Benjamin Cardin on Health Care
Democratic Jr Senator (MD)
"This is the establishment of a major command--an expensive command--and there currently are more questions than answers. The Army should want to make sure that any undertaking this big and this vital is done in a thoughtful and deliberate way rather than being hastily cobbled together," Cardin said. "For perspective, consider that it took the Army almost a decade and multiple studies to establish a new physical fitness test. Surely, a new Army acquisition model should take more than a year to develop."
Cardin, a strong supporter of the law, noted the consequences of repeal, including the loss of a popular provision that allows parents to keep their children on their policies until the age of 26. He also said restrictions on pre-existing conditions would return. "We need to move forward, not repeal ObamaCare," Cardin said.
Sobhani said he supported some aspects of the health care law, including the end of restrictions on pre-existing conditions. However, he believes more effort should be made to include input from patients and doctors.
CARDIN: You know that Iíve introduced legislation to take on the pharmaceutical companies.
ZEESE: Yes, after you voted the wrong way, to not allow less expensive pharmaceuticals into the country.
CARDIN: My bill would reduce the cost of pharmaceutical products by about 2/3rds, using market forces to bring down costs. Iíve taken on the insurance companies. I want Canadians coming to America to buy drugs. Take a look at what Iíve been able to accomplish, and who has stood up to these interests.
Cardin selected, "Part of the solution."
Cardin adds, "America spends more on health care per capita than any other nation in the world, yet our health status and longevity do not reflect that. To reduce inpatient hospitalizations and the costs associated with chronic diseases, we must continue to invest in prevention and early detection. My 1997 legislation established the first-ever comprehensive package of preventive services in traditional Medicare--covering breast, prostate, colorectal, and cervical cancer screenings, bone mass measurement for osteoporosis, and diabetes testing supplies. My subsequent legislation eliminated costsharing for preventive services in the Affordable Care Act (ACA). Additionally, I am proud that the Affordable Care Act established the Prevention Fund, investing monies in communities across the prevention efforts such as childhood obesity prevention, HIV testing, and tobacco cessation."
[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.
[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.
Opponent's Arguments for voting No:
[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.
[Sen. Merkley, D-TK]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Status: Failed 40-57
Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.
Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.
Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.
Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.
Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.
Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.
SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.
OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.
Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.
Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56
SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.
Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.
OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?
LEGISLATIVE OUTCOME:Amendment rejected, 28-67
Proponents support voting YES because:
Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:
Opponents recommend voting NO because:
Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:
Veto message from President Bush:
Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.
Proponents support voting YES because:
This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.
It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.
Opponents support voting NO because:
Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.
Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)
The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.
The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.
Amends the Public Health Service Act to require the Secretary of Health and Human Services to:
Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.
Medicare Access to Rehabilitation Services Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to repeal the cap on outpatient physical therapy, speech-language pathology, and occupational therapy services of the type furnished by a physician or as an incident to physicians' services.
SEC. 2. OUTPATIENT THERAPY CAP REPEAL.
Section 1833 of the Social Security Act (42 U.S.C. 1395(l)) is amended by striking subsection (g).
[Explanatory note from Wikipedia.com "Therapy Cap"]:
In 1997 Congress established per-person Medicare spending limits, or "therapy cap" for nonhospital outpatient therapy, but responding to concerns that some people with Medicare need extensive services, it has since placed temporary moratoriums on the caps. The therapy cap is a combined $1,810 Medicare cap for physical therapy and speech language pathology, and a separate $1,810 cap for occupational therapy ($1870 for 2011). Medicare patients requiring rehabilitation from disabilities, car accidents, hip injuries, stroke, and other ailments would be limited to roughly two months worth of treatments at an outpatient therapy clinic. Any patients that exceed the cap, whether they are healed or not, would have to stop therapy, or pay for the therapy services out of their own pocket.Several medical associations have lobbied against therapy caps because the bill inadvertently restricted disabled seniors, stroke patients, and other severe cases from receiving therapy treatments.
Excerpts from Letter from 20 Senators to President Trump: Repealing the Affordable Care Act (ACA) with no clear plan for replacement will substantially worsen the opioid epidemic. Last year, Congress took important steps to address this national public health crisis, enacting two bipartisan laws to address the opioid epidemic and reform the way our health system treats mental health and substance use disorders.
The Comprehensive Addiction and Recovery Act improved access to substance use disorder prevention, treatment, and recovery services. It promoted the use of best practices when prescribing opioid pain-killers, strengthening state prescription drug monitoring programs, and expanding access to the life-saving drug naloxone.
The 21st Century Cures Act also included critical mental health and substance use disorder reforms, strengthening enforcement of mental health parity laws, promoting the integration of physical and mental health care. Most importantly, the 21st Century Cures Act dedicated $1 billion in new grant funding, which will be essential to helping states provide prevention, treatment, and recovery services to patients These bipartisan advances will be fundamentally undermined by repeal of the ACA.
Opposing argument: (Warren, D-MA, in StatNews.com, 11/28/2016): Senator Elizabeth Warren railed against the 21st Century Cures, saying the bill had been "hijacked" by the pharmaceutical industry. "I cannot vote for this bill,'' Warren said. "I will fight it because I know the difference between compromise and extortion." The current legislation includes $500 million for the FDA, well below the amount Democrats had sought. Warren and Washington Senator Patty Murray have long argued that they would only support Cures legislation that included significant investment in basic medical research. While Warren said she supported many of the provisions, she called others "huge giveaways" to the drug industry.
A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn.
A bill to amend title 10, United States Code, to provide for the treatment of autism under TRICARE. Revises TRICARE (a Department of Defense [DOD] managed health care program) to authorize treatment of autism spectrum disorders, if a health care professional determines that such treatment is medically necessary.
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Chris Van Hollen
Senate races 2019-20:
AK: Sullivan(R,incumbent) vs.Gross(I)
AL: Jones(D,incumbent) vs.Sessions(R) vs.Moore(R) vs.Mooney(R) vs.
AR: Cotton(R,incumbent) vs.
AZ: McSally(R,incumbent) vs.Kelly(D)
CO: Gardner(R,incumbent) vs.Hickenlooper(D) vs.
DE: Coons(D,incumbent) vs.Scarane(D)
GA-2: Isakson(R,resigned) Loeffler(R,appointed) vs.Lieberman(D) vs.Collins(R) vs.Carter(D)
GA-6: Perdue(R,incumbent) vs.Tomlinson(D) vs.Ossoff(D) vs.Terry(D)
IA: Ernst(R,incumbent) vs.Graham(D) vs.Mauro(D) vs.Greenfield(D)
ID: Risch(R,incumbent) vs.Harris(D) vs.Jordan(D)
IL: Durbin(D,incumbent) vs.Curran(R) vs.
KS: Roberts(R,retiring) vs.
KY: McConnell(R,incumbent) vs.McGrath(D) vs.Morgan(R) vs.Cox(D) vs.Tobin(D) vs.Booker(D)
LA: Cassidy(R,incumbent) vs.Pierce(D)
MA: Markey(D,incumbent) vs.
ME: Collins(R,incumbent) vs.Sweet(D) vs.Gideon(D) vs.
MI: Peters(D,incumbent) vs.James(R)
MN: Smith(D,incumbent) vs.
MS: Hyde-Smith(R,incumbent) vs.Espy(D) vs.Bohren(D)
MT: Daines(R,incumbent) vs.Bullock(D) vs.
NC: Tillis(R,incumbent) vs.E.Smith(D) vs.S.Smith(R) vs.Cunningham(D) vs.Tucker(R) vs.
NE: Sasse(R,incumbent) vs.Janicek(R)
NH: Shaheen(D,incumbent) vs.Martin(D) vs.Bolduc(R) vs.O'Brien(f)
NJ: Booker(D,incumbent) vs.Singh(R) vs.Meissner(R)
NM: Udall(D,retiring) vs.Clarkson(R) vs.
OK: Inhofe(R,incumbent) vs.Workman(D)
OR: Merkley(D,incumbent) vs.Romero(R) vs.Perkins(R)
RI: Reed(D,incumbent) vs.Waters(R)
SC: Graham(R,incumbent) vs.Tinubu(D) vs.Harrison(D)
SD: Rounds(R,incumbent) vs.Borglum(R) vs.Ahlers(D)
TN: Alexander(R,incumbent) vs.Sethi(R) vs.Mackler(D) vs.Hagerty(R)
TX: Cornyn(R,incumbent) vs.Hegar(D) vs.Hernandez(D) vs.Bell(D) vs.Ramirez(D) vs.West(D)
VA: Warner(D,incumbent) vs.
WV: Capito(R,incumbent) vs.Swearengin(D) vs.Ojeda(D)
WY: Enzi(R,incumbent) vs.Ludwig(D) vs.Lummis(R)
Senate Votes (analysis)