Thursday, January 7, 2010

Letter from Congressman Dennis Moore, D-KS

Representative Moore,

Thank you for the update. I support your continued advocacy for the Health Care Bill, in all it's sausagey glory. I hope, however, that you will work for process change. The making of this bill has been so ugly, so secretive (despite our president's promises to the contrary) and the result so wrong in so many ways, even though I have concluded that it is better than no bill at all.

Please, if there is still any opportunity, advocate for putting all people who live within our nation's borders, citizens or not, into this bill. It is penny-wise and pound-foolish to think that we are not using tax-payer dollars to support the medical care of illegals by leaving them out of this bill. In fact, we will continue to pay a price many times as illegals use tax-payer subsidized emergency services, wait to get care until disease is far-progressed and more expensive to treat, and of course, disrupt American businesses where they work due to absences and illness-related issues because they do not have adequate preventative and immediate care.

Thank you,

Sandy Price
Leawood, KS 66224

Dear Sandy:

Thank you for sharing with me your support for and ideas regarding pending health insurance reform proposals, including a competitive alternative to private health care insurance such as the public option. I appreciate hearing from you.

I am supportive of a public option - which should be available to those who cannot afford private insurance, who are unemployed, students dropped from their parents' coverage, the uninsured, or those who are not happy with their current private insurance. It would simply be another insurance option. If you are satisfied with your current insurance, like I am, there would be no reason to purchase the public option.

A public health care insurance option based on current Medicare fee-for-service reimbursement rates would not provide a level playing field for private insurance companies. For this reason, I support reforming the fee-for-service reimbursement system by which physicians, hospitals and other health care providers are paid. The fee-for-service system incentivizes physicians to give patients more tests and treatments for which the Medicare reimbursement rate is higher. Instead, we should be incentivizing good outcomes, managed care, and prevention - and transitioning our "sick care" system to a "well care" system.

Our current health care system contains a lot of inefficiencies. I support health care reform legislation that seeks to correct these problems through regulation, modernization, and restructuring the payment systems to providers. Making these changes will save billions of dollars (to both patients and the insurance providers, whether public or private), reduce medical errors, and increase the health and well-being of Americans. For example, full implementation of Health Information Technology would give patients a complete electronic file of their medical history, to which they could give their physicians access. This would reduce duplicative testing by multiple physicians because the health record indicates which tests the patient has already had, saving time, money, and hardship in the process. Not having access to a complete medical record often results in the duplication of expensive tests. The Institute of Medicine estimates that one-third of health care spending is wasted on treatments and tests that accomplish nothing.

Reform should also include incentives for hospital care management, to reduce readmittance and hospital acquired infections. It should also specifically reform the Medicare Advantage payment system, and home health payment rates, and increase rebates from pharmaceutical manufacturers to make drugs more affordable. Health care reform should also include rigorous incentives to recruit primary care physicians, nurses, and other health care professionals into the workforce, as they are in short-supply now and additional professionals will be desperately needed in order to provide care to an additional 47 million Americans.

As you may know, the House, with my support, approved health care reform legislation on November 7, 2009. H.R. 3962, the Affordable Health Care for America Act, offers both public and private insurance as an option, providing coverage to all Americans regardless of pre-existing conditions, providing coverage for (1) primary care and prevention; (2) prescription drugs; (3) emergency care; and (4) mental health services.

The Affordable Health Care for America Act would provide significant benefits in the Third Congressional District of Kansas: up to 18,800 small businesses could receive tax credits to provide coverage to their employees; 9,700 seniors would avoid the donut hole in Medicare Part D; 1,200 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $55 million in uncompensated care each year; and 47,000 uninsured individuals would gain access to high-quality, affordable health insurance. H.R. 3962 would provide:

o Help for small businesses. Under the legislation, small businesses with 25 employees or less and average wages of less than $40,000 qualify for tax credits of up to 50% of the costs of providing health insurance. In addition, the Blue Dog Coalition, of which I am a member, successfully doubled the small business exemption from the requirement to provide insurance to $500,000, with a phase-in of the penalty for failing to do so to $750,000. There are up to 18,800 small businesses in the district that could qualify for these credits.

o Help for seniors with drug costs in the Part D donut hole. Each year, 9,700 seniors in the district hit the donut hole and are forced to pay their full drug costs, despite having Part D drug coverage. The legislation would provide them with immediate relief, covering the first $500 of donut hole costs in 2010, cutting brand name drug costs in the donut hole by 50%, and completely eliminating the donut hole by 2019.

o Health care and financial security. There were 1,200 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill provides health insurance for almost every American citizen and caps annual out-of-pocket costs at $5,000 per year for individuals and $10,000 per year for families, ensuring that no citizen will have to face financial ruin because of high health care costs.

o Financial relief to hospitals and health care providers for uncompensated care. In 2008, health care providers in the district provided $55 million worth of uncompensated care, care that was provided to individuals who lacked insurance coverage and were unable to pay their bills. Under the legislation, these costs of uncompensated care would be virtually eliminated.

o Coverage of the uninsured. There are 87,000 uninsured individuals in the district, 13% of the district's residents under the age of 65. The Congressional Budget Office (CBO) estimates that nationwide, 96% of all Americans will have insurance coverage when the bill takes effect. If this benchmark is reached in the district, 47,000 people who currently do not have health insurance will receive coverage.

o No deficit spending. The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient (through the payment reforms and waste reduction previously mentioned) and half through a surtax on the income of the top 0.3% wealthiest individuals. This surtax would affect only 1,320 households in our district. The surtax would not affect 99.61% of taxpayers in our district. According to the CBO, the bill would cut the deficit by over $30 billion over the next decade and would continue to create a budget surplus over the next 20 years.

I am quite certain that H.R. 3962 is not a perfect bill, but it provides a solid foundation for Congress to consider this year. What I do know is that inaction is not acceptable. The current health care system is bleeding us dry - families, businesses and the government alike. We have 47 million uninsured or underinsured American citizens who have no choice but to seek the most expensive health care there is - emergency care - and $1100 of each insured Kansas family's insurance premium covers that cost. In Kansas in 2007, approximately 278,000 adults and 58,000 children were uninsured (total of 336,000) and that was before the economic downturn. The situation has just gotten worse. We have college kids with chronic diseases who are dropped from their parents' plan, who can then not get insurance because of their pre-existing condition. We have 26 year old women being diagnosed with breast cancer, who just graduated and are looking for employment who find themselves caught with no insurance. In Johnson County, we have a 57 year old man, self-employed, married with 2 small children when he was diagnosed with bladder cancer. He was unable to continue treatment due to being uninsured and unable to afford cost of treatment and medications. The family now has thousands of dollars in medical debt. These are our neighbors, our coworkers, and our friends. What if next week, God forbid, you lose your job or insurance coverage?

Reform will provide coverage and choice in the free market. If you like what you have - your insurance plan, your doctor, your hospital - you can keep it. Would you be upset if your premiums went down? Because that is the likely outcome of insuring everyone - it widens the risk pool to include the young and healthy and reduces those expensive emergency room visits by the uninsured because they can now see a doctor before the health problem becomes an emergency. If you don't like your insurance, reform will allow you to comparison shop among plans so you can decide what plan is best for you and your family. Reform will make more tools available to doctors so that they can provide the best care. Many insurance companies now require that patients try the cheapest treatment option first, even if it's not shown to be the best option. Reform will put an end to insurance companies rationing care, and put the decisions back into the hands of physicians and patients.

For more detailed information about H.R. 3962, including the full bill text, please visit the health care section of my website:§iontree=6,35

As you may also know, on December 24, 2009, the Senate approved their version of health care reform legislation. H.R. 3590, the Patient Protection and Affordable Care Act, differs in many ways from H.R. 3962, and does not contain a public health insurance option. The Senate and House will now have to reconcile their versions and create one unified bill. For more detailed information on the Senate bill, including the full bill text, please visit

Please know that as the health care reform legislation moves forward, I will work with my colleagues in Congress to ensure that it will improve the quality and length of life for Americans, while making citizens and the nation more financially secure.

Thank you again for contacting me. I hope you will continue to keep in touch and please feel free to let me know whenever I may be of assistance.

Very truly yours,

Member of Congress

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