Last year Congress allowed partisanship to sidetrack managed care reform. I don't believe the rank and file - or the leadership of either party - wants to see that happen again. It won't do for us to pass anything with a vote split along party lines. We tried that last year, and the Senate used it as an excuse to pass nothing. We need 300 votes behind whatever reform we approve. For that purpose, I have introduced new health care legislation that doesn't have a thing to do with patient rights or standards in health insurance.

I introduced the Access to Quality Care Act, or AQCA, to address patient rights on January 6 of this year- the first day of the session. At that time, I pointed out that AQCA contained nothing about the affordability of health insurance, or the fact that 43 million Americans have no health coverage. ACQA deals with the quality and accountability of health insurance. The Affordable Health Care Act introduced this week deals with whether people have insurance to begin with. The two bills are mutually exclusive, equally important, and dependent on each other to be fully effective.

Most Americans have health insurance. Unfortunately, for many of them, it doesn't do any good when they become seriously ill, and their plan refuses to pay for the treatment promised in their contract. The plan could be the most affordable policy on the market, and it's still worthless if it won't allow the patient to receive care. That's what AQCA corrects.

Likewise, we can mandate the finest health plans in the world, that pay 100% of any treatment we desire, and it won't do any good if no one can afford the premium. This is what the Affordable Health Care Act corrects.

The bills are mutually exclusive because if we try to combine both in a single bill we guarantee failure. In comparing AQCA to the other competing reform bills in the House and Senate, you'll find at least 27 separate provisions to compare. We face a monumental political task in finding 300 members of the House to agree on which of those 27 patient rights provisions to pass. But we can do it.

Add in another half dozen provisions on affordability, and the task becomes impossible. The Affordable Health Care Act therefore delinks the issues of patient rights from that of affordability.

This bill will provide the typical family of four, that does not have employer-sponsored health coverage, $3600 a year in tax credits to purchase insurance. Families who already have employer coverage would receive up to $1200 a year tax credit to help cover their matching contributions, or to upgrade their health plan. The tax credit would be administered immediately by the insurance company, so the day this bill became law a family could join a health plan, and the plan would be responsible for claiming the credit. Year-end tax credits don't do a bit of good for families on the lower rungs of the economic ladder, so this bill provides the insurance coverage up-front.

This provision has not been scored by CBO, so we don't know the full cost. It is expected to run in the same range as allowing 100% tax deductibility for all health premiums, but this approach will take a much bigger bite out of the number of the uninsured.

Small to mid-size businesses would be able to combine resources in both local and national insurance pools. The basic concept is taken from last year's proposals to create HealthMarts and Association Health Plans, or AHP's. The difference with this bill is that both pools would have to offer a choice of plans, some governed entirely under state law, with no exemptions, and some governed under ERISA. The state-governed plans would offer all the benefits and protections provided by the particular state, while the ERISA plans would offer the guaranteed-issue, community rated requirements of section 702 of ERISA.

These pools would allow companies with as few as 2 employees to have access to group rates, and either full state protections, or whatever new federal protections we pass this year in addition to guaranteed coverage regardless of pre-existing health conditions. The choice between the plans would be entirely up to the employee, who could make their decision based on their family's specific health care needs.

But this bill goes further than simply allowing the consumer to choose between state or federally-governed plans. It begins the process of correcting the basic problem that created ERISA - the problem of health insurers having to deal with 50 different sets of state laws in order to sell a policy nationwide.

In 1974, Congress addressed this problem by overruling the health insurance laws of all 50 states and replacing them with nothing. That was wrong. But in fairness to that Congress, to do nothing to reduce the regulatory cost of health care would have been wrong as well.

What should have been done? Provide uniform standards developed and governed by the states, without the interference of the federal government. We do so with business transactions through the Uniform Commercial Code; we should have done so with health care.

The federal government, because of ERISA, now has to be involved in taking us back to square one. This bill provides the starting point through the formation of AHP's. In addition to requiring AHP's to offer both state and federal plans, the Affordable Health Care Act requires the Secretary of Labor to work with the National Association of Insurance Commissioners to develop uniform standards to be approved and administered at the state level.

It is my hope that in the near future, insurers will enjoy the same ability as currently contained in ERISA to sell uniform plans nationwide, while being governed entirely by the states. If we are successful, we will have permanently eliminated the need for unnecessary federal regulatory intrusion into health care. There will be no significant financial incentive for an insurer to circumvent state protections behind the federal shield of ERISA.

This bill also expands availability of Medical Savings Accounts, or MSA's. The offering of these innovative health plans are currently severely restricted by Congress. The Affordable Health Care Act slashes the deductibles in half, and eliminates the cap on the number of people who can enroll in the plans. This creates a financial incentive for the health insurance industry to aggressively market the option.

These are the major points of the Affordable Health Care Act. But I need to point out that there is a key strategic difference between this bill and AQCA. Under AQCA, there are definite lines in the sand. We must restore full accountability to ERISA plans by eliminating the preemption of state medical malpractice law. We must provide families with a real choice of doctor and hospital. We must provide somewhere to turn in disputes other than the courts, through independent appeals. If we don't do all three, we may as well do nothing.

However, under the Affordable Health Care Act, I am drawing no lines in the sand, other than that we absolutely delink the issues addressed in these two bills. I am asking all interested parties to come forward with suggestions on how to make this bill better. I will listen, and if there are better ideas, I will gladly put them to use.

I am asking the leadership of both parties to push for this new bill to be immediately assigned to the appropriate committees, vigorously debated, amended if necessary, and if approved at the committee level, moved to the floor for a vote. It is the same request I have made for AQCA.

If we pass both, I believe we will provide the patient protections called for not only in AQCA, but also in the Patient's Bill of Rights, the President's Advisory Committee, the Patient Protection Act, the Managed Care Reform Act, the Jefford's, Graham, and Chaffee bills, and the Senate GOP plan. All while reducing the cost of health premiums, and providing health insurance for tens of millions of Americans who are without coverage.

There are 300 votes out there for the provisions in AQCA, as long as we keep the issue of affordability out of the debate. Likewise, there are 300 votes out there for these affordability measures as long as the patient rights issues are not attached. Mix the two and we kill both; split them and we pass both. We know that from last year's experience with the Patient Protection Act.

Last year, we didn't have a choice. This year, with these two bills, we do -- if members of both parties are willing, for once, to put principle above politics.

Sincerely,

P.S. I hope you don't mind, but I'm sending this letter to every newspaper in our district, and to the globalist crowd here in Washington just to let them know somebody's watching.