Health Security

By Joe Sestak

Congressman Joe Sestak's Health Security Accomplishments/Future Proposals

Upon assuming office, one of the first priorities I set was to reform our healthcare system. I requested membership in the Small Business and Education and Labor Committee's healthcare subcommittees and proposed steps for reform. First, shift away from fee-for-service programs; pay providers adequately; give patients the same choices as Members of Congress; share the costs; expand transitional health tax credits; institute mental health parity; improve performance in treating chronic disease; and increase the use of health information technology. I believe we need a health care system that ensures every American has affordable, accessible and quality care through a shared duty between society and government.

HIGHLIGHTS OF MY SUPPORT FOR AMERICA'S HEALTH SECURITY

1. MEMBER OF 2 HEALTHCARE SUBCOMMITTEES

2. VOTED FOR THE PATIENT PROTECTION AND AFFORDABLE CARE ACT 2009 Comprehensive health care reform that: Expands Consumer Protections in the Insurance Market: Ends insurance industry abuses, limits out-of-pocket costs for consumers, and ensures a fair market for health insurance Creates a New Marketplace for Health Insurance: Launches the health insurance exchanges, transparent and functional marketplace where individuals and small businesses can purchase affordable health insurance. Establishes Health Care As A Shared Responsibility: Requires individuals to obtain health insurance and medium and large businesses to provide it. Meets these new requirements with a commitment from the Federal government to ensure the affordability of this insurance for middle-class families. Reduces Waste And Improves Care In Medicare: Extends the solvency of Medicare ten years while eliminating the Medicare Part D Donut Hole and encouraging preventive and high quality care. Strengthens America's Health Care Workforce: Encourages the education of more doctors and nurses, specifically in primary care, to ensure all American's have access to care. Encourages Prevention And Wellness: Invests in programs to encourage healthy behavior and improve access to preventive care.

3. VOTED FOR THE MEDICARE PHYSICIAN PAYMENT REFORM ACT OF 2009 Ensure seniors and service members retain access to high quality care in Medicare and TRICARE by repealing the 21% cut in payments to doctors scheduled under current law and resetting the cost growth targets.

4. VOTED FOR THE HEALTH INSURANCE INDUSTRY FAIR COMPETITION ACT Eliminates the exemption for federal antitrust laws currently afforded to health insurers, opening these companies to federal antitrust investigation.

5. VOTED FOR CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) REAUTHORIZATION ACT

Provides health care for 11 million children, to finally provide cost‐effective health coverage for 4 million more children and preserve coverage for 7 million children already enrolled

6. CHAIR OF THE HOUSE PEDIATRIC CANCER CAUCUS Led Congressional efforts to increase funding for pediatric cancer research, secured $4 million of dedicated funding in for Fiscal Year 2010.

7. AUTHORED/PASSED LEGISLATION TO EXTEND PREMIUM ASSISTANCE FOR LAID-OFF WORKERS Led Congressional effort to extend COBRA premium assistance to 15 months and extend the program to workers laid off in 2010, while unemployment remains at record highs. Additionally, authored legislation that extends COBRA benefits for all Americans from 18 months to 24 months

8. AUTHORED LEGISLATION TO MANDATE AND FUND TREATMENT FOR AUTISM Revises TRICARE's healthcare plan regulations to authorize medically necessary treatment of autism spectrum disorders. Requires that the DoD provide $36,000 in annual assistance to TRICARE registered families with children diagnosed with autism. Previous cap was $2,500 monthly cap.

9. VOTED FOR THE ECONOMIC RECOVERY AND REINVESTMENT ACT (ECONOMIC STIMULUS)

Provides $19 billion to accelerate adoption of Health IT by doctors and hospitals; protects health care coverage for millions of Americans by providing more than $87 billion in additional federal matching funds to help states maintain their Medicaid program.

10. VOTED FOR LABOR HEALTH, AND HUMAN SERVICES APPROPRIATIONS BILL

Expands funding for community health centers and the National Institutes of Health (NIH).

11. VOTED FOR THE MEDICARE DRUG PRICE NEGOTIATION ACT

Directs the Secretary of Health and Human Services to negotiate with drug companies for lower drug prices for Medicare beneficiaries.

12. VOTED FOR THE PAUL WELLSTONE MENTAL HEALTH AND ADDICTION EQUITY ACT

Ends discrimination against patients seeking treatment for mental illnesses by prohibiting insurers and group health plans from imposing treatment or financial limitations when they offer mental health benefits that are more restrictive from those applied to medical and surgical services.

SUMMARY OF FUTURE INITIATIVES

We must ensure the passage of comprehensive health care reform legislation currently under consideration in Congress. This legislation carries out my ideals for health care reform and is a significant step toward the establishment of a health care system that functions for all Americans. Moving forward, we must do more to address the incentives in our health care system that lead to every more expensive care and encourage excessive treatment.

1. Reduce Health Care Costs

• Include incentives for Account Care Organization (ACO) in the Health Insurance Exchange, Public Plan, Require Qualified Health Benefit Plans to contract with ACOs. Alternatively, require the public plan to contract with ACOs.
• Implement Wellness Program in Medicare, Give premium and co-pay reductions to seniors who participate in chronic disease management programs and follow preventative care recommendations.
• Establish Regional Accountable Care Organization reimbursement in Medicare, Provide pilot program to encourage a regional implementation of Accountable Care Organizations.

• Incentivize Primary Care, Increase Medicare bonus to Primary Care Physicians to 10% (from 5% in AAHCA), Maintain 50% of Stimulus bill increase in funding for National Health Services Corps, which provides tuition repayment for Primary Care.
• Increase Health Care Workforce, Expand the National Health Service Corps to include additional providers and increase institutional funding of Nursing Education.
• Invest in Preventative Care, Maintain 50% of new federal investment in prevention and wellness fund at CDC in the Stimulus, Increase funding for Community Health Centers.

• Expand incentives for adoption, Enact bonuses Medicaid providers who implement Health IT. This would include a broader definition of provider and apply to specialties, such as pediatrics, that do not service Medicare patients.
• Require interoperability as a component of "Meaningful use", Direct the Office of the National Coordinator to establish a national standard for interoperability of Health Records by September 1st, 2010. Require the inclusion of interoperability in the definition of meaningful use of health information technology for federal technology incentives.
• Provide Assistance to Small and Ancillary Providers for Health IT adoption, Establish loan guarantee program to aid smaller practices and health care providers excluded from Medicare bonuses in implementing Health IT.

• Encourage Future Research in Pediatric Cancer, Bring leaders of Pediatric Cancer research together with congressional staff and leaders to plot course for future research efforts.
• Funding for NIH and NSF, Maintain funding levels at 50% of Stimulus funding in FY2011 budgets.
• Reform Patent Law to Establish Consistency for Businesses, Establish a singular process for protesting copyright violations, which will reduce uncertainty for innovator companies but preserve the rights of generic manufacturers