Bill provides accessibility, affordability

The numbers show the true cost of maintaining the status quo. There are 50 million people in America living without health insurance, 82 percent of whom have a job.  Those families fortunate to have health insurance pay an average of $1,017 more each year in health insurance premiums to cover the cost of treating the uninsured. With 1,040 people in the state of Michigan alone losing their healthcare coverage each week, this disparity will only continue to grow without comprehensive reform.

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One reason costs have skyrocketed unchecked is a lack of competition within the health insurance industry. In 21 states the two largest health plans control 70 percent or more of the health insurance market. This amounts to a virtual monopoly on health insurance coverage.

H.R. 3962 works to remedy this lack of competition in several ways. First, the bill repeals the antitrust exemption for the health insurance industry, which has been in place since the McCarran-Ferguson Act was passed by Congress in 1945. This exemption was intended to be temporary, but has remained in place. Its repeal is long overdue.  

Second, the creation of the health insurance exchange will provide individuals who do not receive insurance through their employer or who cannot afford health insurance coverage with access to a one-stop shop for private plans as well as a public health insurance option. This option will help to generate the competition necessary to help drive down the cost of health insurance, while ensuring variety and choice.

H.R. 3962 also addresses regional disparities in Medicare reimbursement rates. I was proud to be part of the Quality Care Coalition, which worked with House leadership to add language to H.R. 3962 that would change Medicare reimbursement to be based on quality rather than utilization. We need to pay healthcare providers for how healthy we are rather than on how many tests our doctors perform.

The bill includes other significant improvements to Medicare, such as additional prescription drug coverage beginning next year and completely closing the “donut hole” by 2016. Seniors on Medicare will also, for the first time ever, have preventative care such as checkups and routine exams covered at 100 percent cost.  These provisions will help to lower costs and make healthcare more accessible for all Americans.

H.R. 3962 also provides an important provision to continue a long-standing federal policy of prohibiting federal funding for abortion. Over 30 years of precedent supports adding the Hyde language to this bill.

While there has been much controversy surrounding my amendment I want to be clear about what it does, and does not do.

Under the Stupak-Ellsworth-Pitts amendment, only the public health insurance option and private plans that receive federal subsidies will be prohibited from covering abortion services. Individuals not receiving public funds to buy their health insurance policy are free to purchase a policy that covers abortion services just as insurance companies are free to offer them. Individuals receiving federal subsidies to purchase a plan in the public option or on the exchange cannot use those subsidies to purchase a plan that provides abortion services. However, these individuals may purchase a supplemental policy with private money should they choose. Nothing in this amendment prohibits private companies participating in the exchange from offering abortion services or prevents individuals purchasing their plan with private money from choosing a plan with abortion services.

Contrary to what some have said, this amendment explicitly provides exceptions that allow all policies to cover abortion services in the case of rape, incest or life of the mother.

Many have argued the Capps amendment, as written in H.R. 3962, would have been sufficient to comply with the Hyde language by separating federal dollars from private dollars and allowing only the private funds to pay for abortions. But under Hyde, there have never been two separate pots of money.

The Federal Employees Health Benefits Program (FEHBP) is a good example of this. Federal employees pay a portion of their premium each month, and the federal government pays the balance. Hyde language does not allow these employees to apply a portion of their premium contributions to abortion services. Because the policies are partially paid for by the taxpayers, no coverage of abortion services is permitted. This is a very clear precedent that would have been overturned under Capps language.

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My goal has always been to ensure that the voices of the majority of Americans who oppose federal funding for abortion were heard in this important healthcare debate, a point I have been making since July. With 64 Democrats voting for our amendment and 67 percent of Americans opposed to using federal funds for abortion, our amendment is in line with current policy. Further, House passage of healthcare reform legislation would never have passed without our amendment.

The U.S. Senate must now act and tackle many of the same issues that were the topic of a great deal of debate and discussion in the House. It is my hope that the Senate will act quickly and we can send President Barack Obama a bill that he can sign into law to provide access to quality, affordable healthcare for all Americans.

Stupak is a member of the House Committee on Energy and Commerce.