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Wednesday, September 30, 2009

Brad Miller's Response to Health Care Questions

September 25, 2009

Dear Mr. Owens:

Thank you for contacting me regarding health care reform. I appreciate hearing from you about this issue.

In America, we have the best health care in the world: the best doctors, the best hospitals, and the most sophisticated technology. Despite this, we spend twice as much on health care as other prosperous nations, and Americans don't live as long and aren't as healthy. Currently 47 million Americans are uninsured, which means they only have limited access to health care, and most Americans are at risk of losing their insurance if they get sick, lose their job, or get sick and lose their job. Health insurance reform is essential to ensuring coverage and controlling health care costs, now and in the future.

There are many misconceptions and much misinformation, some sincerely believed and some cynically spread for political advantage, about the bill that the House is now considering. I would like to discuss what I think are the most important parts of this bill, and to discuss what the bill will not do.

The cornerstone of the House health care bill is reforming the health insurance industry. This reform would require new regulation of health insurance that is no stricter than what most states require of car insurance. Regulation would include requiring insurance companies to cover anyone who applies, regardless of their medical history. It would prohibit companies from charging more if someone has a preexisting condition and ensure that basic benefits are included in every insurance policy so you don't find that you aren't covered once you get sick. The bill will also expand Medicaid to the lowest income people as well as help low wage workers buy basic health insurance. The goal of the House bill is to ensure affordable insurance coverage to all Americans.

This bill will preserve the employer-based health care system for 200 million Americans. For people who need to buy insurance, there would be a range of private and public options to help guarantee all Americans a choice of health care plans they can afford. The House reform bill will not raise the cost of health care or decrease quality of care. Currently families pay an enormous hidden cost of nearly $1,100 per year to provide care for the uninsured. The House proposal will eliminate this cost by expanding access to affordable care for all Americans. Additionally, the House proposal invests in reforms to contain the costs of health insurance overburdening businesses, families and the federal deficit. It does this without raising taxes on middle class Americans. Only 1.2% of Americans, those with family incomes of more than $350,000 a year, would see an increase in their taxes

Another misconception about the bill is that government bureaucrats will make end-of-life decisions for seniors. That claim is patently false. Under this bill, all end-of-life decisions will be made by you, in consultation with your doctor and family. The bill will now reimburse doctors for some of the time they spend discussing end-of-life decisions with their patients; this empowers older Americans to have their wishes observed, it does not take power away. My own 94-year-old mother has a "health care power of attorney," which she prepared after such a discussion with her doctor several years ago. It is a great comfort to my mother and her children that she calmly made important decisions for herself.

Finally, the bill does not allow health subsidies for anyone who is not a citizen or a legal resident.

The bill before the House of Representatives includes a "public option," a federally administered insurance plan, similar to Medicare that people could choose to enroll in. The public option is just that, an option. No one will be forced to sign up for the public option and no one will be automatically enrolled, even if they are getting federal assistance paying for their health insurance. Unless you receive health insurance through your employer, you will be able to go to a newly created health insurance "exchange," which will present available insurance policies in an understandable format. You could compare all or your insurance options on the exchange, public or private, and choose the one best for you and your family.

The public option would be a standard by which other insurance plans could be compared. If the public option's benefits are better and provided more cheaply, then private insurance plans will need to improve their benefits and costs in order to keep their customers. The Congressional Budget Office estimates that the public option's competition with private insurance companies will save taxpayers $120 billion over ten years. I personally would choose the public option and will enroll in it if given the choice.

Finally, I know that many people are concerned about the bill's impact on small businesses. Our current health care system disadvantages individuals and small groups seeking health insurance. Small businesses stand to gain the most from health care reform. Most small business owners I talk to desperately want to provide their employees with decent, affordable health care. Unfortunately, they often just are not able to because the cost is prohibitive. In fact, 60 percent of America's uninsured are small business owners, their families and their workers. Under the House bill, small businesses will be able to purchase insurance through the exchange, significantly lowering the cost of insurance. Additionally, small businesses' with an average wage of $40,000 or less will qualify for tax credits for the cost of health insurance policies. Only companies with payrolls in excess of $500,000 will be required to provide health insurance or pay into a fund to help low-income workers buy their own.

Without health care reform the cost of our health care and health insurance will continue to grow, putting more strain on families and businesses and the number of uninsured will continue to rise. Fixing health care in America should be an economic and a moral priority.

I appreciate hearing from you about your position on health care reform. Please contact me about other issues important to you. Thank you.


Brad Miller
Member of Congress

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