Health (top)

As the Senior Democrat on the Ways and Means Committee’s Subcommittee on Health, Rep. Stark continues to be a leader on Medicare and other health issues before Congress.

MEDICARE

THE MEDICARE PRESCRIPTION DRUG BILL (Medicare Modernization Act):  This bill passed Congress in November 2003 by a tiny margin that was only obtained after Republicans held the vote open for an unprecedented 3 hours.  While purported to be a Medicare prescription drug bill for America’s seniors, in fact, the bill fails to provide an adequate drug benefit and endangers Medicare’s very future through dangerous privatization schemes. 

• Stark led the fight against the Medicare Modernization Act (MMA) - in committee and on the floor.  He co-authored the Democratic alternative bill which would have provided a real, meaningful drug benefit – like that which workers get through their employers today.  The bill also protected Medicare’s future by continuing to assure the entitlement to the benefits

• EXPOSING BUSH ADMINSTRATION LIES ON THE MEDICARE BILL: 
• • COST OF THE BILL:  Blew the whistle on Administration's efforts to withhold cost estimates and analyses of last year's Medicare legislation that would have shown that the bill cost $534 billion rather than $400 billion as promised by the White House and Senior House Republicans.  He is continuing to try to hold those accountable who hid the information.
  • DRUG CARD ADVERTISING:  Requested a GAO analysis of advertisements run by the Bush Administration promoting the drug discount cards as enacted under the Medicare law.  GAO found that the Administration violated a government prohibition on “covert” propaganda  by creating what appeared to be news stories about  the drug cards when in fact they were paid advertisements with actors hired by HHS posing as reporters.
  • MEDICARE COST-SHARING INCREASES:  Forced the Administration to release analysis they’d left out of the 2004 Medicare Trustees Report which clearly shows the escalating financial burden that Medicare cost-sharing will place on seniors.   The chart shows Medicare will absorb more than 50% of the average beneficiaries Social Security check by 2021.
  • PROVISIONS WITHIN THE OVERALL BILL THAT STARK HELPED ENACT:  While he opposed the overall legislation because of the bill’s severe shortcomings regarding the prescription drug benefit and its privatization of Medicare, this was an omnibus Medicare bill that included some provisions supported – and even authored – by Rep. Stark.
  • REFORMING MEDICARE’S PAYMENT FOR DRUGS THE PROGRAM CURRENTLY COVERS:  Stark is a leading proponent of reforming Medicare’s payment of prescription drugs already covered by Medicare (mainly chemotherapy medications).  He has worked on this issue for years and requested analysis from the General Accounting Office regarding overpayments and fraud in this arena.  Stark introduced the only free-standing bill on this issue and it became the basis of policy within the MMA.
  • SPECIALTY HOSPITALS:  Introduced legislation to prohibit doctors from setting up their own specialty hospitals -- mostly heart hospitals and orthopedic care hospitals – and personally profiting from their referrals.  These hospitals are threatening the well-being of community hospitals and there is strong evidence from the GAO that they are treating healthier patients and failing to care for those on Medicaid.  Worked with colleagues to include a provision in the MMA legislation that puts an 18 month moratorium on the creation or expansion of specialty hospitals until analysis is completed by HHS and MEDPAC on their impact on our health system.
  • Enactment of selected provisions that improve beneficiary outreach and education such as requiring the placement of Medicare staff in Social Security regional offices and the creation of a Medicare ombudsman program.

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LONG-TERM CARE HOSPITALS:  Released a white paper on the recent rapid growth in Medicare payments to Long Term Care Hospitals (LTCHs) and the fact that the for-profit component of this industry was reporting extremely high profits. The Long Term Care Hospital Moratorium Act (HR 3790) was introduced to curb this growth while research is conducted to determine whether the rapid growth was driven by true medical need. The public awareness generated by the white paper and legislation, couple with recent MedPAC reports, led to CMS finalizing new regulations to limit LTCH growth.

 
FIGHTING FRAUD AND ABUSE:  Is leading the House effort to increase funding for the HHS Office of the Inspector General as part of the ongoing appropriations process in Congress.  This is a bipartisan effort in conjunction with Senator Grassley, the Chairman of the Senate Finance Committee.

MEDICARE PREMIUMS DEVOUR SOCIAL SECURITY COLAS:  Uncovered MMA flaw that shows Republicans failed to protect SS COLA from drug premium increases; introduced legislation to protect the COLA and SS benefits by reserving at least 75 percent of the COLA for expenses other than Medicare premiums.

HOSPITAL ACCREDITATION:  Requested a report by the Government Accountability Office (GAO)--- the investigative arm of Congress --- regarding the effectiveness of the process of ensuring that acute hospitals meet the patient safety and quality conditions required by Medicare. Most hospitals are currently surveyed by a private entity, the Joint Commission for Accreditation of Health Organizations (JCAHO).  The report found significant deficiencies in the JCAHO hospital surveying process. Bipartisan legislation was introduced with Senator Grassley, Chairman of the Senate Finance Committee authoring the Senate companion bill.  That bill, the Medicare Hospital Accreditation Act (HR 4877),  provides the government with increased oversight authority over JCAHO's Medicare hospital approval surveys.

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DEVELOPING COMMON SENSE SOLUTIONS TO COVER THE UNINSURED

PROVIDING HEALTH COVERAGE TO ALL CHILDREN: Nearly one in five children lives below the poverty line – the highest level of any age group.  Despite programs that provide health insurance coverage for kids, more than 8 million children are still uninsured.  Building on the successful Medicare program, Congressman Stark’s MediKIDS bill (H.R. 1205) would establish a comprehensive, guaranteed, universal health insurance benefit for all children.  His legislation is the top legislative goal for the American Academy of Pediatrics. 

ADDRESSING THE FASTEST GROWING UNINSURED POPULATION: One of the fastest growing uninsured populations is 55-65 year olds who can fall through the cracks of our employer-sponsored system, but are too young to qualify for Medicare.  The Medicare Early Access Act (HR 4357) allows people in this age group to buy into the Medicare program, and provides a subsidy to make this coverage affordable.

IMPROVING COVERAGE OPPORTUNITIES FOR SMALL BUSINESSES: Sixty-two percent of uninsured workers are in firms with fewer than 100 employees.  Small employers cite cost as the main barrier to offering coverage.  The Small Business Health Insurance Promotion Act (HR 4356) provides tax subsidies to assist small employers to offer affordable health coverage to their employees through qualified health pooling arrangements.

EXPANDING HEALTH INSURANCE COVERAGE TO FAMILIES: The vast majority of the uninsured live in families with incomes below 200% of poverty ($31,340 for a family of three in 2004).  The easiest way to expand health insurance coverage to this population is to enroll low-income parents in programs that are currently available to children.  The FamilyCare Act (HR 4350) provides incentives for states to cover low-income families in existing public programs.

PROTECTING CONSUMERS: Advocates of corporate interests make daily attempts to undermine the few consumer protections that exist in today’s health system.  Congressman Stark has consistently fought against these efforts, most recently defeating Republican amendments to the Trade Adjustment Assistance Reform Act (TAA) health care tax credit program that would have eliminated such protections.  In addition, Congressman Stark has successfully opposed the expansion of renegade Association Health Plans that operate outside the jurisdiction of state insurance laws.  He is also leading the fight against high-deductible health plans and Health Savings Accounts (HSAs) that would place a greater burden for health costs on the backs of consumers and threaten the employment-based system we have today.

ADVANCING HEALTH SYSTEM REFORM: While Congressional debate on improving our health system has stagnated in recent years, Congressman Stark remains committed to finding solutions to address the serious concerns of coverage, cost, and quality.   In spring 2004 he convened a panel of nationally-recognized experts to offer a broad critique of the U.S. health system and options for reform.  This forum made a significant contribution to the national dialogue.

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OTHER HEALTH INITIATIVES

REDUCING MEDICAL ERRORS:  Developed a bipartisan bill with Ways and Means Health Subcommittee Chairman Nancy Johnson that was passed out of Committee and became basis for House-passed patient safety legislation.  The bill is not as comprehensive as Rep. Stark would hope.  The Senate passed a different version of the legislation.  A conference must be appointed to work out the differences.  As the session is nearing its end, it is likely that Congress will need to revisit the issue next year.

ADDRESSING THE NURSING SHORTAGE AND PROTECTING QUALITY PATIENT CARE:  Stark introduced the Safe Nursing and Patient Care Act to provide a federal prohibition on mandatory overtime for nurses.  This legislation has the support of every major nursing association and the bipartisan support of more than 100 members of Congress.  If enacted, it would encourage nurses to remain in the profession and would improve quality of care they provide to patients.

PROTECTING CONSUMER ACCESS TO AFFORDABLE CONTACT LENSES:  In November 2003, Congress passed, and President Bush signed into law, HR 3140, the Fairness to Contact Lens Consumers Act. This legislation, introduced by Rep. Pete Stark (D-CA), Rep. Richard Burr (R-NC) and a bipartisan group of lawmakers requires eyecare professionals to release contact lens prescriptions to their patients after completing the fitting process. The bill, similar to a current California law, guarantees fairness and choice to the 36 million contact lens wearers nationwide while providing them access to better prices when filling their prescriptions.

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MENTAL HEALTH

PROTECTING CHILDREN’S ACCESS TO NEEDED SERVICES:  Convened a working group of advocates to address the issue of children in welfare and/or mental health treatment settings losing multiple needed services upon transitioning to the adult service system at ages 18-21 --- so called youth in transition. A product of the group’s activities was getting the Substance Abuse and Mental health Services Administration (SAMHSA) to fund a study by the University of Massachusetts Medical Center and the Bazelon Center for Mental Health Law to review all current federal legislation that addresses this issue. The results of this study will be used to develop a more comprehensive approach to meeting the needs of these youth.

KEEPING FAMILIES TOGETHER WHEN THEIR CHILDREN NEED INTENSIVE MENTAL HEALTH SERVICES:  Stark with Representatives Jim Ramstad (R-MN) and Patrick Kennedy (D-RI) introduced the “Keeping Families Together Act,” a bill to help parents obtain necessary mental health treatment for their severely emotionally disturbed children without being forced to relinquish them into state custody to get that care. Senators Susan Collins (R-ME) and Mark Pryor (D-AR) introduced companion legislation in the Senate.

Stark assembled support for this legislation by commissioning with Representative Kennedy and Senator Collins a General Accounting Office report entitled “Child Welfare and Juvenile Justice: Federal Agencies Could Play a Stronger Role in Helping States Reduce the Number of Children Placed Solely to Obtain Mental Health Services.” This report found in Fiscal Year 2001, that parents were forced to relinquish the legal custody of 12,700 children to the juvenile justice or child welfare systems, so that their children could get mental health treatment.   

Welfare (top)

Stark led the battle to make reducing poverty a goal of the main federal welfare program, Temporary Assistance for Needy Families (TANF).  He included this provision in his Child Poverty Reduction Act (H.R. 625). In response to this pressure, the Republicans changed their bill to make poverty reduction a goal of TANF.  Because the Senate refused to go along with some of the draconian cuts in the House-passed Republican Welfare reform bill, this issue has not been resolved.  The existing law was extended and the 109^th Congress will return to revising the welfare law.

CHILD CARE:  Stark led the fight to increase funding for child care subsidies for poor families.  As the 1996 welfare law required many poor parents to go to work, Stark worked to ensure that their children are in safe, affordable and quality child care.  After offering an amendment to increase child care subsidies by $11.25 billion over 5 years in the previous Congress, Stark’s efforts in this Congress led both the House and Senate welfare bills to increase overall funding for child care.

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Stark consistently voted against the irresponsible tax cuts proposed by the Administration and Republicans in Congress because those cuts are targeted toward those with upper incomes and thrust our nation further into debt at a time when we can least afford it.  While Stark is a strong proponent of true-middle income tax relief, the Bush Administration proposals favor the wealthy over working class families, and put the burden of billions of dollars of debt on our children and grandchildren.

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Stark led a bipartisan, bicameral effort in opposition to legislation aimed at blocking the Financial Accounting Standards Board's (FASB) authority to require companies to expense stock options on their Securities and Exchange Commission (SEC) income reports.  This accounting change is necessary so that companies are appropriately reporting their value to stockholders and the public.  Stark joined 21 Members of Congress including Representative Paul Gilmor (R-OH) and Senators John McCain (R-AZ) and Carl Levin (D-MI) in sending a letter to FASB supporting their new rule.  While the House has passed the legislation blocking the FASB rule, Stark's efforts have helped block this legislation from coming to the Senate floor since they alerted key senators to the dangers of this legislation.

Judicial Issues (top)

The Republican campaign against “activist judges” and frivolous lawsuits has been a rallying cry for a much larger effort to weaken civil rights and encroach on the independence of the third branch of government.  The record shows that, to the Republicans, the definition of activist judge is a judge who disagrees with you (they certainly didn’t mind the widely criticized Bush v. Gore decision that interfered with Florida’s state electoral process) and the definition of frivolous lawsuit is a lawsuit that goes against a Republican-leaning interest group or industry.

Congressman Stark has worked against legislation that would:

• For the first time ever in American history, enact a broad ban on Americans’ right to their day in court to challenge the constitutionality of a law (H.R. 3313, the so-called Marriage Protection Act)
• Put an arbitrary $250,000 cap on non-economic damages in cases for medical mistakes
• Delay class action lawsuits and make it harder to receive fair compensation. Class action suits empower average Americans to challenge wrongdoings by wealthy corporations that would otherwise ignore their appeal.

There are more extreme Republican proposals that, thankfully, have not come to the House for a vote, but which Stark vigorously opposes, including legislation that would allow Congress to overturn a Supreme Court decision and legislation that would bar courts from ruling on the constitutionality of displaying the Ten Commandments in public places.

The Constitution is meaningless if Congress can just pass laws and throw in a line to keep them from being held unconstitutional.  Congressman Stark will continue to stand up for our Constitution and for Americans who depend upon an independent judiciary to protect their rights.

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Congressman Stark strongly opposed the Iraq War.  Stark has since advocated for expanding the role of the United Nations in post-war Iraq.  He supports a full partnership between the United States, the UN and a broad international coalition that fully shares the responsibility and cost of securing the country and completing the reconstruction effort.   The President must use all means necessary to garner commitments from other nations to contribute the troops and funding necessary to offset the US’s current overcommitment in Iraq.

Stark has pushed for a thorough investigation into the Bush Administration’s handling of faulty intelligence used to justify the war, including sponsoring a resolution of inquiry requesting proof of Iraq’s possession of weapons of mass destruction, and supporting the creation of a bipartisan, independent commission and a select-congressional committee to investigate the Administration’s false intelligence claims.

Post-War Funding

Stark is a cosponsor of HR 1738, the American Parity Act, legislation introduced by Rep. Rahm Emanuel (D-IL) on June 10, 2003 that would require that the $1.7 billion provided for housing, schools, health care, and infrastructure in post-war Iraq be matched for the same priorities here at home.

Stark voted in favor of HR 1559, the Emergency Wartime Supplemental Appropriations bill that provided $60 billion in emergency funds for our troops in combat and subsequent rebuilding efforts in Iraq.  Although opposed to the war, Stark believed it was vital that once in harms way our troops had to have the resources to bring the war to a swift end.  The measure passed the House and Senate and was signed into law by President Bush.

Stark voted against providing $87 billion in Supplemental Appropriations for ongoing military operations and rebuilding in Iraq and Afghanistan citing the Bush Administration’s lack of strategy for carrying out the US occupation.  Stark supported an amendment to the bill rescinding the Bush Tax Cuts on the top 1% richest Americans.  Despite the potential for raising up to $150 billion for the war effort, Republicans did not allow the amendment to be offered.

Stark voted against the Fiscal-Year 2005 Defense Appropriations Act, which included $25 billion for Iraq. Congress must provide troops in Iraq all the support and protection they need, but it does them no service by approving more money without first demanding a clear exit strategy, especially as troop deployments are extended indefinitely. Americans have a right to know what lies ahead and at what cost.  A no vote was an attempt to hold the President accountable.

Stricter Oversight of Reconstruction

In December 2003, Stark joined colleagues in cosponsoring the War Profiteering Prevention Act, legislation that would provide new criminal penalties of up to 20 years in prison and a $1 million fine for those who knowingly defraud the taxpayers in carrying out their post-war reconstruction contracts in Iraq.

In November 2003, Stark joined Rep. Charles Rangel (D-NY) in introducing H. Con. Res. 323, a Congressional resolution urging the President to immediately request the resignation of Defense Secretary Donald Rumsfeld for his irresponsible conduct in the planning and carrying out of the US occupation of Iraq.

Stark is a cosponsor H. Res. 358, a Congressional resolution introduced on September 6, 2003, requesting the release of “Operation Iraqi Freedom Strategic Lessons Learned,” an internal Defense Department report detailing the flawed planning for war and reconstruction in Iraq. The Bush Administration continues to refuse its release to Congress.

Troop Safety and Support

On November 4, 2003, Stark joined colleagues in a letter to the House Armed Services Committee requesting that it hold a hearing into what contributed to the shortage of body armor, how to best equip our deployed troops and the factors that contributed to the lapse in military readiness.

On November 7, 2003 Stark joined colleagues in sending a letter to Defense Secretary Donald Rumsfeld requesting an investigation into poor living conditions for National Guard Troops at Fort Stewart and Fort Knox, where reports indicate many are living in ill-equipped housing often without indoor toilets and substandard medical care.  Secretary Rumsfeld responded reporting that troops had been moved into permanent housing and efforts were being undertaken to improve health care services.

On November 21, 2003, Stark joined colleagues in sending a letter to President Bush expressing strong concerns with unacceptably low levels of support armed services personnel are receiving from the Administration.  Specific concerns cited in the letter were (1) the shortage of Kevlar vests and body armor for troops in Iraq; (2) the lack of radio jammers to block signals for detonating remote control bombs; (3) 250,000 defective and unaccounted for bio-chem suits that have likely been outfitted to deployed troops; (4) the large number of US helicopters in Iraq that lack anti-missile equipment; (5) wounded soldiers having to wait weeks for medical treatment; (6) National Guard and Reserve troops being denied health coverage; and (7) the reduction in imminent danger pay and family separation allowances.

Prisoner Abuse

DEFENSE SPENDING

Stark voted against the National Defense Authorization bills for both 2004 and 2005 and the Department of Defense Appropriations Acts for both Fiscal Year 2004 and 2005 due to the huge increases in military spending and wasteful expenditures on Star Wars, low-yield nuclear weapons and duplicative or non-functional weapons development.

NUCLEAR NON-PROLIFERATION

Stark is a cosponsor of the Nuclear Nonproliferation Treaty Commitments Act, which would require the President to initiate multilateral negotiations to eliminate nuclear weapons, reaffirm the moratorium on nuclear testing, begin large-scale reductions in the US’ nuclear arsenal, terminate construction of new weapons facilities, end development of missile defense system, and provide progress reports on efforts promoting international nuclear disarmament.

On May 21, 2003, Stark voted in favor of an amendment to the Fiscal-Year 2004 Defense Appropriations bill offered by Rep. Ellen Tauscher (D-CA) to remove $15 million provided for development of the so-called Robust Nuclear Penetrator bomb and transfer it to offset the cost of conventional weaponry.  The amendment failed by a vote of 226 to 199.

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Stark serves as Ranking Democrat on the Joint Economic Committee which is comprised of Members of both the House and Senate.  The JEC was established by the Employment Act of 1946 and is directed to study how to achieve low unemployment and low inflation and advise Congress concerning the economic policies of the Administration.

Stark has produced numerous analyses on a variety of economic topics such as those highlighted below.  For more details, please visit the JEC website at http://jec.senate.gov/democrats/index.html.

• Issue a monthly press release when the Administration releases its employment report.   These serve to highlight a different interpretation of the employment data than that provided by the Administration.  Through this mechanism, the JEC was the first to coin the now common phrase that the Bush Administration is on its way to be the first Administration since Hoover not to create any net new jobs during its term in office.
• Established a “ Bush Economic Record” that keeps up-to-date key economic statistics relative to progress under prior Administrations.
• Produced numerous reports on the Unemployment Insurance program illustrating the need to extend unemployment benefits – and highlighting that previous Republican Administration’s have been willing to do so in less extreme recessions than has been experienced during the Bush presidency.
• Requested the Congressional Budget Office to detail the distributional impact of the Bush tax cuts.
• Wrote a report on the impact of Medicare premiums on the Social Security cost of living adjustment.  This report led to the introduction of the COLA Protection Act introduced by a large group of Members of Congress including Stark.