5.

On the second anniversary of the Affordable Care Act, we should be fighting to make healthcare more accessible for our people, not less.

Mahalo nui loa (thank you very much).


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