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Health Care Reform

As you may know, the ACA, commonly referred to as Obamacare, was signed into law on March 23, 2010.  Since then, as I have traveled around Wisconsin, I have heard from countless individuals whose families or businesses have been harmed as a direct result of the ACA.  Businesses, policy experts, government actuaries, and even some supporters of the law have confirmed what the country already knew: the ACA is bad policy.  The law has spent trillions of dollars we do not have, raised taxes on workers, businesses and families, and put the federal government squarely in the middle of health care decisions.  In forcing Americans to buy government-approved insurance plans that they do not like, do not need, and cannot afford, Obamacare hurts more people than it helps.  Left unchecked, the damage wrought by Obamacare will continue to spin out of control, get worse, and harm more patients and families.  Its very structure has proven fundamentally unworkable and unsustainable.

Congress continues to have the responsibility to advance solutions that strengthen health care security by taking power away from the government and insurance companies, and empowering patients with control over their care instead.  These solutions should realign incentives so that individuals and their doctors – not government bureaucrats or insurance company bureaucrats – are the nucleus of our health care system.  This requires reforms, which I have introduced in the past, to equalize the tax treatment of health care insurance, invite true choice and competition, and ensure critical programs like Medicare and Medicaid can deliver on their promises in the 21st century.

From the start, our approach to repeal and replace Obamacare has been a step-by-step process.  During the previous Congress, House Republicans introduced a health care policy rollout as part of our bold, clear, conservative agenda, “A Better Way: Our Vision for a Confident America.”  We outlined our vision for repealing and replacing Obamacare and achieving patient-centered reform in “A Better Way,” and continue to work with a president committed to ending the nightmare that is Obamacare to pass legislation based on that vision.  In order to fully and effectively fulfill our duty to show the country what our ideas look like in action, we need to deliver relief from the ACA’s taxes and mandates and lay the groundwork for a 21st century health care system.

This is why, on March 20, 2017, Representative Diane Black introduced H.R. 1628, the American Health Care Act (AHCA).  This fiscally responsible legislation – the first of three intended phases of our comprehensive plan for health care reform – would not only repeal Obamacare, but replace it with the patient-centered reforms Americans need.  The AHCA would create more choices, lower costs, and give back control to individuals and families – and in the process, move decisions away from Washington and into state programs, doctors’ offices, and family living rooms.

The AHCA would make a dramatic improvement in our health care system and provide relief to those hurting under Obamacare.  The strong and sustainable foundation it would provide for families and taxpayers would allow for further legislative efforts and regulatory relief to build on its bold reforms, enhance competition, promote federalism and, most importantly, empower patients with more choices, greater purchasing power, and the peace of mind that comes with enjoying reliable coverage that fits their wants and needs.  Patients should be the focal point of our health care system.  They – not politicians or Washington bureaucrats – should be able to make choices about their own care, and insurance companies should compete for their business, not enjoy mandates that force people to buy plans they can neither afford nor use.

After the initial introduction of the ACHA, conversations continued about ways to make this strong bill even stronger.  My colleagues and I were able to build upon the original draft of the AHCA by enhancing the protections offered in the bill for patients with pre-existing conditions.  Unfortunately, defenders of the unacceptable status quo continue to put forth objectively false and intentionally misleading claims about the AHCA, especially on this crucial issue.  Ensuring that people with pre-existing conditions can afford to buy health insurance without facing discriminatory barriers or higher costs is too important to allow myths to stand in the way of real reform.  Therefore, I need to set the record straight by focusing on discussion and debate and being clear about the facts.

In fact, to build on the protections maintained and provided by the original legislative text, Republicans and Congress went even further to protect those with pre-existing conditions.  Specifically, on April 25, 2017, Representative Tom MacArthur introduced an amendment to the AHCA which explicitly states that the bill cannot be construed in any way other than to maintain protections for patients with pre-existing conditions.  This amendment unambiguously reaffirms that no state may, under any circumstances, seek or obtain a waiver to alter the existing requirement of guaranteed issue of coverage, guaranteed renewability of coverage, or the prohibition on denying coverage due to pre-existing conditions – ever.  In other words, it specifically clarifies that the AHCA does not allow insurers to limit coverage for patients with pre-existing conditions, and that these crucial protections will remain the law of the land if the AHCA is enacted.  On May 4, 2017, the House passed the amended version of the AHCA by a vote of 217 to 214.  I voted in favor of final passage.  At present, the bill remains pending in the Senate.    

Further, on May 24, 2017, the nonpartisan Congressional Budget Office (CBO) released its official scoring of the AHCA as passed by the House on May 4, 2017.  Their comprehensive report confirms that the AHCA will lower premiums and improve access to quality, affordable care, as well as provide massive tax relief, dramatically reduce the deficit, and bring forth the most fundamental entitlement reform in more than a generation.  I recognize and appreciate concerns surrounding access to coverage.  Our plan is not about forcing anyone to buy an expensive, one-size-fits all plan.  Rather, it is about providing Americans with more choices and better access.  The CBO report confirms a fundamental principle of basic economics: when people have more choices, costs go down.

Additionally, I would like to clarify and put to rest any confusion regarding Member and staff exemptions under this bill.  I, like you, believe that Senators, Members of the House of Representatives, and congressional staff should abide by the same rules as everyone else – period.  This is precisely why, on April 27, 2017, Representative McSally introduced H.R. 2192, a bill to amend the Public Health Service Act to eliminate the non-application of certain State waiver provisions to Members of Congress and congressional staff.  This bill guarantees that Members and staff are not exempt from the State waiver provisions of the AHCA.  On May 4, 2017, in overwhelming bipartisan fashion, the House passed H.R. 2192 by a vote of 429 to 0.  I voted in favor of final passage.  The passage of H.R. 2192 ensures that there is not, contrary to popular misconception, any congressional exemption for Members or their staff from any portion of the AHCA.  There is no carve out, nor are there any special privileges.  Those who make our nation’s laws ought to live by them, and so should members of their staff – it should be, and is, as simple as that.

This bill delivers on the promises we have made to the American people.  I believe that my employers, and citizens across this great nation, deserve a health care system that works for them – not for any special interest or industry.  The current health care crisis is the direct result of the government takeover of health care that is the ACA.  It is a failed experiment that has worsened the problems it attempted to solve.  If we don’t act, more people will feel more pain and face more anxiety that they simply do not deserve.  The status quo is simply no longer an option, and the AHCA is a better way forward.  It gives us the opportunity to raise our gazes and set a bold course for our country.  It shows that we have the resolve to stop the drift of arrogant, big-government policies in our lives and begin a new era of reform based on liberty and self-determination.  That said, the passage of the AHCA is just one step in the process to repeal Obamacare and replacing it with a stronger, better system.  We still have much work to do, but one thing now is clear: Republicans remain committed to keeping our promise to lift the burden of Obamacare from the American people and enact the patient-centered reforms that this country so desperately needs.

Should you be interested in further information about the AHCA, I encourage you to visit: readthebill.gop, which provides the full text of the bill to download, as well as summaries of amendments and frequently-asked-questions.

House Proposals to Reform Medicare

Our government has a spending problem—a problem so large that it is driving up our debt, hurting our nation’s ability to create jobs, and threatening our future.  In the past, Washington has not been truthful about the magnitude of these problems facing our country, but we can no longer afford to put off an honest, fact-based conversation on how to solve them.

No one person or party is responsible for the looming crisis.  Yet the facts are clear: major spending increases have failed to deliver promised jobs.  The safety net for the poor is coming apart at the seams.  Government health and retirement programs are growing at unsustainable rates.  The Affordable Care Act has created a tremendous fiscal burden.

The House-passed budget incorporates the House passage of the American Health Care Act and protects the health and retirement security of those who need it.  With the creation of Medicare in 1965, the United States made a commitment to help fund the medical care of elderly Americans to ensure that a serious illness would not exhaust their life savings or the assets and incomes of their working children and younger relatives. 

Recognizing the problems facing Medicare, the House-Passed Budget:

  • Strengthens health and retirement security by taking power away from government bureaucrats and empowering patients with control over their care.

  • Incorporates the House passed American Health Care Act

  • Establishes that Medicare will provide a premium-support payment and a list of guaranteed coverage options – including a traditional fee-for-service option – from which recipients can choose a plan that best suits their needs.

  • Provides premium support, competitive bidding, and more assistance for those with lower incomes or greater health care needs will ensure guaranteed affordability for all seniors.

Allowing the federal government to break its promises to current seniors and to future generations is unacceptable.  The reforms outlined in the budget passed by the House protect and preserve Medicare for those in and near retirement, while saving and strengthening this critical program so that future generations can count on it to be there when they retire.

House Proposals to Reform Medicaid

Medicaid is meant to offer affordable health care to those with limited financial resources including low income children, parents, women who are pregnant and seniors.  Unfortunately, the program’s costs are bursting at the seams.  In fact, the Congressional Budget Office projects federal spending for Medicaid to reach $650 billion annually by 20207.   Should this trend continue to be ignored, Medicaid will continue to overwhelm state and federal budgets and fail the vulnerable people who need it most.

Specifically, the House-Passed Budget builds on the reforms contained within the American Health Care Act.  All Americans will pay more because of this broken Medicaid system – and not just in higher taxes.  Because Medicaid’s reimbursement rates have been ratcheted down to below-market levels, the care that Medicaid patients receive is often substandard.  Offering states more flexibility for their Medicaid beneficiaries will remove the stigma Medicaid recipients face, and allow them to take advantage of a range of available options.  Several of the nation’s governors have made innovative proposals to fix Medicaid.  The House passed budget encourages further efforts in this direction.

Children’s Health Insurance Program

On January 22, 2017, the House passed a Continuing Resolution to provide government funding, which was later signed into law by President Trump.  As part of that legislation, the Children’s Health Insurance Program (CHIP) was funded through FY 2023, marking the longest reauthorization in the program’s history. 

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