Christopher Shays on Health Care

Republican Representative (CT-4)

Voted YES on overriding veto on expansion of Medicare.

Congressional Summary:

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.

Pres. GEORGE W. BUSH's veto message (argument to vote No):

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.

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:

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

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

Voted YES on Veto override: Extend SCHIP to cover 6M more kids.

OnTheIssues Explanation: This vote is a veto override of the SCHIP extension (State Children's Health Insurance Program). The bill passed the House 265-142 on 10/25/07, and was vetoed by Pres. Bush on 12/12/07.

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.

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

LEGISLATIVE OUTCOME:Veto override failed, 260-152 (2/3rds required) Reference: SCHIP Extension; Bill Veto override on H.R.3963 ; vote number 08-HR3963 on Jan 23, 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]:

It terminates the coverage of childless adults.
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.
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.

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

Voted NO 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 YES 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:

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

Reference: Reconciliation resolution on the FY06 budget; Bill H Res 653 on S. AMDT. 2691 ; vote number 2006-004 on Feb 1, 2006

Voted YES 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 YES 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 YES 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 YES 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 YES 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 YES 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 YES 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

Tax credits for those without employee health insurance.

Shays adopted the Republican Main Street Partnership agenda item:

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.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP4 on May 24, 2002

Tax deduction for long-term care insurance.

Shays adopted the Republican Main Street Partnership agenda item:

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.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP5 on May 24, 2002

Support telemedicine for underserved areas.

Shays adopted the Republican Main Street Partnership agenda item:

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.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP6 on May 24, 2002

$350 billion for prescriptions for poor seniors.

Shays adopted the Republican Main Street Partnership agenda item:

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.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP7 on May 24, 2002

Rated 22% by APHA, indicating a anti-public health voting record.

Shays scores 22% 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

Provide mental health services for older Americans.

Shays co-sponsored providing mental health services for older Americans

OFFICIAL CONGRESSIONAL SUMMARY: A bill to provide for mental health screening and treatment services, and to provide for integration of mental health services and mental health treatment outreach teams.

SPONSOR'S INTRODUCTORY REMARKS: Sen. CLINTON: This bill is an effort to improve the accessibility and quality of mental health services for our rapidly growing population of older Americans. As we look forward to increased longevity, we must also acknowledge the challenges that we face related to the quality of life as we age. Chief among these are mental and behavioral health concerns.

It is estimated that nearly 20% of Americans age 55 or older experience a mental disorder. It is anticipated that the number of seniors with mental health problems will increase from 4 million in 1970 to 15 million in 2030. Mental disorders do not have to be a part of the aging process because we have effective treatments for these conditions. But in far too many instances our seniors go undiagnosed and untreated because of the current divide in our country between health care and mental health care.

That is why I am reintroducing the Positive Aging Act. This legislation would strengthen the delivery of mental health services to older Americans. Specifically, the Positive Aging Act would fund grants to states to provide screening and treatment for mental health disorders in seniors. It would also fund demonstration projects to provide these screening and treatment services to older adults residing in rural areas and in naturally occurring retirement communities, NORC's.

I believe that we owe it to older adults in this country to do all that we can to ensure that high quality mental health care is both available and accessible. This legislation takes an important step in that direction.

LEGISLATIVE OUTCOME:Referred to Senate Committee on Health, Education, Labor, and Pensions; never came to a vote.

Source: Positive Aging Act (S.1116/H.R.2629) 05-S1116 on May 25, 2005

Improve services for people with autism & their families.

Shays co-sponsored improving services for people with autism & their families

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

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;
establish a multi-year demonstration grant program for states to provide evidence-based autism treatments, interventions, and services.
establish planning and demonstration grant programs for adults with autism;
award grants to states for access to autism services following diagnosis;
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;
make grants to protection and advocacy systems to address the needs of individuals with autism and other emerging populations of individuals with disabilities; and
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.
Directs the Comptroller General to issue a report on the financing of autism services and treatments.

Source: Promise for Individuals With Autism Act (S.937 & HR.1881) 07-HR1881 on Apr 17, 2007

Remove restrictions on estriol (menopause medication).

Shays co-sponsored removing 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:

physicians are in the best position to determine which medications are most appropriate for their patients;
the FDA should respect the physician-patient relationship; and
the FDA should reverse its policy that aims to eliminate patients' access to compounded medications containing estriol.

Source: SCR88/HCR342 08-SCR88 on Jun 10, 2008

Collect data on birth defects and present to the public.

Shays co-sponsored the Birth Defects Prevention Act

collect and analyze, and make available data on the causes of birth defects and on the incidence and prevalence of such defects;
operate regional centers for the conduct of applied epidemiological research on the prevention of such defects;
provide information and education to the public on the prevention of such defects;
collect and analyze data by gender and by racial and ethnic group9/6/2004
collect such data from birth and death certificates, hospital records, and such other sources; and
(3) encourage States to establish or improve programs for the collection and analysis of epidemiological data on birth defects and to make the data available.

Corresponding House bill is H.R.1114. Became Public Law No: 105-168. Source: Bill sponsored by 35 Senators and 164 Reps 97-S419 on Mar 11, 1997

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