Health Care

Thank you for visiting my Health Care information page. It is my goal to provide my constituents with as much relevant information regarding federal Health Care developments as possible. Below you will find information on frequently discussed topics and links to more information/resources that you may find helpful. Thank you again for visiting and as always please let me know how I may be of assistance.

The Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) is the new health care reform law in America. It reforms the nation’s health care system by providing more Americans with affordable quality health insurance by curbing the growth in health care spending in the U.S. These reforms have included ending gender-based charges, limiting rescissions (insurance companies dropping the insureds when they get sick), mandating coverage of certain preventative services, and the expansion of Medicaid and Medicare. 

Currently, there are 46 million American citizens without healthcare insurance, of which 8.6 million. In Illinois, this translates to 700,000 uninsured American citizens, or 16.8% of the state population. Access to affordable health care should be a right, and I believe that the ACA is the best way we can move towards making this a reality. 

To find out more please visit HHS.gov/HealthCare.

My Work on the ACA

As a senior member of the House Energy and Commerce Committee — the Committee with primary jurisdiction over the drafting of the ACA — I have spearheaded efforts to expand outpatient eligibility for the discount drug program under the Medicaid 340B Program, expand Mental Health Services (including a study on the causes, impacts and treatments for Postpartum depression) and authorized Trauma Center Grants for renovation or construction of trauma centers and preparedness networks in struggling urban and rural areas. 

How the ACA Relates to Medicaid

Medicaid is a joint federal and state funded program that provides health care for over 60 million Americans that are in need of assistance and the ACA expands Medicaid coverage to even more people that otherwise would not be able to attain health insurance. The ACA provides states with additional federal funding to expand their Medicaid programs to cover adults under 65, with income up to 133 percent of the federal poverty level. The federal government pays 100 percent of expansion costs for the first three years and 90 percent thereafter until 2022. Many states have shown that expanding Medicaid actually raises money for the state, and therefore Medicaid is saving taxpayers’ money.

To find out more about Medicaid please visit:

• Medicaid.gov
• Medicaid.gov’s Information on Illinois
• Illinois Department of Healthcare and Family Services
• CountyCare — A Cook County Medicaid Health Plan

How the ACA Relates to Medicare

Medicare is a joint federal- and state-funded program that provides health care for 40 million Americans that are over the age of 65, and an additional 8 million Americans who have a disability. Medicare offers preventive services, like mammograms or colonoscopies, without charging for the Part B coinsurance or deductible. Individuals in the prescription drug plans coverage gap (also known as the “donut hole”) will also get a 55 percent discount when buying Part D-covered brand-name prescription drugs. Medicare coverage is protected, so you don’t have to replace your Medicare coverage with the Marketplace coverage, under ACA.

For more information on Medicare and the ACA please see Medicare.gov — The Affordable Care Act & Medicare.

The Sustainable Growth Rate Formula

I believe that the Sustainable Growth Rate (SGR) formula, used to determine updates to Medicare’s physician fee schedule, is not working and needs to be replaced.

The SGR sets the reimbursement levels for doctors who serve patients covered under Medicare. Created to control Medicare spending on physician services, the SGR functioned as intended for a few years, with expenditures not exceeding targeted costs, before fundamental flaws in the formula began creating instability for both doctors and patients. In 2002, expenditures for critical patient services began exceeding allowed targets, and the situation has gotten worse with every passing year. Congress has tried to remedy this problem by passing multiple short-term overrides of the SGR formula, but has not yet passed a full repeal.

I believe we must repeal and replace the SGR with a formula that meets the needs of Medicare patients and gives doctors the certainty needed to continue offering services to patients. The cost associated with repealing the SGR while ensuring patients receive the care they need has changed from year to year, but the nonpartisan Congressional Budget Office’s report that estimated the cost of repeal in 2014 at $116.5 billion — the lowest figure ever determined — has driven momentum toward finally getting it done. Efforts are underway in the House and Senate to find a way to offset the cost of repeal of the SGR as soon as possible. I will continue to work with my colleagues on both sides of the aisle to bring an agreement to the floor of the House for a vote.

To learn more about the SGR and what is being done fix it please see Repealing and Replacing the SGR.

Sequestration Cuts to the National Institutes of Health

The 5.1 percent cut on all non-defense spending levied by sequestration has and will have a devastating effect on medical research projects, induce layoffs among scientists and cuts to equipment, all of which could influence scientific and medical advances and ultimately affect patient care.

I have always supported strong federal funding for the National Institutes of Health (NIH). In 2005, as a member of the Energy & Commerce Subcommittee on Health, I co-authored a bill to create the National Commission on Digestive Diseases, which was enacted as part of the Omnibus Appropriations bill and signed into law by President Bush. Diseases to be examined by this commission include Heartburn, Peptic Ulcers, Lactose Intolerance, Colorectal Cancer and Hepatitis. The Commission has examined and will continue to examine the incidences and impact of digestive diseases on the population, evaluating the public and private facilities and resources available for the diagnosis, prevention and treatment of digestive disease and identifying programmatic factors to improve digestive disease management and treatment.

I believe Congress must consider the special importance of properly funding medical research and the scientific community to ensure that the choices we make do not harm our ability to discover treatments for diseases like diabetes, cancer, Alzheimer’s and HIV/AIDS.

To that end, I am a proud supporter of the Medical Research Protection Act of 2013 (H.R. 729). This bill seeks to exempt the NIH from any sequestration cuts ordered by the President for FY2013. I have also cosigned a letter to the House Committee on Appropriations urging a funding level of $35 million in FY2014 to the NIH for biomedical research and supported the increase of Minority representation in clinical trials.