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Grace Napolitano on Health Care

Democratic Representative (CA-38)


Voted NO on the Ryan Budget: Medicare choice, tax & spending cuts.

Proponent's Arguments for voting Yes:

[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-TK]: 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.

Reference: Ryan Budget Plan; Bill HCR34&SCR21 ; vote number 11-HV277 on Apr 15, 2011

Voted YES on expanding the Children's Health Insurance Program.

Congressional Summary:

Proponent's argument to vote Yes:

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.

Reference: SCHIP Reauthorization Act; Bill H.R.2 ; vote number 2009-H016 on Jan 14, 2009

Voted YES on overriding veto on expansion of Medicare.

Congressional Summary:Pres. GEORGE W. BUSH's veto message (argument to vote No):In addition, H.R. 6331 would delay important reforms like the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies competitive bidding program. Changing policy in mid-stream is also confusing to beneficiaries who are receiving services from quality suppliers at lower prices. In order to slow the growth in Medicare spending, competition within the program should be expanded, not diminished.

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.

Reference: Medicare Improvements for Patients and Providers Act; Bill HR.6331 ; vote number 2008-H491 on Jul 15, 2008

Voted YES on giving mental health full equity with physical health.

CONGRESSIONAL SUMMARY:

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

Reference: Mental Health and Addiction Equity Act; Bill H.R.1424 ; vote number 08-HR1424 on Mar 5, 2008

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.

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]:

  1. It terminates the coverage of childless adults.
  2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
  3. It contains adequate enforcement to ensure that only US citizens are covered.

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.

Reference: Children's Health Insurance Program Reauthorization Act; Bill H.R. 3963 ; vote number 2007-1009 on Oct 25, 2007

Voted YES on requiring negotiated Rx prices for Medicare part D.

Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.

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.

Reference: Medicare Prescription Drug Price Negotiation Act; Bill HR 4 ("First 100 hours") ; vote number 2007-023 on Jan 12, 2007

Voted NO on denying non-emergency treatment for lack of Medicare co-pay.

Vote to pass a resolution, agreeing to S. AMDT. 2691 that removes the following provisions from S 1932:
Reference: Reconciliation resolution on the FY06 budget; Bill H Res 653 on S. AMDT. 2691 ; vote number 2006-004 on Feb 1, 2006

Voted NO on limiting medical malpractice lawsuits to $250,000 damages.

Vote to pass a bill that would limit the awards that plaintiffs and their attorneys could be given in medical malpractice cases. The bill would limit non-economic damages, including physical and emotional pain to $250,000. The bill would also limit punitive damages to $250,000 or double economic damages, whichever amount is greater. Punitive damages would be banned against makers and distributors of medical products if the Food and Drug Administration approved those products. The bill would call for all states to set damage caps but would not block existing state statutory limits. The bill would cap attorneys' contingency fees to 40% of the first $50,000 in damages; 33.3% of the next $50,000; 25% of the next $500,000; and 15% of any amount in excess of $600,000.
Reference: Medical Malpractice Liability Limitation bill; Bill HR 4280 ; vote number 2004-166 on May 12, 2004

Voted NO on limited prescription drug benefit for Medicare recipients.

Medicare Prescription Drug and Modernization Act of 2003: Vote to adopt the conference report on the bill that would create a prescription drug benefit for Medicare recipients. Starting in 2006, prescription coverage would be made available through private insurers to seniors. Seniors would pay a monthly premium of an estimated $35 in 2006. Individuals enrolled in the plan would cover the first $250 of annual drug costs themselves, and 25 percent of all drug costs up to $2,250. The government would offer a fallback prescription drug plan in regions were no private plans had made a bid.Over a 10 year time period medicare payments to managed care plans would increase by $14.2 billion. A pilot project would begin in 2010 in which Medicare would compete with private insurers to provide coverage for doctors and hospitals costs in six metropolitan areas for six years. The importation of drugs from Canada would be approved only if HHS determines there is no safety risks and that consumers would be saving money.
Reference: Bill sponsored by Hastert, R-IL; Bill HR.1 ; vote number 2003-669 on Nov 22, 2003

Voted YES on allowing reimportation of prescription drugs.

Pharmaceutical Market Access Act of 2003: Vote to pass a bill that would call for the Food and Drug Administration to begin a program that would permit the importation of FDA-approved prescription drugs from Australia, Canada, the European Union, Iceland, Israel, Japan, Lichtenstein, New Zealand, Norway, Switzerland and South Africa.
Reference: Bill sponsored by Gutknecht, R-MN; Bill HR.2427 ; vote number 2003-445 on Jul 24, 2003

Voted NO on small business associations for buying health insurance.

Vote to pass a bill that would permit the creation of association health plans through which small companies could group together to buy insurance for their employees. Association health plans that cover employees in several states would be excused from many individual state insurance regulations but would be regulated by the Labor Department.
Reference: Small Business Health Fairness Act; Bill HR 660 ; vote number 2003-296 on Jun 19, 2003

Voted NO on capping damages & setting time limits in medical lawsuits.

Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2003: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. Limits the availability of punitive damages, and sets a 3-year limit for suing.
Reference: Bill sponsored by Greenwood, R-PA; Bill HR 5 ; vote number 2003-64 on Mar 13, 2003

Voted NO on allowing suing HMOs, but under federal rules & limited award.

Vote to adopt an amendment that would limit liability and damage awards when a patient is harmed by a denial of health care. It would allow a patient to sue a health maintenance organization in state court but federal, not state, law would govern.
Bill HR 2563 ; vote number 2001-329 on Aug 2, 2001

Voted NO on subsidizing private insurance for Medicare Rx drug coverage.

HR 4680, the Medicare Rx 2000 Act, would institute a new program to provide voluntary prescription drug coverage for Medicare beneficiaries through subsidies to private plans. The program would cost an estimated $40 billion over five years and would go into effect in fiscal 2003.
Reference: Bill sponsored by Thomas, R-CA; Bill HR 4680 ; vote number 2000-357 on Jun 28, 2000

Voted NO on banning physician-assisted suicide.

Vote on HR 2260, the Pain Relief Promotion Act of 1999, would ban the use of drugs for physician-assisted suicide. The bill would not allow doctors to give lethal prescriptions to terminally ill patients, and instead promotes "palliative care," or aggressive pain relief techniques.
Reference: Bill sponsored by Hyde, R-IL; Bill HR 2260 ; vote number 1999-544 on Oct 27, 1999

Voted NO on establishing tax-exempt Medical Savings Accounts.

The bill allows all taxpayers to create a tax-exempt account for paying medical expenses called a Medical Savings Account [MSA]. Also, the measure would allow the full cost of health care premiums to be taken as a tax deduction for the self-employed and taxpayers who are paying for their own insurance. The bill would also allow the establishment of "HealthMarts," regional groups of insurers, health care providers and employers who could work together to develop packages for uninsured employees. Another provision of the bill would establish "association health plan," in which organizations could combine resources to purchase health insurance at better rates than they could separately.
Reference: Bill sponsored by Talent, R-MO; Bill HR 2990 ; vote number 1999-485 on Oct 6, 1999

Rated 100% by APHA, indicating a pro-public health record.

Napolitano scores 100% by APHA on health issues

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.

Source: APHA website 03n-APHA on Dec 31, 2003

Require insurers to cover breast cancer treatment.

Napolitano co-sponsored Breast Cancer Patient Protection Act

Congressional Summary: Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require coverage and radiation therapy for breast cancer treatment.

Congressional Findings:

  1. According to the American Cancer Society, excluding cancers of the skin, breast cancer is the most frequently diagnosed cancer in women.
  2. An estimated 40,480 women and 450 men died from breast cancer in 2008, and an estimated 182,460 new cases of invasive breast cancer were diagnosed in women, plus 1,990 cases in men.
  3. Most breast cancer patients undergo some type of surgical treatment.
  4. Treatment for breast cancer varies according to type of insurance coverage and State of residence.
  5. Currently, 20 States mandate minimum inpatient coverage after a patient undergoes a mastectomy.
  6. Breast cancer patients have reported adverse outcomes, including infection and inadequately controlled pain, resulting from premature hospital discharge following breast cancer surgery.
    Source: H.R.111 11-HR111 on Jan 5, 2011

    Increase funding for occupational & physical therapy.

    Napolitano signed Medicare Access to Rehabilitation Services Act (MARS)

    Medicare Access to Rehabilitation Services Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to repeal the cap on outpatient physical therapy, speech-language pathology, and occupational therapy services of the type furnished by a physician or as an incident to physicians' services.

    SEC. 2. OUTPATIENT THERAPY CAP REPEAL.

    Section 1833 of the Social Security Act (42 U.S.C. 1395(l)) is amended by striking subsection (g).

    [Explanatory note from Wikipedia.com "Therapy Cap"]:

    In 1997 Congress established per-person Medicare spending limits, or "therapy cap" for nonhospital outpatient therapy, but responding to concerns that some people with Medicare need extensive services, it has since placed temporary moratoriums on the caps. The therapy cap is a combined $1,810 Medicare cap for physical therapy and speech language pathology, and a separate $1,810 cap for occupational therapy ($1870 for 2011). Medicare patients requiring rehabilitation from disabilities, car accidents, hip injuries, stroke, and other ailments would be limited to roughly two months worth of treatments at an outpatient therapy clinic. Any patients that exceed the cap, whether they are healed or not, would have to stop therapy, or pay for the therapy services out of their own pocket.Several medical associations have lobbied against therapy caps because the bill inadvertently restricted disabled seniors, stroke patients, and other severe cases from receiving therapy treatments.

    Source: HR.1546&S829 11-HR1546 on Apr 14, 2011

    Expand the National Health Service Corps.

    Napolitano signed Access for All America Act

      A bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs. Amends the Public Health Service Act to:
    1. increase and extend the authorization of appropriations for community health centers and for the National Health Service Corps scholarship and loan repayment program for FY2010-FY2015, and provide for increased funding for such programs in FY2016 and each subsequent fiscal year; and
    2. revise and expand provisions allowing a community health center to provide services at different locations, adjust its operating plan and budget, enter into arrangements with other centers to purchase supplies and services at reduced cost, and correct material failures in grant compliance.
    Source: S.486&HR1296 2009-S486 on Mar 4, 2009

    Supported funding women's health needs.

    Napolitano adopted the Women's Caucus policy agenda:

    Source: Women's Caucus Agenda-106th Congress 99-WC2 on Jul 15, 1999

    Supported funding older women's health.

    Napolitano adopted the Women's Caucus policy agenda:

    Source: Women's Caucus Agenda-106th Congress 99-WC3 on Jul 15, 1999

    Supported funding Prenatal and Postpartum Care.

    Napolitano adopted the Women's Caucus policy agenda:

    Source: Women's Caucus Agenda-106th Congress 99-WC5 on Jul 15, 1999

    Supported funding Family and Children's Coverage.

    Napolitano adopted the Women's Caucus policy agenda:

    Source: Women's Caucus Agenda-106th Congress 99-WC6 on Jul 15, 1999

    2012 Governor, House and Senate candidates on Health Care: Grace Napolitano on other issues:
    CA Gubernatorial:
    Antonio Villaraigosa
    Eric Garcetti
    Hilda Solis
    Jerry Brown
    Jerry Sanders
    Neel Kashkari
    CA Senatorial:
    Barbara Boxer
    Dianne Feinstein

    Left 113th Congress, 2013-2014:
    AL-1: Jo Bonner(R,resigned)
    FL-13:Bill Young(R,deceased)
    FL-19:Trey Radel(R,arrested)
    IL-2: Jesse L. Jackson(D,convicted)
    LA-5: Rodney Alexander(R,resigned)
    MA-5: Ed Markey(D,elected)
    MO-8: Jo Ann Emerson(R,resigned)
    NC-12:Mel Watt(D,appointed)
    NJ-1: Rob Andrews(D,investigated)
    SC-1: Tim Scott(R,appointed)

    Newly-elected special elections 2013-2014:
    AL-1: Bradley Byrne(R)
    FL-13:David Jolly(R)
    FL-19:Curt Clawson(R)
    IL-2: Robin Kelly(D)
    LA-5: Vance McAllister(R)
    MA-5: Katherine Clark(D)
    MO-8: Jason Smith(R)
    NC-12: Pending Jul.15
    NJ-1: Pending Nov.4
    SC-1: Mark Sanford(R)
    Won primary 2014:
    TX-4: John Ratcliffe(R)
    VA-7: Dave Brat(R)

    Retiring to run for Senate in 2014:
    AR-4: Tom Cotton(R)
    CO-4: Cory Gardner(R)
    GA-1: Jack Kingston(R)
    GA-10:Paul Broun(R)
    GA-11:Phil Gingrey(R)
    HI-1: Colleen Hanabusa(D)
    IA-1: Bruce Braley(D)
    LA-6: Bill Cassidy(R)
    MI-14:Gary Peters(D)
    MT-0: Steve Daines(R)
    OK-5: James Lankford(R)
    TX-36:Steve Stockman(R)
    WV-2: Shelley Moore Capito(R)

    Former Reps running for House in 2014:
    AL-5: Parker Griffith(R)
    CA-3: Doug Ose(R)
    GA-11:Bob Barr(R)
    CA-31:Joe Baca(D)
    IL-10:Bob Dold(R)
    IL-17:Bobby Schilling(R)
    MS-4: Gene Taylor(D)
    MT-0: Denny Rehberg(R)
    NH-1: Frank Guinta(R)
    NY-11:Vito Fossella(R)
    NY-18:Nan Hayworth(R)
    OH-7: John Boccieri(D)
    PA-13:Marjorie Margolies(D)
    TX-23:Francisco Canseco(R)
    Lost primary 2014:
    TX-4: Ralph Hall(R)
    VA-7: Eric Cantor(R)

    Retiring to run for State Office in 2014:
    AR-2: Tim Griffin(R)
    CA-35:Gloria McLeod(D)
    ME-2: Mike Michaud(D)
    PA-13:Allyson Schwartz(D)
    VI-0: Donna Christensen(D)

    Retiring effective Jan. 2015:
    AL-6: Spencer Bachus(R)
    AZ-7: Ed Pastor(D)
    CA-11:George Miller(D)
    CA-25:Howard McKeon(R)
    CA-31:Gary Miller(R)
    CA-33:Henry Waxman(D)
    CA-45:John Campbell(R)
    IA-3: Tom Latham(R)
    MI-4: Dave Camp(R)
    MI-6: Tom Petri(R)
    MI-12:John Dingell(D)
    MN-6: Michele Bachmann(R)
    NC-6: Howard Coble(R)
    NC-7: Mike McIntyre(D)
    NJ-3: Jon Runyan(R)
    NJ-12:Rush Holt(D)
    NY-4: Carolyn McCarthy(D)
    NY-21:Bill Owens(D)
    PA-6: Jim Gerlach(R)
    UT-4: Jim Matheson(D)
    VA-8: James Moran(D)
    VA-10:Frank Wolf(R)
    WA-4: Doc Hastings(R)
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    Page last updated: Jul 16, 2014