Duncan Hunter on Health Care Republican Representative (CA-52)

Romney’s plan has 1,000 mandates; drives up cost by 35%

ROMNEY: We took as many mandates out as we could. And the legislature kept some there. It was a compromise. But the price of the premium for an individual [was] basically cut it in half by deregulating. Congressman, you’re absolutely right that taking regulation out of insurance brings the price down, and that’s why my plan would go state by state, & deregulate them.

Bring back family doctor, with tax breaks & less malpractice

A: The first thing you’ve got to have is the ability to buy your health care insurance across state lines. And right now, nobody in the US can do that. Secondly, I think we bring back the family doctor. And I think one way you bring back the family doctor is by taking away massive malpractice burdens, these massive insurance premiums that we place on people. And finally, let’s try a little freedom. How about if we said in the tax code that if a doc will be a family doc, in the barrio, in the community, and he will do office visits for 30 bucks or 40 bucks a visit, he doesn’t have to pay taxes on that, he doesn’t have to have three accountants, he doesn’t have to do all those things? Bring back the family doctor.

Oppose mandated health insurance and universal coverage

• HUCKABEE: Yes.
• TANCREDO: Yes.
• COX: Yes.
• BROWNBACK: Yes.
• PAUL: Yes.
• HUNTER: Yes.
• KEYES: Yes.

Allow Americans to buy health insurance across state lines

SCHIP bill is the first extension of socialized medicine

States locking up insurance industry adds to high Rx prices

A: We need to be able to buy our health care insurance across state lines. Right now the same single policy that can be purchased in Long Beach for $73 costs $334 in New Jersey. The states lock up the insurance industry. They won’t let Americans buy across state lines just like they do everything else. If we’re able to do that, we’re going to bring down the cost of health insurance.

Free enterprise invents drugs; Third World can’t do that

Voted YES on overriding veto on expansion of Medicare.

• Extends Medicare to cover additional preventive services.
• Includes body mass index and end-of-life planning among initial preventive physical examinations.
• Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.

I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it because:
• It would harm beneficiaries by taking private health plan options away from them.
• It would undermine the Medicare prescription drug program.
• It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.

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.

Voted NO on giving mental health full equity with physical health.

• Paul Wellstone Mental Health and Addiction Equity Act of 2008: Requires group health plans to apply the same treatment limits on mental health or substance-related disorder benefits as they do for medical and surgical benefits (parity requirement).
• Genetic Information Nondiscrimination Act of 2008: Prohibits a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information.

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

Voted NO on Veto override: Extend SCHIP to cover 6M more kids.

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.

1. It terminates the coverage of childless adults in 1 year.
2. It prohibits States from covering children in families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.
4. It encourages securing health insurance provided through private employer.

Voted NO on requiring negotiated Rx prices for Medicare part D.

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.

Voted YES on denying non-emergency treatment for lack of Medicare co-pay.

• Allows hospitals to refuse treatment to Medicaid patients when they are unable to pay their co-pay if the hospital deems the situation to be a non-emergency
• Excludes payment to grandparents for foster care

Voted YES on limiting medical malpractice lawsuits to $250,000 damages.

Voted YES on limited prescription drug benefit for Medicare recipients.

Voted YES on allowing reimportation of prescription drugs.

Voted YES on small business associations for buying health insurance.

Voted YES on capping damages & setting time limits in medical lawsuits.

Voted YES on allowing suing HMOs, but under federal rules & limited award.

Voted YES on subsidizing private insurance for Medicare Rx drug coverage.

Voted YES on banning physician-assisted suicide.

Voted YES on establishing tax-exempt Medical Savings Accounts.

Rated 11% by APHA, indicating a anti-public health voting record.

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Prohibit mandatory mental health screen for students.

To prohibit the use of Federal funds for any universal or mandatory mental health screening program.

Introductory statement by Sponsor:

Rep. PAUL: This bill forbids Federal funds from being used for any universal or mandatory mental health screening of students without the express, written, voluntary, informed consent of their parents or legal guardian. This bill protects the fundamental right of parents to direct and control the upbringing and education of their children.

[A Congressional commission] recommends that universal or mandatory mental health screening first be implemented in public schools as a prelude to expanding it to the general public. However, neither the commission's report nor any related mental health screening proposal requires parental consent before a child is subjected to mental health screening. Federally-funded universal or mandatory mental health screening in schools without parental consent could lead to labeling more children as "ADD" or "hyperactive" and thus force more children to take psychotropic drugs, such as Ritalin, against their parents' wishes.

Many children have suffered harmful side effects from using psychotropic drugs. Some of the possible side effects include mania, violence, dependence, and weight gain. Yet, parents are already being threatened with child abuse charges if they resist efforts to drug their children. Imagine how much easier it will be to drug children against their parents' wishes if a Federally-funded mental health screener makes the recommendation.

Repeal the Job-Killing Health Care Law.

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.

Remove all funding from the 2010 national healthcare law.

Congressional Summary: Declares that no funds are authorized to be appropriated to carry out the Patient Protection and Affordable Care Act (PPACA), the Health Care and Education Reconciliation Act of 2010 (HCERA), and any amendments made by either such Act.

OnTheIssues Explanation:This bill proposes to defund ObamaCare, instead of repealing it. This bill uses Congress' "power of the purse" to undo the previously-passed law, while still leaving that law on the books. In contrast, H.R. 2 repeals ObamaCare rather than defunding it; and H.R. 4 attempts to undo ObamaCare one piece at a time.

Fully repealing ObamaCare is important, but not sufficient.

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:

1. The wreck of private insurance: Ours has been the only healthcare system in the world designed to avoid sick people. For-profit insurers have spent billions finding and marketing their policies to healthy people--while rejecting people with preexisting conditions, or at high risk.
2. We could not continue with this travesty of a healthcare system: ObamaCare is a modest solution. It still relies on private insurers--merely setting minimum standards and "exchanges" where customers can compare policies.
3. The moral imperative: Even a clunky compromise like the ACA between a national system of health insurance and a for-profit insurance market depends, fundamentally, on a social compact in which those who are healthier and richer are willing to help those who are sicker and poorer. Such a social compact defines a society.

Legislative outcome: Passed House 239-186-8; never came to a vote in the Senate.