Statements on Introduced Bills and Joint Resolutions

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - January 18, 2007)

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By Mr. WYDEN:

S. 334. A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; to the Committee on Finance.

Mr. WYDEN. Mr. President, it has been more than a decade since the U.S. Senate last addressed fixing health care. I do not think it is morally right for the Senate to duck on health care any longer and that is why I am proposing legislation today to provide affordable, guaranteed, private health coverage for all Americans.

The legislation, called the Healthy Americans Act, ensures care for the 46 million Americans who now live without health insurance, frees business owners from the skyrocketing costs of insuring their workers, and promises every American health care coverage that can never be taken away. My proposal is fully paid for, holds down health care cost growth in the future and provides coverage just like Members of Congress can get now.

America spent $2.2 trillion on health care last year. PriceWaterhouseCoopers expects premiums will increase 11 percent this year alone and I believe the American health care system as we know it is not sustainable.

Our current employer-sponsored health insurance system is a historic accident. In the 1940s, employers needed a way to attract workers as wage and price controls continued. Our country needs a uniquely American solution that works for an economy that is competing not just with the company across town but the company across the world. Americans need a health care system that works for individuals and families, and encourages people to stay healthy instead of only seeking care after they are sick.

The Healthy Americans Act does this and more. It doesn't take long to explain how the Healthy Americans Act works. From the first day individuals, families and businesses win. The Healthy Americans Act cuts the link between health insurance and employment altogether. Under the Healthy Americans Act, businesses paying for employee health premiums are required to increase their workers' paychecks by the amount they spent last year on their health coverage. Federal tax law is changed to hold the worker harmless for the extra compensation, and the worker is required to purchase private coverage through an exchange in their State that forces insurance companies to offer simplified, standardized coverage, with benefits like a Member of Congress gets, and prohibits insurers from engaging in price discrimination.

Requiring employers to cash out their health premiums, as I propose in the Healthy Americans Act, is good for both employers and workers. With health premiums going up 11 percent this year, employers are going to be glad to be exempt from these increases. With the extra money in their paycheck, workers have a new incentive to shop for their health care and hold down their cost. If a worker can save a few hundred dollars on their health care purchase, they can use that money for something else they need.

In addition, the Healthy Americans Act is easy to administer and guarantees lifetime health security. Once you have signed up with a plan through an exchange in the State in which you live, that is it; you have completed the administrative process. Even if you lose your job or you go bankrupt, you can never have your coverage taken away. Sign up, and the premium you pay for the plan and all of the administrative activities are handled through the tax system. For those who cannot afford private coverage, the Healthy Americans Act subsidizes their purchases.

Businesses that have not been able to afford health coverage for their workers, under the new approach, will pay a fee--one that is tiered to their size and revenue, with some paying as little as 2 percent of the national average premium amount per worker for that basic benefit package.

It will be easy to administer, locally controlled, with guaranteed coverage as good as your Member of Congress gets. The Lewin Group has costed out my proposal and reports that it is fully paid for and in addition to expanding coverage for millions of people, guaranteeing health benefits as good as their Member of Congress gets, it also saves $4.5 billion in health spending in the first year. Money is saved by reducing the administrative costs of insurance, reducing cost shifting, and preventing those needless hospital emergency room visits. Also, there are substantial incentives that come about because insurance companies would have to compete for the business of consumers, who would have a new incentive to hold down health costs.

There are other parts of the Healthy Americans Act I wish to describe briefly. As the name of the legislation suggests, I believe strongly that fixing American health care requires a new ethic of health care prevention, a sharp new focus in keeping our citizens well, and trying to keep them from falling victim to skyrocketing rates of increase in diabetes, heart attack, and strokes.

Spending on these chronic illnesses is soaring, and it is especially sad to see so many children and seniors fall victim to these diseases. Yet many Government programs and private insurance devote most of their attention to treating Americans after they are ill and give short shrift to wellness.

Under the Healthy Americans Act, there will be for the first time significant new incentives for all Americans to stay healthy. They are voluntary incentives, but ones that I think will make a real difference in building a national new ethic of wellness and health care prevention.

Parents who enroll children in wellness programs will be eligible for discounts in their own premiums. Instead of mandating that parents take youngsters to various health programs--and maybe they do and maybe they don't--the Healthy Americans Act says when a parent takes a child to one of those wellness programs, the parent would be eligible to get a discount on the parent's health premiums.

Under the Healthy Americans Act, employers who financially support health care prevention for their workers get incentives for doing that as well. Medicare is authorized to reduce outpatient Part B premiums so as to reward seniors trying to reduce their cholesterol, lose weight, or decrease the risk of stroke. It has never been done before. For example, Part B of Medicare, the outpatient part, doesn't offer any incentives for older Americans to change their behavior. Everybody pays the same Medicare Part B premium right now. The Healthy Americans Act proposes we change that and ensures that if a senior from Virginia or Oregon or elsewhere is involved in a wellness program, in health care prevention efforts, like smoking cessation, they could get a lower Part B premium for doing that.

The preventive health efforts I have described are promoted through new voluntary incentives under the Healthy Americans Act, not heavy-handed mandates. What this legislation says is--let's make it more attractive for people to stay healthy and change their behaviors to promote the kind of wellness practices we all know we should do but need an incentive to follow.

Finally, and most importantly, the Healthy Americans Act does not harm those who have coverage in order to help those who have nothing. The legislation makes clear that all Americans retain the right to purchase as much health care coverage as they want. All Americans will enjoy true health security with the Healthy Americans Act, a lifetime guarantee of coverage at least as good as their Member of Congress receives.

A recent ``Health Affairs' article pointed out that more than half of the Nation's uninsured are ineligible for public programs such as Medicaid, but do not have the money to purchase coverage for themselves.

At present, for most poor people to receive health benefits, they have to go out and try to squeeze themselves into one of the categories that entitles them to care. Under the Healthy Americans Act, low-income people will receive private health coverage, coverage that is as good as a Member of Congress gets, automatically. Like everyone else, they will sign up through the exchange in their State. When they are working, the premiums they owe are withheld from their paycheck. If they lose their job, there is an automatic adjustment in their withholding.

In addition, under the Healthy Americans Act, it will be more attractive for doctors and other health care providers to care for the poor. Those who are now in underfunded programs, such as Medicaid, are going to be able to have private insurance that pays doctors and other providers commercial rates which are traditionally higher than Medicaid reimbursement rates.

Because low-income children and the disabled are so vulnerable, if Medicaid provides benefits that are not included in the kind of package Members of Congress get, then those low-income folks would be entitled to get the additional benefits from the Medicaid Program in their State.

The Healthy Americans Act also makes changes in Medicare. As the largest Federal health program, Medicare's financial status is far more fragile than Social Security. Two-thirds of Medicare spending is now devoted to about 5 percent of the elderly population. Those are the seniors with chronic illness and the seniors who need compassionate end-of-life health care. The Healthy Americans Act strengthens Medicare for both seniors and taxpayers in both of these areas.

In addition to reducing Medicare's outpatient premiums for seniors who adopt healthy lifestyles and reduce the prospect of chronic illness, primary care reimbursements for doctors and other providers get a boost under the Healthy Americans Act. Good primary care for seniors also reduces the likelihood of chronic illness that goes unmanaged. This reimbursement boost is sure to increase access to care for seniors--and I see them all over, in Oregon and elsewhere--who are having difficulty finding doctors who will treat them.

To better meet the needs of seniors suffering from multiple chronic illnesses, the Healthy Americans Act promotes better coordination of their care by allowing a special management fee to providers who better assist seniors with these especially important services.

Hospice law is changed so that seniors who are terminally ill do not have to give up care that allows them to treat their illness in order to get the Medicare hospice benefit. In addition, the Healthy Americans Act empowers all our citizens wishing to make their own end-of-life care decisions. The legislation requires hospitals and other facilities to give patients the choice of stating in writing how they would want their doctor and other health care providers to handle various end-of-life care decisions.

When I announced the Healthy Americans Act last December, I stood with an unprecedented coalition of labor and business. Andy Stern, president of SEIU said ``It is time for fundamental, not incremental change and Senator Wyden has a plan that is practical and principle, and sets down a moral test' 'Why doesn't every American have the right to the same health care as the President, the Vice President, 535 members of Congress and 3 million Federal workers?' ' Steve Burd, the CEO of Safeway, a Fortune 50 company that has focused on prevention and wellness, called the Healthy Americans Act ``an innovative proposal that lays a foundation to begin a serious discussion on health care reform in this country.'

Ron Pollack of Families USA, listed the principles embodied in the Healthy Americans Act that he believes are important: universality; subsides to make the coverage affordable; community rating rules so the sicker and older are not priced out of the market; and benefits like a Member of Congress has today.

Also at my press conference was Mike Roach, of Portland, OR, a 30-year member of National Federation of Independent Businesses. He owns a clothing store in Portland and employs eight people. He believes the Healthy Americans Act will help him attract good employees. And Bob Beal, president of Oregon Iron Works, an Oregon-based company that competes internationally, believes that we must also address the skyrocketing health care costs that make it harder for companies like his in the international market place.

Like me, the people who stood by me when I announced the Healthy Americans Act believe we need to move the health care debate forward and cannot afford to let more time to go by. The last time Congress took a serious look at reforming health care, there wasn't anything resembling this kind of coalition of labor, business, low-income and end-of-life advocates standing together to call for action.

In tackling one-seventh of the economy, invariably technical issues arise. I want to thank many people who have assisted along the way. Len Nichols of the New America Foundation sent me e-mails at 2 in the morning that helped refine provisions. John Sheils, Randy Haught and Evelyn Murphy of the Lewin Group assisted in telling us our numbers worked or didn't. The Congressional Research Service staff followed up on questions from the common to the obscure. That group included: Bob Lyke, Jeanne Hearne, April Grady, Julie Whitaker, Christine Scott, Chris Peterson, Richard Rimkunas, Karen Trintz, Julie Stone and Andrew Sommers. The Senate Legislative Counsel staff translated the ideas and concepts into legislative language. They devoted an enormous amount of time in getting the ideas and the language right. I'd like to thank Mark Mathiesen, Mark McGunagle, Bill Baird, John Goetcheus, Stacy Kern-Sheerer, Kelly Malone and Ruth Ernest for their patience and extraordinary effort.

On my staff, Joshua Sheinkman, my legislative director and Jeff Michaels, my administrative assistant, were instrumental in completing the tax and business sections of the bill. Emily Katz who started in my office as a legislative fellow and became a permanent part of the Wyden health team made sure we had credible facts and statistics. Last but not least, I would like to thank Stephanie Kennan, my Senior Health Policy Adviser for the last 9 years who played devil's advocate, worked through the conflicting and evolving ideas, and kept the many threads of the bill working together.

The full text of the Healthy Americans Act and the Lewin analysis are available on my Web site.

In closing, I believe that without your health, you don't get to the starting line of life. For too long, the Congress has dodged the debate and chosen to slice off parts of the issue. And as worthy as those past efforts have been to help certain segments of our citizens, all Americans deserve guaranteed coverage like their Member of Congress, and no one should go to bed at night worrying about losing their health care. It is time for Congress to provide 21st century solutions to one of the most important issues our country must address. The Healthy Americans Act starts that debate.

I ask unanimous consent, that the Healthy Americans Act section-by-section summary, and examples of how the legislation would affect individuals and families and employers be printed in the RECORD.

There being no objection, the material was ordered to be printed in the RECORD, as follows:

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