Tonight, the House of Representatives voted to approve historic health care reform legislation.
I know first hand how providing access to affordable health care isn’t a political issue, but a deeply personal one for every family. My late husband Paul waged a long, courageous fight against cancer and during that time, our family had the benefit of excellent care from extraordinarily able and dedicated professionals. I understand the fear and helplessness so many feel when faced with an illness in their family. But I have also experienced the hope our health care system can offer and shudder to think what our experience might have been if our family had been uninsured. I ran for Congress over two years ago because I believe that every American deserves access to the same level of high quality care that my family received. Today we took a step toward making that a reality.
For the last year and a half, Congress has been debating the best way to reform our broken health care system. This effort was born out of the reality that if nothing is done to rein in exploding health care costs, increasing numbers of families will no longer be able to afford coverage, businesses will no longer be able to offer health insurance to their employees, and our unsustainable deficits and long-term debt will continue to grow. These realities will compromise our country’s future competitiveness, and perhaps most importantly, our own health and well-being. This debate about how best to address problems with our health care system has also been echoed at town hall meetings, diners and coffee shops, and at kitchen tables across the country.
I have made it a point to talk with as many Fifth District residents as possible and seek their input and views over the past 15 months. Through my Congress On Your Corner program which has taken me to every corner of our district, at town hall meetings, during meetings in each of my offices, and in regular visits to the communities that I represent, I have had literally thousands of conversations with those I represent on this subject.
I have heard from small business owners about how the cost of health care is preventing them from expanding their business and forcing them to seriously consider laying off workers just to make ends meet. I have talked with Fifth District residents who have been denied coverage based on a preexisting medical condition and the painful consequences of not having access to medical care as a result. I have met with seniors who cannot afford the prescription drugs that they need to stay healthy. I have met with doctors and nurses who would like nothing better than to be able to provide care to their patients based on their medical needs, not on what their insurance plan covers. I have heard from residents who simply want to keep the plan and doctor that they currently have. And, I heard from one of the district’s major employers who said providing health care for all Americans is a moral necessity.
Because this health care reform legislation addresses these many problems and accomplishes many of the goals that I believe are essential to making our system of health care more affordable, accessible and sustainable, I voted to support it this evening.
The bill takes several critical steps to address our system’s out of control costs. First, by requiring insurance companies to cover, with no extra charge, routine checkups and preventive care, like mammograms, colonoscopies, and routine vaccinations. For example, if a senior chooses not to get a mammogram because she could not afford it, or because it was not covered in her insurance plan, she is at greater risk of developing breast cancer and letting that cancer grow, unchecked, requiring even more expensive and potentially less effective care later on. We can avoid these additional costs and this unnecessary suffering by providing access to preventive care.
The bill helps move towards a system in which we pay doctors for the quality of care they provide, rather than the number of tests and procedures they perform. It invests in electronic health records, which will avoid the cost of duplicative tests and treatments. And it makes use of comparative effectiveness research – which will help doctors ensure that patients get the best care possible.
It reduces the growing cost of health care premiums and co-pays by ensuring that health insurers cannot implement excessive rate increases, and requires them to spend at least 85% of premiums on providing consumers with additional benefits, rather than on profits and overhead costs. By permitting young Americans to stay on their parents plan until the age of 26, the bill will provide them with increased financial flexibility at a time in their lives when insurance is often difficult to afford or is not offered by their employers.
Approximately 6 million seniors – 7,400 of whom live in the Fifth District – currently fall into the Medicare ‘donut hole’, the gap in which prescription drugs are not covered. This bill ensures those seniors will see that gap in coverage completely closed over time. Contrary to what some critics have claimed, the bill does not reduce Medicare benefits in any way; in fact, the improvements made to Medicare strengthen the program for today’s seniors and future generations and are why the bill has garnered the support of the AARP.
Women are uniquely impacted by our broken health care system, and this bill enacts reforms that will have a tremendously positive effect on the lives of women all over our country. It prohibits the practice of ‘gender rating’, in which insurers can charge women many times more in premiums than their male counterparts, often for less comprehensive coverage. It prohibits discrimination based on so-called ‘pre-existing conditions’ such as a history of domestic violence or cesarean sections. And it prohibits insurers from denying maternity care to a woman who is already pregnant. It prohibits discrimination based on so-called ‘pre-existing conditions’ such as a history of domestic violence or cesarean sections. And it prohibits insurers from denying maternity care to a woman who is already pregnant. Many women are presently forced to rely on their tax refunds to pay medical bills, instead of having regular access to care.
Small businesses are not required to offer health insurance to their employees under this bill, but for those who do, they will have access to an Exchange where they can shop for plans that will be much less expensive than what is currently offered. This is because insurers will be forced to compete for their business in a transparent manner, and because they will be able to band together and use their collective purchasing power to get low-cost, high quality plans much like large employers have access to now. Small businesses will also be eligible for a tax credit to pay for 50% of the cost of premiums for their employees. This is not something that is currently available to small businesses in Massachusetts, and is an added benefit because of national health care reform.
In fact, the bill holds many benefits that will directly impact residents in the Commonwealth of Massachusetts. Many middle class families who do not currently qualify for subsidies through the Commonwealth Connector will qualify because of national reform. For example, a family of three making up to $73,240 a year will be eligible for subsidies that will make insurance more affordable for them. Insurers in Massachusetts will no longer be allowed to implement lifetime or annual caps on benefits, ensuring that all residents of the Commonwealth can count on their insurance no matter how sick they get or how seriously they need to see a doctor. This legislation invests in more primary care doctors and nurses, which ensures that there are more providers available to care for patients in our state. Small businesses in the Commonwealth who offer health insurance to their employees will be eligible for a tax credit to pay for the cost of that coverage. Finally, Massachusetts taxpayers will no longer have to pay for the emergency care that uninsured patients across the country currently receive.
While access to care is not a pervasive problem in Massachusetts, tens of millions of Americans do not have health care coverage they can afford and that number increases by 14,000 every day. The legislation takes significant steps towards covering all Americans, while enabling anyone happy with their current plan to keep it, facts which have earned it the endorsement of the American Medical Association, Alliance for Retired Americans, Consumers Union, Families USA, Massachusetts Medical Society, and many other leading health care provider and patient advocacy groups.
I also stated when health care reform was first being crafted that it should not add to our debt and deficit. Not only is this bill fully paid for, it cuts the federal deficit by more than $143 billion dollars over the course of the next 10 years, and reduces it by another $1.2 trillion in the decade that follows according to the nonpartisan Congressional Budget Office. Additionally, more than 40 of the nation’s leading economists – including three winners of the Nobel Prize – signed a letter urging the swift passage of comprehensive health reform to slow ‘unsustainable’ health care spending facing our country.
As with any undertaking of this magnitude, the legislation is not perfect. I was disappointed that attempts to add a public option, which would have further lowered health care costs and increased competition, were unsuccessful. And, this legislation unfortunately contains hurdles that place unnecessary restrictions on a woman’s reproductive rights.
But, overall, I strongly believe that this bill succeeds in expanding access to health care, takes many commonsense steps to rein in health care costs, and reflects so many of the concerns that my constituents have raised with our current health care system. It is for these reasons that I voted in support of this historic legislation today.
Sincerely,
Niki Tsongas