Issue Position: Health Care

Issue Position

Issue Position: Health Care

Health Care

With more than 47 million Americans lacking health insurance and health care spending accounting for an estimated 18 percent of our country's Gross Domestic Product, there is no question that our health care system is on an unsustainable path. Too many middle class families across New Hampshire face bankruptcy due to medical debt and more and more small businesses can't afford to offer their employees adequate coverage because of the high cost of health care.

In December, Senator Shaheen joined with her Senate colleagues to pass landmark legislation to provide better quality and more cost effective health care to all Americans. The Patient Protection and Affordable Care Act will provide access to health insurance for over 30 million Americans and tens of thousands of people in New Hampshire who are currently uninsured. It will prevent insurance companies from denying coverage to patients who have pre-existing conditions and it will provide New Hampshire's small businesses with significant tax credits to help them provide health insurance for their employees. Seniors will see a reduction in the price of prescription drugs, and under this legislation, Medicare is strengthened. And this legislation is fully paid for -- it will not add one dime to our national deficit. In fact, it will reduce the deficit by $132 billion over the next 10 years. Although this bill is not perfect, it will put us on the path to a stable and secure health care system.

Throughout the health reform process, Senator Shaheen worked with her colleagues to improve the Patient Protection and Affordable Care Act and authored these important measures:

* Access to Affordable Medicines Act -- increases access to lower-cost generic drugs by closing a loophole used by brand name drug companies to delay generic drugs from entering the market. As the law currently stands, when brand name manufacturers make labeling changes, generic drug labeling must reflect this change prior to approval and introduction to the market. This law was created with consumer safety in mind, so that all current drug safety and warning information would be reflected on the label. However, many brand name drug companies make last minute changes to labels not because of safety concerns, but instead to delay the introduction of cost-saving generic drugs by weeks or months to maintain market exclusivity. The brand name drug companies make hundreds of millions of dollars in profit using this delay tactic, resulting in consumers paying monopoly prices. The Shaheen measure stops these costly practices by providing a 60-day grace period for the generic drug company to submit the new labeling for approval and marketplace distribution, while preserving important safety regulations. Shaheen introduced this measure with Senator David Vitter (R-LA) and it has been endorsed by the AARP, Generic Pharmaceutical Association, and Consumer's Union.

* Medicare Transitional Care Act - the Senate health care reform bill includes key provisions of legislation introduced by Shaheen and Senator Susan Collins (R-ME) to reduce preventable hospital readmission of Medicare beneficiaries. In 2004, Medicare spent an estimated $17.4 billion on unnecessary re-hospitalizations. The Senate bill provides for a pilot program where a qualified transitional care clinician would ensure that appropriate follow-up care is provided during the vulnerable time after discharge from a hospital. Services provided may include instructions for patients and caregivers on how and when to take or administer medication; help scheduling and getting to follow-up appointments with doctors; and help coordinating support services, such as meal delivery, transportation, and assistance with other daily activities. Experts estimate the Medicare Transitional Care Act could save up to $5,000 per Medicare beneficiary.

* Accountable Care Organizations (ACO) - a concept championed by Dr. Elliott Fisher of Dartmouth, ACOs are groups of providers held responsible for the quality and cost of health care for their patients. The Shaheen provision would expand ACOs and allow them to work with private plans to align Medicare, Medicaid, and private sector strategies for improving care. This provision creates incentives for doctors to provide higher-quality care at lower costs, maximizes the effectiveness of quality improvement and reform initiatives, and helps ensure that all Americans receive high quality care, no matter how they are insured.

* Comparative Effectiveness Research -- compares different treatments and identifies those that are most effective. This research is an essential element of improving patient outcomes while containing costs, and it has been pioneered by renowned institutions like Dartmouth. Shaheen's provision allows for open dissemination of valuable, unbiased information on how to deliver high quality, low cost care to doctors and patients. The provision also ensures proper oversight and accountability of the research by clarifying membership of the Board of Governors of the Patient Centered Outcomes Research Institute.

Senator Shaheen recognizes that the Patient Protection and Affordable Care Act is an important first step in improving our health care system and that more work needs to be done to make care affordable and accessible. She remains committed to offering common sense ideas that will improve the quality of care people receive while containing costs. As the House and Senate continue negotiations in health care reform, Senator Shaheen will continue to ensure New Hampshire's interests are represented.

Quality Care that Controls Costs

Senator Shaheen believes we can control health care costs while also improving the quality of care. For decades, research at the Dartmouth Institute for Health Policy and Clinical Research has demonstrated that more costly care does not mean better care. Building off of this important premise, Senator Shaheen has authored legislation to make health care delivery more coordinated and efficient.

Senator Shaheen authored legislation to reduce overutilization of emergency rooms. Frequent users of health care services make up a small but costly portion of emergency room visits and contribute to overcrowding. Studies show that providing these individuals with increased coordination of care and outreach services can result in significant savings to taxpayers. Shaheen's REDUCE act is based on this successful work.

Senator Shaheen also worked with her freshman colleagues on the "Innovation and Value" amendment package which was accepted in the Patient Protection and Affordable Care Act. These cost-saving provisions aim to encourage, expand, and expedite delivery reforms and reduce costs for consumers throughout the health care system. Specifically, the amendments reward health care providers for quality outcomes, promote transparency and competition, and inject accountability and responsibility into the system. The "Innovation and Value" amendment package gained bipartisan support and was endorsed by a number of business, labor, and professional health care organizations.

Coverage for Children

Access to quality health care is critical to a good start in life, and throughout her career, Senator Shaheen has fought to ensure that children have access to the care they need. As Governor, she launched New Hampshire's Children's Health Insurance Program, known as CHIP, which provides affordable health and dental coverage to tens of thousands of New Hampshire children. In the United States Senate, she helped pass a major expansion of CHIP that expands eligibility to cover an additional 9,300 children in New Hampshire. This was an important step forward in making sure our nation's children are healthy, and Senator Shaheen will continue working to ensure that children get the best quality health care possible.

Prescription Drugs

Senator Shaheen is not afraid to stand up to the big drug companies. Throughout her career, she has initiated programs to lower prescription drug costs for consumers and the government. As Governor, she created a prescription drug program to provide relief for seniors struggling with the high cost of prescription drugs.

Senator Shaheen understands the consumer benefit to getting generic drugs to the marketplace through faster and easier channels and is working with her colleagues to improve access to generic drugs. She successfully fought to include her bipartisan Access to Affordable Medicines Act in the Senate health care reform bill; cosponsored legislation to create a pathway for FDA approval of biogeneric drugs; and cosponsored legislation that would allow for the reimportation of prescription drugs from Canada and other countries. Senator Shaheen will continue to fight for better access to affordable prescription drugs as long as Americans continue to struggle to pay for the medications they need.

Stem Cell Research

Stem cell research is critical to the scientific understanding of diseases, therapies, and cures that impact millions of Americans. Embryonic stem cell research could lead to treatments for diseases that afflict up to 100 million Americans, including Alzheimer's and Parkinson's disease, diabetes, cancer, heart disease, spinal cord injuries, and other debilitating conditions. Senator Shaheen has cosponsored legislation to strengthen future efforts in this promising field.

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