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Both the market and government have roles in ensuring the availability and affordability of health insurance. The market provides a variety of insurance products for consumers and employers with different needs and preferences. These products differ on many dimensions, including the breadth of provider networks, amount of beneficiary cost-sharing, and techniques for managing the use of healthcare services. The federal government helps ensure access to healthcare coverage through public programs, such as Medicare and Medicaid, and it influences the market for private insurance through tax and regulatory policies. Some tax subsidies help people purchase insurance, and other- including those for Health Savings Accounts - help pay for medical expenses not covered by insurance. By far the largest subsidy is the tax deduction for employer-provided health benefits. Because of this deduction, most people receive health insurance through their employer.
On October 29, 2009, the Congressional Majority introduced H.R. 3962. They were able to pass the bill in the House by a vote of 220 to 215 on November 7, 2009. This bill would establish a mandate for most residents of the U.S. to obtain health insurance, regulate the pricing and terms of private health insurance policies, set up insurance “exchanges” through which certain individuals and families could receive federal subsidies to purchase insurance, offer a government-run “public plan” option and impose approximately $730 billion in new taxes and fees, including a $460 billion income-tax surcharge on small businesses and individuals. The bill also creates 118 new federal boards, bureaucracies, commissions, and programs.
The Congressional Majority’s healthcare bill will cost over $1.2 trillion and will be paid for by massive new taxes and cuts to Medicare. With unemployment over 10%, many small businesses throughout the country are struggling to survive. In addition, President Obama has pledged to let the Bush tax cuts expire, which will result in a second tax hike on our nation’s small businesses in only two years. I oppose placing a higher tax burden on small businesses.
The legislation also relies on over $400 billion in cuts to Medicare in order to fund the programs it creates. The bill cripples the Medicare Advantage Program (which utilizes a public-private partnership for Medicare Part B) by cutting over $170 billion from it. In the 21st Congressional District, 55,000 seniors currently use Medicare Advantage as their health insurance. As a result of the cuts these seniors could face reductions in their healthcare choices.
The high cost of health insurance is the principle reason many of the uninsured do not purchase insurance and also why many businesses do not offer health insurance to their employees. Unfortunately, this bill does nothing to bring down, or even slow down, the rising cost of health insurance. According to the Center for Medicare and Medicaid Services, the federal government agency that administers both of these programs, the bill will actually raise the cost of healthcare by nearly $300 billion. This increase would make it more difficult for the uninsured and businesses to purchase affordable healthcare and will make health insurance more expensive for those that have it now.
The bill also includes a new burdensome Medicaid expansion that, according to the non-partisan Congressional Budget Office (CBO) analysis of the bill, will require the States to pay an additional $34 billion in matching funds over the next decade. That provision will cost Florida over $1 billion a year. States, such as Florida, already have difficulty paying for their current Medicaid programs and as a result could be forced to cut state programs, such as education, or raise taxes to pay for the mandated Medicaid expansion.
The Congressional Majority’s bill also forces all businesses, even those fighting to survive in these tough economic times, to significantly increase their costs by providing health insurance coverage or pay a fine. The Congressional Budget Office (CBO) has warned Congress that the legislation will result in further unemployment. I believe that job creation must be our primary goal at this time. I strongly support healthcare reform, for example by offering tax credits for individuals to purchase healthcare insurance, by allowing small businesses to pool-together beyond state lines to gain bargaining leverage to purchase more affordable health insurance policies for their workers, and by disallowing insurance companies from denying coverage due to pre-existing conditions.
I believe H.R. 3962, however, would force many physicians to close their practices, limit access to high-quality healthcare, reduce the quality of care and stunt the growth of new medical research and technology.
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