Quality, Affordable Health Care for All Americans

Proposal Embodies President Obama’s Goals of Lower Costs, More Choices, and Access to Quality, Affordable Care

The chairmen of the three committees with jurisdiction over health policy in the U.S. House of Representatives unveiled their discussion draft for health care reform that would reduce out-of-control costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans. The discussion draft would guarantee that almost every American is covered by a health care plan that is both affordable and offers quality, standard benefits by 2019.

Consistent with President Obama’s goals, the draft builds on what works in the current health care system by strengthening employer-provided care, while fixing what is broken with it. The draft would cover more Americans than any other proposal released to date.

Over the past several months House Committees on Education and Labor, Ways and Means, and Energy and Commerce have been working together as one committee – an unprecedented approach – to develop one proposal for health care reform. In releasing their discussion draft today, the chairmen reiterated that they will continue to seek the input of all members and stakeholders during hearings and markups in the coming weeks.

"Today's draft is the result of cooperation between members of the House.  The bill provides affordable, quality health care for all," said U.S. Rep. Pete Stark (D-CA).  "The discussion draft builds on what works.  It keeps employer-sponsored insurance, makes market reforms, and limits catastrophic costs.  The draft improves the Medicare program; eliminating co-pays for preventive care and the 'donut hole.'"

 “President Obama issued a call to action to reform our nation’s health care system and the House Committees have answered in an unprecedented way, working as one to produce a draft that will help control costs, preserve and expand coverage and strengthen Medicare and Medicaid,” said Ways and Means Committee Chairman Charles B. Rangel (D-NY).  “In the coming weeks, we will continue working with our colleagues and stakeholders to move this draft forward so we can create a new day in American health care that will benefit our nation for generations to come.”

 “This draft sets out a very practical and uniquely American proposal,” said U.S. Rep. Henry A. Waxman (D-CA), the Chairman of the Energy and Commerce Committee.  “It fulfills President Obama’s commitment to provide quality, affordable health care for all.  Nothing is more important to the long term health of the American people.”

 “Today marks a historic moment in America’s urgent quest to fix our broken health insurance system,” said U.S. Rep. George Miller (D-CA), the Chairman of the Education and Labor Committee. “Our discussion draft is the first step in delivering on the fundamental change that President Obama has called for, and that families and businesses need, by building a truly American solution to reduce costs, offer real choice, and guarantee affordable, quality health care for all.”

 “We are beginning an important process that I am confident will make history. The discussion draft is the first step towards creating a distinctly American Solution to our health care crisis. This bill includes a public option, which will provide the American people with a real choice,” said U.S. Rep. John Dingell (D-MI), Chairman Emeritus of the Energy and Commerce Committee. This public option will lower costs and establish consumer protections that private companies have refused to commit to. The cooperation between Chairmen Miller, Rangel and Waxman is unprecedented and it is my pleasure to be working with them. We are committed to working with all the members in writing a bill that will provide quality, affordable care for all but also prevent the next great economic crisis we face.”

"While this country has the best medical care in the world, fewer and fewer people are able to access it and more and more people can't afford it," said U.S. Rep. Frank Pallone, Jr. (D-NJ), chairman, Energy and Commerce Subcommittee on Health. "Today we are taking a big step towards historic health care reform for all Americans. History is not often made in a day and it certainly won't be made without continued hard work, but this plan is a big step on a truly meaningful issue. A new day for health care is now closer in sight."

"We are not going to have economic growth until our health care system is fixed. Nearly a fifth of our economy is spent on health care, and while our world competitors continue to offer more efficient care, America lags behind,” said U.S. Rep. Rob Andrews (D-NJ), chairman of the Health, Employment, Labor and Pensions Subcommittee. “Insured Americans bear the heavy financial burden for those who cannot afford coverage and millions of struggling families cannot meet the rising costs. This plan is about freeing financial waste within our system and getting more value for our dollar so that we can afford to cover the 46 million uninsured Americans and freeing up money to be invested toward out nation’s economic growth.”

The key principles of the House Democratic discussion draft for health care include, among other things:

Increasing choice and competition. First, the proposal would protect and improve consumers’ choices.

• If an individual likes their current plan, they would be able to keep it.

• For individuals who either aren’t currently covered, or wanted to enroll in a new health care plan, the proposal would establishes a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance plan or a plan offered by private insurers. People will have similar choices that Members of Congress have.

• This new marketplace would reduce costs, create competition that leads to better care for every American, and keep private insurers honest. Patients and doctors would have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. Second, the proposal would ensure that Americans have portable, secure health care plans – so that they wouldn’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.  

• It would end increases in premiums or denials of care based on pre-existing conditions, age, race or gender.

• The proposal would also eliminate co-pays for preventative care, cap out-of-pocket expenses and guarantee catastrophic coverage that protects every American from bankruptcy.

 Improving quality of care for every American. Third, the proposal would ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental and vision benefits.

• Provides better preventative and wellness care. Every health care plan offered through the exchange would cover preventative care.

• Grows the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.

• Strengthens Medicare and Medicaid so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

 Ensuring shared responsibility. Fourth, the draft would ensure that individuals, employers and the federal government all share responsibility for a quality and affordable health care system.

• Employers who currently offer coverage would be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to pay for their workers to gain health care coverage through the exchange or pay a penalty.
• All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
• The federal government would provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

 Protecting consumers and reduces waste, fraud and abuse. Fifth, the proposal would put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud and abuse.

• Provides complete transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.
• Establishes Consumer Advocacy Offices as part of the exchange to protect consumers, answer questions and assist with any problems related to their plans.
• Would identify and eliminate waste, fraud and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers and employers would all encounter a streamlined, less confusing, more consumer friendly system.

 To view a complete summary of the discussion draft, click here

To view detailed fact sheets, click here

A few private health insurance companies have built a near-monopoly in the Nevada market, burdening families and businesses with premiums that grew 2.5 times faster than wages from 2000 to 2007.

• Nevada’s biggest health insurer, Sierra Health Services Inc. (which was acquired by UnitedHealth Group Inc. in 2008) held 29 percent of the Nevada market for health insurance in 2007. Together with WellPoint Inc. they controlled 57 percent of the market that year.

• Local markets were more concentrated; in Carson City, Washoe Health System and WellPoint Inc. together held 90 percent of the market

• Health insurance premiums for Nevada working families have skyrocketed, increasing 55 percent from 2000 to 2007.

• • For family health coverage in Nevada during that period, the average annual combined premium for employers and employees rose from $6,688 to $10,341.

• • For family health coverage in Nevada, the average employer’s portion of annual premiums rose 41 percent, while the average worker’s share grew by 135 percent.

• • From 2000 to 2007, the median earnings of Nevada workers increased 21 percent, from $25,411 to $30,859. During that time health insurance premiums for Nevada working families rose 2.5 times faster than median earnings.

• If one company holds more than a 42 percent share of a market the U.S. Justice Department would consider that market “highly concentrated.”

• The U.S Justice Department uses a rating system based on market share to determine if a market is concentrated or highly concentrated. If the market is rated from 1,000 to 1,800, it is considered to be “concentrated.”

• Markets rated higher than 1,800 are deemed to be “highly concentrated.”

• This means that an insurer could raise premiums and/or reduce the variety of plans or quality of services offered to customers with impunity

Percent Increase in Premiums vs. Income in Nevada, 2000–2007

Individual Income:      21%

Premiums:                 55%

Sources: Families USA, “Premiums Versus Paychecks,” September 2008

Republican Bill would “Supersize” Proposed Dump, Doubling Danger to Families and Communities; New Cost $200 Billion, $300 Billion????    

Congresswoman Shelley Berkley issued the following statement on energy legislation from House Republicans that calls for doubling the amount of nuclear waste to be dumped at Yucca Mountain.  The plan seeks to “Supersize” the proposed dump 90 minutes outside Las Vegas by lifting current restrictions on the amount of high-level radioactive waste that could be dumped at the site.  The proposal would also increase the danger to communities in Nevada and nationwide by increasing the number of nuclear waste shipments on America’s roads and railways. 

 “House Republicans have unveiled an energy plan that seeks to jump-start the failed Yucca Mountain project. Nevada families are wondering how spending $100 billion or more to dump nuclear waste 90 minutes from their homes and businesses is going to help America become energy independent.   

 “Burying this toxic garbage in Nevada will not create more solar power or help us harness the wind.  And it certainly will not lead to the development of geothermal heat from deep in the Earth to affordably power schools, homes and hospitals. 

 “And Republicans are not just pushing to build this dump, they are calling for Yucca Mountain to be ‘Supersized’.  The GOP’s legislation would shred the existing law that caps the amount of waste that can be shipped to Nevada so that they can jam twice as much of this radioactive garbage down our throats.  This plan to more than double the size of the Yucca dump will only double the danger to families in Nevada and across our nation.

 “And just how much will a ‘Supersized Yucca’ cost?  No one is saying.  But whatever the price, Republicans appear content to pass along the bill to America’s families who could be hit with a tab for $200, $300, $400 billion or more to fund this dangerous scheme.  That money will be raised in the form of higher monthly energy bills for millions of families in states with nuclear power.  Every time they write a check to the power company, these hardworking men and women are paying a toxic nuclear tax for dealing with the pollution created by this heavily subsidized energy source.

 “Add to that decades of waste shipments barreling down America’s roads and railways that will put communities at risk, not to mention the cost of an accident involving this deadly radioactive pollution.  All of which makes this legislation too costly and far too risky to embrace.

 “Congress must pass a package that promotes true energy independence, increases national security and addresses global climate change.  With its focus on increasing the size and amount of spending on Yucca Mountain, the Republican plan fails to achieve that goal.”