The uninsured in America are hard to characterize. The very young are covered by the Federal Children’s Health Insurance Plan (CHIP) and state programs. The elderly are covered by Medicare, and the very poor are covered by Medicaid. The greatest number of uninsured Americans fall between 125 percent and 300 percent above the poverty line. Most are employed and most are between the ages of 18 and 34. They are without insurance for a variety of reasons, ranging from the fact that their employer may not offer it to their own decision not to purchase it.
Because of the diversity of this group, it is difficult for the federal government to target subsidies or programs – the only common characteristic of these individuals is that they do not have insurance. Therefore, I am working on several different ideas to help people get the quality health coverage they need.
Helping the Uninsured. I believe Congress should work to remove obstacles to accessible, affordable quality health care. To this end, I support legislation that would provide the self-employed and the uninsured greater access to health care through Medical Savings Accounts (MSAs), 100% tax deduction of premiums for the self-employed and uninsured, 100% tax deduction for long-term care, the creation of community health center networks for medically underserved areas, and the ability for self-employed and small businesses to jointly purchase coverage through Association Health Plans (AHPs).
Encourage Innovative State Programs. In addition, I believe in the importance of innovative state programs such as the highly successful BadgerCare program, which was established under former Governor Tommy Thompson, to assist lower-income working families. The program provides health care for children and their parents who are currently uninsured, but who are not eligible for Medicaid. In the last Congress, I included a congressional resolution within the federal budget that passed the House calling on former U.S. Department of Health and Human Services (HHS) Secretary Donna Shalala to expedite a waiver that would permit Wisconsin to expand BadgerCare coverage to include all eligible persons. I am happy to report that Wisconsin was finally granted the waiver to expand this program this year.
Patient’s Bill of Rights. With 44 million uninsured people in the United States, it is clear that we must overcome the obstacles of accessibility and affordability of quality health care and provide additional choice in delivering needed health services. In addition, we must ensure that managed care providers are held accountable for the decisions they make in treating patients. As we work to meet these challenges, we must strike a delicate balance to encourage the continued availability of coverage through employers and maintain the doctor-patient relationship, while expanding coverage options for the uninsured.
The Patient’s Bill of Rights legislation, H.R. 2563, would improve the quality of Americans' health care by providing patients the right to independent medical review for denials of medical care by their health plan. It also gives patients new legal options for holding their health plans accountable when they have been hurt by wrongful denial or delay of medical care. The House and Senate have both passed their versions of the Patients’ Bill of Rights and are currently working on reconciling the differences in the two pieces of legislation.
The House bill discourages excessive lawsuits that would increase health care costs, by first directing patients to an independent medical review of health care decisions by a medical team of experts before they may seek expanded damages in court from their HMO or their employer. This process puts patients and doctors in charge of their health care, not the government, insurance companies, trial lawyers or the courts.
Independent medical review prior to court action is vitally important. In order to ensure that workers maintain health care coverage from their employers, protecting employers against unfair liability must be part of any patient protection legislation. Currently, three-fourths of Americans are insured by their employers, and keeping costs to employers low will encourage them to continue offering health benefits or to expand benefits. On the other hand, if they are exposed to liability for simply offering health insurance, small and medium-size businesses would face an impossible choice. Being one lawsuit away from bankruptcy, most of these businesses would likely stop offering health benefits to their employees. Moreover, one big lawsuit could leave their employees not only without health care, but also without jobs.
Finally, to encourage employers to offer more health insurance, the Patient’s Bill of Rights Act also strives to make health care more accessible and affordable by: