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Issue Position: Health Care

Issue Position

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Issue Position: Health Care

* Chairman and Ranking Member of the Labor, Health and Human Services, and Education Appropriations Subcommittee.
* Since 1996 has doubled funding for the National Institutes of Health to increase medical research for illnesses, including cancer, Alzheimer's, ALS, Parkinson's, and HIV/AIDS.
* A leading advocate for stem cell research.
* Works to ensure Medicare beneficiaries access to quality health care services and affordable prescription drug.
* Supports legislation that ensures health care providers receive fair reimbursement in order to maintain quality and accessible health care.

Throughout my tenure in the United States Senate, I have continued to work on many health care issues of great importance to Pennsylvanians. As Ranking Member of the Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee, I remain committed to making quality health care more accessible and affordable. Among the many important issues faced by Congress are: Medicare and Medicaid reform; the uninsured and rising costs of health and malpractice liability insurance; and the continuation of funding for important medical research, such as stem cell research.

Medicare & Prescription Drugs
One of my health care priorities continues to be providing a quality prescription drug benefit for Medicare beneficiaries. On January 1, 2006, Medicare provided a new optional prescription drug benefit which makes a dramatic difference for millions of Americans with lower incomes and chronic health care needs. Low-income Medicare beneficiaries, who make up 30 percent of all Medicare beneficiaries, are provided with prescription drug coverage with minimal out of pocket costs. In Pennsylvania, this benefit is further enhanced through coordination with the Prescription Assistance Contract for the Elderly (PACE) program to provide increased cost savings for low-income beneficiaries.

I understand that there are many criticisms directed at this law. Some beneficiaries would like to see the prescription drug program cover all of the costs without deductibles and copays. The current plan, depending upon levels of income, has several levels of coverage from a deductible to almost full coverage under a "catastrophic" illness. One area of concern is a coverage gap sometimes called the "donut hole." The donut hole is a gap in insurance coverage in which beneficiaries are required to pay the full cost of their prescription drugs, between $2,400 and $5,400 in Medicare and beneficiary fees ($865-$3,000) in beneficiary out-of-pocket expenses). After this point Medicare pays for 95% of a beneficiary's drug costs. Medicare will provide protection against high out-of-pocket prescription drug costs, with copays of $2 for generics and preferred multiple source drugs and $5 for all other drugs. Though I am seriously troubled by the so-called donut hole, it is calculated to encourage people to seek the medical care they really need, and be affordable for those with lower levels of income. Then, when the costs move into the catastrophic illness range, the plan would pay for nearly all of the medical costs.

In order to lessen the financial burden for beneficiaries who find themselves paying the full cost of their prescription drugs in the donut hole, I am a cosponsor of S. 3703, "Medicare Prescription Drug Lifeline Act." This bill will allow beneficiaries to withdraw from their current prescription drug plan and enroll in another plan that provides coverage in the donut hole. I am also a cosponsor of S. 2810, "Medicare Late Enrollment Assistance Act," which would prevent beneficiaries who have not yet enrolled from being penalized for late enrollment under Medicare's prescription drug benefit.

I also support Congressional action that would allow the Secretary of the Department of Health and Human Services to negotiate Medicare's prescription drug prices. I introduced S. 273, which would authorize the Secretary of Health and Human Services to negotiate for lower Medicare prescription drug prices directly with prescription drug manufacturers. This could help Medicare beneficiaries dollars go further. I introduced a similar version of this bill in the 108th and the 109th Congresses, S. 2766 and S. 813, respectively.

Further, I support Congressional action that would protect U.S. citizens' right to purchase imported prescription drugs provided that this action will result in no public health risk. I am a cosponsor of S. 334, "Pharmaceutical Market Access and Drug Safety Act." This bill creates a framework through which Americans can safely purchase imported pharmaceuticals from registered countries to provide a significant cost savings. Additionally, I supported a provision to the Fiscal Year 2007 Homeland Security Appropriations Bill, which allows U.S. residents to personally transport a 90-day supply of FDA-approved prescription drugs from Canada.

The Medicare Modernization Act, which provided the Medicare prescription drug benefit, also provided rural health care providers much needed increases in Medicare reimbursement including higher reimbursements for hospitals that serve a disproportionately high number of low-income Medicaid patients. Hospitals across Pennsylvania have benefited from these higher reimbursements including teaching hospitals who received increase reimbursements for medical educational professionals. Furthermore, this law provides $900 million for hospitals in metropolitan statistical areas with high labor costs due to their close proximity to urban areas that provide a disproportionately high wage. I introduced S. 4017, "Hospital Payment Improvement and Equity Act" which addresses both of these problems. The bill would provide an increased reimbursement for acute care hospitals and inpatient rehabilitation facilities that are disadvantaged by Medicare payments under the Medicare area wage index reclassification system. On December 9, 2006, as part of H.R. 6111, "Tax Relief and Health Care Act," the program was extended by six months until October 2007. This provides an additional $18.4 million to Pennsylvania hospitals.

I staunchly support legislation that ensures that health care providers receive fair and adequate reimbursement in order to maintain quality and accessible health care for Medicare beneficiaries. I am pleased that the Medicare Prescription Drug, Improvement and Modernization Act contained a number of improvements for the providers of health care to Medicare beneficiaries. Physicians, who were originally scheduled to receive cuts in 2004 and 2005, received a 1.5 percent increase each year. I am a cosponsor of S. 1081, "Preserving Patient Access to Physicians Act of 2005," to provide a positive physician payment update of at least 2.7 percent in 2006, and an update in 2007 that reflects physician practice cost inflation, which is expected to be 2.6 percent. The recently passed H.R. 6111, "Tax Relief and Health Care Act", also," included a provision to prevent a scheduled 5.1% reduction in Medicare reimbursements for physicians by freezing payments at the 2006 rate. Physicians can receive a 1.5 percent bonus next year if they report on a set of quality-of-care measures. If the scheduled cut was put into place, it would have been a $125 million reduction in 2007 payments to Pennsylvania physicians.

Access to health care is critical, particularly for low-income individuals in our society who are served by Medicaid. I have opposed reducing Medicaid funding and limiting access to health care for our poorest citizens. During consideration of the Fiscal Year 2006 Budget Resolution, I voted to eliminate a proposal that we cut Medicaid funding by $15 billion over 5 years. On March 17, 2005, this amendment passed by a vote of 52-48.

To enhance access to health care for the most vulnerable individuals, I am a cosponsor of S. 311, the "Early Treatment for HIV Act of 2005" which would give those states that provide Medicaid coverage for low-income HIV-infected individuals increased federal funding. Providing early intervention care significantly delays the progression of HIV, reduces the death rate for those living with HIV, and allows those with the virus to continue to be healthy, active members of society. I am also a cosponsor of S. 401, "Medicaid Community-Based Attendant Services and Supports Act of 2005." This legislation would give individuals who are currently eligible for nursing home services and institutional health care facilities equal access to community-based health care attendant services and support. Further, I am a cosponsor of S. 1903, "Generic Prescription Drug Fairness Act of 2005." The bill would increase access to less expensive generic drugs for Medicaid beneficiaries and create a cost savings for Medicaid.

Health Insurance
According to the U.S. Census Bureau, 46.6 million Americans lacked vital health insurance last year. To reduce the number of uninsured individuals, I am a co-sponsor of S. 406, "Small Business Health Fairness Act of 2005," which allows for the establishment of association health plans (AHPs). AHPs would give small businesses the ability to provide medical insurance to their employees by grouping together and using the same bargaining power that larger employers have in negotiating contracts with insurers. Through this increased bargaining power, AHPs may be able to offer reduced priced plans, thereby enabling more employers to afford to offer such coverage and reducing the number of small-firm employees without access to health insurance.

Medical Liability
I also recognize that maintaining an accessible, high quality pool of physicians, specialists and hospitals is critical to our health care system. From my travels throughout the state, I understand the problems faced by medical professionals, as well as by people injured in the course of medical treatment; I am working with my colleagues in the Senate to provide an appropriate legislative solution to address Pennsylvania's medical liability insurance crisis. I support caps on non-economic damages so long as they do not apply to catastrophic injuries such as the paperwork mix-up that led to the double mastectomy of a woman or the death of a 17-year-old woman in North Carolina due to an erroneous blood test. Beyond the issue of caps, I believe there could be savings on the cost of medical liability insurance through eliminating frivolous cases by requiring plaintiffs to file with the Court a certification by a doctor in the field that it is an appropriate case to bring to court. This proposal, which is now part of state procedure, would be expanded federally, thus reducing claims and saving costs. Further savings could be accomplished through patient safety initiatives identified by the Institute of Medicine. On May 8, 2006, I voted to Invoke Cloture (to end debate) on the Motion to Proceed to S. 22, "Medical Care Access Protection Act of 2006" and S. 23, "Healthy Mothers and Healthy Babies Access to Care Act of 2006." S. 22 would apply to all healthcare providers and institutions and would provide unlimited economic damages for the victim. S. 23 would regulate lawsuits for liability claims related to obstetrical or gynecological services, as well as provide unlimited economic damages for the victim. Ultimately, the Senate failed to end debate on the bills and neither bill could be voted on.

Medical Research
I have also worked to increase funding for important medical research initiatives. As both Chairman and Ranking Member of the LHHS Subcommittee, I have fought to double funding for the National Institutes of Health (NIH). I firmly believe that NIH is the crown jewel of the Federal government, and substantial investment in NIH is crucial for the continuation of breakthrough research into the next decade. Such research benefits not only Americans, but victims of disease throughout the world. The success realized by this investment in NIH has spawned revolutionary advances in our knowledge and treatment of diseases; only the Federal government can advance the funds necessary to ensure continued breakthroughs in medical science. I will continue to support Federal programs that provide valuable assistance, guidance, and biomedical research for the benefit of all Americans.

Stem Cell Research
With the increased availability of Federal research dollars, it is also important for Congress to help facilitate the availability of ethical and innovative research techniques. For this reason, I have continued to advocate stem cell research for the purposes of discovering knowledge that may lead to cures for ailments such as cancer, Parkinson's, and Alzheimer's. I have held 20 hearings on this topic as both Chairman and Ranking Member of the LHHS Committee. On February 8, 2005, I joined a bipartisan group of senators in introducing S. 471, "Stem Cell Research Enhancement Act of 2005." Current federal policy on human embryonic stem cell research only allows federally funded research be conducted on those stem cells derived before August 9, 2001. Today, only 22 stem cell lines are available to federally funded scientists. S. 471 would lift the date restriction and allow federally funded scientists to research a greater number of stem cell lines. The legislation would also provide stronger ethical requirements on stem cell lines eligible for funding including donor consent, certification that embryos donated are in excess of clinical need, and that the embryos would be otherwise discarded. The House companion bill, H.R. 810, passed the House of Representatives on May 24, 2005, and passed the Senate on July 18, 2006. The legislation was vetoed by the President on July 19, 2006. The House voted 235-193, short of the 2/3 vote needed to override President Bush's veto. On May 5, 2006, I introduced S. 2754, "Alternative Pluripotent Stem Cell Therapies Enhancement Act," which would authorize research to obtain stem cells using alternative methods that would not result in the destruction of an embryo. On July 18, 2006, the U.S. Senate unanimously passed this bill, 100-0.

Prevention, Treatment, and Education Programs
Congress holds an important role in funding prevention, education and treatment programs for substance abuse, domestic violence and AIDS. I have continued to help fund the Substance and Mental Health Services Administration (SAMHSA), which improves the quality and availability of prevention, treatment, and rehabilitative services for substance abuse and mental illnesses. During Fiscal Year 2006, I helped secure $3.3 billion for SAMHSA. In the fight against domestic violence, I support increased funding for the Violence Against Women Act (VAWA) and the Office of Justice Programs (OJP). These funds will continue to help combat domestic violence by making available needed educational and financial services for community action groups.

I further worked to secure $554.5 million for a U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Fighting the AIDS epidemic here at home is equally important. I have consistently supported Ryan White AIDS programs, which assist localities that are disproportionately affected by the HIV epidemic. In Fiscal Year 2006, I helped secure over $2 billion for Ryan White AIDS programs and services for AIDS and HIV patients.

Finally, I am personally opposed to abortion, but I am a supporter of a woman's right to choose. I believe that it is not the role of the federal government to interfere in an issue best handled by women and families in consultation with their minister, priest, or rabbi. Through my role as Chairman and Ranking Member of the LHHS Subcommittee, I also helped focus substantial resources on family planning and abstinence education in an effort to reduce the number of teenage pregnancies in the United States. In Fiscal Year 2006, I helped provide a total of $113 million for abstinence education.

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