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Health Care
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Mike believes improving health care is one of the most pressing issues facing our nation today, and he is committed to promoting a health care system with lower prices, better access, and full coverage. He has sponsored a number of bills that impact a wide variety of important health care issues, including disease prevention, public health efforts, expanded access to care, and increased access to affordable prescription drugs.
REFORMING HEALTH INSURANCE
The final package the President signed into law gives patients and doctors more control over health decisions, not insurance companies, and ends practices like denying coverage for pre-existing conditions and dropping patients when they become sick. It also provides valuable tax credits to individuals and small businesses to help them purchase health insurance. And it will set up insurance exchanges that will provide small businesses and families additional choices and the purchasing power that only big businesses currently enjoy. Though the final bill didn’t accomplish everything that everyone would have preferred, Mike believes that it is something that we can build on.
- Repealing Health Care Reform: What it Means for Maine
- HealthCare.gov – Official government site, which provides information on finding insurance options, prevention, comparing care quality and understanding the new law along with FAQs
- AARP feature – to better help AARP members understand the details of the new reform law and how it applies to them
- Small Business Majority's Health Insurance Premium Tax Credit Calculator
MAKING THE HEALTH INSURANCE INDUSTRY MORE COMPETITIVE
One way that we can make the health insurance industry more competitive and make health insurance more affordable is by repealing the section of the McCarran Ferguson Act which exempts the insurance industry from federal anti-trust laws. There is no reason that the insurance industry is better than, or different from, all other businesses in the United States that have to comply with federal anti-trust laws. The government should not be picking winners or losers. Rather, all businesses should be on an equal playing field in the eyes of the law.
For that reason, Mike supported a bill in the 111th Congress that would remove this anti-trust exemption for the health insurance industry. It passed overwhelmingly in the House by a vote of 406 – 19, but the Senate never acted on the legislation. In the 112th Congress, Mike is a cosponsor of the bill, H.R. 1150, the Competitive Health Insurance Reform Act and will fight for its passage.
Removing this antitrust exemption will allow the federal government to prosecute health insurance companies for any anti-trust activities. Because health insurance companies now use collusion and other practices to discriminate against individuals and provide limited or no care, this bill will increase competition among health insurance companies and increase access to affordable health care.
WORKING TO MAKE PRESCRIPTION DRUGS MORE AFFORDABLE
Unbelievably, the United States is the only industrialized nation that does not negotiate for lower cost prescription drugs. The first bill Mike introduced after coming to Congress was a national version of the innovative Maine Rx law, called America Rx. The idea behind America Rx was to allow the federal government to negotiate with the pharmaceutical industry for lower prices. The bill used the power of the free market and volume purchasing to make medicines more affordable.
Leaders in Congress recognized that this approach made commonsense. On January 12th, 2007, the House of Representatives passed H.R. 4, the Medicare Prescription Drug Price Negotiation Act, which directs the Secretary of Health and Human Services to negotiate with drug companies for lower drug prices for Medicare beneficiaries. Unfortunately H.R. 4 died in the Senate. Most recently, the House health insurance reform bill required the Secretary of Health and Human Services to negotiate drug prices on behalf of Medicare beneficiaries. Mike is committed to this cause and will continue to fight for these important changes so that overall health care costs and the prices that seniors pay for their medications can be reduced.
In addition to his efforts in Congress, Mike has worked to bring low-cost medicine directly to Mainers. In 2003, in the wake of massive job losses throughout the state, Mike joined with Senator Snowe to ask the Pharmaceutical Research and Manufacturers of America (PhRMA) to help Mainers gain access to lower cost medicines. The result was Rx Cares for ME, a joint effort between PhRMA and a number of Maine health organizations designed to give Mainers a single, central point of access for patient assistance programs. Through Rx Cares for ME, Mainers can determine if they are eligible for hundreds of programs that provide thousands of medicines free or at a reduced cost. Applicants are asked four simple eligibility questions, and are then given assistance in the application process in any programs for which they meet the eligibility requirements.
PROTECTING MEDICARE & MEDICAID
Mike is a staunch opponent of privatizing Medicare. He also opposes the idea of turning Medicaid into a block grant program. Both of these ideas are the centerpieces of the Republican Fiscal Year 2012 budget, which Mike opposed when it came to the floor in the House for a vote.
Mike knows there is no question that we must rein in our debt, but he thinks we should do so in a balanced way that doesn’t threaten our economic recovery or place overwhelming burdens on our most vulnerable citizens. The 2012 budget bill would turn Medicare into a voucher program, leaving seniors to fend for themselves in the health insurance market. In fact, the non-partisan Congressional Budget Office estimates that the budget plan would double or even triple seniors’ Medicare costs. It will also severely undermine Medicaid, which is a major way seniors are able to receive long-term care. But it does all this while barely reducing defense spending, cutting taxes for the wealthiest Americans, and continuing unaffordable subsidies for major oil companies.
Making sure that Medicare beneficiaries have access to quality care has always been one of Mike's primary concerns. Mike has been fighting to make sure that rural providers are treated fairly by ensuring fair and adequate payments for Maine physicians who participate in Medicare and Tricare. He supported the “Medicare Physician Payment Reform Act of 2009,” to prevent scheduled cuts to Medicare and Tricare reimbursement rates. This bill represents a step in that process, and it will help ensure that providers in rural areas get reimbursed at a rate that allows them to continue to provide care to our seniors and military families.
Mike believes that the passage of this bill was important because it will ensure Medicare beneficiaries are able to continue to see the doctors that they trust. By improving payments, this bill helps ensure that community hospitals, critical access hospitals, and ambulances can continue to provide much-needed services to Maine residents.
Mike has also worked to successfully block damaging Medicaid regulations, which would have slashed Medicaid funding by billions and put in jeopardy needed services and protections for millions of vulnerable beneficiaries.
LEADING THE CHARGE TO IMPROVE HEALTH CARE FOR VETERANS
As the previous Chairman (currently Ranking Member) of the Veterans' Affairs Committee's Subcommittee on Health, Mike has taken a leadership role in promoting the wellbeing of our nation's veterans. The subcommittee has legislative and oversight jurisdiction of the Department of Veterans Affairs' health care system, programs, and research apparatus. From his position as Chairman, Mike has successfully fought for an increase in the VA health care budget, passed several bills to improve health care for veterans, and continues to provide necessary oversight of the VA health care system.
Congress passed into law a bill Mike helped author called the “Joshua Omvig Veterans Suicide Prevention Act,” which established a comprehensive program to reduce the incidence of suicide among veterans. The House also passed another bill Mike authored called the “Traumatic Brain Injury (TBI) Health Enhancement and Long-Term Support Act,” which would develop a comprehensive program for the long-term traumatic brain injury rehabilitation. This work is the result of the efforts of members from both sides of the aisle to address TBI and to begin to improve the outreach and oversight of health care provided to our rural veterans. And most recently, the VA implemented a new program to assist the home caregivers of veterans, which was the result of a bill Mike authored and passed into law in May of 2010.
PROMOTING COMMUNITY HEALTH CENTERS
Mike is a strong supporter of our country’s community health centers. Community health centers provide much needed care for our most vulnerable populations in medically underserved areas. In the current economic climate, they are crucial to providing health care services to the uninsured and underinsured.
Community health centers, which have been leading the charge in integrated, cost containing health care, offer a range of services, including: primary care, mental health care, substance abuse treatment, oral health treatment, and pharmacy services.
The Recovery Act provided funding to the community health centers at a crucial time in our economy. This funding created much-needed jobs and expanded access to health care for the unemployed and uninsured. To see how that funding was spent in Maine, click HERE.
INCREASING ACCESS TO HEALTH CARE FOR CHILDREN
The State Children's Health Insurance Program (SCHIP) was created to provide health care coverage to children in families who earn too much to qualify for Medicaid, but not enough to afford private insurance. Many families in Maine benefit from SCHIP.
Without health coverage, many children get their care through emergency rooms - the most expensive way to get care - or even worse, they get no care at all and the long-term bills for their health care get much higher. In the long run, study after study shows that a healthy child is more likely to succeed in education and in life. Covering kids is an efficient use of tax dollars and a great investment in the future productivity of our nation.
Mike has been a strong supporter of expanding SCHIP so that no child in Maine goes without medical care. On February 4, 2009, H.R. 2, the State Children’s Health Insurance Program (SCHIP) Reauthorization, became law. The bill provides health care coverage for 11 million children – preserving coverage for the 7 million children currently covered by SCHIP and extending coverage to 4 million uninsured children who are currently eligible for, but not enrolled in, SCHIP and Medicaid.
SUPPORTING PREVENTATIVE HEALTH CARE
Mike strongly believes that preventive health care must be an integral part of our health care system. The United States spends almost all of its health care dollars on treatment and only about 1% on prevention. Experts agree that if we really want to start cutting back on the cost of health care, a robust investment in prevention would be a good place to start. Not only does preventive care results in healthier patients, but it is also a cost containment measure.
Mike has supported efforts to provide health insurance premium discounts for healthy behaviors such as quitting smoking, reducing blood pressure, lowering cholesterol, and lowering body mass index. Legislation like this will encourage healthy lifestyles and lower health care costs.
Mike is also a strong supporter of measures that promote preventative health care, including the Preventive Health and Health Services Block Grant (PHHS) program. The PHHS program was created to give states the flexibility to tailor prevention and health promotion programs to their particular needs. According to Maine's CDC, the funding obtained through these grants helps provide vital services such as laboratory testing diseases, enhanced surveillance for rabies, and coordinated health programs for children. The funding also goes toward ensuring that people can access preventive health services, improving the collection of disease and health data, providing education to improve public health, and targeting resources to assist populations at high risk for disease and injury.
FINDING A SOLUTION TO MEDICAL MALPRACTICE
Rapidly rising medical malpractice insurance premiums are crippling medical practices all across America. Immediate steps must be taken to end frivolous lawsuits and reduce premiums to ensure that physicians in Maine can do what they do best - practice medicine.
To remedy this problem, Mike believes that we must have a comprehensive and effective solution to help weed out frivolous lawsuits with a stringent pre-trial review process and with post-trial sanctions in cases where claims are found to be without merit. It is also important to repeal the federal antitrust exemption for medical malpractice insurance companies in order to increase competition and decrease premiums, and Mike believes that we should require insurance companies to pass along savings to their customers, rather than use high premiums as a tool to drive profits. Finally, Mike believes that we need to support doctors who want to practice in fields with higher risks by providing grants so they can practice in all fields and areas, and so that all patients have access to high quality health care.
Mike remains firmly committed to protecting physicians and other health care providers in Maine from rising malpractice premiums, and will work with his colleagues to find a balanced approach that attacks the problem on all fronts.
SUPPORTING MAINE HEALTH CARE ADVANCES
Over the years, Mike has helped secure over $5.6 million in funding for the Maine Institute for Human Genetics and Health (MIHGH). The Institute's three partnership institutions -- Eastern Maine Healthcare Systems (EMHS), The Jackson Laboratory, and the University of Maine Graduate School of Biomedical Sciences -- attract nationally ranked scientists, research grants, students and faculty. The Institute is considered a natural progression of the pioneering work created by these three entities to help lower health care costs. The Institute is working to produce new medical breakthroughs that can move from the laboratory to human populations, especially aging and chronically ill populations in rural Maine. This research could improve the health status and lower health care costs in rural Maine.
PROMOTING MENTAL HEALTH PARITY
Under the Paul Wellstone Mental Health and Addiction Equity Act, an insurer or group health plan must ensure that any financial requirements -- such as deductibles, co-payments, coinsurance, and out-of-pocket expenses -- applied to mental health and addiction benefits are no more restrictive or costly than the financial requirements applied to comparable medical and surgical benefits that the plan covers. Mike has been a long time supporter of this legislation and worked hard to get it signed into law. The State of Maine already requires full mental health parity, but this bill followed the good work of Maine in making it a national law.
ADDRESSING SUBSTANCE ABUSE
Many communities in Maine are fighting substance abuse. Our friends, relatives, neighbors, and co-workers may be secretly fighting addiction today without anyone's knowledge. As a member of the Addiction, Treatment and Recovery Caucus, Mike is fighting in Congress to increase funding for substance abuse prevention as well as addiction recovery.
Mike has cosponsored a number of important bills to increase access to treatment, including the Paul Wellstone Mental Health Equitable Treatment Act, which became public law on October 3, 2008. This bill will improve insurance coverage for substance abuse treatment, bringing them up to par with other medical and surgical benefits. Without parity in insurance coverage, treatment is often unaffordable and underutilized, worsening the dependence on the substances and increasing the cost to society.
These are important steps in promoting recovery, but prevention must also be a focus. With assistance and access to treatment and support groups, addiction can be overcome, but there must be help from a supportive group. Mike believes strongly that addiction and substance abuse are not problems that we can afford to ignore.