Tom Price on Health Care
Republican Representative (GA-6)
Price introduced the Empowering Patients First Act to the 113th Congress (2013--14)--which was described on his Congress website as "legislation that fully repeals ObamaCare and starts over with patient-centered solutions." The bill is almost 250 pages long. "We think it's important that Washington not be in charge of health care," he told The Wall Street Journal in an interview last summer. "The problem that I have with `ObamaCare' is that its premise is that Washington knows best."
On the third anniversary of the ACA rollout, Price delivered the weekly Republican address to criticize the law and tout the Better Way agenda. "We repeal things like the individual mandate, and we say that you should be free to pick whichever insurance plan you need, not the one Washington forces you to buy," he said.
Price responded, "No. I think it would be determined by how that is set up."
The Medicare recipient would choose, from an array of guaranteed-coverage options, a health plan that best suits his or her needs. This is not a voucher program. A Medicare premium support payment would be paid, by Medicare, directly to the plan or the fee-for-service program to subsidize its cost.
Pres. OBAMA: I don't think I said that. What I said was, within the context of health care, I welcome ideas that you might provide. I didn't say that you haven't provided ideas.
Rep. PRICE: Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions. In spite of the fact that we've offered positive solutions to all of the challenges we face.
Pres. OBAMA: If you say, "We can offer coverage for all Americans, and it won't cost a penny," that's just not true. So I am absolutely committed to working with you on these issues, but it can't just be political assertions that aren't substantiated when it comes to the actual details of policy. So there's got to be some test of realism in any of these proposals, mine included.
Pres. OBAMA: I am willing to work with you tort reform, but the CBO says, at best, this could reduce health care costs relative to where they're growing by a couple of percent, or save $5 billion a year, and it will not bend the cost curve long term or reduce premiums significantly. If we're going to do multi-state insurance so that people can go across state lines, I've got to be able to go to an independent health care expert, who can tell me that this won't result in cherry-picking and the least healthy being worse off. I've read your legislation, and the good ideas we take.
[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.
[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.
Opponent's Arguments for voting No:
[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.
[Sen. Merkley, D-OR]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Proponent's Argument for voting Yes:
[Rep. Pitts, R-PA]: Section 4002 of PPACA establishes a Prevention and Public Health Fund, which my bill, H.R. 1217, would repeal. The PPACA section authorizes the appropriation of and appropriates to the fund from the Treasury the following amounts:
Opponent's Argument for voting No:
[Rep. Waxman, D-CA]: This bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation.
Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.
Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.
Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.
Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.
Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.
Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.
SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. PALLONE. This is a comprehensive bill which will establish full mental health and addiction care parity. The Mental Health Parity Act of 1996 authorized for 5 years partial parity by mandating that the annual and lifetime dollar limit for mental health treatment under group health plans offering mental health coverage be no less than that for physical illnesses. This bill requires full parity and also protects against discrimination by diagnosis.
OPPONENT'S ARGUMENT FOR VOTING NO:Rep. DEAL of Georgia: I am a supporter of the concept of mental health parity, but this bill before us today is not the correct approach. This path will raise the price of health insurance, and would cause some to lose their health insurance benefits and some employers to terminate mental health benefits altogether.
The bill's focus is also overly broad. Our legislation should focus on serious biologically-based mental disorders like schizophrenia and bipolar disorder, not on jet lag and caffeine addiction, as this bill would include. There are no criteria for judicial review, required notice and comment, or congressional review of future decisions.
I would ask my colleagues to vote "no" today so that we can take up the Senate bill and avoid a possible stalemate in a House-Senate conference on an issue that should be signed into law this Congress.
LEGISLATIVE OUTCOME:Bill passed House, 268-148
CONGRESSIONAL SUMMARY: This Act would enroll all 6 million uninsured children who are eligible, but not enrolled, for coverage under existing programs.
PRESIDENT'S VETO MESSAGE: Our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. My Administration strongly supports reauthorization of SCHIP. [But this bill, even with changes, does not meet the requirements I outlined].
It would still shift SCHIP away from its original purpose by covering adults. It would still include coverage of many individuals with incomes higher than the median income. It would still result in government health care for approximately 2 million children who already have private health care coverage.
SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill protects health insurance coverage for some 6 million children who now depend on SCHIP. It provides health coverage for 3.9 million children who are eligible, yet remain uninsured. Together, this is a total of better than 10 million young Americans who, without this legislation, would not have health insurance.
The bill makes changes to accommodate the President's stated concerns.
Proponents support voting YES because:
Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:
Opponents recommend voting NO because:
Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:
Veto message from President Bush:
Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.
Proponents support voting YES because:
This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.
It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.
Opponents support voting NO because:
Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.
Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
The Club for Growth's "Repeal-It!" Pledge for incumbents states, "I hereby pledge to the people of my district/state to sponsor and support legislation to repeal any federal health care takeover passed in 2010, and replace it with real reforms that lower health care costs without growing government."
To deauthorize appropriation of funds to carry out the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA). Notwithstanding any other provision of law, no funds are authorized to be appropriated to carry out the provisions of the Patient Protection and Affordable Care Act (Public Law 111-148), the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendment made by either such Act.
[OnTheIssues Note: these two bills are the core of the Democratic healthcare plan, known as "Obamacare." Deauthorizing funding for Obamacare means almost the same as repealing it, except that the laws would still stay on the books so perhaps it's a little more likely to get votes. This bill is an exercise of "the power of the purse", over which the House has sole control.]
Repeals the Patient Protection and Affordable Care Act, effective as of its enactment. Restores provisions of law amended by such Act.
Repeals the health care provisions of the Health Care and Education and Reconciliation Act of 2010, effective as of the Act's enactment. Restores provisions of law amended by the Act's health care provisions.
Heritage Action Summary: This vote would fully repeal ObamaCare.
Heritage Foundation recommendation to vote YES: (2/3/2015): ObamaCare creates $1.8 trillion in new health care spending and uses cuts to Medicare spending to help pay for some of it. Millions of Americans already have lost, and more likely will lose, their coverage because of ObamaCare. Many Americans have not been able to keep their doctors as insurers try to offset the added costs of ObamaCare by limiting the number of providers in their networks. In spite of the promise, the law increases the cost of health coverage.
Secretary of Labor Robert Reich recommendation to vote NO: (robertreich.org 11/22/2013): Having failed to defeat the Affordable Care Act, Republicans are now hell-bent on destroying the ObamaCare in Americans' minds, using the word "disaster" whenever mentioning the Act, and demand its repeal. Democrats [should] meet the Republican barrage with three larger truths:
Legislative outcome: Passed House 239-186-8; never came to a vote in the Senate.
Obamacare is making things worse by the day. It drives up premiums and deductible costs for individuals, families, and businesses. It forces people off the plans they like. It fuels waste, fraud, and abuse. And it cannot be fixed. Its knot of regulations, taxes, and mandates cannot be untangled. Obamacare must be fully repealed so we can start over and take anew approach. This isn't a return to the pre-Obamacare status quo. And it isn't just an attempt to replace Obamacare and leave it at that. This is a new approach. It's a step-by-step plan to give every American access to quality, affordable health care. Our plan recognizes that people deserve more patient-centered care, not more bureaucracy. That means more choices, not more mandates. You should have the freedom and the flexibility to choose the care that's best for you. Insurers should compete for your business, and treat you fairly--no matter what. You and your family should have access to the best lifesaving treatments in the world. And as you get older, Medicare should give you more choices too. At every step, you should be in the driver's seat. This is a better way.
MORE CHOICES AND LOWER COSTS Our health care system is too bureaucratic and too expensive. It didn't work before Obamacare, and it most certainly doesn't work now. Instead of the old, top-down way of doing things, we need to open up the system to innovation and competition.
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Keisha Lance Bottoms
Senate races 2019-20:
AK: Sullivan(R,incumbent) vs.Gross(I)
AL: Jones(D,incumbent) vs.Sessions(R) vs.Moore(R) vs.Mooney(R) vs.
AR: Cotton(R,incumbent) vs.
AZ: McSally(R,incumbent) vs.Kelly(D)
CO: Gardner(R,incumbent) vs.Hickenlooper(D) vs.
DE: Coons(D,incumbent) vs.Scarane(D)
GA-2: Isakson(R,resigned) Loeffler(R,appointed) vs.Lieberman(D) vs.Collins(R) vs.Carter(D)
GA-6: Perdue(R,incumbent) vs.Tomlinson(D) vs.Ossoff(D) vs.Terry(D)
IA: Ernst(R,incumbent) vs.Graham(D) vs.Mauro(D) vs.Greenfield(D)
ID: Risch(R,incumbent) vs.Harris(D) vs.Jordan(D)
IL: Durbin(D,incumbent) vs.Curran(R) vs.
KS: Roberts(R,retiring) vs.
KY: McConnell(R,incumbent) vs.McGrath(D) vs.Morgan(R) vs.Cox(D) vs.Tobin(D) vs.Booker(D)
LA: Cassidy(R,incumbent) vs.Pierce(D)
MA: Markey(D,incumbent) vs.
ME: Collins(R,incumbent) vs.Sweet(D) vs.Gideon(D) vs.
MI: Peters(D,incumbent) vs.James(R)
MN: Smith(D,incumbent) vs.
MS: Hyde-Smith(R,incumbent) vs.Espy(D) vs.Bohren(D)
MT: Daines(R,incumbent) vs.Bullock(D) vs.
NC: Tillis(R,incumbent) vs.E.Smith(D) vs.S.Smith(R) vs.Cunningham(D) vs.Tucker(R) vs.
NE: Sasse(R,incumbent) vs.Janicek(R)
NH: Shaheen(D,incumbent) vs.Martin(D) vs.Bolduc(R) vs.O'Brien(f)
NJ: Booker(D,incumbent) vs.Singh(R) vs.Meissner(R)
NM: Udall(D,retiring) vs.Clarkson(R) vs.
OK: Inhofe(R,incumbent) vs.Workman(D)
OR: Merkley(D,incumbent) vs.Romero(R) vs.Perkins(R)
RI: Reed(D,incumbent) vs.Waters(R)
SC: Graham(R,incumbent) vs.Tinubu(D) vs.Harrison(D)
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TX: Cornyn(R,incumbent) vs.Hegar(D) vs.Hernandez(D) vs.Bell(D) vs.Ramirez(D) vs.West(D)
VA: Warner(D,incumbent) vs.
WV: Capito(R,incumbent) vs.Swearengin(D) vs.Ojeda(D)
WY: Enzi(R,incumbent) vs.Ludwig(D) vs.Lummis(R)
Senate Votes (analysis)