As a physician who has cared for thousands of uninsured patients and families in Louisiana, I believe Congress must do more to expand access to affordable health-insurance coverage. Congress can also be effective in pushing our health care system to improve treatment outcomes, limit waste, reduce waiting times, and improve patient satisfaction.
We must also do more to empower health care consumers and providers with better information about health care costs and quality, and protect patients’ control over their individual treatment decisions. We should also allow individuals to choose the coverage that best suits their individual needs and make health insurance portable between jobs.
These goals will remain among my top priorities as I continue fighting for the interests of Louisiana patients and caregivers.
SCHIP
In 2007, Congress focused much of its attention on expanding coverage through the State Children’s Health Insurance Program (SCHIP), which provides health coverage to the families of children who earn too much to qualify for Medicaid. Many low income families in hurricane damaged areas of Louisiana’s 7th Congressional District remain eligible but not enrolled in SCHIP. According to the State of Louisiana, more than 68,000 children in families that make less than 200 percent of the federal poverty level remained eligible but unenrolled in SCHIP as of May 2007.
I voted for legislation that provided significant funding for the SCHIP program through 2009. The legislation, signed into law by the President on December 29, 2007, included more than $5 billion in federal funding for health care. That said, I remain concerned that some children who are enrolled in SCHIP and Medicaid still have trouble finding a physician. I regret that House Democrat leaders refused to permit any amendments to SCHIP legislation that would address access problems for children on SCHIP and Medicaid.
Nursing Shortage
As the sponsor of the Nursing Education Opportunities Act of 2007, I’ve also been a leader in bipartisan efforts to reverse our nation’s looming nursing shortage. The shrinking of this workforce makes health care more expensive for all Americans, while delaying our access to life-saving treatment. The Department of Health and Human Services (HHS) recently warned that the nation’s nursing shortage could exceed one million nursing vacancies by the year 2020. Adding to the crisis, U.S. nursing schools must turn away thousands of qualified applicants every year.
According to one survey, these schools turned away 42,866 qualified applicants in 2006, citing faculty shortages as their primary reason. My bill would help to avert the impending crisis. I’m pleased that it is supported by a growing coalition, including The American Academy of Nursing, American Association of Colleges of Nursing, American Nephrology Nurses' Association, American Nurses Association, American Organization of Nurse Executives, Association of Women's Health, Obstetric and Neonatal Nurses and the National League for Nursing.
Community Health Centers
If we fail to modernize our state’s healthcare system by attracting and keeping healthcare providers, and improving patient’s access to community-based primary care, Louisiana patients will continue to suffer in overcrowded emergency departments and face life-threatening waiting lists, while medical bills, insurance premiums and taxes become even more exorbitant.
I have been in frequent contact with the Department of Health and Human Services to urge the Bush Administration to direct adequate funding for the expansion of Federally Qualified Health Centers in high-need areas of Louisiana’s 7th Congressional District. In August 2007, HHS officials contacted my office and finally agreed to provide extra help for underserved communities in our area through its High Poverty County Initiative.
I’m also a cosponsor of the Health Centers Renewal Act (H.R. 1343), legislation to reauthorize federal funding for community health centers between 2008 and 2012. To help these community health centers attract and retain health care providers, I’m also a cosponsor of another bill (H.R. 1518) to allow health center employees to enroll in the Federal Employee Health Benefit Program. More information about federally qualified community health centers can be found on the Internet at: http://www.cms.hhs.gov/MLNProducts/downloads/fqhcfactsheet.pdf.
Ensuring Freedom to Choose Private Insurance Coverage
Moving towards the 2008 Presidential election, many groups have become more vocal in their support for leveling our entire health care system and shifting to a single-payer system. This quick fix solution would soon lead to dangerous waiting lists – as we’ve already seen in Canada. Waiting lists prevent early detection and increase the risk of death. Researchers report that 19 percent of Americans who develop prostate cancer die, compared to 25 percent in Canada and 57 percent in Great Britain. Likewise, breast cancer kills 25 percent of American victims, compared to 46 percent of similar patients in Great Britain and New Zealand.
Worse yet, under single-payer legislation, 70 percent of Americans would be forced to drop their existing coverage, and trust unelected Washington bureaucrats not to ration medically necessary care when a family member needs it most. Single payer proposals would make it illegal for Americans to purchase private insurance coverage for medically appropriate or necessary care. On June 9, 2005 the Canadian Supreme Court struck down a law that banned private health insurance for services covered under that country’s socialized health care program. In doing so, the court fittingly noted that: "Access to a waiting list is not access to health care."
Customize Coverage for Those Who Lack It
Instead of creating more problems with access in the United States, it seems more reasonable to customize coverage solutions for the different populations of uninsured Americans, beginning with low to moderate income Americans.
More than half of the uninsured have incomes below 200 percent of the federal poverty level. Many families simply can’t afford insurance premiums without some type of assistance. I support legislation to provide a refundable tax credit to low income Americans for the purchase of health insurance.
Last year, I also supported legislation that allows employers to increase their contributions paid to Health Savings Accounts (HSAs) opened by lower-paid employees. This bill is now law. Recent news articles highlight the importance of expanding health savings accounts for America's families. One woman mentioned in these news articles switched to an HSA with a high-deductible health plan after her insurance premiums increased by 42 percent in one year. As a result, the monthly cost of her asthma medication consumed all the money in her HSA.
Patients with chronic conditions shouldn't have to pay a high deductible before their coverage begins. Giving patients with HSAs the freedom to choose plans that offer up-front coverage will avoid hospitalizations and reduce the costs that are borne by all Americans. To address this problem, I introduced H.R. 2639, the Promoting Health for Future Generations Act of 2007. The bill permits HSA owners to receive prescription drugs before paying a deductible. It also permits working families to accumulate more money in these accounts, resolving situations like the one experienced by the woman with asthma.
One of the most important changes consumers have been clamoring for is a tax deduction for premiums paid for HSA products. My bill would make this a reality. My bill would also eliminate many of the confusing and complex limitations that currently apply to HSAs. For example, it would permit a parent to leave funds from an HSA or MSA to a surviving son or daughter in the same way he may now do for a surviving spouse. It also would allow VA and military retirees to contribute to an HSA, allow seniors who have HSAs to use these funds to purchase a Medigap policy, increase the amount consumers may contribute to their HSAs, and allow persons age 50 and older to make “catch-up” contributions to their HSAs. These and other provisions of H.R. 2639 will help make HSAs more workable and attractive to consumers who may be looking for another way to fund their health care needs. I’m pleased that the National Federation of Independent Business (NFIB) and the U.S. Chamber of Commerce [attach links] have written letters in support of this legislation to make coverage more affordable and portable.
Millions of Americans lose health coverage for all or part of the year when changing jobs. Moreover, at least 12 million uninsured Americans are employed by small businesses. I have and will continue to cosponsor the Health Care Freedom of Choice Act (H.R. 636), legislation to make health insurance portable between jobs by providing for the tax deductibility of medical expenses by individuals. I also voted for a proposal to permit small businesses to purchase health insurance through professional associations, giving them the advantages of greater bargaining power.
While practicing medicine, I often saw patients who were excluded by insurance companies due to a “pre-existing” condition. The system is beyond deplorable when it punishes sick patients. At least 34 states, including Louisiana, have acknowledged this and set up high risk pools to provide coverage to patients with pre-existing conditions. In 2005, I voted in support of the law that increased federal funding for these programs. I also cosponsored legislation to prevent insurers from using genetic information to deny insurance coverage. This bill is now law.
I depend on your input as I continue working on this issue. If you would like to speak with my staff about health-care legislation, please contact my Washington, D.C. office at 202-225-2031.
