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HR 3590, the Patient Protection and Affordable Care Act, and the related budget reconciliation legislation, HR 4872, the Student Aid and Fiscal Responsibility Act of 2009, are the subject of the anticipated vote, which Congressman Mike Thompson (D-St. Helena) told reporters on Friday that he expects to happen this weekend.
Congress' Republican leadership strongly opposes the legislation, arguing that Republicans “are on the side of the American people,” and that the American people oppose government-run health care.
On Friday Thompson said he was planning to vote for the bill.
“I think this is an important measure that has finally come to fruition,” he said.
However, Thompson – who said that health care reform has been one of the major planks in his platform since he first ran for elected office – said of the legislation, “It's not everything that I wanted.”
He said he ideal legislation “would look a lot different,” but this is a step in the right direction.
Thompson said the legislation would extend health care coverage to 95 percent of all Americans, including 65,000 people in his First Congressional District – which stretches from Del Norte County south to include Humboldt, Mendocino, Sonoma, Napa, lake and Yolo counties – who currently don't have it.
By giving those 65,000 people health care, it would reduce uncompensated care costs by nearly $70 million annually, he said, citing a study from Congress' Energy and Commerce Committee.
Those costs, he said, have to be absorbed by health care providers, who in turn pass them on to other patients.
On Thursday the Congressional Budget Office released a report that stated the legislation is supposed to reduce federal deficits by $138 billion from 2010 to 2019, but that number has come under fire from critics who say it underestimates the bill's true costs.
Thompson said his Washington office and four district offices have been receiving a lot of calls, letters and e-mails from constituents all over the spectrum on the legislation.
He said they've received reactions ranging from people who don't want “Obamacare” to those who want a 100-percent government-run, single-payer health care system.
“It's running overwhelmingly pro-health care reform from the contacts in the district,” he said.
He said that's because health care costs are going through the roof, with premium costs in some cases increasing by 40 percent. “The system is not sustainable.”
Thompson also is getting calls from out of state, all of which are against health care reform.
Reacting to concerns over the bill's impacts for small business, Thompson – who is a member of the House's Ways and Means Committee, and helped write the House version of the bill – said it has “a small business perspective” in that it exempts out employers with fewer than 50 employees.
Instead, it would allow those smaller businesses to go into an exchange and pool their buying power to get better coverage at a lower cost, he explained.
Other provisions in the bill include prescription drug reforms to deal with the “doughnut hole” for seniors in the Medicare Part D plan, a ban on denying coverage to children with preexisting conditions and a temporary provision to allow adults with such conditions to buy into a high risk pool until further preexisting provisions go into effect.
Thompson, who said he supports preventive health care, said the bill increases training programs for primary care physicians, nurse practitioners and other public health officials. It also will test certain types of health care delivery and, if they work, expand their usage.
Doctors, he added, will be paid for the quality of the health care they provide, not the quantity.
Although he had voted for the bill in committee and on the floor of the House, Thompson said he remained uncommitted until Friday, when he found out everything that was in it, what it would cost and what it would save. The bill, he said, is paid for.
He also thinks the necessary votes are in place.
“I think people are anxious to get this vote behind us so we can start delivering some of these benefits to the American people,” he said. “We're making some major changes.”
Student loan reform is bundled into the legislation through the reconciliation process because it also saves money, said Thompson.
That legislation will no longer require the federal government to take the risk in guaranteeing loans while the private sector benefits, and put more dollars back into higher education and opportunity for students, he said.
Thompson said the public option is not in the health care legislation, but he added, “I don't think the idea of a public option is dead and buried, I think it's something that is very much alive and there will be efforts to revisit that.”
Different sides of the issue
Lake County News called local groups for input on the legislation.
Clear Lake Chamber of Commerce Executive Director Lori Peters did not return a call, and Lake County Chamber of Commerce Chief Executive Officer Melissa Fulton forwarded requests for comment to the chamber's board members, none of whom responded to Lake County News.
Fulton said that last October the chamber board and legislative committee met with Thompson specifically to discuss health care reform, but they have taken no official position on the current legislation.
She said she's sent out a survey to members, the results of which she expects to have next week.
The US Chamber of Commerce said it strongly opposes the legislation, which it called “fundamentally flawed.” The group said the bill would hurt businesses through increased taxes and new entitlements while cutting Medicare, increasing some costs and ultimately doing “little to control the long term spiraling” of health care costs.
The Mendocino-Lake County Medical Society also did return several messages left Friday.
The California Medical Association released a statement this week explaining that it was lobbying Congress for changes to the bills.
The group said that while the legislation represents a step forward in many regards, “it comes up short in ways that could ultimately hamper patients' ability to see a doctor in a timely manner.”
Changes the group was seeking included the “Sustainable Growth Rate” formula that could cut Medicare funding by 40 percent in coming years, having Congress retain full authority over Medicare rather than delegating it to an advisory board, increasing Medicaid's low reimbursement rates, boosting Medicare payments in 14 high-cost California counties where many physicians are opting out of the program and seniors are having trouble accessing doctors, and improving quality reporting requirements to track Medicare treatment so they don't mislead patients.
Another group offering support with some specific reservations is the California Hospital Association
Jan Emerson, spokesperson for the association, said that group's board of trustees met Friday morning and decided to support the bills.
“With that, we do have one concern that goes along with that support,” she said.
Emerson explained that they are concerned about a proposal still under discussion that would address the geographic variation in costs.
Medicare payments to hospitals vary somewhat by geographic regions of the country, Emerson said. Because the cost of living in states like California is higher, the payments are correspondingly.
Emerson said there has been an effort by smaller states to have those payment disparities addressed, which would be done by taking funds from California and other large state.
“We remain concerned that that is included in the health reform proposals,” she said. “We have long made our concerns known to our congressional delegation and continue to do so.”
Thompson, who called himself an “eternal optimist,” said he hoped after the bill passed that Congress could move on. “The American people didn't send us up here to fight,” but to work, he said.
He was clear, however, that the legislation was far from a complete solution.
“You never cast a vote that solves a problem,” he said. Rather, bills address problems.
“You're making it better but you're still working on whatever that may be, and this will be no different,” he said, adding that, before the ink is dry on the bill, they'll be working on new aspects of health care.
“It's a very fluid process,” he said.
E-mail Elizabeth Larson at This email address is being protected from spambots. You need JavaScript enabled to view it. . Follow Lake County News on Twitter at http://twitter.com/LakeCoNews and on Facebook at http://www.facebook.com/pages/Lake-County-News/143156775604?ref=mf .
