Amy Klobuchar on Health Care DFL Sr Senator (MN); Democratic presidential contender

Medicare-for-All will kick 149 million off their insurance

Sanders responded that the "status quo" offered by Biden will cost even more. "We are spending twice as much per capita as the people of any other country," Sanders told Biden, who was vice president during the passage of the Affordable Care Act championed by President Barack Obama. "Maybe it has something to do with the fact that the health care industry last year made $100 billion in profit."

Klobuchar then broke in. "I keep listening to this same debate, and it is not real. It is not real, Bernie, because two thirds of the Democrats in the Senate are not on your bill, and because it would kick 149 million Americans off their current health insurance in four years," she said, garnering a loud reaction from the crowd.

Non-profit public option: I have a plan for that

KLOBUCHAR: Senator Sanders and I have worked together on pharmaceuticals for a long, long time. And we agree on this. But what I don't agree with is his position on health care. This debate isn't real. Over 2/3 of the Democrats in the U.S. Senate are not on the bill that you and Senator Warren are on. You have numerous governors that are Democratic that don't support this. The answer is a nonprofit public option. The real debate we should be having is how do we make it easier for people to get coverage for addiction and mental health. I have a plan for that. And then, what should we do about long-term care? We need to make it easier for people to get long-term care insurance.

We need a paid-for healthcare plan, not a pipe dream

Sen. Bernie SANDERS: Medicare for all ends all premiums, all copayments. It ends the absurdity of deductibles. It ends out-of-pocket expenses. It takes on the pharmaceutical industry, which in some cases charges 10 times more for the same prescription drugs sold abroad as sold here. A Medicare for all single-payer program will end the $100 billion a year that the health care industry makes and the $500 billion a year we spend dealing with thousands of separate insurance plans. Health care is a human right.

Take on Big Pharma, to make drugs more affordable

KLOBUCHAR: Make sure the HIV community can get the drugs they need. That means the PrEP drug and that means to take on pharmaceutical companies to make drugs more affordable. The second thing is to make sure we keep the protections of the Affordable Care Act. Make it easier for the generics to get online. Bring in less expensive drugs from other countries to start competition.

More mental health resources for LGBTQ

KLOBUCHAR: Second cause of death of teenagers right now is suicide, with the numbers for LGBTQ being higher. Get rid of the stigma by treating mental illness like any other disease. Making sure insurance companies are offering the insurance and coverage. More beds. And prevention lines, hot lines, all of those kinds of things. More counselors in the schools to work with LGBTQ youth.

Do not eliminate employer insurance plans

Provide immediate health care for undocumented immigrants

Allow Medicare to negotiate drug prices & re-import

Medicare/Medicaid can be step towards universal care

Backs Medicare Advantage, alternative to Medicare

Ensure vets get equal support for mental health

When it comes to the veterans, a lot of them go home to small towns. Sometimes they don't have the kind of access especially if they're in the reserve. So they're just coming back sporadically to our V.A. facilities. We have to do a lot better job when they're coming back to evaluate them, to see what they need, to touch base with them.

Supports public option for Medicaid & Medicare

Take on Big Pharma on prices & lack of competition

For public option, taking on Big Pharma

We can bring drug prices down; Trump can't

A: There are a number of things that he's said he wants to do, like bring down prescription drug prices, that I agree with. My problem is, he doesn't have the will to actually get it done. Insulin, simple drug prices tripling, quadrupling, doesn't make any sense. We can bring those drug prices down.

Medicare-for-all is aspirational and for the future, not now

Klobuchar's centrist positions puts her largely in a category alone, as many of her Democratic opponents have opted to fully embrace Medicare-for-all and the Green New Deal. But she may soon be joined in that group by other moderate candidates, such as Ohio Sen. Sherrod Brown.

On health care, Klobuchar said she wanted to "build on" the Affordable Care Act, highlighting her support for a public option, rather than calling for an immediate transition to Medicare-for-all. "It could be a possibility in the future," she said, "but I'm looking for what's working now."

Medicare-for-All for the future; public option now

A: I believe we have to get to universal health care in this country. We have to make sure that we build on the work of the Affordable Care Act. We need to expand coverage so that people can have a choice for a public option. You can do it with Medicare. You could also do it with Medicaid. This is a bill that I am an original co-sponsor of. It basically says let's expand Medicaid so you can buy into Medicaid and it will bring the prices down and we can cover more people. The other part of the equation is doing something about prescription drugs. I have one of the original bills to push to have Medicare negotiate prices, lift the ban, bring in less expensive drugs from Canada and stop the practice where pharma pays off generics to keep their products off the market.

Q: And Medicare for all?

A: I think it's something that we can look to for the future, but I want to get action now.

Expand Medicare to age 55

Allow Medicare to directly negotiate prices

Allow sick people to obtain insurance

Democrat Klobuchar, meanwhile, told the Minnesota Public Radio debate audience that federal laws such as allowing sick people to obtain insurance should be continued, said she agrees with a majority of scientists who think climate change is at least partly due to human activity and felt Mexican border security should be a combination of a wall, fence and personnel.

In a rare area of agreement, Klobuchar and Newberger said the federal government needs to find a way to keep prescription medicine costs down.

1996: testified & passed 48-hr maternity hospital stay rule

Summoning the courage to talk about episiotomies and breast pumping in front of TV cameras. And I quickly realized that my testimony had the advantage of being so embarrassing to a still male-dominated legislature that it was nearly impossible to NOT pass the legislation.

Noting the support for the bill by pediatricians and ob-gyns alike, I concluded my testimony before one Senate committee by appealing for bipartisan support and pointing out that New Jersey's Republican governor Christine Todd Whitman had made such a bill one of the centerpieces of her legislative agenda. "Certainly the women and babies of Minnesota," I said, "should be protected as much as the women and babies of New Jersey." The 48-hour maternity hospital stay rule became law on March 20, 1996.

Crack down on the price of health care

Universal coverage is our goal

I will fight to improve the quality of health care in America. In many ways, we already enjoy the very best quality of care in the world?for those who have access and can afford it.

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

[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.
Status: Failed 40-57

Voted YES on regulating tobacco as a drug.

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.

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

• Reauthorizes State Children's Health Insurance Program (SCHIP) through FY2013 at increased levels.
• Gives states the option to cover targeted low-income pregnant women
• Phases out coverage for nonpregnant childless adults.

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.

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 means-testing to determine Medicare Part D premium.

SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.

OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Voted NO on allowing tribal Indians to opt out of federal healthcare.

TRIBAL MEMBER CHOICE PROGRAM: Members of federally-recognized Indian Tribes shall be provided the opportunity to voluntarily enroll, with a risk-adjusted subsidy for the purchase of qualified health insurance in order to--
1. improve Indian access to high quality health care services;
2. provide incentives to Indian patients to seek preventive health care services;
3. create opportunities for Indians to participate in the health care decision process;
4. encourage effective use of health care services by Indians; and
5. allow Indians to make health care coverage & delivery decisions & choices.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.

Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.

OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?

LEGISLATIVE OUTCOME:Amendment rejected, 28-67

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

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:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

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.

Voted YES 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.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)

Improve services for people with autism & their families.

Amends the Public Health Service Act to require the Secretary of Health and Human Services to:

1. convene, on behalf of the Interagency Autism Coordinating Committee, a Treatments, Interventions, and Services Evaluation Task Force to evaluate evidence-based biomedical and behavioral treatments and services for individuals with autism;
2. establish a multi-year demonstration grant program for states to provide evidence-based autism treatments, interventions, and services.
3. establish planning and demonstration grant programs for adults with autism;
4. award grants to states for access to autism services following diagnosis;
5. award grants to University Centers of Excellence for Developmental Disabilities to provide services and address the unmet needs of individuals with autism and their families;
6. make grants to protection and advocacy systems to address the needs of individuals with autism and other emerging populations of individuals with disabilities; and
7. award a grant to a national nonprofit organization for the establishment and maintenance of a national technical assistance center for autism services and information dissemination.
8. Directs the Comptroller General to issue a report on the financing of autism services and treatments.

Establish a national childhood cancer database.

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of:
1. activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
2. activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
3. direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.

Merge Alzheimers diagnosis and care benefit.

Congressional Summary:The purpose of this Act is to increase diagnosis of Alzheimer's disease and related dementias, leading to better care and outcomes for Americans living with Alzheimer's disease and related dementias. Congress makes the following findings:

1. As many as half of the estimated 5.2 million Americans with Alzheimer's disease have never received a diagnosis.
2. An early and documented diagnosis and access to care planning services leads to better outcomes for individuals with Alzheimer's disease.
3. Combining the existing Medicare benefits of a diagnostic evaluation and care planning into a single package of services would help ensure that individuals receive an appropriate diagnosis as well as critical information about the disease and available care options.

Proponent's argument for bill: (The Alzheimer's Association, alz.org). The "Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act" (S.709/H.R. 1507) is one of the Alzheimer's Association's top federal priorities for the 113th Congress. The HOPE for Alzheimer's Act would improve diagnosis of Alzheimer's diseas

Keep ObamaCare's prevention, treatment, & recovery services.

Excerpts from Letter from 20 Senators to President Trump: Repealing the Affordable Care Act (ACA) with no clear plan for replacement will substantially worsen the opioid epidemic. Last year, Congress took important steps to address this national public health crisis, enacting two bipartisan laws to address the opioid epidemic and reform the way our health system treats mental health and substance use disorders.

The Comprehensive Addiction and Recovery Act improved access to substance use disorder prevention, treatment, and recovery services. It promoted the use of best practices when prescribing opioid pain-killers, strengthening state prescription drug monitoring programs, and expanding access to the life-saving drug naloxone.

The 21st Century Cures Act also included critical mental health and substance use disorder reforms, strengthening enforcement of mental health parity laws, promoting the integration of physical and mental health care. Most importantly, the 21st Century Cures Act dedicated $1 billion in new grant funding, which will be essential to helping states provide prevention, treatment, and recovery services to patients These bipartisan advances will be fundamentally undermined by repeal of the ACA.

Opposing argument: (Warren, D-MA, in StatNews.com, 11/28/2016): Senator Elizabeth Warren railed against the 21st Century Cures, saying the bill had been "hijacked" by the pharmaceutical industry. "I cannot vote for this bill,'' Warren said. "I will fight it because I know the difference between compromise and extortion." The current legislation includes $500 million for the FDA, well below the amount Democrats had sought. Warren and Washington Senator Patty Murray have long argued that they would only support Cures legislation that included significant investment in basic medical research. While Warren said she supported many of the provisions, she called others "huge giveaways" to the drug industry.

Keep healthcare mandate, according to CC survey.

The Christian Coalition Voter Guide inferred whether candidates agree or disagree with the statement, 'Repealing the Nationalized Health Care System that Forces Citizens to Buy Insurance ' Christian Coalition's self-description: "Christian Voter Guide is a clearing-house for traditional, pro-family voter guides. We do not create voter guides, nor do we interview or endorse candidates."

Disclose payments from manufacturers to physicians.

An amendment to provide for transparency in the relationship between physicians and applicable manufacturers with respect to payments and other transfers of value and physician ownership or investment interests in manufacturers.
• Requires any manufacturer of a covered drug, device, biological, or medical supply that makes a payment or another transfer of value to a physician, a physician medical practice, or a physician group practice to report annually, in electronic form, specified information on such transactions to the Secretary of Health and Human Services.
• Requires any such manufacturer, or related group purchasing organization, also to report annually to the Secretary, in electronic form, certain information regarding any ownership or investment interest (other than in a publicly traded security and mutual fund) held by a physician (or an immediate family member) in the manufacturer or group purchasing organization during the preceding year.
• Prescribes administrative penalties for failure to comply with these requirements.
• Requires report submission procedures to ensure public availability of required information on a website.