[Congressional Record Volume 156, Number 40 (Thursday, March 18, 2010)]
[Extensions of Remarks]
[Pages E408-E410]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

                                 ______
                                 

                          HON. JASON CHAFFETZ

                                of utah

                    in the house of representatives

                        Thursday, March 18, 2010

  Mr. CHAFFETZ. Madam Speaker, the one-size-fits-all federally 
controlled health care plan proposed by the Democrats as ``reform'' 
will never address the particular needs of each state the way a 
successful health care system must do.
  It is essential that Congress allow states the flexibility to respond 
to local markets, institutions, demographics, and issues. At the very 
least a federal plan must contain opt-out provisions for states. The 
current plan does not include these provisions and could seriously 
undermine years of hard work and progress in Utah.
  Utah's Governor recently sent a letter to the members of our 
delegation outlining some of

[[Page E409]]

his concerns with the current proposal for a federal takeover of health 
care. In his letter, the Governor criticized the current health care 
legislation as not providing Utah the flexibility to create solutions 
and address problems in a manner best suited to Utah's unique needs.
  The Utah state legislature shares the Governor's concerns about 
increased federal restrictions on states' abilities to regulate health 
care. The legislature passed a bipartisan concurrent resolution urging 
Congress, should it pass health reform legislation that further 
restricts states, to grandfather certain state laws, regulations and 
practices that have proven very successful in Utah.
  I stand with the Utah legislature and the Governor in urging Congress 
to refuse to enact any legislation that imposes further restrictions on 
a state's ability to regulate health care in the way that best meets 
the needs of its citizens.


                                       Office of the Governor,

                             Salt Lake City, Utah, March 11, 2010.
     Hon. Jason Chaffetz,
     Longworth Building,
     Washington DC.
       Dear Congressman Jason Chaffetz, I am writing to encourage 
     you to resist the Obama Administration's current push to pass 
     the White House health care reform plan as quickly as 
     possible. As I have outlined in previous communications, the 
     White House plan is not in the best interests of the citizens 
     of the State of Utah.
       While in Washington recently with the National Governors 
     Association, I discovered, through discussions with my 
     counterparts, that many are working on state-based health 
     system reform. It quickly became clear, however, that the 
     country's governors were not welcome to participate in the 
     national dialog, which is an unfortunate and critical 
     mistake. States must have the opportunity to address local 
     needs with local solutions and to help shape the national 
     debate.
       Simply put, the White House plan does not provide Utah with 
     the flexibility to create solutions and address problems in a 
     manner best suited to our unique needs. A one-size-fits-all 
     ``solution'' will never address the particular needs of each 
     state and its citizens. States must be allowed flexibility to 
     respond to local markets, institutions, demographics, and 
     issues. At the very least, a federal plan must contain opt-
     out provisions for states like Utah, which has already come 
     so far in reforming our own health care systems. The current 
     plan does not contain these provisions and, as it stands 
     today, could seriously impede three years of hard work and 
     progress in Utah. These opt-out provisions are critical to 
     states like Utah, which is leading the way in reform.
       The White House plan is a rejection of the concept of 
     federalism, which is so vital to our nation. It ignores the 
     fact that the right way to go about reform is to allow the 50 
     states to be 50 laboratories of innovation. This is the only 
     way to really learn what works and what doesn't, and for 
     whom. For the past three years, Utah has been one of the 
     leading states in developing health care reform, and the 
     results are beginning to show great promise. We have had 
     several successes, particularly with the Utah Health 
     Exchange, and we continue to build on those successes.
       Our friends in other states are also beginning to learn 
     what works for them and what does not. If Washington leaders 
     are serious about finding a good solution for the nation, 
     shouldn't they be looking to these states for guidance?
       If designed correctly, federal reform that creates 
     flexibility and rewards innovation will provide benefits well 
     into the future. In fact, I would like nothing more than to 
     lend my support to a meaningful bipartisan federal health 
     reform bill. However, there appears to be little interest 
     from the White House to create such a bill. The process the 
     Administration is pursuing all but guarantees that no 
     bipartisan bill will emerge. Yet, here in Utah, all of our 
     health system reform legislation has enjoyed broad bipartisan 
     support. It can--and it should--be done. That message must be 
     heard in Washington.
       As Governor, I ask that you continue to work toward a 
     bipartisan federal reform bill. One that recognizes the 
     proper role of the states as laboratories and provides the 
     support we need to be flexible in addressing our unique 
     situations and demographics.
       Thank you for your leadership and assistance with this very 
     important issue.
           Sincerely,
                                                  Gary R. Herbert,
     Governor.
                                  ____


                         Utah State Legislature

                           H.C.R. 8 Enrolled

          Concurrent Resolution on Federal Health Care Reform


                               LONG TITLE

       General Description: This concurrent resolution of the 
     Legislature and Governor urges Congress to refuse to pass any 
     health care legislation that contains certain provisions, 
     urges Congress to pass health care legislation with specific 
     provisions, and urges Congress, should it pass health reform 
     legislation that further restricts states, to grandfather 
     certain state laws, regulations, and practices.
       Highlighted Provisions: This resolution urges Congress to 
     refuse to enact, and the President of the United States to 
     refuse to sign, any legislation that imposes further 
     restrictions on any state's ability to regulate the payment 
     and delivery of health care, imposes additional financial 
     burden related to health care on any state, or limits the 
     ability of consumers and businesses to create innovative 
     models for higher quality, lower cost health care; urges 
     Congress to pass, and the President to sign, legislation that 
     grants states greater flexibility under federal laws and 
     regulations related to health care and encourages states to 
     create health reform demonstration projects with the 
     potential for replication elsewhere; and urges that should 
     Congress pass, and the President sign, legislation that 
     further restricts states in any manner, the legislation 
     recognize states' efforts to reform health care by 
     grandfathering any state laws, regulations, or practices 
     intended to contain costs, improve quality, increase 
     consumerism, or otherwise implement health system reform 
     concepts.
       Special Clauses: None.
       Be it resolved by the Legislature of the state of Utah, the 
     Governor concurring therein:
       Whereas, people's health affects not only their sense of 
     well being, but their capacity to contribute to their 
     families, to their employers, and to society at large;
       Whereas, the improvement and maintenance of individual 
     health depends to a significant extent on the widespread 
     availability of affordable, high quality health care;
       Whereas, the widespread availability of affordable, high 
     quality health care is threatened by long-term runaway 
     spending in a system that too often delivers suboptimal care;
       Whereas, runaway spending and suboptimal care are 
     attributable to various factors, but are perpetuated to a 
     large extent by a third-party payer system that fails to 
     reward individual effort to preserve and improve one's health 
     and that fails to reward delivery of the most effective care 
     at the lowest cost;
       Whereas, for many years, Utah has been laying the 
     foundation for genuine long-term health system reform;
       Whereas, this foundation includes the creation of the Utah 
     Health Data Authority in 1990 and the subsequent collection 
     and publication of hospital charges by facility and adjusted 
     for risk;
       Whereas, this foundation includes the establishment in 1993 
     of the Utah Health Information Network, a nationally 
     recognized statewide system for processing health insurance 
     claims at a small fraction of the cost often charged by other 
     claims processors;
       Whereas, this foundation includes the 2005 requirement that 
     the Utah Health Data Authority publish reports that compare 
     health care facilities based on charges, quality, and safety;
       Whereas, this foundation includes the 2007-08 development 
     of an all-payer database that will report payments, as 
     opposed to charges, for entire episodes of medical care, and 
     will ultimately allow consumers to choose from among 
     competing providers of treatments for any particular 
     condition based on outcomes, price, and other attributes 
     important to the consumer;
       Whereas, this foundation includes the 2008-09 creation of 
     the first statewide system in the nation for standardized 
     electronic exchange of clinical health information across 
     provider systems, including exchange of diagnostic test 
     results and electronic medical record information;
       Whereas, this foundation includes the 2008 creation of the 
     Health System Reform Task Force, a legislative body that has 
     engaged consumers, employers, doctors, hospitals, and 
     insurers in a voluntary, cooperative effort spanning two 
     years, and involving thousands of hours, to develop a 
     strategic plan for health system reform;
       Whereas, this foundation includes the 2009-10 creation of 
     payment and delivery reform demonstration projects designed 
     to align third-party payment structures with provider 
     practices that result in the highest quality of care for 
     both chronic and acute conditions;
       Whereas, this foundation includes the 2009 creation of the 
     nation's second-only health insurance exchange, a virtual 
     marketplace where employees may enroll under a defined 
     contribution arrangement, select from a range of plans 
     broader than what an employer traditionally offers, and fund 
     premiums with contributions from multiple sources;
       Whereas, this foundation outlined above is the result of an 
     iterative process of creation and refinement that has relied 
     heavily on the input of all major stakeholders in the health 
     care system and has been established largely on the basis of 
     cooperation and consensus rather than compulsion;
       Whereas, many of the perverse incentives that plague our 
     health care system are rooted in federal Medicare and 
     Medicaid payment policies, which exert a disproportionate 
     influence on the privately funded portions of our health care 
     system;
       Whereas, federal proposals for health system reform 
     recently considered by Congress emphasize enrollment 
     expansion rather than cost containment, much like boarding 
     additional passengers on an already sinking Titanic;
       Whereas, those proposals include laudable authorizations 
     for payment and delivery reform demonstration projects but 
     otherwise largely lack significant cost containment 
     provisions;
       Whereas, those proposals include many provisions to improve 
     quality of care but fall

[[Page E410]]

     short of the systemic changes needed to fully link outcomes 
     and payment;
       Whereas, states have consistently proven themselves 
     laboratories of policy innovation, in spite of sometimes 
     stifling federal regulatory restrictions;
       Whereas, the best hope for health system reform lies with 
     individual states, where an iterative process of 
     experimentation, evaluation, and modification will minimize 
     the unintended consequences of one-size-fits-all national 
     policies and will produce results worth replicating; and
       Whereas, states are in need of additional financial 
     resources and flexibility to experiment rather than 
     additional benefit mandates, Medicaid eligibility mandates, 
     and rating restrictions, all of which will inevitably drive 
     up health care spending and costs to states: Now, therefore, 
     be it resolved, that the Legislature of the state of Utah, 
     the Governor concurring therein, urge Congress to refuse to 
     enact, and the President of the United States to refuse to 
     sign, any legislation that imposes further restrictions on 
     any state's ability to regulate the payment and delivery of 
     health care, imposes additional financial burden related to 
     health care on any state, or limits the ability of consumers 
     and businesses to create innovative models for higher 
     quality, lower cost health care; be it further resolved, that 
     the Legislature and the Governor urge that Congress pass, and 
     the President sign, legislation that grants states greater 
     flexibility under federal laws and regulations related to 
     health care and encourages states to create health reform 
     demonstration projects with the potential for replication 
     elsewhere; be it further resolved, that the Legislature and 
     the Governor urge that should Congress pass, and the 
     President sign, legislation that further restricts states in 
     any manner, the legislation recognize states' efforts to 
     reform health care by grandfathering any state laws, 
     regulations, or practices intended to contain costs, improve 
     quality, increase consumerism, or otherwise implement health 
     system reform concepts. Be it further resolved, that a copy 
     of this resolution be sent to the Majority Leader of the 
     United States Senate, the Speaker of the United States House 
     of Representatives, the President of the United States, and 
     the members of Utah's Congressional delegation.

                          ____________________