[Congressional Record Volume 141, Number 196 (Monday, December 11, 1995)]
[House]
[Pages H14244-H14245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


        INTRODUCTION OF AMERICAN HEALTH SECURITY PARTNERSHIP ACT

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from Wisconsin [Mr. Obey] is recognized for 60 
minutes as the designee of the minority leader.
  Mr. OBEY. Mr. Speaker, I do not normally these days take special 
orders because, as everyone understands, there is no legislative 
business to be conducted, but I do today take this time to simply 
announce that I am introducing the Health Security Partnership Act of 
1995 because I think this Congress is going in a totally wrong 
direction on the issue of health care and I think we ought to start 
talking about how to reverse that.
  Last year the country missed a historic opportunity to reform our 
health care system by getting a handle on costs and strengthening the 
health security of every American family. The public wanted action but 
Washington became so polarized that the opportunity was missed. That 
does not mean that the problem has gone away.
  Since the failure of Washington to provide health care reform last 
year, 1 million more Americans have lost health care coverage and 
Americans concerned about being able to hold on to affordable health 
insurance have seen that concern intensify greatly. At a time when we 
ought to be reducing insecurity and increasing access to quality health 
care, Congress is going in the opposite direction.

  Instead of reducing the number of uninsured Americans, this Congress 
is 

[[Page H14245]]
moving millions of people to the rolls of the uninsured by shredding 
the Medicaid safety net for millions of poor families and working 
families who need nursing home coverage for a loved one. It is making 
Medicare more insecure for millions of recipients. The median income 
for women on Medicare is $8,500 a year. And it is increasing the cost 
for the uninsured, a cost which will therefore be shifted to families 
who do have insurance and to employers who provide that insurance.
  That is morally wrong, it is economically wrong, and the bill that I 
am introducing today goes against the prevailing tide in this Congress 
in order to try to correct it. I know that we are moving against the 
tide, but this is a matter of principle and it is well worth the fight.
  I should say also that I am being joined in this effort by the 
gentleman from New York [Mr. Hinchey], the gentleman from New York [Mr. 
Owens], the gentlewoman from California [Ms. Pelosi], and the gentleman 
from Minnesota [Mr. Oberstar].
  Last year's health care battles have made it quite clear to me that 
while the public wants reform, they do not want reform that creates new 
huge Federal bureaucracies. There are some things that the Federal 
Government can and should do, and this bill would do them.
  For example, the National Government can and should insist on 
insurance reform so that people with preexisting conditions cannot be 
denied coverage. It can and should expand the Community Options Program 
such as we have in Wisconsin, so that home and community-based health 
care can be an affordable option to institutionalized care. And we can 
attack the inequity that allows corporations to deduct the full cost of 
providing health insurance to their employees but only allows the self-
employed businessman to deduct 30 percent of the cost of coverage.
  There are nonbureaucratic reforms that can and should be made at the 
Federal level. But we can also create a Federal-State partnership that 
will leave to the States the major choices about how to deal with the 
shortcomings in today's health care system.
  That is why the bill I am introducing today, beyond the issue of 
insurance reform, will have only one Federal requirement. The 
requirement will simply be that States ensure that every citizen in 
each State has health insurance coverage, and that such coverage is 
comparable to that which is now available to Members of Congress, 
Federal employees and their families.
  Under the plan, States could establish whatever system they want, be 
it public, private or a mixture of both. Each State would decide 
whether to use devices such as risk-sharing pools or subsidies to 
provide coverage for those who are unemployed, those who are working 
but unable to afford health insurance, and those who are high risk and 
unable to get insurance from carriers.
  In the best Progressive tradition--and I mean that in a capital P 
because the Progressive Party was born in Wisconsin--in the best 
Progressive tradition, we can use States as laboratories of democracy 
to help find alternative health care reform models that work. The 
elements of the plan would work like this.
  States would be required to submit a plan by July 1, 1999, to the 
Secretary of Health and Human Services which would have to show that 
every citizen in that State is covered by health insurance which has 
benefits comparable to those available under the Federal Employees 
Health Benefits Plan.

  Second, the rules of the insurance game would be changed to guarantee 
that people could no longer be turned away because of preexisting 
conditions, income, employment, or other health status. Insurance 
companies could no longer deny, cancel, or refuse to renew coverage 
unless the premiums had not been paid, unless fraud or 
misrepresentation had been involved, or the plan is ceasing coverage in 
an entire geographical area. Home and community-based care would be 
provided as an option to institutional care when it would be medically 
appropriate.
  Third, the Secretary of Health and Human Services would annually 
certify the plans. Only those States that participate will be eligible 
for Federal Medicaid funds, and participating States would be eligible 
to share in the Federal pool of funds created in the bill to assist 
States in the effort.
  As I said earlier, currently self-employed individuals can deduct 30 
percent of their health insurance costs on their Federal tax return. 
This bill would increase that deduction to 100 percent, and it would 
also allow workers whose employers do not provide health insurance to 
deduct up to 80 percent of their health insurance cost.
  Congress is right to want to reform Medicare and Medicaid, but health 
care for persons struggling to make ends meet should not be squeezed in 
order to provide a rich man's tax cut. Medicare and Medicaid reform 
should not be done in isolation. They should be done in the context of 
overall care reform, to effectively and fairly control costs, and to 
minimize cost-shifting to persons who are insured and to employers who 
do provide insurance.
  Until we can ensure that everyone has health coverage, the problem of 
cost-shifting will not go away. Cost-shifting is a hidden tax that 
continues to drive the cost of health care higher and higher. Until we 
get a handle on cost-shifting, prices will continue to rise forcing 
more people out of the system and escalating the problem.
  No one can convince me that in last November's election the public 
was telling us that they wanted us to weaken health care coverage and 
increase its cost, especially to the most vulnerable among us. They 
want us to make health care more affordable and more accessible. They 
do not want us to go in the other direction.
  This is a proposal which would help move us back in the right 
direction. Right now 40 million Americans are being left behind, and 
that is a disgrace. It is an even larger disgrace that if the Medicaid 
reforms, so-called reforms being pushed by the Republican leadership in 
this House go through, that you could almost double the number of those 
who are uninsured in this country because of the loss of the Medicaid 
guarantee.
  These are problems which this Congress ought to be willing to solve. 
We ought to be including more people in the blessings of this country 
when it comes to health care, not fewer. I would hope that someday the 
Congress will get about doing that, because that indeed is the people's 
business.

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