The debate about how to reshape health insurance in order to reduce skyrocketing costs, and increase access, has dominated the attention of Congress for the past year. While there are many areas of agreement, Congress and the American public remain divided and it is easy to see why.


The debate about how to reshape health insurance in order to reduce skyrocketing costs, and increase access, has dominated the attention of Congress for the past year. While there are many areas of agreement, Congress and the American public remain divided and it is easy to see why.

While I am glad the "deem and pass" procedure was abandoned, and the House of Representatives allowed an actual vote on the bill Sunday night, I feel strongly that Congressional leaders and the President have missed a real opportunity to take incremental, bipartisan steps that recognized the concerns of Americans who feel as though they will foot the bill for widespread reforms that they do not embrace.

To expand access, HR 3590 will enact mandates for both individuals and employers, with hefty fines for non-compliance, at a time when our economy has already challenged cash-strapped small businesses across the nation. This new mandate to acquire health insurance will greatly expand the bankrolls of insurance companies without any new standards against price fixing, or steps to encourage competition across state lines-- both of which would create vast incentives to drive down costs. Such giveaways to the insurance companies only reward the rising costs of health care with higher taxpayer subsidies to cover them.

Throughout the debate, I have advocated for common sense policies that aim to lower costs and expand access, without compromising the quality of American medicine or raising taxes on the American people. I have urged leaders to consider legislation to drive down the costs of care first, in order to increase access and coverage through affordability.

According to the Congressional Budget Office, the legislation would cost nearly a trillion dollars, the cost of health insurance premiums would actually rise, and it would be paid for through new taxes and fees and nearly $500 billion in reductions in spending on Medicare. What CBO can't accurately report, is that the bill is also littered with budget gimmicks to cover the actual, long-term cost of the bill.

This bill includes:
• paying for six years of coverage with 10 years of tax increases and back-loads the cost in the years ahead in order to disguise the true costs. The proposed cuts to Medicare are unlikely to ever occur; Congress is likely to override them.
• $70 billion for the new long-term care program, spent before any benefits are paid out.
• $53 billion taken from the Social Security Trust Fund to offset new health care spending.
• punting the fix for Medicare reimbursements to doctors, costing $371 billion, which Congress has committed to passing.
• using the revenues from an expansion in federally financed student loans as offsets, instead of putting those savings back into education or for lower payments from students.

What I do support

There are many common-sense steps we could be taking, some of which are in this bill and have widespread support:
• reforms that forbid insurance companies from denying coverage based on a pre-existing condition or disability, and ban lifetime and annual spending caps that put patients at risk for bankruptcy when faced with a serious illness;
• allowing unmarried children to remain on their parents' insurance through age 26;
• incentives for Americans to seek preventive care;
• helping seniors afford prescription drugs through closing the donut hole, and development of lifesaving drugs and therapies that protect patient safety and innovation;
• an increase in support for community health centers that provide routine care for thousands of patients in Delaware; and provisions to address physician and nursing shortages.

These are steps we could have taken, and they should have been coupled with increases in competition and cost-controlling measures.

What should be in the bill

Additional policies absent from the plan that deserve an up or down vote:
• Making health insurance more portable and affordable by allowing patients to shop for health insurance plans across state lines;
• Small Business pooling and tax credits without mandates that threaten jobs and productivity;
• Eliminating the $60 billion in Medicare fraud each year;
• Increasing efforts to enroll the 4.3 million who already qualify into existing programs like Medicaid and SCHIP; and
• Limiting abusive lawsuits, which would reduce costs of care.

While there are policies embedded in this legislation that have bipartisan support, they are buried under budget gimmicks that threaten the long-term solvency of Medicare, Medicaid and Social Security-- the existing entitlement programs that are draining the federal budget based on their current obligations.

Health care reform will impact the lives of every American, our federal budget, and 1/6 of our economy. Reform should hold insurance companies accountable, eliminate barriers to competition and quality care, promote prevention, and drive down health care costs. To ignore the costs and enact unrealistic and misleading legislation will only prolong our health care challenges for generations to come.