By Authority: Cummings for Congress, Ron Thompson, Treasurer
PROTECTING OUR HEALTH

More and more Americans now understand the urgency - and the difficulty - of reforming our nation’s health insurance system.  The time to fix our broken health care system is now.

We also must do all that we can to protect our children’s dental health, eliminate the mortal threat of disease, and end the reality that a person’s race continues to be a mortality factor in this country.

Although these are not all of the health policy issues that we must face together and overcome, our success in solving these national problems would go a long way toward making America a better, healthier country.

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Health Insurance Reform

America is the only industrialized nation that does not guarantee health care to all of her citizens - and, as a result, far too many Americans are dying before our time.

For some time now, we have understood that at least 18,000 Americans die every year because they lack the affordable health insurance that could have saved their lives.  More recently, Harvard University research has asserted that the annual death toll could be as high as 45,000 casualties. 

If radical terrorists were killing tens of thousands of American every year, there would be national outrage and an overwhelming public demand for the President and the Congress to act immediately and decisively.  Yet, the uninsured neighbors in every community who are perishing as the result of callous political indifference and delay are just as lost to their families.

Many of their concerns are shared by the millions of Americans who are fortunate enough to have health insurance coverage.

A recent Robert Wood Johnson Foundation poll found that 1 out of every 4 Americans is worried that he or she will lose health insurance coverage during the next 12 months.  They also are worried about rising health insurance costs and whether an injury or serious illness might push them into bankruptcy.

Their fears are well-founded.  Shrinking employer-based coverage, combined with insurance industry efforts to deny individual coverage to those who are aging or might have a “preexisting condition,” are leaving more and more Americans “segregated” from health security.

Even those who qualify for individual coverage are facing prohibitive costs, as demonstrated by the 30-39 percent premium hike now confronting the policy-holders of Anthem Blue Cross and Blue Shield coverage in California.

These premium increases, I should note, are being imposed at a time when Anthem’s parent company, “Wellpoint,” like most other insurers, enjoyed a $4.75 billion profit in the last year alone.

“If we don’t act,” President Obama observed, “this is just a preview of coming attractions.  Premiums will continue to rise for folks with insurance; millions more will lose their coverage altogether; [and] our deficits will continue to grow larger.”

Americans are all in this struggle together.  We cannot afford to allow the opponents of expanded health insurance coverage to divide us.

The need for health care reform is clear.  Far too many Americans are being harmed by the current, broken system:

-The breast cancer survivor or asthmatic child who can’t get coverage because of a pre-existing condition,
-The family who simply can’t afford the skyrocketing out-of-pocket costs and premiums, and
-The millions of insured Americans who each pay an extra $1,100 in premiums to compensate for the costs of the uninsured, and
-The state and local governments, along with small businesses, that are seeing their budgets broken because of skyrocketing health insurance premiums

It is hardly surprising, therefore, that the same Robert Wood Johnson poll that I mentioned also found that 3 out of every 4 Americans want the President and Congress to continue to make health insurance reform a top priority this year.

Whether we live or die - keep our homes or are pushed by ill health into bankruptcy - should not be determined by having the wealth or good fortune to afford the health care.

We Democrats understand that health care reform is essential, demanding a heightened sense of national urgency.  To varying degrees, moreover, we have accepted the practical reality that active regulation and participation by the federal government is required if we are to fix our fatally broken system.

Single-Payer: My Long-Term Goal

Congressman John Conyers, Jr. of Michigan and I - along with 86 of our more progressive House colleagues - have been pushing for the last 7 years for a true, single-payer, national health care system based upon Medicare - H.R. 675, the United States National Health Care Act.

Candidly, we would go further toward assuring universal health insurance coverage than many other legislators.  Yet, there is little doubt that the Senate Legislation that we ultimately passed and the President signed into law will do much to alleviate the hardships that millions of Americans are struggling to endure today.

The New Healthcare Reform Law

I realize that many Americans have concerns about health insurance reform, but several facts are clear. 

Our health care system is broken.  Nearly 47 million Americans do not have any health insurance, including more than 9 million children - and the number of our countrymen and women who are uninsured has grown steadily each year for the past decade.

Americans are dying every day because we have not yet reformed our health care insurance system. 

As a moral nation, we have no more time to wait.
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The Facts

Expert analysts working for the House Committee on Energy and Commerce took a careful look at the new healthcare reform law, drawing upon information from the following sources: the U.S. Census (data on insurance rates, small businesses, and young adult population); the Centers for Medicare and Medicaid Services (data on Medicare and Part D enrollment); the Department of Health and Human Services (data on health care-related bankruptcies, uncompensated care, and pre-existing conditions); the Health Resources and Services Administration (data on community health centers); and the Congressional Budget Office (estimates of the percentage of citizens with health insurance coverage under health care reform legislation).

Here is what the Committee’s experts concluded:

“This legislation will make health care affordable for the middle class, provide security for seniors, and guarantee access to health insurance for the uninsured while reducing the federal deficit by over $100 billion over the next decade.”

Here in Our Community

In Maryland’s 7th Congressional District of Maryland alone, the new legislation will:

Improve coverage for 403,000 residents with health insurance.

Approximately 61% of the district (403,000 residents) receives health care coverage from an employer or through policies purchased on the individual market. Under the legislation, individuals with insurance can keep the coverage they have now, and it will get better. The insurance reforms in the bill prohibit annual and lifetime limits, eliminate rescissions for individuals who become ill while insured, ban coverage denials for pre-existing conditions, and reduce the cost of preventive care. To rein in soaring insurance costs, the reforms also limit the amount insurance companies can spend on administrative expenses, profits, and other overhead.
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Extend coverage to 28,000 uninsured residents.

The legislation would extend coverage to 94% of all Americans. If this level of coverage is reached in the Maryland’s 7th District, 28,000 residents who currently do not have health insurance will receive coverage.
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Guarantee that 9,600 residents with pre-existing conditions can obtain coverage.

There currently are 9,600 uninsured individuals in the district who have pre-existing medical conditions like cancer, heart disease, and diabetes. Under the bill’s insurance reforms, they cannot be denied affordable coverage.
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Improve Medicare for 90,000 beneficiaries, including closing the donut hole.

Improving Medicare. There are 90,000 Medicare beneficiaries in the district. The legislation improves their benefits by providing free preventive and wellness care, improving primary and coordinated care, and enhancing nursing home care. The bill also strengthens the Medicare Trust Fund, extending its solvency from 2017 to 2026.

Closing the Part D donut hole. Each year, 4,700 Medicare beneficiaries in the district enter the Part D donut hole and are forced to pay the full cost of their prescription drugs. Under the bill, these beneficiaries will receive a $250 rebate in 2010, 50% discounts on brand name drugs beginning in 2011, and complete closure of the donut hole within a decade. A typical beneficiary who enters the donut hole will see savings of over $700 in 2011 and over $3,000 by 2020.
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Give tax credits and other assistance
to up to 147,000 families and 14,000 small businesses
to help them afford coverage.

Those who do not receive health care coverage through their employer will be able to purchase coverage at group rates through the new health insurance exchange. To make this insurance affordable, the legislation contains the largest middle-class tax cut for health care in history, providing middle class families with incomes up to $88,000 for a family of four with tax credits to help pay for coverage in the exchange. For a family of four making $50,000, the average tax credit will be approximately $5,800. There are 147,000 households in the district that could qualify for these credits if they purchase health insurance through the exchange or, in the case of households with incomes below 133% of poverty, receive coverage through Medicaid.
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Protect 900 families from bankruptcy each year
due to unaffordable health care costs.

There were 900 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill caps annual out-of-pocket costs at $6,200 for individuals and $12,400 for families who purchase insurance through the exchange or who are insured by small businesses. It also eliminates annual and lifetime limits on all insurance coverage. These reforms ensure that no family will have to face financial ruin because of high health care costs.
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Allow 56,000 young adults to obtain coverage
on their parents’ insurance plans.

The legislation will allow young adults to remain on their parents’ policies until they turn 26. There are 56,000 young adults in the district who could benefit from this option. For individuals under age 30, the bill creates new, inexpensive policies that allow them to obtain protection from catastrophic health care costs
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Provide millions of dollars in new funding
for 37 community health centers.

There are 37 community health centers in the district that provide health care to the poor and medically under-served. Nationwide, the legislation would provide $11 billion in new funding for these centers. If the community health centers in the district receive the average level of support, the 37 centers will receive $48.1 million in new assistance.
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Reduce the cost of uncompensated care
for hospitals and other health care providers
by $122 million annually.

In 2008, health care providers in the district provided uncompensated care to individuals who lacked insurance coverage and were unable to pay their bills. Under the legislation, these costs of uncompensated care will be reduced by $122 million
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Help Small Businesses

Under the legislation, small businesses with 100 employees or less will be able to join the health insurance exchange, benefiting from group rates and a greater choice of insurers. There are 16,000 small businesses in the district that could benefit from this provision.

Small businesses with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 14,000 small businesses in the district that could qualify for these credits.
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Reduce the Deficit

The cost of health care reform under the legislation is fully paid for, in large part by eliminating waste, fraud, abuse, and excessive profits for private insurers. The legislation will reduce the deficit by $130 billion over the next ten years, and by about $1.2 trillion over the second decade.
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ASSURING THAT ALL CHILDREN
RECEIVE HIGH-QUALITY DENTAL CARE

In the wealthiest country in the world, there is absolutely no excuse for the dental problems that are plaguing our children. No child should be refused the right to good health. According to the Children’s Dental Health Project, tooth decay is the single most-common chronic childhood disease - 5 to 8 times more common than asthma, a. That is why former U.S. Surgeon General David Satcher, MD, called dental and oral disease a “silent epidemic” that disproportionately affects poor children. In 2007, Deamonte Driver, who was homeless, died when an untreated tooth infection spread to his brain. A simple, eighty dollar tooth extraction could have saved his life, but his mother was unable to find a dentist willing to accept Medicaid.

It is critical that we, as a nation, enact common sense proposals to assure that no other children die from lack of dental care.

There are 7 key commitments that will go a long way toward meeting this national responsibility.  I worked hard to include them in the State Children’s Health Insurance Program (SCHIP) Reauthorization in 2007 which President Bush vetoed twice.  However, many of these same commitments from my original proposal were included in the final version of SCHIP that was passed and signed into law in 2009.


I believe that we, as a nation, should:

-Guarantee a dental benefit for children covered by SCHIP that includes preventive, restorative, and emergency dental care;

-Provide dental education for parents of newborns;

-Allow community health centers to contract with private dentists for the purpose of providing dental care under Medicaid and SCHIP;

-Require states to report the status of children’s oral health for children covered by Medicaid and SCHIP;

-Improve access to dental provider information for Medicaid and SCHIP patients through the Insure Kids Now website (http://www.insurekidsnow.gov)  and hotline (1-877-KIDS-NOW);

-Require the GAO to conduct a study assessing children=s access to dental care within 18 months of the bill’s enactment; and

-Direct the Secretary of Health and Human Services to establish a core set of child health quality measures for assessing states’ Medicaid and SCHIP programs, including measures for the availability of dental services and the quality of pediatric dental care.

I also will continue to advance legislation that would extend dental benefits to children who are eligible for SCHIP but have private medical insurance that does not include dental insurance.
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ELIMINATING MINORITY HEALTH CARE DISPARITIES

According to recent, compelling research:

-African Americans have death rates more than 40 percent higher than whites for heart disease, seven times higher for HIV/AIDS, double for prostate cancer, and 30 percent higher for all cancers.

-Hispanic Americans  have death rates 41 percent higher than whites for diabetes, 168 percent higher for chronic liver disease and cirrhosis, 168 percent higher for HIV/AIDS, and 18 percent higher for strokes.

-American Indians and Alaskan Natives have death rates 750 percent higher than whites for tuberculosis, 190 percent higher for diabetes, and 550 percent higher from alcoholism.

Unlike the past, hostile prejudice is not the primary reason that so many minority Americans are dying before their time.  Rather, the reasons are more complex.

That is why I joined Congressman Jesse Jackson, Jr., (D-Ill.), in proposing H.R. 2778, the Health Equity and Accountability Through Research Act of 2009.  Our legislation  would elevate the National Center on Minority Health and Health Disparities (NCMHD) to the level of Institute, giving it the authority to better address the appalling health disparities that are plaguing our nation’s minority communities. Congressman Jackson and I are confident providing the NCMHD with clear authority over issues relevant to eliminating minority health disparities will be another important step forward in addressing the factors that are killing so many Americans of Color. We applauded the Democratic House leadership for including our proposal to elevate the NCMHD within H.R. 3962, the Affordable Health Care for America Act.  By whatever legislative means, we must do a better job of protecting the health of all of our citizens.




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