Ginny Brown-Waite on Health Care Republican Representative (FL-5)

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 NO 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 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 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 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.

Tax credits for those without employee health insurance.

H.R. 1181 the Health Insurance Affordability and Equity Act
With 40 million Americans currently living without health insurance, Republican Main Street Partnership members have been leading the effort to find new and innovative ways to secure health care for our citizens. Easing the burden on businesses entering into insurance purchasing pools, and expanding the use of medical savings accounts (MSAs) have been included in previous economic stimulus packages. RMSP Congresswoman Nancy Johnson (CT) in conjunction with Representatives Jo Ann Emerson (MO), Melissa Hart (PA), Jim Kolbe (AZ), Connie Morella (MD), Doug Ose (CA), Marge Roukema (NJ), Rob Simmons (CT), Fred Upton (MI), and Jim Walsh (NY) introduced legislation that targets tax credits to those that are not offered employee provided health insurance, or are self employed.

Tax deduction for long-term care insurance.

H.R. 831/S. 621 the Long Term Care and Retirement Security Act.
Republican Main Street Partnership Senators Lincoln Chafee (RI), Susan Collins (ME), and Gordon Smith (OR) joined House of Representatives sponsors Reps. Charlie Bass (NH), Dave Camp (MI), Tom Davis (VA), Greg Ganske (IA), Ben Gilman (NY), Dave Hobson (OH), Steve Horn (CA), Nancy Johnson (CT), Sue Kelly (NY), Ray LaHood (IL), Connie Morella (MD), Deborah Pryce (OH), Jim Ramstad (MN), and Rob Simmons (CT) in securing health insurance for seniors and those in long-term care facilities. As new medicines and healthier lifestyles are extending life, more and more Americans need to prepare for their long-term health needs. This legislation allows a tax deduction on long-term care insurance premiums for taxpayers, including accelerated deductions persons for people 55 years of age and up.

Support telemedicine for underserved areas.

H.R. 2706, The Medicare Telehealth Validation (MTV) Act.
Republican Main Street Partnership members Congressman Doug Ose (CA) and Jo Ann Emerson (MO) have introduced this bill to increase the use of telehealth services under the Medicare program. Currently, telehealth services are restricted to use in certain geographically underserved areas. The MTV Act provides sufficient funding and regulatory relief to expand high technology medical diagnostic tools, across the Internet, to urban as well as rural underserved areas. The bill further provides for expansion of store-and-forward techniques, and for a study of the restrictions on telemedicine due to state licensing rules.

$350 billion for prescriptions for poor seniors.

Medicare Prescription Drug Benefit
One of issues to be addressed this year by Congress is that of providing a prescription drug benefit to our nation's Medicare beneficiaries. Legislation currently being drafted [by Republican Main Street Partnership members] intends to authorize $350 billion over the next 10 years to provide purchasing assistance for prescription medications. The benefit reaches out to low and moderate income seniors by extending coverage to incomes up to 150% of the poverty level. The bill could also include provisions to correct reimbursement reductions for physicians, nurses, hospitals, technicians, home health care providers, and long-term care facilities.

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.

Remove restrictions on estriol (menopause medication).

A concurrent resolution expressing the sense of Congress that the Food and Drug Administration's (FDA) new policy restricting women's access to medications containing estriol does not serve the public interest.

• Whereas menopause is often a challenging transition for millions of women that requires specialized medications and medical treatments;
• Whereas physicians prescribe a variety of pharmaceutical treatment options to treat women experiencing the symptoms of menopause;
• Whereas individual women respond differently to different treatment options;
• Whereas women's physicians determine on a case-by-case basis which treatment option is optimal for each woman;
• Whereas many physicians prescribe compounded estrogen and other bioidentical hormone treatments for patients for a variety of reasons;
• Whereas many physicians prescribe compounded estrogen treatments that contain estriol to treat menopausal and perimenopausal women;
• Whereas estriol is one of three estrogens produced by the human body;
• Whereas estriol has been prescribed and used for decades in the United States;
• Whereas the Food and Drug Administration (FDA) has announced that it will no longer permit compounding pharmacists to prepare medications containing estriol pursuant to a doctor's prescription;
• Whereas insurers are now denying women reimbursement for compounded medications containing estriol as a result of the FDA's announcement; and
• Whereas the FDA has acknowledged that it is unaware of any adverse events associated with use of compounded medications containing estriol:

Now, therefore, be it Resolved, That it is the sense of the Congress that--
1. physicians are in the best position to determine which medications are most appropriate for their patients;
2. the FDA should respect the physician-patient relationship; and
3. the FDA should reverse its policy that aims to eliminate patients' access to compounded medications containing estriol.

Sponsored bill establishing Health Care Fraud Prevention.

CONGRESSIONAL SUMMARY:
• There is hereby established, in the Department of H, the Office of the Deputy Secretary for Health Care Fraud Prevention.
• The Office shall provide contracts for the design, development, and operation of a predictive model antifraud system, based on the risk level assigned to claims activity, and develop a comprehensive antifraud database for health care activities carried out or managed by Federal health agencies.
• The Office shall promulgate and enforce regulations relating to the reporting of data claims to the health care antifraud system.

SPONSOR'S INTRODUCTORY REMARKS:

Sen. LeMIEUX. The current proposal for health care is a $1 trillion proposal. If we spent as much time caring about the money we are spending now, as opposed to the money some in this Chamber want to spend, I suspect we could find plenty of money to either return to the people or to find money for these new programs.

Today, I wish to talk about just such an idea, an idea to recover some of the waste, fraud, and abuse that is currently happening in our current provision of health care--in Medicare and Medicaid. Estimates are that some $60 billion to a staggering $226 billion a year to waste, fraud, and abuse.

This health care proposal that we are discussing in the Senate is $1 trillion over 10 years. That is about $100 billion a year. We may be wasting $226 billion a year. If we captured just half of that, we might be able to pay for this program.

Why can't we do the same thing the credit card companies are doing for health care? Why can't we use a predictive modeling system that says a health care claim is not going to be paid when a red flag comes up? Right now we are on a pay-and-chase system. If we put this predictive modeling system in, it stops the fraud before it happens. The credit card industry benchmark is 0.1% while fraud losses in the health care business run from 3% to 14%.