Sunday, January 10, 2010

Maria Cantwell on health care reform (with video)

Maria Cantwell (email), with video (17:16):
We are near the culmination of a very long legislative journey aimed at reining in spiraling health care costs while improving the quality of care and increasing access to coverage for individuals and families. We are closer to the goal of achieving health care reform than ever before in American history. The final step involves working to merge the House-passed bill with the legislation we passed in the Senate on Christmas Eve. (Click here to listen to my floor remarks made on the eve of bill passage.)
As we work through the final steps in this debate, I will be fighting to ensure that the health care reform we send to the President retains the strong reforms I have worked to include in the Patient Protection and Affordable Care Act (H.R.3590). And I will push to strengthen the legislation where there are remaining weaknesses. The Senate bill would be stronger if it included elements I have supported, such as a public option, that would further reduce costs and improve choice. Still, the bill now in the final stages of debate can accomplish our key goals of cost control, quality and coverage.With President Obama’s signature on this bill we will be providing 94 percent of Americans with health care coverage. Insurance companies will be tightly regulated. They will no longer be able to deny anyone due to a preexisting medical condition, and they won’t be able to raise rates on the sick. Small businesses will have access to many of the advantages large employers have now, finally making their health coverage affordable. For seniors, Medicare benefits will be improved, with better coverage for medication and primary care doctors, and there will be limits on how much more an insurance plan can charge a senior citizen over a younger person. This will prevent insurance companies from continuing to exclude older and sicker people. These gains and many others will be achieved while reducing the federal deficit by $130 billion over the first ten years, and $650 billion over the following decade. Savings will grow as critical reforms begin to improve health care quality and efficiency. In addition to reducing the federal deficit, the bill will also help to shore up Washington state’s struggling budget. Our state is in a better position than almost any state to take advantage of the reforms included in this bill. For decades Washington has been penalized under federal policies that don’t reward effective innovation at the state level. The Senate bill contains several provisions I’ve authored that will begin to correct these flaws.Washington state has won a significant victory with the Senate-passed bill. Allow me to outline exactly how my provisions will benefit Washingtonians:Basic Health Plan: This provision, based on Washington state’s Basic Health Plan, gives all 50 states the option to negotiate directly with health insurers to provide high quality health care coverage at a lower cost. The plan, which would fully fund Washington state’s Basic Health Plan, directs money to participating states and lets them use their purchasing power to negotiate with private insurance carriers. The annual cost of a typical individual plan under the Basic Health Plan would be 30 percent less than the same plan would cost in the private market without reform. And the out-of-pocket cost to a qualified individual would be substantially less – $400 versus $1,200 per year. In Washington, residents will see improved benefit packages under the Basic Health Plan, and the state will be able to save much needed funds. Basic Health Plan Bridge Funding: The main provisions of the bill, including the Basic Health Plan, do not take effect until 2014. For that reason, I’ve authored a provision to provide critical short-term support for Washingtonians by relieving our state budget of a major cost item while stabilizing a program that has a 20-year record of proven success. The bill allows the state to apply for federal funding that would cover up to two-thirds of the cost of the state’s Basic Health Plan and other state-funded health care programs until 2014. The state would be eligible for federal funding of up to $180 million per year under this provision. Medicare Reform:A new Medicare reimbursement model called the “value-index” will significantly benefit Washington state doctors, patients and taxpayers by bringing more money to Washington state providers and substantial savings to the Medicare trust fund. Washington patients and doctors will no longer be penalized by payment formulas that favor inefficient providers in other parts of the country instead of the overwhelmingly efficient providers we have in our state. If the level of efficiency we have achieved in Washington could be realized nationwide, we could save $55 billion per year.This is just one of many examples of how the Medicare reforms in the bill save money across the country while actually bringing more funding into Washington state. We often hear about Medicare cuts. But the fact is this bill adds benefits for Washington’s senior citizens. It does so while correcting an imbalanced system that has allowed extra funding to flow into other parts of the country for decades. Under the flawed system we have today, providers and Medicare Advantage plans in other parts of the country get more federal funding per patient and provide more benefits than in Washington state. Medicare Advantage plans in Washington will actually get bonus payments under the bill as a reward for their long history of efficiency. This will create a more equitable Medicare program across the country and bring substantial benefits to Washington state’s senior citizens.Long-Term Care: The Senate bill includes $3.4 billion that will help seniors in need of long-term care who prefer to remain in their homes and communities. The funding helps states transition their Medicaid programs to support home and community-based care, which is 70 percent less expensive than nursing home care and offers numerous other benefits such as allowing seniors to stay active and independent for as long as possible. Over half of all long-term care in America is provided under Medicaid. Due to the current lack of options for home-based support, seniors are forced to enter into nursing homes that deplete their savings much faster than home or community-based care. On average, just six months after entering into nursing homes, seniors qualify for Medicaid. We will make it easier for people to access home and community-based support before they are impoverished. This will give people the support they need to stay healthy in their homes and communities, which will cut overall costs and improve the quality of their lives. Primary Care: The bill includes measures to expand the number of medical students pursuing careers as primary care physicians. Primary care doctors can play a significant role in cutting health care costs by skillfully coordinating and overseeing patient care. But these care-givers are underpaid in our current system. The measure expands training capacity for primary care physicians and includes incentives for medical students who opt for a career in primary care.Pharmacy Benefit Managers: Serving as the middlemen between health insurance plans, pharmaceutical manufacturers and pharmacies, PBMs manage most of the prescriptions filled in the United States but are the only unregulated area of the health insurance industry. My provision requires reporting by PBMs to ensure that savings from drug price negotiations are passed on to consumers and not contributing more to pharmaceuticals’ bottom lines.If we fail to pass reform now, we will trade all of these gains for the continuation of a system that forces more than 14,000 people to lose their health insurance each day. Sixty-two percent of all personal bankruptcies are the result of medical expenses and 80 percent of these occur in families who already have health insurance. If we fail to pass reform, we will be stuck with a system that refuses to cover people once they get sick. Our current system allows the cost of health care to increase at more than twice the rate of general inflation. Under our current system, costs have increased 120 percent over the last ten years, and they are expected to double again in the next ten years. This health care legislation stabilizes skyrocketing costs, encourages quality and extends affordable health care coverage to 31 million uninsured Americans. The final product will not include everything I believe we need to improve our system. But make no mistake: This is a landmark bill that puts in place significant reform, offers immediate relief and provides a framework we can use for the long-term as we consider future reforms.Our job now is to make sure a strong bill comes out of the House and Senate negotiations and goes to President Obama for his signature. Then our task is to ensure the bill’s provisions are effectively implemented so the cost savings and quality improvements we seek are realized. For the full text and various summaries of the health care bill as passed by the Senate on Christmas Eve, please see: I invite you to follow this historic journey to the finish line, and please be in touch with me along the way via email or phone to share your thoughts.

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