Christopher Smith on Health Care
Republican Representative (NJ-4)
[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.
[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.
Opponent's Arguments for voting No:
[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.
[Sen. Merkley, D-OR]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Proponent's Argument for voting Yes:
[Rep. Pitts, R-PA]: Section 4002 of PPACA establishes a Prevention and Public Health Fund, which my bill, H.R. 1217, would repeal. The PPACA section authorizes the appropriation of and appropriates to the fund from the Treasury the following amounts:
Opponent's Argument for voting No:
[Rep. Waxman, D-CA]: This bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation.
Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.
Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.
Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.
Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.
Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.
Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.
SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. PALLONE. This is a comprehensive bill which will establish full mental health and addiction care parity. The Mental Health Parity Act of 1996 authorized for 5 years partial parity by mandating that the annual and lifetime dollar limit for mental health treatment under group health plans offering mental health coverage be no less than that for physical illnesses. This bill requires full parity and also protects against discrimination by diagnosis.
OPPONENT'S ARGUMENT FOR VOTING NO:Rep. DEAL of Georgia: I am a supporter of the concept of mental health parity, but this bill before us today is not the correct approach. This path will raise the price of health insurance, and would cause some to lose their health insurance benefits and some employers to terminate mental health benefits altogether.
The bill's focus is also overly broad. Our legislation should focus on serious biologically-based mental disorders like schizophrenia and bipolar disorder, not on jet lag and caffeine addiction, as this bill would include. There are no criteria for judicial review, required notice and comment, or congressional review of future decisions.
I would ask my colleagues to vote "no" today so that we can take up the Senate bill and avoid a possible stalemate in a House-Senate conference on an issue that should be signed into law this Congress.
LEGISLATIVE OUTCOME:Bill passed House, 268-148
CONGRESSIONAL SUMMARY: This Act would enroll all 6 million uninsured children who are eligible, but not enrolled, for coverage under existing programs.
PRESIDENT'S VETO MESSAGE: Our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. My Administration strongly supports reauthorization of SCHIP. [But this bill, even with changes, does not meet the requirements I outlined].
It would still shift SCHIP away from its original purpose by covering adults. It would still include coverage of many individuals with incomes higher than the median income. It would still result in government health care for approximately 2 million children who already have private health care coverage.
SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill protects health insurance coverage for some 6 million children who now depend on SCHIP. It provides health coverage for 3.9 million children who are eligible, yet remain uninsured. Together, this is a total of better than 10 million young Americans who, without this legislation, would not have health insurance.
The bill makes changes to accommodate the President's stated concerns.
Proponents support voting YES because:
Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:
Opponents recommend voting NO because:
Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:
Veto message from President Bush:
Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.
Proponents support voting YES because:
This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.
It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.
Opponents support voting NO because:
Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.
Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
OFFICIAL CONGRESSIONAL SUMMARY:
EXCERPTS FROM CONGRESSIONAL FINDINGS:
LEGISLATIVE OUTCOME: Referred to the House Committee on the Judiciary; never called for a House vote.
The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.
The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.
Amends the Public Health Service Act to require the Secretary of Health and Human Services to:
Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.
The Club for Growth's "Repeal-It!" Pledge for incumbents states, "I hereby pledge to the people of my district/state to sponsor and support legislation to repeal any federal health care takeover passed in 2010, and replace it with real reforms that lower health care costs without growing government."
Medicare Access to Rehabilitation Services Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to repeal the cap on outpatient physical therapy, speech-language pathology, and occupational therapy services of the type furnished by a physician or as an incident to physicians' services.
SEC. 2. OUTPATIENT THERAPY CAP REPEAL.
Section 1833 of the Social Security Act (42 U.S.C. 1395(l)) is amended by striking subsection (g).
[Explanatory note from Wikipedia.com "Therapy Cap"]:
In 1997 Congress established per-person Medicare spending limits, or "therapy cap" for nonhospital outpatient therapy, but responding to concerns that some people with Medicare need extensive services, it has since placed temporary moratoriums on the caps. The therapy cap is a combined $1,810 Medicare cap for physical therapy and speech language pathology, and a separate $1,810 cap for occupational therapy ($1870 for 2011). Medicare patients requiring rehabilitation from disabilities, car accidents, hip injuries, stroke, and other ailments would be limited to roughly two months worth of treatments at an outpatient therapy clinic. Any patients that exceed the cap, whether they are healed or not, would have to stop therapy, or pay for the therapy services out of their own pocket.Several medical associations have lobbied against therapy caps because the bill inadvertently restricted disabled seniors, stroke patients, and other severe cases from receiving therapy treatments.
Congressional Summary:The purpose of this Act is to increase diagnosis of Alzheimer's disease and related dementias, leading to better care and outcomes for Americans living with Alzheimer's disease and related dementias. Congress makes the following findings:
Proponent's argument for bill: (The Alzheimer's Association, alz.org). The "Health Outcomes, Planning, and Education (HOPE) for Alzheimer's Act" (S.709/H.R. 1507) is one of the Alzheimer's Association's top federal priorities for the 113th Congress. The HOPE for Alzheimer's Act would improve diagnosis of Alzheimer's disease and increase access to information on care and support for newly diagnosed individuals and their families. It would also ensure that an Alzheimer's or dementia diagnosis is documented in the individual's medical record.
Heritage Action Summary: This vote would fully repeal ObamaCare.
Heritage Foundation recommendation to vote YES: (2/3/2015): ObamaCare creates $1.8 trillion in new health care spending and uses cuts to Medicare spending to help pay for some of it. Millions of Americans already have lost, and more likely will lose, their coverage because of ObamaCare. Many Americans have not been able to keep their doctors as insurers try to offset the added costs of ObamaCare by limiting the number of providers in their networks. In spite of the promise, the law increases the cost of health coverage.
Secretary of Labor Robert Reich recommendation to vote NO: (robertreich.org 11/22/2013): Having failed to defeat the Affordable Care Act, Republicans are now hell-bent on destroying the ObamaCare in Americans' minds, using the word "disaster" whenever mentioning the Act, and demand its repeal. Democrats [should] meet the Republican barrage with three larger truths:
Legislative outcome: Passed House 239-186-8; never came to a vote in the Senate.
A bill to amend title 10, United States Code, to provide for the treatment of autism under TRICARE. Revises TRICARE (a Department of Defense [DOD] managed health care program) to authorize treatment of autism spectrum disorders, if a health care professional determines that such treatment is medically necessary.
Stop Federal Vaccine Mandates for Employees Act: No emergency standard may require any drug or vaccine or other biological product to be administered to any employee.
White House Press Release by President Joe Biden on Vaccination Requirements (Nov. 4, 2021; these emergency standards prompted H.R.6304): For our country, the choice is simple: get more people vaccinated, or prolong this pandemic and its impact on our country. The virus will not go away by itself, or because we wish it away: we have to act. Vaccination is the single best pathway out of this pandemic. And while I would have much preferred that requirements not become necessary, too many people remain unvaccinated for us to get out of this pandemic for good. So I instituted requirements--and they are working. They protect our workers and have helped us reduce the number of unvaccinated Americans from approximately 100 million in late July when I began requirements to just about 60 million today. Vaccination requirements are good for the economy. They help send people back to work--as many as 5 million American workers. They make our economy more resilient in the face of COVID and keep our businesses open.
WFMZ-TV 69-News, "Trump's endorsement of vaccines aligns with most Republicans' views," (Dec. 24, 2021): Trump confirmed that he had been vaccinated and had gotten a booster shot, attracting boos from some audience members. Trump stated his opposition to vaccine mandates but again touted the shot's efficacy. "The vaccine worked. But some people aren't taking it. The ones that get very sick and go to the hospital are the ones that don't take the vaccine." While Trump didn't acknowledge it, most unvaccinated Americans now belong to or lean toward the GOP. In the most recent CNN poll, Republicans and Republican-leaning independents make up a solid majority of the relatively small bloc of US adults still entirely unvaccinated against Covid.
|2021-22 Governor, House and Senate candidates on Health Care:||Christopher Smith on other issues:|
|Republican Freshman class of 2021:
AL-1: Jerry Carl(R)
AL-2: Barry Moore(R)
CA-8: Jay Obernolte(R)
CA-50: Darrell Issa(R)
CO-3: Lauren Boebert(R)
FL-3: Kat Cammack(R)
FL-15: Scott Franklin(R)
FL-19: Byron Donalds(R)
GA-9: Andrew Clyde(R)
GA-14: Marjorie Taylor Greene(R)
IA-2: Mariannette Miller-Meeks(R)
IA-4: Randy Feenstra(R)
IL-15: Mary Miller(R)
IN-5: Victoria Spartz(R)
KS-1: Tracey Mann(R)
KS-2: Jake LaTurner(R)
LA-5: Luke Letlow(R)
MI-3: Peter Meijer(R)
MI-10: Lisa McClain(R)
MT-0: Matt Rosendale(R)
NC-11: Madison Cawthorn(R)
NM-3: Teresa Leger Fernandez(D)
NY-2: Andrew Garbarino(R)
NY-22: Claudia Tenney(R)
OR-2: Cliff Bentz(R)
PR-0: Jenniffer Gonzalez-Colon(R)
TN-1: Diana Harshbarger(R)
TX-4: Pat Fallon(R)
TX-11: August Pfluger(R)
TX-13: Ronny Jackson(R)
TX-17: Pete Sessions(R)
TX-22: Troy Nehls(R)
TX-23: Tony Gonzales(R)
TX-24: Beth Van Duyne(R)
UT-1: Blake Moore(R)
VA-5: Bob Good(R)
WI-5: Scott Fitzgerald(R)
Incoming Democratic Freshman class of 2021:
CA-53: Sara Jacobs(D)
GA-5: Nikema Williams(D)
GA-7: Carolyn Bourdeaux(D)
HI-2: Kai Kahele(D)
IL-3: Marie Newman(D)
IN-1: Frank Mrvan(D)
MA-4: Jake Auchincloss(D)
MO-1: Cori Bush(D)
NC-2: Deborah Ross(D)
NC-6: Kathy Manning(D)
NY-15: Ritchie Torres(D)
NY-16: Jamaal Bowman(D)
NY-17: Mondaire Jones(D)
WA-10: Marilyn Strickland(D)
Republican takeovers as of 2021:
CA-21: David Valadao(R) defeated T.J. Cox(D)
CA-39: Young Kim(R) defeated Gil Cisneros(D)
CA-48: Michelle Steel(R) defeated Harley Rouda(D)
FL-26: Carlos Gimenez(R) defeated Debbie Mucarsel-Powell(D)
FL-27: Maria Elvira Salazar(R) defeated Donna Shalala(D)
IA-1: Ashley Hinson(R) defeated Abby Finkenauer(D)
MN-7: Michelle Fischbach(R) defeated Collin Peterson(D)
NM-2: Yvette Herrell(R) defeated Xochitl Small(D)
NY-11: Nicole Malliotakis(R) defeated Max Rose(D)
OK-5: Stephanie Bice(R) defeated Kendra Horn(D)
SC-1: Nancy Mace(R) defeated Joe Cunningham(D)
UT-4: Burgess Owens(R) defeated Ben McAdams(D)
Special Elections 2021-2022:
CA-22: replacing Devin Nunes (R, SPEL summer 2022)
FL-20: replacing Alcee Hastings (D, SPEL Jan. 2022)
LA-2: Troy Carter (R, April 2021)
LA-5: Julia Letlow (R, March 2021)
NM-1: Melanie Stansbury (D, June 2021)
OH-11: Shontel Brown (D, Nov. 2021)
OH-15: Mike Carey (R, Nov. 2021)
TX-6: Jake Ellzey (R, July 2021)
Rayburn HOB 2373, Washington, DC 20515