We're all looking for our economy to rebound. We're also looking for any signs of growth in the job market. Any legislation that comes out of Washington these days must be viewed through the lens of our economy.
That's why the upcoming vote on Speaker Pelosi's health care reform bill concerns me and so many others across the country and back in East Alabama.
This bill could seriously hurt our jobs through mandates and tax increases. It's another step toward bigger government — all 1,990 pages of it, and I oppose it.
As I've said all along, I agree with the authors of this bill that our country needs some sort of health care reform. We've got to lower the cost, improve the quality of care, and help increase access to health insurance for more people.
But not this kind of massive reform.
Speaker Pelosi's $1 trillion health care bill, H.R. 3962, offers a government-run plan also known as a "public option" that is supposed to compete with private insurance companies.
The problem with this is, besides further expanding the Federal government's role, it actually incentivizes companies to drop their private insurance and force their employees into the "public option."
Over time, it can only cause unfair competition with the private sector, and ultimately threatens to force all Americans into the government-run plan.
House Democrats have decided the bill will be funded mostly by cutting Medicare by almost $500 billion and raising taxes on some small business. During these tough economic times, that's tough medicine for our employers to swallow.
I'm concerned the tax increases and insurance mandates will dampen too many employers' ability to hire and expand.
To get a bipartisan solution, I believe the "public option" should be taken off the table.
Congress should allow Association Health Plans (AHPs) so that your church or business association, for example, could pool its members and help spread the risks and lower costs.
Or how about having the option to purchase insurance across state lines to drive down costs through competition?
Tort reform should also be addressed in true health care reform. Doctors sometimes are forced to practice defensive medicine and perform additional tests on patients to avoid law suits. These practices should cease when unnecessary, which would help make insurance more affordable.
But that's not the bill presented in the House. Speaker Pelosi's health care bill cuts Medicare, and if passed, could result in a massive expansion of the Federal government when we can least afford it.
Most of all, I am concerned it further threatens too many jobs.
Congress can do better, and folks across East Alabama deserve better.
As always, check out my YouTube page at www.YouTube.com/MikeRogersAL03, please contact me at www.house.gov/mike-rogers or follow me at www.twitter.com/RepMikeRogersAL.
Good morning Congressman Rogers,
I am encouraged by your demonstrable improvement in tone, although you can’t seem to quite break away from “market tested” phrases e.g. “massive reform”, and “Speaker Pelosi’s $1 trillion health care bill”, obviously the Speaker’s public negatives are extremely high, therefore, emotionally conflating the bill into a referendum of her personally, is a powerful marketing tactic.
Although you state being against the entire bill, the general issues raised here will benefit the voters to specifically discuss.
Point 1
“incentivizes companies to drop their private insurance and
force their employees into the “public option.”
The statement “force their employees into the “public option.” is simply false, period.
Let’s help people review precisely what you mean about incentives; the bill provides for the following:
Require employers to offer coverage to their employees and contribute at least 72.5% of the premium cost for single coverage and 65% of the premium cost for family coverage of the lowest cost plan that meets the essential benefits package requirements or pay 8% of payroll into the Health Insurance Exchange Trust Fund. (Effective January 1, 2013)
Eliminate or reduce the pay or play assessment for small employers with annual payroll of less than $750,000:
Annual payroll less than $500,000: exempt
Annual payroll between $500,000 and $585,000: 2% of payroll;
Annual payroll between $585,000 and $670,000: 4% of payroll;
Annual payroll between $670,000 and $750,000: 6% of payroll.
(Effective January 1, 2013)
Require employers that offer coverage to automatically enroll into the employer’s lowest cost premium plan any individual who does not elect coverage under the employer plan or does not opt out of such coverage. (Effective January 1, 2013)
Require a government study of the impact of employer responsibility requirements and recommend to Congress whether an employer hardship exemption is appropriate. (Report due January 1, 2012) (Kaiser Family Foundation http://www.kff.org/healthreform/sidebyside.cfm)
As we have discussed, it’s great to implicitly suggest “ it’s un-American to force someone to buy insurance they do not want, until the rest of us are forced to pay the bill. Each of these penalties target companies that choose not to provide insurance, how does this discourage employers from providing basic coverage?
You state this will force people into a public option, however CBO projects within 10 years well under 10 million will make that choice, none of which would be forced. In addition, because the initial public option high risk pool would cost approximately 125% more than the prevailing rate for individual coverage (Health Affairs, Tim Jost, Oct 30, 2009), precisely how is this anti competitive? CBO also reports the negotiated fee schedule requirements within the public option, after full implementation, would make it difficult to match well entrenched private companies on price.
Point 2
“Over time, it can only cause unfair competition with the private sector, and ultimately threatens to force all Americans into the government-run plan”
This theme runs through each of your press releases, however, the CBO score of H.R. 3962, written Oct 29, 2009, estimates by 2019 the total number of people getting insurance through an exchange will be 21 million out of a current non elderly privately insured population of ~200 million. (http://www.census.gov/hhes/www/cpstables/032009/health/h01_001.htm) From that 21 million, CBO estimates ~6 million will choose a public option which translates to ~3% of the privately insured population.
Congressman, where are your facts to support anything that remotely approaches your assertion that in the long run, private plans will be run out of business?
Point 3
“House Democrats have decided the bill will be funded mostly by cutting Medicare by almost $500 billion and raising taxes on some small business”
The plan is funded over 10 years by a combination of $426 billion in spending growth reductions and actual cost cuts stemming from productivity improvements in Medicare, market basket updates, reducing payments to Medicare Advantage plans, changing the Medicaid drug rebate provisions, and cutting Medicaid and Medicare DSH payments.
DSH or disproportionate share hospitals, are paid a premium to cover the direct, and indirect, cost of training physicians. The indirect cost, which is over $6 billion annually has been increasing at an annual rate of 5.5%, while indirect hospital cost increases associated with medical residents has be estimated at 2.2% (MedPAC Report to Congress March 2009 page 69).
Medicare Advantage is the program within Medicare that pays private companies about 14% over traditional Medicare to cover about 22% of Medicare beneficiaries. These companies spend about 76.6% of this money on more healthcare benefits for beneficiaries (MedPAC Report to Congress March 2009 page 261 Table 3-4).
Although Congressmen Rogers does not raise the issue, this bill does have serious a flaw in not addressing what’s called the SGR or Sustainable Growth Rate formula which calls for a 21.5% cut in January worth about $245 billion. Companion bill H.R.3961 does address this, however, the net effect is to put H.R. 3962 in deficit $141 billion (-104 245) which must be addressed before final passage.
Although 99.5% of physicians accept Medicare (MedPAC 2008), primary care physicians, by all accounts, are under paid relative to demonstrated market conditions.
The bill begins to address this problem by increasing Primary care physician payments under Medicaid to 100% of Medicare by 2012. Pages 653-671 of H.R. 3962 outline an excellent start by setting up a Medicare pilot ACCOUNTABLE CARE ORGANIZATION program to provide primary care physicians the right incentives to increase their compensation while improving care integration and controlling overall cost. Page 693 also specifically provides a 5% increase for primary care, and a 10% increase for primary care in designated “health professional shortage areas”. Does this solve the problem? No, but it represents a first step towards developing reasonable pay incentives for primary care physicians.
The bill creates an income tax surcharge of 5.4% family’s earning over 1 million which is the primary component of the $572 billion in revenue. Is your suggestion taxing 4% of small business will kill jobs? If so; what data do you have to support this assertion? Demonstrate credible evidence to support this claim.
Point 4
“allow Association Health Plans (AHPs)”
Conceptually, Association Health Plans, allow trade and professional associations to pool employees to make larger groups, all things equal, this does favorably spread risk. In the Republican Amendment offered by Senator Boehner, however, the incentive remains for insurance companies to reject coverage out right or charge rates many multiples (varies state to state) of the standard rate coverage, which is largely why the CBO scored the Republican bill to have no appreciable impact on the uninsured population over ten years.
Congressman, the key focus of the access portion of healthcare reform is to decrease our percentage of uninsured, the approach you espouse, does zero toward that end, what exactly is the value you are referring to here?
Point 5
“Tort reform should also be addressed in true health care reform”
Tort reform would offer saving in direct and indirect cost without question. The question is, while we are spending 2.5 trillion annually in healthcare, why are you are offering tort reform as a major solution to the problem? The total value of tort reform was valued October 9, 2009 by CBO at $11 billion if applied to 2009.
In other words, the US is spending 2.2 trillion annually and you are promoting five tenths of one percent annual savings as one of two major initiatives? Neither initiative seriously addresses the cost or access problem.
Point 6
“Speaker Pelosi’s health care bill cuts Medicare could result in a massive expansion of the Federal government when we can least afford it.”
Assuming this is a typo, and you meant to say “cuts in Medicare”, the sentence still makes no sense. If we are cutting Medicare, how does that increase the size of the Federal government? Of course, it would do the opposite.
Point 7
“folks across east Alabama deserve better”
Congressmen Rogers, most Alabamians have every confidence that you and your staff are bright, competent and generally “good people” all, however, these press releases do not reflect a reasonable effort to demonstrate even a base line understanding of the issues that impact a substantial portion of our economy.
Irrespective of any differences we may have, the citizens of the 3rd Congressional District deserve a serious conversation concerning healthcare, which with all due respect, these news releases have thus far failed to deliver, by any reasonable measure.
David