Energy and Commerce Committee Markup of H.R. 3200

America's Affordable Health Choices Act of 2009

July 16, 2009

            More than 47 million Americans do not have health insurance, and millions more are underinsured and cannot afford to pay for the medical care they need.

            Due to the cost shifting that comes from treating the uninsured in emergency rooms, the costs imposed on private health insurance, Medicare, and Medicaid are enormous and are growing each year as the numbers of uninsured Americans increases. Society as a whole bears the costs.

            The status quo is unsustainable. We need to assure affordable access to health care for all Americans. The cost of taking that step will be less than the cost of doing nothing.

            And so I support the approval by this Committee of a health care reform.

            But the bill before us is a long way from where I think it needs to be.

            I am skeptical of a government operated health care plan. I prefer the creation of a health care cooperative, owned and operated by its members, which would compete with private, for-profit health care plans. As a non-profit, the cooperative would effectively serve as a check on the cost of health insurance generally.

            Use of a cooperative instead of a public plan would also enhance our prospects of obtaining bi-partisan support for the reform effort. On a matter of this scope and importance to all Americans, I think that every reasonable effort should be made to enlist our Republican colleagues in drafting and passing the bill.

If there's going to be a public plan, its reimbursements for health care services should not be based on Medicare reimbursement rates.

The hospitals in my district and across rural America struggle financially. Medicare does not currently pay them what it costs to provide patient care. They depend on privately insured patients to remain financially viable. If a public plan using Medicare reimbursement rates undermines the private insurance market, the struggling rural hospitals could close.

I have other concerns, including the need to do more to raise Medicare reimbursements for services delivered by rural providers.

I hope that over the coming week, the Committee will be responsive to these concerns.