John Garamendi on Health Care

Fight for robust public option; advocate for single-payer

1970s: Pushed reimbursements for psychiatric health

My legislation in the State Legislature in the 1970s:
• Broadened clinic access to tens of thousands of residents in unserved and underserved communities
• Created certification of ambulance and trauma care personnel
• Funded well over $100 millio for tobacco, cancer, and pulmonary disease research
• Improved services for the developmentally disabled; and
• Required insurance companies to include in their plans reimbursements for procedures conducted at psychiatric health facilities.

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-OR]: 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.

Voted NO on repealing the "Prevention and Public Health" slush fund.

Proponent's Argument for voting Yes:
[Rep. Pitts, R-PA]: Section 4002 of PPACA establishes a Prevention and Public Health Fund, which my bill, H.R. 1217, would repeal. The PPACA section authorizes the appropriation of and appropriates to the fund from the Treasury the following amounts:

• $500 million for FY 2010
• $750 million for FY11
• $1 billion for FY12
• $1.25 billion for FY13
• $1.5 billion for FY14
• and for FY15 and every fiscal year thereafter, $2 billion.

Opponent's Argument for voting No:
[Rep. Waxman, D-CA]: This bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation.

Require insurers to cover breast cancer treatment.

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.

• Prohibits restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection; or
• Prohibits requiring that a provider obtain authorization from the plan for prescribing any such length of stay.

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

   Establish a public insurance option via healthcare Exchanges.

   Garamendi co-sponsored Public Option Deficit Reduction Act

   Amends the Patient Protection and Affordable Care Act [PPACA, known as ObamaCare] to require Exchanges to offer a public health insurance option that ensures choice, competition, and stability of affordable, high-quality coverage throughout the United States. Declares that the primary responsibility is to create a low-cost plan without compromising quality or access to care. Sets forth provisions related to the establishment and governance of the public health insurance option, including that such plan:

   1. may be made available only through Exchanges;
   2. must comply with requirements applicable to other health benefits plans offered through such Exchanges; and
   3. must offer bronze, silver, and gold plan levels.
   Requires the Secretary of Health and Human Services to:
   1. establish an office of the ombudsman for the public health insurance option;
   2. collect such data as may be required to establish premiums and payment rates;
   3. establish geographically adjusted premiums at a level sufficient to fully finance the costs of the health benefits provided and administrative costs related to the operation of the plan; and
   4. establish payment rates and provide for greater payment rates for the first three years.
   Requires repayment of start-up costs for the public health insurance option. Authorizes the Secretary to utilize innovative payment mechanisms and policies to determine payments for items and services under the public health insurance option. Source: H.R.191 11-HR191 on Jan 5, 2011

   Sponsored merging Alzheimers diagnosis and care benefit.

   Garamendi co-sponsored HOPE for Alzheimer's Act

   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 disease and increase access to information on care and support for newly diagnosed individuals and their families. It would also ensure that an Alzheimer's or dementia diagnosis is documented in the individual's medical record.

   Source: S.709/H.R. 1507 13-H1507 on Apr 11, 2013

   GOP can't beat ObamaCare, so they pretend it's a "disaster".

   Garamendi voted NAY Full Repeal of ObamaCare

   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.

   Source: Congressional vote 15-H0132 on Feb 3, 2015

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