[Congressional Record Volume 158, Number 48 (Thursday, March 22, 2012)]
[Extensions of Remarks]
[Pages E425-E426]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PROTECTING ACCESS TO HEALTHCARE ACT

                                 ______
                                 

                               speech of

                          HON. MAZIE K. HIRONO

                               of hawaii

                    in the house of representatives

                       Wednesday, March 21, 2012

       The House in Committee of the Whole House on the state of 
     the Union had under consideration the bill (H.R. 5) to 
     improve patient access to health care services and provide 
     improved medical care by reducing the excessive burden the 
     liability system places on the health care delivery system:

  Ms. HIRONO. Mr. Chair, this week we celebrate the 2nd anniversary of 
the Affordable Care Act.
  The Affordable Care Act is designed to fix so many of the things that 
ail our health care system and burden everyday families. The new law 
has already had a major impact on families in Hawaii.
  Senior citizens in Hawaii now have some relief from the high cost of 
prescription drugs. In 2010, over 24,000 people with Medicare in Hawaii 
received tax rebates to cover prescription drug costs.
  One senior from Waimea on Hawaii Island told me her $250 Medicare 
rebate check was ``a blessing'' in these tough economic times. She was 
able to use that money to pay for her other medical bills.
  In 2011, more than 21,000 people in Hawaii with Medicare saved close 
to $7 million on prescription drugs. The ``donut hole'' gap in coverage 
will be closed by 2020.
  A mother in Kailua told me that because of the Affordable Care Act, 
she could now add her 21 year-old son and 24 year-old daughter to her 
work-sponsored insurance plan.
  These are just two of the over 5,000 Hawaii young adults who can now 
stay on their parents' plan until age 26. This Kailua family is now 
using the thousands of dollars saved on health insurance each year for 
other household needs, including paying down past medical debt.
  The old saying is true, that ``an ounce of prevention is worth a 
pound of cure.'' Preventive services like mammograms, colonoscopies, 
and wellness visits can detect problems early and prevent higher costs 
later.
  Thanks to the Affordable Care Act, nearly all 210,000 Hawaii people 
with Medicare can now get preventive services without a co-pay or 
deductible. In addition, 240,000 people in Hawaii with private 
insurance are now eligible for preventive services--including women's 
health services such as domestic violence screenings and 
contraception--without a co-pay or deductible.
  The Hawaii Prepaid Health Care Act already covers employees who work 
for more than 20 hours per week. As a result, a large percentage of our 
people can get the healthcare they need to stay healthy. We have a low 
rate of uninsured. And that saves all of us money.
  This is why I fought hard to preserve the Hawaii Prepaid Health Care 
Act in the House bill. I offered an amendment to preserve Hawaii's law 
and defended my amendment in committee, convincing my colleagues to 
support my amendment. Then, all of us in the delegation worked together 
to make sure the final Affordable Care Act law maintained Hawaii's law.
  Because of Hawaii's Prepaid Health Care Act, most employers in Hawaii 
already provide health coverage. The Affordable Care Act makes it 
easier for Hawaii small businesses by providing tax rebates to help pay 
for health care costs. Nearly 29,000 Hawaii businesses are eligible for 
tax credits under the law.
  Today I also met with leaders from eight of Hawaii's Community Health 
Centers. The Affordable Care Act helps fund these 73 health center 
sites that serve our highest-need rural and underserved communities, 
especially on the Neighbor Islands and rural Oahu. These health centers 
care for over 130,000 people and provide nearly 1,300 jobs throughout 
the state. The message these health leaders shared with me today is 
that the Affordable Care Act has made a positive difference in the 
lives of so many.
  Given how much the Affordable Care Act is already helping Hawaii, it 
is unfortunate that some in Congress want to repeal it. Because they 
can't repeal the law all at once, they have continued to try to de-fund 
the law or repeal one piece at a time.
  Today we're seeing another example of this, with H.R. 5. This bill 
would repeal the law's Independent Payment Advisory Board, also known 
as the IPAB.
  This board is a panel of experts that will make recommendations so 
taxpayers aren't paying for unnecessary Medicare procedures. This will 
save taxpayers billions of dollars, while protecting Medicare patients. 
The board would not be allowed to recommend any cuts to reimbursement 
rates that ration or harm patient care. Congress would vote on the 
board's recommendations, or come up with an alternative that reduces 
cost growth by more.
  In fact, because the Affordable Care Act has already reduced the 
growth in Medicare costs, the Board's recommendations wouldn't even be 
triggered until 2022 at the earliest.
  I have heard from some medical providers in Hawaii who are worried 
the IPAB will recommend cuts to their specialty. These providers say 
they might choose not to see Medicare patients. I can understand their 
concerns, but here's the thing: Medicare costs are going

[[Page E426]]

up partly because of expensive and sometimes unnecessary procedures. 
Most members of Congress aren't scientists or health care researchers, 
so a panel of experts would be better suited to use the best research 
to recommend reforms. I will vote against a bill to repeal IPAB that 
doesn't put a better system in its place.
  Unfortunately, this week the House Majority released a budget plan 
(the Ryan Budget) that would end the Medicare guarantee for our 
seniors. The Ryan Budget would again turn Medicare into a voucher 
system where seniors would have to purchase private plans. Private 
plans could deny and delay coverage, without Medicare's consumer 
protections our seniors get today. Last year's House budget tried this 
same plan, and the Congressional Budget Office said it would increase 
costs to people on Medicare by $6,000 per person starting in 2022.
  The bill we're voting on today, H.R. 5, also recycles an old 
misguided proposal for medical negligence reform. Someone who is harmed 
by misconduct by a health professional should not be barred from 
appropriate compensation for a permanent disability or loss of a loved 
one.
  The reality is that most medical providers are doing the right thing. 
A small percentage of doctors are responsible for over half the medical 
malpractice cases. We shouldn't be protecting this minority of 
providers over the rights of patients injured through these providers' 
negligence. Today's bill would deny justice to those who have been 
harmed by a small number of medical providers.
  Today's bill, H.R. 5, would also hurt states' rights by preempting 
state medical malpractice laws. A cap on damages for physical 
impairment, pain, suffering, and even death could not exceed $250,000, 
regardless of individual states' existing limits.
  Today's bill also extends far beyond medical malpractice. It would 
also apply to limit patients' rights in all ``health care lawsuits,'' 
which could include cases against pharmaceutical and medical device 
manufacturers, nursing homes, HMOs, insurance companies, and hospitals.
  While proponents of medical malpractice reform argue that frivolous 
lawsuits are driving up insurance premiums, the fact is, economic 
studies have shown that medical malpractice payouts are not the cause 
of higher premiums for consumers. Instead, premium increases are caused 
by other factors, such as too little competition in the private 
insurance market.
  I urge my colleagues to reject H.R. 5.
  On the second anniversary of the Affordable Care Act, we should be 
fighting to make healthcare more accessible for our people, not less.
  Mahalo nui loa (thank you very much).

                          ____________________