Service Members Home Ownership Tax Act Of 2009
Floor Speech
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Mr. WYDEN. Mr. President, the Patient Protection and Affordable Care Act is a fundamental first step toward providing all Americans with affordable, quality health care. The health care system is complex, and that is why this Senate and two of its committees, including the Senate Finance Committee of which I am a member, have taken the better part of this past year crafting this legislation. I believe several provisions of this bill are transformational for American health care and will begin to move America toward more competition, choice, and quality.
The first provision is in the managers' amendment, and it is called free choice vouchers. This section creates something that has never existed before in the American health care system: a concrete way for middle-income Americans who cannot afford their health care to actually push back against the insurance lobby and force insurance companies to compete for their business in the insurance exchanges. Unlike today, where if a hard-working, middle-class American can't afford just the one health insurance policy available to him at his job, with this new provision, there will be a different health care marketplace, with free enterprise choices that can actually drive down costs for the middle class while ensuring those choices are of good quality. And in that new marketplace, a worker who cannot afford his employer's health plan can get a tax-free voucher for the same amount the employer contributes under the health plan and use that voucher to buy a more affordable plan in the insurance exchange.
I have been an advocate for consumer empowerment and choice my entire career in public service. Exchanges are a new pathway to creating a competitive marketplace for the first time for health care in this country. Massachusetts led the way, opening the door to showing Federal legislators the potential for insurance exchanges when Massachusetts enacted its own health reform law. Many other States lead the way with innovation in health care, including States like Oregon and Vermont. That is why I have authored and championed in the Senate Finance Committee section 1332, the waiver for State innovation. If States think they can do health reform better than under this bill, and they cover the same number of people with the same comprehensive coverage, they can get a waiver exempting them from the legislation and still get the Federal money that would have been provided under the bill. To me, this provision is a safety valve, if certain provisions in this bill will not work as intended in a given State. This provision will give States a way to tailor health reform to best meet the needs of their citizens. I intend to work with Senator Sanders and other colleagues to make sure that State waivers will be available even sooner than they are under the current bill.
The waiver for State innovation and free choice vouchers will improve the number of choices in the bill, for states, for employers and for employees. The Patient Protection and Affordable Care Act will also increase quality of care, particularly in the Medicare Program. I worked in the Finance Committee to increase bonus payments to high quality plans in the Medicare Advantage Program. In Oregon, Medicare Advantage is a lifeline given the low traditional Medicare reimbursement rates in the State. This amendment will reward the high quality plans that exist in Oregon, but will also encourage other plans across the country to increase the quality of the care they provide. By boosting payments to the highest quality plans--the four and five star plans--the Federal Government will be incentivizing plans that provide preventive care, manage chronic diseases well, and have high levels of consumer satisfaction.
Another provision that will add quality to the Medicare Program is Independence at Home, IAH, section 3024 of the bill, that I won approval for in the Finance Committee. This provision stems from legislation that I introduced with 11 other Members on both sides of the aisle. As the name indicates, the Independence at Home program will provide a way for seniors with chronic medical conditions to get medical treatment at home. The IAH program is based on a house call team approach that has proven successful in reducing costs and improving the quality of care for high cost patients with multiple chronic illnesses, patients who account for 66 percent--85 percent of Medicare spending. The Independence at Home program requires providers to achieve minimum savings on health care provided to the highest cost Medicare beneficiaries as a condition of participating in the program.
Providing care at home makes sense, and is the right direction for the future of health care delivery. But there is another aspect of the future of health care that I think holds much promise: personalized medicine. I won approval in the Finance Committee, along with Senator Carper, for including section 3113 in the bill. This provision will increase access to innovative molecular diagnostic tests that provide the foundation for the application of personalized medicine for individuals suffering from life threatening diseases such as cancer and heart disease. These tests hold the promise of getting patients the right type of chemotherapy for their specific case of cancer. Personalized medicine is the future, and I am thrilled that the Patient Protection and Affordable Care Act takes steps to move toward 21st century medicine.
I have spent the better part of my career trying to make the health care marketplace more competitive and trying to improve the quality of care for all Americans. I take many lessons from my home State of Oregon, and have tried to apply the innovation that Oregon is known for as an example for how other States can provide higher quality care at a lower cost. Through free choice vouchers, State waivers, Medicare Advantage bonus payments, Independence at Home, and personalized medicine, I believe this bill improves competition, choice and quality across the entire country.
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