Johnny Isakson, United States Senator

Johnny Isakson's Position Statement on Health Care

As a member of the Senate Committee on Health, Education, Labor, and Pensions, I am committed to enhancing our nation’s healthcare by addressing the issues of cost, quality, coverage and accessibility.

There are currently 44 million uninsured individuals in America and 9 million uninsured children. It is critical that Congress work to provide access to affordable healthcare insurance for all Americans.

Health Care Reform

On July 15, 2009, the Senate Health, Education, Labor and Pensions Committee passed health care reform legislation. I voted against this flawed health care reform plan that will cost more than $1 trillion, will put the federal government in an unfair competition with private health insurers and managed care providers and will place a massive financial burden on Georgia and other states to pay for a proposed expansion of Medicaid.

As a member of the HELP Committee, I recognize the frustrations many Americans have with the current cost and delivery of health care. I agree we must look for solutions to find ways to provide affordable health care to individuals who lack access to health insurance through an employer.

I believe that the government-run plan included in the bill will decrease choice and quality, because it would be difficult for private entities to compete with the government that regulates them and taxes them and that is exempt from having to pay taxes. I also oppose a mandate in the legislation that would require employers with more than 25 workers provide insurance or pay a penalty, because I believe it will force many small businesses to eliminate jobs.

With a likely cost of more than $1 trillion, I am disappointed that the Committee rejected several amendments designed to reduce frivolous medical lawsuits, which drive up costs and force doctors to order wasteful tests and treatments to cover liabilities.

As part of the legislation, Senate Democrats also have proposed an expansion of Medicaid, which would allow individuals who earn up to 150 percent of the federal poverty level to be eligible for full Medicaid benefits. Currently, Medicaid is available only to those who earn up to 100 percent of the poverty level, so the Democrats’ plan represents a 50 percent increase. When Medicaid was originally created in 1968, Georgia’s total Medicaid spending was nearly $7.7 million, or 1 percent of all state spending. In 2008, Georgia’s total Medicaid spending was over $2.4 billion, or 12 percent of all state spending. This proposal would cost Georgia and other states billions of additional dollars to meet the 50 percent increase to their required share of Medicaid costs.

I believe the key to health care reform is stimulating competition in a market-based system that will encourage private health insurers and managed care providers to compete for business and make health insurance more affordable for consumers. I also think Congress needs to look carefully into proposals that will increase coverage of preventative and wellness care, which will help control the cost of managing chronic disease and drive down the cost of treating largely preventable conditions.

I am a co-sponsor of S.1099, Patients' Choice Act of 2009, which seeks to strengthen the relationship between the patient and the doctor by using choice and competition, rather than rationing and restrictions, to contain costs and ensure affordable health care for all Americans.

The Senate Finance Committee is also drafting a health care bill dealing with how to pay for this massive health care reform. The HELP and Finance committees are working separately, but at some point their two proposals would be merged in some fashion to bring the issue to the Senate floor.

Patients’ Choice Act

I am proud to co-sponsor S.1099, Patients' Choice Act of 2009, which seeks to strengthen the relationship between the patient and the doctor and ensure universal, affordable health care for all Americans by:

Preventing disease and promoting healthier lifestyles
Creating affordable and accessible health insurance options
Equalizing the tax treatment of health care, empowering all Americans with real access to coverage
Modernizing the Medicaid benefit and protecting Medicare beneficiary choice
Ensuring compensation for injured patients
Establishing transparency in health care price and quality

During consideration of overall health care reform legislation, the Patients' Choice Act was offered as a full substitute amendment to the Democrats’ proposal. However, it was defeated in a 14 to 9 vote.

The Patients’ Choice Act would restore fairness in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by:

Decoupling health insurance from an individual’s job by treating the employer-subsidized portion of the benefit as taxable income and replacing it with an advanceable and refundable tax credit of $2,300 per individual or $5,700 per family;
Improving the operation of Health Savings Accounts [HSAs] by allowing health insurance premiums to be paid with HSAs without a tax penalty;
Allowing preventative services to be covered by High Deductible Health Plans; and
Increasing the amount of money an HSA owner may annually contribute to their account.

The Patients’ Choice Act also would create affordable and accessible health insurance options through state or regional health insurance exchanges that offer everyone risk-adjusted private options. State or regional exchanges would not be allowed to discriminate based on pre-existing conditions and participating plans would have to meet the definition of coverage employed in Federal Employee Health Benefit Plans.

The Patients’ Choice Act would establish transparency in health care pricing and quality through the creation of a public-private Healthcare Services Commission that would publish and enforce quality and price information.

The Patients’ Choice Act would alleviate state budget concerns and the stigma of Medicaid by allowing those who chose to enroll switch into higher quality private plans through direct assistance.

The Patients’ Choice Act also encourages increased coordination of federal and state prevention efforts to reduce rates of chronic disease such as heart disease and diabetes.

Medicare Physician Payment Cuts

In December, Congress passed S.2499, the Medicare, Medicaid, and SCHIP Extension Act of 2007, which delayed for a six months a scheduled cut in physician payment rates under Medicare. This delay is set to expire on June 30, 2008. I am well aware of and understand the concerns regarding cuts to physician payments. These annual cuts are the result of a flawed formula – the Sustainable Growth Rate – that regulates physician payment levels under Medicare.

On June 6, 2008, Senate Finance Committee Chairman Max Baucus introduced a bill to delay the scheduled 10.1 percent cut from taking effect for 18 months. However, this bill also contained an unnecessary expansion of certain programs, while simultaneously making inappropriate cuts to programs to pay for the physician update. On June 12, 2008, I voted against the motion to proceed to S.3101, the Baucus bill.

Senate Finance Committee Ranking Member Charles Grassley has introduced an alternative bill that also delays the 10.1 percent cut to physician payments for 18 months but without making the cuts to programs to pay for the physician update. I support Senator Grassley’s alternative bill.

I am very concerned about the prospect of a 10.1 percent cut in physician reimbursement, but I believe Congress must find a fair and responsible solution in the short-term as well as a long-term solution to prevent future cuts from occurring. Physicians deserve this fix, and they also deserve a bill that will be enacted into law. Because I believe these cuts are bad for all Americans, I voted against Senator Baucus’ bill and will lend my full support to Senator Grassley’s alternative.

Stem Cell Research

Stem cell research is one of the most important issues we will deal with and I have tried to approach the debate in as careful a manner as possible. I understand both the potential and promise that such research holds as well as its moral implications. I have consulted preeminent scholars and researchers around the country who are on the verge of breakthroughs in several areas and who believe that embryonic stem cell research could hold the key to their success. In every meeting or conversation I’ve had on this issue, I also have raised the moral implications that concern us all. Certain methods of obtaining embryonic stem cells could destroy a potential life in the process, and that is unacceptable. There are also concerns that this research could lead to human cloning or fetal farming, both of which I adamantly oppose.

I have worked during the past year to draft a solution that would allow this important research to move forward without compromising moral standards. My proposal is based on research that is being conducted at the University of Georgia in which embryonic stem cell lines are created from the natural byproducts of in-vitro fertilization. This byproduct material includes only those embryos that could never become a fetus. This is a good compromise because we receive the benefit of embryonic stem cells without destroying a potential life.

In March 2007, I introduced S.30, the Hope Offered through Principled and Ethical Stem Cell Research (HOPE) Act, with Senator Norm Coleman (R-Minn.). The HOPE Act allows science to move forward in an ethical and moral way by permitting federal funding of scientific research that does not harm embryos, such as deriving cells from amniotic fluid and placentas, and from embryos that have died naturally.

On April 11, 2007, the U.S. Senate approved the HOPE Act by a vote of 70 to 28. I was extremely pleased that an overwhelming, bipartisan majority of my Senate colleagues voted in support of the HOPE Act. The vote was an affirmation of the need to expand embryonic stem cell research. It was also an affirmation that there is a way to expand this important research while still respecting the ethical and moral concerns that exist. The bill now goes to the U.S. House of Representatives, and President Bush has said he will sign the legislation into law if it reaches his desk.

Reauthorization of the State Children’s Health Insurance Program

The State Children’s Health Insurance Program, which is known as PeachCare in Georgia, is expected to be reauthorized, and I am working diligently to help revise the funding formula so that states such as Georgia will receive appropriate compensation for the children they enroll.

I believe formula updates for this program must encourage states to enroll as many eligible children as possible without penalization. Formulary flaws in the past have contributed to programs such as Georgia’s PeachCare running out of money in fiscal year 2007. Although emergency funding was appropriated to fix this shortfall, one of my goals is to ensure this situation does not happen again. The program needs to have updated formulas that reward states for lowering the number of uninsured children and that appropriately allocate funds based on population and growth data.

This program has proven to be a success across all 50 states, and I would like to see to it that the program remains true to its original intent – healthcare access for children.

Medicare

I understand the frustration seniors have with the price of prescription drugs, and I am a strong supporter of access to affordable healthcare coverage. Congress has created Medicare Part D as an option for seniors to help pay for prescription drugs. The Medicare prescription drug plan is the first federally funded insurance program for prescription drugs. Many seniors have signed up for the coverage and have saved money through these plans.

Under Medicare Part D, public hospitals, private providers, insurance companies and pharmacies all negotiate their drug prices with drug manufacturers. With so many providers negotiating with drug companies, you get maximum competition and better prices. Open market negotiations cause the companies wagering for Part D plan coverage to provide the best possible price. Through this competition, the private sector has provided drug coverage for amounts under $5,100 a year.

The program has recently seen great success. Through competition, providers are competing for the lowest price and premiums are down 30 percent since the bill went into effect. Thanks to the Medicare Modernization Act, seniors are able to access a prescription drug plan that provides the most choice at the best possible price.

I am aware that a small group of seniors have been caught in the so-called ‘doughnut hole’ and I will work to remedy the situation. The doughnut hole is a gap in coverage that occurs when the beneficiary spends more than $2,250 and must pay 100 percent of drug costs until they reach $5,100. Once they reach that threshold, they are only responsible for 5 percent of their drug costs and Medicare will pay for the rest. An estimated 92 percent of Medicare beneficiaries will never enter the Medicare drug benefits coverage gap and every beneficiary enrolled in a drug plan is protected against catastrophic expenditures.

I am sympathetic to those who are facing this financial burden, and I am working with my colleagues to see that every senior has access to affordable healthcare. Some options to help with these costs are listed on the Center for Medicare and Medicaid Services webpage at www.cms.hhs.gov.

Drug Reimportation

I am concerned with the high price of prescription drugs but I disagree that importing drugs from other countries is the answer. I will always support policies that protect consumers by requiring all prescription drugs to be approved for safety measures, regardless of its country of origin. I believe a ban on importation is appropriate unless the Secretary of the Department of Health and Human Services can ensure the quality and safety of imported drugs. As the world leader in healthcare innovation, the United States is looked to for standards of safety. The Food and Drug Administration has a duty to preserve our standards by providing that all drugs purchased and brought into the United States are safe.

Health Insurance for Small Business

I know firsthand how difficult it is for small businesses to provide health insurance to their employees because I faced the same challenge when I ran a small business, Northside Realty in Atlanta, for more than 20 years. Today, 44 million Americans lack health insurance, and 62 percent of those uninsured are either employed by a small business or dependent on someone who is.

I support legislation that would allow small businesses to pool together, nationally, to create Association Health Plans and either purchase their health insurance from a provider, or self insure in the same way that large employers and unions currently do. This would give small businesses the same market-based advantages and competitive leverage that large employers and unions enjoy when providing employees health insurance. It would also open the doors to affordable health insurance to millions who have to this day gone without, as well as helped to stem the tide of rising health care costs.