Doctors Caucus

Floor Speech

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Mr. GINGREY of Georgia. I thank the gentleman from Tennessee for yielding to me. He has already alluded to some of the things that I am going to say in my remarks but the most important thing that he stated: On Tuesday night, President Obama stood here in this Chamber and he gave his State of the Union address and said:

Patients enjoy stronger protections than ever before. Already, the Affordable Care Act is helping to slow the growth of health care costs.

Well, President Obama obviously didn't get the memo. We must not have read the same CBO report, Mr. Speaker. ObamaCare is not slowing the growth of health care costs. ObamaCare is driving up the costs, jeopardizing insurance coverage, and placing excessive burdens on small businesses, limiting their potential for growth.

In 2010, President Obama and the Democrats assured us that their health care law would lower costs, it would cover millions of uninsured Americans. Well, as Dr. Roe said, fast forward 3 years and we have seen nothing but broken promises and this enormous pricetag. Just last week, the CBO--the Congressional Budget Office--the unbiased scorekeeper that works for Congress, reported that under ObamaCare--PPACA, health care costs will increase and 7 million Americans will lose their coverage. These are the facts, despite any State of the Union rhetoric.

Young Americans will also be severely impacted with an exorbitant rise in health insurance premiums due to a provision in ObamaCare. A lot of people are not aware of this, Mr. Speaker. This provision requires insurance companies to reduce their rates for seniors--a laudable goal. Premium costs for individuals under the age of 40, though, are going to significantly rise to even out that balance. By limiting these--we call them age ban discounts--that are called for in ObamaCare, a 3-to-1 ratio. So someone, let's say as an example, that is in their very early sixties and they're not eligible for Medicare at age 65, and they already possibly have multiple systems diseases, as we say in medical parlance, and are on many prescription drugs, expensive drugs--they're a much greater risk in regard to an insurance premium coverage of busting the ceiling on that every year. But under ObamaCare it says their premiums cannot be more than three times the premium of someone who is 28 years old, 10 feet tall, and bulletproof.

As a result, these are some of the problems that that creates within these exchanges. It will absolutely discourage the younger people from buying insurance. They'll pay the fine. They will not pay those higher premiums so that they stay within that 3-to-1 ratio. It will likely force young healthy individuals out of the insurance market. That's some of those 7 million we're talking about that are going to lose their insurance because of this.

Let me just give a real specific, and then I'll yield back to the gentleman so he can yield time to our other colleagues. For a 27-year-old earning $33,500 a year, premiums are expected to jump from $2,400 a year to almost $3,200 a year. This is an outrageous increase in costs that young people can't afford. If they get a job in this current climate where we've had 7.6 percent or higher unemployment--the entire time that President Obama has been in office--they're not going to be able to afford these premiums. And they clearly are not going to pay for them. ObamaCare is negatively impacting the insurance market on two fronts: it forces rising premium costs on the young, and it increases the total uninsured population, as I stated earlier.

So at this point I'll yield back to the gentleman from Tennessee and I hope to remain with my colleagues for the remainder of the hour as we continue this colloquy.

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Mr. GINGREY of Georgia. Mr. Speaker, the gentleman from Tennessee is generous with his time. I did want to follow on to what the gentleman doctor from Maryland is just talking about in regard to tort reform. Yes, he covered that very, very clearly and pretty completely.

But there are other things in this law, the so-called Affordable Care Act--well, Patient Protection and Affordable Care Act. And, yes, I think President Obama proudly likes to have it called ObamaCare. Maybe he hopes that one day that will be his legacy. There are provisions that, particularly in these exchanges that are being set up in all 50 States, the States that are doing it, the territories and the District of Columbia, that basically say what best practices are for the different physician specialties, including the specialty of obstetrics and gynecology which Dr. Roe and I practiced many years. But in these descriptions of what's the best practice for a general surgeon or an internist or a pediatrician, in some cases, they're not a carbon copy of what our specialty societies recommend. The American College of Obstetricians and Gynecologists, as an example, does a wonderful job of making sure that each one of their members gets a monthly bulletin and current updates on what the best practices are for our specialty. It's based on science by the best and brightest. And, yet, this law may ask us to do something that goes against that.

I have introduced a bill, Mr. Speaker, to protect our physicians. If they are following the guidelines of their specialty, or, on the other hand, if they're following the guidelines of the government that some government bureaucrat says is the best standard of care, if they're doing that and they have a bad outcome, this provider shield would protect those physicians from liability. It's something that's desperately needed because of this law.

There is another bill that I have introduced called the SCOPE Act. SCOPE is an acronym for the Safeguarding Care of Patients Everywhere. What would prevent the Secretary, Ms. Sebelius, or whomever, from saying what qualifies a physician to be on a provider group in one of these exchanges? Is it what she says or what their specialty society says?

So, again, these are things that we're working on very hard to correct, I think, a very bad situation. We members of the Doctors Caucus, we on this side of the aisle will continue to fight for that. I thank the gentleman.

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Mr. GINGREY of Georgia. Again, I thank the gentleman from Tennessee for yielding because I wanted to follow on in this line of discussion with regard to costs.

The way doctors were paid by Medicare in 1965 was, to my understanding--I think I'm correct on this--just like private insurance: an 80/20 indemnity kind of coverage, and the cost was accelerating.

Then in 1998, I believe, the Balanced Budget Act of 1997 put in this formula to control Medicare spending, particularly the spending that goes to the health care providers, which by the way is only about 12 percent of total Medicare spending.

In any regard, that seemed to be the greatest concern, controlling how much the doctors were getting paid. So they put in this formula that's called SGR, sustainable growth rate, based on some calculus. But it was flawed. It was flawed badly. And for the last, I would say, 10 years, when you calculate that formula for the expenditures for doctor fees for the previous year, the formula would call for a cut of 1 percent, 2 percent, 4 percent. Over those 10 years, it's up to 26.5 percent. Well, thank goodness Congress, we Members of Congress on both sides of the aisle, have the ability to mitigate that; and we have done that because we know the formula is flawed and it needs to be repealed and replaced. Yet we have not been able to do that.

I'll tell you this, though: in this House of Representatives, in this 113th Congress, with Republican control under Speaker Boehner and Leader Cantor and committee chairmen like Fred Upton in Energy and Commerce and Dave Camp on Ways and Means, we are going to fix that flawed formula once and for all. We're not going to keep putting Band-Aids on it, mitigating a little bit at a time, and kicking the can down the road. That is our pledge to the American people.

I hope our colleagues in the other Chamber, controlled by the Democratic Party, will go along with us on this because what we realize is that all of the doctors in the House and in the Senate, they understand that if you enact those cuts that will come due again at the end of this year, almost a 30 percent cut in what you reimburse for Medicare providers, then there will be no doctors. People will have a Medicare card, but they will not be able to find a physician to take care of them.

This ObamaCare bill did nothing except, in fact, enact a provision, which I know my colleague from Tennessee wants to talk about, that makes it worse, that doubles down on it. We need to repeal SGR and figure out a better way to reimburse, to pay physicians based on quality of care, rather than volume. I think that's a good idea. But there's a provision in ObamaCare that could trump all of that and make all of our efforts in that direction go for naught.

So I want to end here so the gentleman from Tennessee can explain what I'm talking about because he has the repeal bill for that.

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