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Health Care

Good health care is a very personal matter for me and my family. When my daughter was born she was very sick. But due to an insurance company rule, I was forced to leave the hospital just 24 hours after she was born. I went to the state legislature and got one of the first laws passed in the country guaranteeing new moms and their babies a 48-hour hospital stay. That experience was a crucial part of my decision to enter public service and fight for common-sense health care solutions.

For years, many of our businesses - particularly small businesses - have been struggling to afford the rising costs of health insurance. Employees often face the choice of paying a larger share of the premiums or going with no health insurance at all. And before health care reform, Minnesotans struggled with preexisting conditions exclusions and were unable to get insurance.

Health spending accounts for more than one-sixth of our economy. Unchecked, it would increasingly choke our family, local, state and federal budgets. This situation calls for significant reforms to make the system cost-effective, proactive, and stable.

To address escalating health care spending, Congress passed and the President signed into law health care reform legislation - the Patient Protection and Affordable Care Act. While this bill is projected to reduce health care costs, allow adults children to stay on their parent's insurance until age 26, make prescription drugs more affordable for seniors, and start us on the road to increased quality, lower-cost care, there are still improvements to be made.

For specific questions about the Act, please visit: www.healthcare.gov

As Minnesota's U.S. Senator, I will continue to focus on these health care priorities:

• Rewarding high-quality, efficient care. Minnesota is known for its high-quality health care delivery systems and innovative quality measures that provide Medicare beneficiaries with better value. Despite periodic efforts at reform, Medicare has not rewarded this high-quality. States that have historically delivered low quality, inefficient care are paid for wasteful practices, while efficient states such as Minnesota are punished. For example, according to a study by the Dartmouth Institute for Health Policy and Clinical Practice, if spending for chronically ill patients everywhere in the country mirrored the efficient level of spending in the Mayo Clinic's home region of Rochester, MN, Medicare could save $50 billion in taxpayer money over five years. To rein in costs, we need to have all states aiming for high-quality, cost-effective results like those we have achieved in Minnesota.
• Reducing costs for small businesses. In recent years, small businesses have been paying 20 percent more than big businesses spend on health care. As a result, many small businesses have been forced to reduce health benefits for their workers or drop them altogether. I have been focused on supporting our small businesses and making it easier for them to continue to provide coverage to their employees.
• Lowering prescription drug prices. I support a prescription drug benefit for seniors as part of Medicare, though I believe it can be simpler, more customer-friendly and less expensive than the program that Congress adopted in 2003. Unfortunately, the "non-interference" clause in the Medicare Part D prescription drug benefit expressly prohibits Medicare from negotiating lower prices from pharmaceutical companies. With Medicare barred from negotiating discounts, seniors face inflated prices for their medications, while the pharmaceutical industry gets a financial windfall. I am fighting to change that so our seniors can have access to their medicines at the lowest possible prices. I also believe we should allow for the reimportation of safe, less-expensive drugs from abroad.
• Taking care of our seniors. Almost 10 million seniors today need some type of long-term care. Seniors want to be able to live independently and stay in their own homes as long as possible and family support is essential to making that option available. And while nursing homes and paid care providers serve our elderly in some situations, the vast majority of elder care comes from informal care givers - more than half of whom are adult children taking care of their parents. Millions of families already find themselves as members of the "sandwich generation," coping with the challenges and costs of care for elderly parents at the same time they are caring for their own children. As the baby boom generation ages, the numbers will continue to grow. Just as the country addressed the needs of working moms and dads in the 1970s, we must now address the needs of our working daughters and sons.
• Incentivizing preventative care. Our health care system needs to reward prevention. It's better for both the patient and the employer if a chronic medical problem can be prevented or managed early to stave off complications and the need for costly care.
• Providing stable coverage. We need to make health care coverage stable so that families have the peace of mind in knowing that a procedure or surgery won't threaten their family's finances.
• Cracking down on health care fraud. Law enforcement authorities estimate that health care fraud costs taxpayers more than $60 billion every year. These criminals scheme the system to rob the American taxpayers of money that should be used to provide health care to those who need it most. We must put a stop to this.
• Responding to the drug shortage crisis. Hospitals, physicians, pharmacists, and patients in Minnesota and across the nation are currently confronting unprecedented shortages of important medications. Over the past five years the number of life-saving drugs in shortage has increased dramatically - from 55 to 231 reported drug shortages in 2011. This is a crisis that has grown to such proportions that current drug shortages have impacted individuals all across the country, forcing some patients to delay their lifesaving treatments or use unproven, less effective alternatives. In some cases, drug shortages have even resulted in patient deaths. This is a national public health crisis that must be addressed.
• Promoting workforce wellness initiatives. A healthier lifestyle benefits not only individuals and their families, but also the businesses that employ them. Developing a healthy, productive workforce helps lower health care costs, lifting a heavy burden off the shoulders of our businesses and sharpening America's competitive edge. As co-chair of the Bipartisan Congressional Wellness Caucus, I am working to educate my colleagues in Washington and the American public about the value of workplace wellness programs.
• Investing in science. In Minnesota, we value science and the progress its represents. The National Institute of Health (NIH) is our nation's primary entity for biomedical research, and we must continue to invest in ground-breaking research so that our scientists can concentrate on finding life-saving cures and not on finding the money to do their research.
• Utilizing technology. Information technology is transforming all aspects of our modern society, and it holds the same promise for the health care industry. Over 30 percent of every health care dollar is being spent on paperwork and administration. That money should be going to medical care, not paper pushers. We must modernize our health care system and continue to invest in health information technology.

As Minnesota's U.S. Senator I have fought for better health care for Minnesotans:

• Making health care more affordable. I authored legislation creating a "value index" for Medicare reimbursement rates. The value index, which was included in the Patient Protection and Affordable Care Act, will help control costs by rewarding the value of care instead of the volume of services. It will also strengthen the safety net of Medicare by ensuring that funds are there to pay for our seniors' health care. Finally, this value index will help ensure that Minnesota and other states that deliver high-quality, efficient care are rewarded for this care, not punished.
• Making health care more accessible. I fought to ensure that the health care reform law implements safeguards so people can no longer be denied coverage due to a pre-existing condition and children will continue to be eligible for family coverage through the age of 26. Because of this provision, approximately 2.5 million more young adults now have insurance coverage. I also worked to make sure the health care reform bill closed the Medicare Prescription Drug Program "doughnut hole" and lowered prescription drug costs for seniors. As a result, over 40,000 seniors saved an average of $559 dollars in 2011 in prescription drug costs. And, due to the health care law, nearly all of the 800,000 Medicare beneficiaries in Minnesota can now receive certain preventive services.
• Combating health care fraud. To help deter health care fraud, I cosponsored bipartisan legislation to help save billions of dollars each year and put an end to waste, fraud and abuse in Medicare and Medicaid. The IMPROVE Act, which was included in the Patient Protection and Affordable Care Act, requires direct depositing of all Medicare and Medicaid payments made to providers to prevent fraudulent billing practices.
• Supporting our small businesses. In health care reform, I fought to make sure that we made health care more affordable and accessible for small businesses. Since the start of 2011, small businesses have been eligible for tax credits worth up to 35 percent of their contribution to their employees' health insurance plans. In 2014, the tax credits will increase. As an original sponsor of the Small Business Health Options Program Act (SHOP Act), I also fought to include this bill in the final health reform legislation. The SHOP Act allows small businesses to pool together to spread financial risk, reduce cost, and increase choice of health care plans.
• Requiring Medicare to negotiate lower drug prices for our seniors. I have introduced legislation - the Medicare Prescription Drug Price Negotiation Act of 2011 - to eliminate the current ban that prevents Medicare from negotiating directly with drug companies for lower prices, which has imposed substantial, and unnecessary, costs on America's taxpayers and seniors, who are paying excessive prices for prescription drugs.
• Allowing the reimportation of safe, less expensive prescription medicines from Canada and other approved countries. American seniors pay inflated prices for their prescription drugs. But just to the north, Canadians enjoy inexpensive and safe prescription drugs. I voted for an amendment during the health care reform debate to permit safe importation of prescription drugs. We could not pass this amendment in the Senate, but I will continue fighting for a system that allows the importation of safe, FDA-approved medications from Canada and other approved countries.
• Fighting price gouging by pharmaceutical companies. There is evidence that pharmaceutical companies target outrageous price increases for selected drugs used by vulnerable populations or for rare diseases. Since my time in the Senate, I've called on the Federal Trade Commission (FTC) to investigate pharmaceutical companies for anticompetitive practices and price manipulation.
• Increasing breast cancer awareness. The EARLY Act, legislation I introduced and included in the health reform law, calls for the implementation of a national education campaign to provide increased support and awareness to young women with breast cancer.
• Ensuring access to vital drugs. I authored the bipartisan Preserving Access to Life-Saving Medications Act to require prescription drug manufacturers to give early notification to the FDA of any incident that would likely result in a drug shortage, as well as direct the FDA to provide up-to-date public notification of any actual shortage situation and the actions the agency would take to address them. The key provisions of my bill to help prevent drug shortages were included in Food and Drug Administration Safety and Innovation Act that was signed into law in July 2012.
• Providing support for seniors who want to stay in their homes. When seniors choose to remain in their own communities, it is not only often better for their health and peace of mind but also a more cost-effective option. To increase the use of remote monitoring technology for homebound seniors, I introduced the bipartisan Fostering Independence Through Technology Act with Senator John Thune of South Dakota, which would encourage the use of remote monitoring technology by home health agencies. I have also supported funding for initiatives like Community Innovations for Aging in Place to improve the quality of life for seniors who want to remain in their communities.
• Assisting families in caring for seniors. I introduced the Americans Giving Care to Elders Act, which would establish a federal tax credit to assist with the costs of caring for an aging family member and would help expand programs such as the National Family Caregivers Support Program, which provide education, guidance and support to people taking care of loved ones with long-term care needs. I'm also a cosponsor of the Alzheimer's Breakthrough Act, which would strengthen federal support of Alzheimer's research and increase the focus on clinical treatments for people with the disease.
• Reducing burdensome regulations. Over the past few years the FDA's regulation has become increasingly longer and more difficult, delaying, and in some cases preventing, new and innovative devices from reaching the market. That is why I introduced bipartisan legislation - the Medical Device Regulatory Improvement Act - that would help streamline the FDA's regulation of medical devices by clarifying FDA's current least burdensome requirements. Key provisions of this bill to promote innovation and help get new, lifesaving products to the market quicker without compromising patient safety were signed into law in July 2012.
• Expanding health care coverage for children. I supported the Children's Health Insurance Program Reauthorization Act of 2009, which extended health coverage to children who do not qualify for Medicaid and whose families cannot afford private insurance. The passage of this legislation, which was signed into law by President Obama in February 2009, ensures health care coverage for an additional 4.1 million uninsured children.
• Supporting stem cell research to seek new cures. Stem cell research promises to be the pathway for a new generation of life-saving cures, offering hope to millions of Americans and their families. I voted in favor of the bipartisan Stem Cell Research Enhancement Act, which would expand the number of embryonic stem cell lines accessible to federally funded scientists seeking new treatments and cures for severe medical conditions, such as juvenile diabetes, Parkinson's disease, Alzheimer's disease, Lou Gehrig's disease, spinal cord injuries, and certain types of cancer.
• Expanding the use of health information technology. I have also sponsored legislation that would give health providers the resources they need to establish secure and effective health IT systems that will reduce administrative costs and bring health care into the 21^st century.

For more information about health care reform please visit: www.healthcare.gov

Text of the Patient Protection and Affordable Care Act & the Health Care and Education Reconciliation Act

• Full Text of the Patient Protection and Affordable Care Act (P.L. 111-148)
• Full Text of the Health Care and Education Reconciliation Act (P.L. 111-152)