Health Care

HEALTH CARE -- (Senate - February 01, 2007)

Mrs. MURRAY. Mr. President, I rise this morning to talk about the health care proposals President Bush mentioned in his State of the Union Address last Tuesday. For too long, our working families and our businesses have really struggled with rising costs and shrinking access, and Washington, DC, has virtually ignored that health care crisis.

Now, with Democrats in control of Congress, the President is finally bringing some ideas to the table and saying he wants to be part of the solution. Well, I want to thank him for joining the debate, and I hope he is serious about working with us to address the challenges that have only gotten worse over the past 7 years. There may well be valuable ideas in his proposals. I want to get more details than we heard in just the State of the Union Address because there may be areas on which we can agree.

However, I have to say, from what I have seen of the President's plan so far, I do have some serious concerns that his initiatives will undermine the employer-based health insurance system; may push people into the risky and expensive individual insurance market; may fail to provide coverage for our most vulnerable; and may divert funds for the health care safety net to experimental programs.

My first concern is that the President's proposal will jeopardize the employer-based health insurance system. The most stable form of health insurance for America's working families today is through their employers. Mr. President, 155 million Americans receive health insurance today from their employers.

One of the primary reasons why employers offer health insurance to their workers is because those benefits are excluded from taxable income. But the President's proposal, as I hear it, would take away that incentive by putting all forms of health insurance on an equal playing field. Even if employers choose not to drop health care coverage, they may be forced to do so in the future as the healthiest employees drop out of their employers' plans. If insurance becomes unaffordable, employers may be forced to stop offering health care benefits. I think many of my colleagues agree with me that we should be strengthening the employer-based health insurance system, not taking steps that will jeopardize it.

Secondly, I am very concerned that the President's proposal will push people into the individual insurance market. Today, when workers cannot get coverage through their employer, they need to purchase health insurance in the individual insurance market. But as any small businessman or self-employed woman will tell you, the individual insurance market today is not a good alternative to employer-provided coverage. In many States, insurers can cherry-pick applicants to avoid enrolling those with high health needs, or insurance companies can sell different policies to high- or low-risk individuals. If you have a chronic disease such as diabetes--or even any health problem--good luck getting reasonably priced, comprehensive coverage in the individual market today. Any proposal to increase access to health insurance should support the ability of Americans to receive affordable and comprehensive coverage, not force people into expensive, barebones insurance plans.

Third, I am troubled that the President's proposal will not increase access to health insurance for the uninsured. We have 46 million uninsured men, women, and children in this country today. That is a staggeringly high number, and those people face daily challenges trying to avoid getting sick and going into debt when something unexpected happens. Every day, I hear from people in my home State of Washington who struggle to pay for their health care costs. Unfortunately, the President's proposal will not help those people because they do not pay enough money in taxes to benefit from this tax deduction he is proposing. That really makes me question whether the President's plan will actually reduce the number of uninsured Americans.

Finally, I am very concerned that the President's plan will further chip away at our health care safety net because it would divert critical Medicaid dollars into an experimental grant program. Now, we do not have a lot of details yet, but it appears he is proposing to use Medicaid disproportionate share hospital payments to give States the ability to experiment with health care reform. Those DSH payments keep the doors of our public hospitals open. Public hospitals are the foundations of our communities. They not only provide emergency care, but they train our doctors, they support rural health care, and they are the first lines of defense against pandemic flu or bioterror attacks. I am very concerned that his proposal could seriously jeopardize my State's Medicaid funds and, therefore, undermine those critical services.

I want to give an example of how these proposals could exacerbate the worst parts of our health insurance system.

Last week, I received a letter from my constituents Alice and Michael Counts. They live in Vancouver, WA. Their son Wesley was diagnosed with a kidney condition at age 16. Their family's personal health insurance insisted that his kidney disease was preexisting, and the insurer refused to pay for the medical tests that diagnosed his condition. His parents appealed to our insurance commissioner, and they won, but the insurer raised its rates far beyond the reach of a self-employed individual. So later, when Wesley was going through dialysis and a kidney transplant, his employer dropped insurance coverage because it had become too costly.

Throughout all these medical and financial ups and downs, Wesley has worked and has now graduated from Clark College. Thankfully, his parents have been able to help him navigate a health care system that failed him.

Wesley's parents wrote to me, and they said:

We would rather pay higher taxes that give everyone affordable health care than live with the fear of losing everything through catastrophic illness.

Wesley's story shows just how risky the individual market is and how people with serious health problems can be severely affected when an employer is forced to drop coverage. No patient--no one--should have to live in fear that their next dialysis treatment will not be covered by insurance.

What Wesley deserves--and what all Americans deserve--is access to affordable, dependable, comprehensive health care. The President's plan does not guarantee that. It does not even come close. It just makes the health insurance market more unstable and more risky and leaves more people like Wesley vulnerable. He deserves better than that. I think all Americans do.

So, as I said at the beginning of my statement, I welcome the President's attention to the health care crisis we are facing in this country. Last year, on the Senate floor we devoted 3 days--3 days--to health care. The President probably spent even less time talking about health care. So this is an improvement. We desperately need a serious and a very thoughtful debate about how we increase access to health insurance.

My colleagues and I have put forward a number of good ideas about how to increase access to health care. One of the first things we can do is reauthorize and strengthen the State Children's Health Insurance Program--that is the SCHIP program--that provides quality health care to millions of uninsured children. Congress should give States the funding and the flexibility to cover more of our kids.

Secondly, we have to fund community health centers so they can continue to provide quality health care to our uninsured.

Third, I agree with the President, we should help States devise new ways to increase access to health care. My home State of Washington, like a lot of States, is working on innovative initiatives to expand coverage. But we can accomplish this in ways that do not chip away at the foundation of our public hospitals.

Finally, we can expand health insurance for small businesses and the self-employed by creating Federal and State catastrophic cost pools in ways that will help us lower costs and still protect our patients.

I look forward to working with Chairman Kennedy and Chairman Baucus and my colleagues on both sides of the aisle and the President on real health care reform. There are people like Wesley across the country in every one of our States who are crying out for change, and we owe it to them, in this body, to finally make the progress that is long overdue.

http://thomas.loc.gov/