Health Care And Education Reconciliation Act Of 2010

Floor Speech

Mr. WYDEN. Before he leaves the floor, let me echo the praise for our friend from New Jersey, who has prosecuted the case against cigarettes for so many years. We are thankful to him. What a strong advocate he is.

I thank the chairman as well for all his efforts. I wish to highlight a couple provisions he and I worked on together that speak to the headlines we are seeing in this morning's newspaper; in particular, the provision he and I partnered on that allows States to innovate and take their own fresh approaches in terms of addressing health care challenges. We all read today about how roughly a dozen States are already challenging the important, recently-signed health care law on the grounds that the individual mandate is unconstitutional. He and I worked very closely together to ensure that States could have a waiver to, in effect, go out and set up their own approach. In fact, counsel to the Senate Finance Committee specifically said, in response to our questions during the markup of health reform, that if a State could meet the general framework of our legislation, it did not have to do it with an individual mandate.

I thank the chairman for stepping up and empowering the States. I want the country to know that under the legislation Chairman Baucus worked on with me, every State does not have to litigate. They can innovate. They can go out and look at fresh approaches to address our health care challenges. That would include doing health reform without an individual mandate. I have followed the discussion on the floor over the last couple days about how somehow reform would Europeanize the health care system. On the contrary, what Chairman Baucus has done, with Section 1332 of the health reform bill, similar to what I sought to do in the legislation I drafted that had bipartisan support, is to send a message to all the States all across the country that we invite them to come up with the kind of fresh, creative ideas that are going to help us hold health care costs down. In fact, the chairman and I spent a lot of time trying to make sure States could tailor their own health insurance exchanges, which would be fresh marketplaces, so that, for example, an approach in Montana or Oregon that folks there thought made sense, could be entirely different than a strategy New York would try on its own.

Not only is section 1332 a provision that allows for State innovation, but, as the chairman knows, there is also another approach that our colleague Senator Cantwell came up with that advances similar State innovation, allowing States to set up a basic health care plan.

So my message to these States talking about litigating right now is, why would you say at this point you are going to go out and go to court and sue everybody in sight when, in fact, what the President signed yesterday gives the States the authority to come up with their own approach? Senate Finance Committee counsel is on record as saying that States could pursue their own approach without an individual mandate. I hope--given the amount of attention that is being paid this afternoon to the question of States filing these lawsuits, alleging the law is unconstitutional because of the individual mandate--I hope some of those States will take a look at section 1332 that, in my view, ought to be attractive to elected officials all across the political spectrum who share the view Chairman Baucus and I share; which is, we would like to empower the States.

Another area where innovation is encouraged to occur is the Medicare Advantage provision in our legislation. We have had a lot of discussion on the floor about Medicare Advantage. Having been involved with this program for a number of years, and its predecessors during the days when I was codirector of the Gray Panthers, I wish to offer up to colleagues that not all Medicare Advantage is created equal. Two years ago, we heard testimony in the Senate Finance Committee about some Medicare Advantage products that, as far as I am concerned, are so shoddy and so devoid of consumer protection the people who sold them ought to be in jail. We have taken steps to add consumer protection to the Medicare Advantage Program.

On the other hand, there are very good Medicare Advantage Programs in our part of the country that have been able to win recognition from the Federal Government as high quality plans. In fact, under this legislation, plans that have earned a high quality rating from the Federal Government on the basis of, for example, how they manage chronic conditions, the kinds of screenings they do of a preventive nature, and their responsiveness to member complaints, when they get a high rating from the Federal Government on the basis of such criteria and earn those extra stars, they will get bonus payments. This was an idea the Chairman worked closely with me on when the legislation was advanced by the Finance Committee.

We will probably have further discussions on the floor about Medicare Advantage, but I only come to the floor today to say--for those who are interested in promoting quality; for those who believe that no matter how much you do to contain costs, you also have to beef up quality--take a look at the work that was done with respect to Medicare Advantage. It acknowledges that not all Medicare Advantage is created equal.

(Mr. MERKLEY assumed the Chair.)

Mr. WYDEN. The Presiding Officer in the Senate, who has just joined us, knows that our home State has the largest percentage of folks in Medicare Advantage than any other State in the United States: over 40 percent. They happen to be in good plans with those high ratings I mentioned from the Federal Government. So clearly, our States with high quality are going to be appreciative of this. But so will all the other programs across the land that have similar ratings, and we will have created an incentive for all of those other Medicare Advantage Programs in the years ahead to meet our standards.

I come to the floor briefly this afternoon to point out these two provisions in the bill that promote quality and innovation. First, I hope States will use the provision that creates incentives for them to innovate. Our message ought to be innovate rather than litigate. I hope attorneys general will remember that in the days and weeks ahead.

Second, I hope colleagues will look at the new incentives in this legislation to promote quality in the Medicare Advantage program and beyond because I believe those two provisions in this legislation--that encourage State innovation, that promote quality in the Medicare Program--ought to be widely supported by colleagues on both sides of the aisle in the days ahead.

That is, in my view, the kind of approach that can bring the American people together and help us implement this law in a fashion that is in line with what Americans want: good quality, affordable care, and reform that works for them.

Mr. Chairman, I thank you for this time and particularly for your help on those two provisions that I think ought to appeal to both Republicans and Democrats in the days ahead.

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