[Congressional Record Volume 152, Number 99 (Tuesday, July 25, 2006)]
[Extensions of Remarks]
[Pages E1530-E1531]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         INTRODUCING THE AMERICARE HEALTH INSURANCE ACT OF 2006

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Tuesday, July 25, 2006

  Mr. STARK. Mr. Speaker, it gives me great pleasure to introduce the 
AmeriCare Health Insurance Act of 2006. I am joined by the AFL-CIO, the 
American Academy of Pediatrics, the American Nurses Association, the 
Center for Medicare Advocacy, Consumers' Union, Families USA, SEIU, the 
Universal Health Care Action Network, and the National Association of 
Community Health Centers in supporting this common sense solution to 
achieve universal health insurance coverage.
  In my tenure in the House, I have been involved in many discussions 
about how to reform our health system. These debates tend to occur 
every 10 to 15 years when health costs rise to a level that attracts 
our attention. Unfortunately, the minor tweaks and threats of reform we 
have made in the past have not resulted in lasting change. As a result, 
we are spending more--and getting less--than any industrialized nation.
  If history is any guide, we are nearing yet another health reform 
discussion in this country. This time, we need to get it right. To that 
end I offer AmeriCare--a practical proposal to ensure that everyone has 
affordable health insurance.
  AmeriCare is based on the principles that the U.S. health system 
should cover everyone, be affordable, and be meaningful.
  Eighty percent of the people who file for bankruptcy because of 
medical bills have health insurance, but their benefits do not meet 
their needs. Policies that are unaffordable, that discourage people 
from seeking care, or that do not cover necessary benefits are empty 
solutions.
  AmeriCare builds on what works--both employer coverage and Medicare--
in an effort to dramatically expand coverage with minimal disruption to 
the current system. It addresses the broader issues in our health 
system overall, and provides an important marker for a renewed 
discussion on health reform.
  For the past four decades since it was enacted, the stability and 
affordability of Medicare have helped millions of seniors and people 
with disabilities live longer, healthier lives. Because of Medicare, 
families have been able to save for their children's education rather 
than having to pay for their parents' health care.
  Since the program began, Medicare's per capita costs have grown at a 
slower rate than private health insurance or the Federal Employees 
Health Benefits Program.
  Providers, too, have benefited from Medicare. Without Medicare as a 
consistent payer, providers would not be able to offer the top quality 
care they deliver today. Indeed, uncompensated care for people who are 
uninsured or underinsured is pushing some providers toward the breaking 
point. Meaningful coverage for all makes good business sense for 
providers.
  AmeriCare also recognizes the important role that job-based benefits 
play in our current health system. Under AmeriCare, people would 
continue to obtain health coverage through their employer--as most of 
us currently do--or they would be covered under the new AmeriCare 
system. Expanding insurance coverage to all will end the cost shifting 
that results from the high number of uninsured we have today. This 
could reduce premiums for job-based insurance by as much as $1,000 for 
family coverage, according to the Institute of Medicine.
  Expanding coverage to all will also strengthen the economy and 
improve our competitiveness. General Motors recently admitted it spends 
more on health care than on steel; Starbucks spends more on health 
insurance than on coffee. The need to address health reform is more 
urgent than ever before.
  AmeriCare is a sensible solution for our Nation's employers--many of 
whom are already meeting the challenge of providing coverage for their 
employees. I plan to reach out to the business community to begin a 
dialogue about how we might move forward with AmeriCare.
  AmeriCare creates a new Title XXII in the Social Security Act. It 
uses Medicare's existing administrative infrastructure, but improves 
upon Medicare's benefits to address some of the current gaps in 
coverage, such as mental health parity, coverage for children, and 
family planning and pregnancy-related services for women. State 
Medicaid programs would remain responsible for long-term care, but 
AmeriCare would now cover low-income children, women, and others who 
currently receive non-long term care services under Medicaid.

  AmeriCare is financed through premiums, paid 20 percent by 
individuals and families and 80 percent by employers, general revenues, 
and state funds. People with incomes under 200 percent of poverty would 
be fully subsidized, and premiums and cost-sharing would be phased in 
for those with incomes between 200-300 percent of poverty.
  There is also a limitation on out-of-pocket spending to ensure that 
no one spends a disproportionate share of their income on health care. 
Employers could continue to offer their own coverage, so long as it is 
equivalent to AmeriCare. Payment of premiums would be reconciled at the 
annual tax filing in April.
  Everyone in the room should be aware that there is an effort underway 
to reform our health system, but not in the way we would like. 
Republicans have been pursuing stealth reform for the past decade in 
their dogged determination to dismantle the employer-based system and 
force everyone into high deductible health plans, regardless of whether 
they open or benefit from a Health Savings Account.
  Their rhetoric makes it sound like you ``own'' your health care. But 
what they really mean is that you are on your own. It's not just that 
you have to fend for yourself when purchasing health care, it's that 
for most people--especially the currently uninsured--the Health Savings 
Account is purely theoretical. Employers don't have to contribute to 
these accounts, and most don't.
  The Republican agenda expands the class of people who are 
underinsured, putting both patients and providers at greater risk. More 
and more doctors and hospitals are being forced to act as bill 
collectors rather than care providers, and patients are saddled with 
debt and even bankruptcy because their insurance benefits are 
inadequate. For example, many high deductible policies do not cover 
maternity benefits. The situation will only get worse if we continue to 
allow high-deductible health plans to take hold.
  Without the security of a universal health plan that covers everyone, 
each of us is at risk. For years we have accepted that people fall 
through the cracks in our health system. No parent should ever have to 
deny their child a lifesaving treatment because they cannot afford the 
cost. No family should ever lose a parent because their condition was 
treated too late.
  We need a strong alternative vision for health reform. That is why I 
am putting AmeriCare forward today. This proposal promotes shared risk 
and responsibility, not individual risk and greater fragmentation. 
AmeriCare offers an alternative vision that is simple and 
straightforward, fair and manageable.
  Our Nation is at a crossroads. Our legacy should be a future where 
our children are not saddled with debt, where they do not fear 
financial ruin due to an illness. Whether we build a healthy future for 
our children or not depends upon the decisions we make today. True 
compassion means offering real solutions, not empty promises.
  Working together, applying common sense approaches that build on what 
works, we can ensure that no-one risks the loss of insurance coverage. 
All we need is the will to do it.

[[Page E1531]]

  As we edge closer to our next discussion on health reform, we need to 
ask, is medical care a civic and social right like police and fire 
services, education, and environmental protection?
  Or is health care ``you're on your own?''
  This decision must be made. I hope I can count on my colleagues and 
our endorsing organizations to advance a shared vision for health 
reform by adopting AmeriCare.
  Attached is a short summary of AmeriCare. More can be found on my 
website at www.house.gov/stark.

            Americare Health Care Act of 2006--Bill Summary

       Overview: The AmeriCare Health Care Act (``AmeriCare'') is 
     a practical proposal to ensure that everyone has health 
     coverage in our country. It builds on what works in today's 
     health care system to provide simple, affordable, reliable 
     health insurance. People would continue to obtain health 
     coverage through their employer or they would be covered 
     under the new AmeriCare system, modeled on Medicare.
       Using the administrative efficiencies within Medicare and 
     building on the existing coverage people receive through 
     their jobs today, we can create an affordable, efficient, and 
     stable universal health care system in America--and guarantee 
     access to medical innovation and the world's most advanced 
     providers and facilities.
       Benefits: All residents of the U.S. and its territories are 
     eligible to receive benefits through AmeriCare. The practical 
     AmeriCare benefits package is tailored to meet the needs of 
     working people and their families, including: preventive 
     services; physician services; hospital services; maternity 
     coverage; prescription medications; mental health services; 
     affordable cost sharing and a realistic limit on out-of-
     pocket costs.
       AmeriCare provides additional benefits for children under 
     age 24 and people with modest income. Supplemental benefits 
     could be offered by employers or purchased through private 
     insurance companies. It also improves Medicare's existing 
     benefit structure to conform with AmeriCare, providing 
     streamlined cost-sharing and lower drug prices--without a 
     donut hole.
       Financing: AmeriCare is financed through contributions from 
     employers, individuals, and states, all of whom pay into our 
     current health care system. Unlike today's system, however, 
     AmeriCare will save billions of dollars by utilizing 
     Medicare's highly efficient administrative infrastructure 
     that operates on a 2% margin. Requiring the Secretary to 
     negotiate with the pharmaceutical industry for reasonable 
     prices and expanding the use of health information technology 
     in the clinical setting will achieve additional savings. The 
     efficiencies gained from these steps will keep AmeriCare's 
     premiums affordable.

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