Providing For Consideration Of H.R. 3962, Affordable Health Care For America Act, And Providing For Consideration Of H.R. 3961, Medicare Physician Payment Reform Act Of 2009

Floor Speech

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Mr. JOHNSON of Georgia. Mr. Speaker, I speak in support of the rule and the underlying legislation. I want everybody to look into their heart of hearts, their conscience, the loneliness of the recesses of their consciousness, and in that moment you know that all Americans deserve health care, not just the rich and wealthy. What we are doing today is giving that to the average American.

I support the rule and the underlying legislation.

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Mr. JOHNSON of Georgia. Mr. Speaker, I rise today to support the rule and the underlying legislation, H.R. 3962, the Affordable Health Care for America Act. I would like to thank Chairman Rangel and Chairman Waxman for their leadership and hardwork in bringing this important legislation swiftly to the floor. Your efforts are commendable and will benefit all Americans.

Mr. Speaker, today I and many of my colleagues will take a historic vote in favor of extending quality affordable health insurance to millions of Americans. This is a moral question as well as a financial question. When this bill becomes law, 96 percent of Americans will have access to primary care doctors, prescription drugs, and preventive health services. When this bill becomes law 96 percent of Americans will no longer have to worry about choosing between their or their children's health and other essentials like food and shelter. If that were not enough then I remind my colleagues that the Congressional Budget Office says that this bill will reduce the national debt. The status quo is no longer acceptable.

I urge my colleagues to stand today on the right side of history as this Congress takes the first step in bringing the security of affordable health insurance to millions of people.

Congress and the public have had ample opportunity to review, comment on, and improve upon the health reform legislation that we will vote on today. During the month of August many Members of Congress, including myself, held town hall meetings. During my town hall meetings I heard testimony from constituents across the Fourth District and from across the political spectrum. I considered the views of everyone who wishes to share their opinion and I came to the consideration that the thousands of my constituents--and the millions of Americans--without health insurance could no longer wait. I ran for Congress on a pledge to take care of home and I believe that there is no better way to take care of home than to ensure that all of my constituents and all Americans have access to quality affordable health care.

I have advocated--consistently and strongly--for the inclusion of a public option in health reform legislation. While my preference remains the more robust version of the public option, I am proud that H.R. 3962 contains a public option that will create competition in the insurance market to drive down costs for everyone, including the Federal Government.

I worked hard to make this the best bill that it could be. In addition to advocating for the public option, I worked to ensure that the recommendations of specialty medical associations, patient advocacy groups, and scientific societies are considered as part of the minimum benefit package by the Task Force for Clinical Preventive Services. Currently, when the task force has insufficient evidence to recommend a service, it provides an ``I'' or insufficient evidence grade. Many valuable preventive interventions do not yet have the evidence base needed to obtain a positive recommendation. Others can never be evaluated using the gold standard of a randomized clinical trial because a trial would be too expensive, recruiting participants is not feasible, or investigator interest or funding is lacking. I am pleased to report that H.R. 3962 contains report language which clarifies that the benefits commission can look beyond Task Force recommendations to other sources of evidence and that the commission can consider the recommendations of specialty medical associations, patient advocacy groups, and scientific societies as part of the minimum benefits package.

Additionally, I worked with my colleague, Mr. Green of Texas, on sec. 2587 of the bill which requires a report to Congress on the current state of parasitic diseases that have been overlooked among the poorest Americans. A 2008 study identified high prevalence rates of parasitic infections in the poorest areas of the United States--potentially up to 100 million infections of Acariasis, Chagas Disease, Cysticercosis, Echinococcosis, Toxocariasis, Toxoplasmosis, Trichomoniasis, or Strongyloidiasis. These diseases disproportionately affect minority and impoverished populations, producing effects ranging from asymptomatic infection to asthma-like symptoms, seizures, and death. These diseases receive less financial support than they deserve with a mere $231,730 of research funding allocated by NIH since 1995. This discrepancy in funding is known as the ``10/90 gap''; a mere 10 percent of global health research funding is directed towards diseases affecting 90 percent of the global population. For example, between 1995 and 2009, the National Institutes of Health funded a mere $231,730 of Toxocariasis research. The report required by this section would provide an up-to-date evaluation of the current dearth of knowledge regarding the epidemiology of these diseases and the socioeconomic, health and development impact they have on our society. The Secretary of Health and Human Services will report to Congress on this as well as the appropriate funding required to address neglected diseases of poverty, including neglected parasitic diseases. I look forward to the completion of this report so that Congress can take appropriate action in the future to address these diseases.

Finally, the goal of health reform is to expand access to quality affordable health care. The underlying bill makes commendable strides to expand access but I believe that we must go further to ensure that Americans can afford the care they need. Many Americans--our friends and neighbors--suffer from debilitating and chronic illnesses such as multiple sclerosis or severe arthritis. The medications available to them are so expensive that insurers create so-called ``specialty tiers'' within their formularies for these medications. People living with chronic conditions incur heavy financial burdens for treatment and prescription drugs--and they are at the breaking point. High out of pocket costs limit access to care and ultimately reduce their chances of living healthy lives. In a recent study of medical bankruptcies, out-of-pocket medical costs averaged $17,749 for the privately-insured, and $26,971 for the uninsured. Patients with neurologic disorders such as multiple sclerosis faced the highest costs, at an average of $34,167. I believe it is time to put a limit on these outrageous costs. Last night in the Rules Committee I waited over 4 hours to offer two amendments to do just that.

My first amendment would cap out-of-pocket prescription drug costs at $200 per monthly prescription and $500 per month, total. This would apply to all insurance plans, including Medicare Part D. My amendment would also amend the current Medicare Part D exemption process so low-income beneficiaries can request an exemption for specialty tier drugs that would lower their costs. The amendment would also request two MedPAC studies of discrimination and cost-sharing. This amendment is supported by the Arthritis Foundation and the Lupus Foundation of America.

My second amendment would build on the underlying legislation by reducing the cap on out of pocket medical expenses from $5,000 annually to $1,250 quarterly. People whose care results in high out of pocket costs could easily reach the $5,000 limit in a one or two month span. This is potentially unaffordable for people with chronic disease and dividing the cap quarterly would achieve the same policy outcome while increasing its affordability. This amendment is supported by the Arthritis Foundation and the Lupus Foundation of America.

According to a 2008 study by the Commonwealth Fund, more than half of chronically ill patients did not get recommended care, fill prescriptions, or see a doctor when sick because of costs. My amendments would have reduced out of pocket costs for the most expensive prescriptions, making health care affordable for some of our county's neediest citizens.

While my language was not ultimately included in this legislation, I support the underlying bill and I would urge my colleagues to do likewise for the benefit of all Americans.

Mr. Speaker, in my district, the Fourth Congressional District of Georgia, the Affordable Health Care for America Act will: improve employer-based coverage for 349,000 residents; provide credits to help pay for coverage for up to 166,000 households; improve Medicare for 65,000 beneficiaries, including closing the prescription drug donut hole for 5,400 seniors; allow 15,400 small businesses to obtain affordable health care coverage and provide tax credits to help reduce health insurance costs for up to 14,200 small businesses; provide coverage for 153,000 uninsured residents; protect up to 2,200 families from bankruptcy due to unaffordable health care costs; and reduce the cost of uncompensated care for hospitals and health care providers by $98 million.

I urge my colleagues to support the rule and the underlying bill and I thank you for your consideration.

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