Congressman Mike Thompson. Courtesy photo.

There are a lot of questions about the health care bill in Congress. Here are answers to some of the most commonly asked questions about the bill that passed the Ways and Means Committee.

Question: Has Congressman Thompson read the bill?

Answer: I have read and was involved in drafting the bill I voted on. For weeks before the introduction of H.R. 3200, members of the Ways and Means Committee, myself included, met daily to go through the bill line by line and section by section. As a group, we spent 86 hours going over this legislation.

Question: Will health reform force all Americans out of their private insurance plans and into a one-size-fits-all government plan?

Answer: No. H.R. 3200 builds on the current system of employer-based coverage, it doesn’t replace it. If you are happy with your current plan, you can keep it. H.R. 3200 includes a public plan that individuals will have the option of purchasing, along with a variety of other private plans. This public plan will be required to be financially self-sustaining, as private plans are, covering its costs through premiums and co-pays.

Question: Does page 16 of the bill require me to join the public plan if I lose my private insurance coverage?

Answer: No one will be required to join the public plan. If you lose your insurance, you will be able to shop for a new plan at an online exchange that includes information on all insurance options. This exchange will bring together information that is currently scattered giving consumers the opportunity to quickly and effectively compare plans to make informed decisions about what coverage works best for them. The provision on page 16 merely requires individuals joining a private insurance plan after 2013 to do so through the exchange.

Question: Are members of Congress exempt from changes that are being proposed for the rest of the country?

Answer: No. Members of Congress receive the same health care options as other federal employees, with a choice of plans from private insurers that vary by benefits, premiums and co-pays. This legislation would affect federal employees in the same ways that it affects everyone else who gets their health insurance through their employer.

Question: Will proposed legislation provide free health care to illegal immigrants?

Answer: No. Section 246 of H.R. 3200 explicitly prohibits the payment of affordability credits designed to help low and moderate incomes families purchase insurance to anyone who is not lawfully present in the United States.

Question: Will all small businesses be forced to provide coverage to their employees?

Answer: This bill exempts small businesses with a payroll of less than $250,000 from the requirement to provide health insurance for their workers. Businesses with payrolls above $250,000 that do not provide coverage will be charged a payroll tax that will gradually increase with the size of their payroll. The current version of the bill has this tax will start at 2 percent for payrolls above $250,000 and increase to a maximum of 8 percent for payrolls above $400,000, however, there are currently discussions to raise this exemption to $500,000. Proceeds from this tax will go to offset the cost of coverage for individuals purchasing insurance through the exchange. Small businesses that opt to offer insurance will receive tax credits to offset the cost of insurance.

Question: What does this bill do to stop fraud and abuse in Medicare?

Answer: This bill strengthens existing compliance and enforcement tools for Medicare, increases funding to support these efforts and creates new, tougher penalties for individuals who submit false claims or applications to Medicare. The Congressional Budget Office (CBO) has estimated that for every $1 we invest in fighting waste fraud and abuse we will produce $1.75 in savings.

Question: Can our nation afford health care reform?

Answer: The truth is that the rising cost of health care for all Americans is a problem that will not fix itself and that we can’t afford to not address. Today, our nation spends one out of every $6 we earn on health care. If we don’t take action to slow the increase in costs, within a decade we will spend one out of every $5 on health care, and within 30 years this will rise to one in every $3. These facts make it clear, the longer we wait, the more it will cost to fix our broken health care system.

Question: How much will this bill cost?

Answer: There is no question that there will be significant costs to implement this legislation. The CBO’s latest estimate puts the price tag at $1.042 trillion over 10 years. Here is how we are going to pay for the bill. First, we are going to address inefficiencies in Medicare and Medicaid and crack down on fraud, waste and abuse in these programs to save $465 billion over the next ten years. Second, we will need to raise $583 billion in revenues to cover the rest of the cost. The Ways and Means Committee proposes to do this through a surcharge on the wealthiest 1.2 percent of income earners, who have enjoyed a tremendous advantage for the last eight years because of the Bush tax cuts (the average reduction in federal taxes for the top 1 percent in these tax cuts was $44,622). The Senate is considering other ways to raise these funds, and it is unclear how this issue will be dealt with in the final bill.

Question: Will this plan lead to rationing of health care? Will Congress be legislating what care my doctor can or must give me?

Answer: No. I believe that medical decisions should be left between patients and their doctors. Section 1401 explicitly forbids any studies or research called for in H.R. 3200 from being used to either mandate or deny care to a patient in any public or private plan. This research will gather data about what procedures are most effective to give doctors more information to consider when treating patients, not to replace your doctor’s judgment with that of a bureaucrat from a private insurer or the government. The bill protects the ability of doctors to do what they think is necessary to help their patients without having to constantly worry about whether they will be reimbursed by an insurance company, which is why this bill has earned the strong support of the American Medical Association.

Question: Why is this bill being “rushed” through Congress?

Answer: Universal health care was first proposed by Teddy Roosevelt in 1912. President Harry Truman called for it in 1945. Former Representative John Dingell Sr. introduced a bill to provide universal health care in 1947 and his son, Representative John Dingell Jr., has reintroduced a bill every Congress since 1955. So, this is not a new issue and it was supported by both President Obama and Sen. McCain in the November presidential election. This particular legislation has been crafted, reviewed and revised repeatedly since the 111th Congress began, and it has been changed to reflect the considerable input from those in the health care community, members on both sides of the aisle and constituents. This bill is not being rushed – it is long overdue.

Mike Thompson (D-St. Helena) represents Lake County in the US House of Representatives.

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