[Congressional Record (Bound Edition), Volume 155 (2009), Part 1]
[Extensions of Remarks]
[Pages 218-219]
[From the U.S. Government Publishing Office, www.gpo.gov]




       INTRODUCTION OF THE AMERICARE HEALTH INSURANCE ACT OF 2009

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Tuesday, January 6, 2009

  Mr. STARK. Madam Speaker, it gives me great pleasure to reintroduce 
the AmeriCare Health Care Act of 2009. I have often spoken before this 
body about the great need to reform our health care system. For too 
long, we have been plagued with an inadequate patchwork system that 
today leaves nearly 46 million Americans uninsured. We spend more per 
person than any other country in the world, yet our health outcomes lag 
well behind that of other industrialized nations.
  The failing economy is even more proof of our need to act now. Our 
broken health system is a tremendous financial burden on our Nation's 
families and businesses alike. Since 1999, family premiums for 
employer-sponsored insurance have increased 119 percent, nearly 4 times 
the increase in wages (34 percent) and inflation (29 percent) during 
that same time. About one in three Americans reported a serious problem 
``paying for health care and health insurance'' in October 2008. Half 
of all bankruptcies can be traced to medical bills. 49 percent of 
people in foreclosure named medical problems as a cause of their 
financial difficulties.
  According to the New America Foundation, our economy lost as much as 
$207 billion last year because of the poor health and shorter lifespans 
of those without health insurance. General Motors spends more on health 
care than on steel. While I'm not suggesting we import the Canadian 
health system, it is worth highlighting that if we paid the same amount 
for health care as Canada, G.M. would have accumulated an additional 
$22 billion in profits over the last decade. Inadequate health coverage 
is crippling our economy.
  The President-elect declared that health care reform should happen 
``this year''. Chairman Rangel and I are ready to work with him, 
Chairmen Waxman and Miller, our leadership and the Senate to achieve 
this goal.
  AmeriCare is a template of a way that we can achieve universal health 
care. AmeriCare

[[Page 219]]

is built on a framework that is consistent with many of the principles 
that President-elect Obama identified during the campaign.
  Like President-elect Obama's plan, it includes a public plan option. 
It uses Medicare's existing administrative infrastructure, but improves 
upon Medicare's benefits to address some of the current gaps in 
coverage. A public plan option is the only way to ensure that 
beneficiaries have access to an option that promotes people over 
profit. As Medicare itself includes both public and private plan 
options, one could make the case that AmeriCare has an exchange, like 
Obama's plan as well.
  Like President-elect Obama's plan, it maintains employer sponsored 
coverage. People can keep the coverage they have if they like it. We 
need to build on what works, not create an entirely new system.
  Like President-elect Obama's plan, it includes a pay-or-play 
component to ensure that the private sector continues to play a role in 
providing health care.
  AmeriCare meets the Health Care for America Now! reform principles. 
It was endorsed last year by the coalition, as well as provider groups, 
beneficiary advocates, and unions including: American Academy of 
Pediatrics, American Nurses Association, Center for Medicare Advocacy, 
Consumers Union, Families USA, National Association of Community Health 
Centers, National Association of Public Hospitals, SEIU, Universal 
Health Care Action Network.
  AmeriCare is a practical proposal to ensure that everyone has 
affordable health coverage in our country. It builds on what works in 
today's health care system to provide simple, affordable, reliable 
health insurance. I look forward to working with President-elect Obama 
as he assumes the office of the President to achieve a universal health 
care program that meets the principles that he will outline to 
Congress.
  I will submit for the Record a short summary of AmeriCare. More can 
be found on my website at http://www.house.gov/stark.

                   AmeriCare Health Care Act of 2009

       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 be covered under the new 
     AmeriCare system, modeled on Medicare, or they would continue 
     to obtain health coverage through their employer.
       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.
       Structure and Administration: Creates a new title in the 
     Social Security Act, ``AmeriCare.'' Provides universal health 
     care for all U.S. residents, with additional coverage for 
     children (under 24), pregnant women, and individuals with 
     limited incomes (< 300 percent FPL). Sets out standards for 
     supplemental plans with a focus on consumer protection. 
     Requires the Secretary to negotiate discounts for 
     prescription drugs.
       Benefits: Adults receive Medicare Part A and B benefits; 
     preventive services, substance abuse treatment, mental health 
     parity; and prescription drug coverage equivalent to the BC/
     BS Standard Option in 2008. Children receive comprehensive 
     benefits and Early and Periodic Screening, Diagnostic, and 
     Treatment (EPSDT) coverage with no cost-sharing.
       Cost Sharing: There is a $350 deductible for individuals/ 
     $500 for families (indexed over time), and 20 percent 
     coinsurance. Total spending (premiums, deductibles, and co-
     insurance) is capped at out-of-pocket maximum of $2,500 
     individual/$4,000 family (indexed over time), or 5 percent of 
     income for beneficiaries with income between 200 percent-300 
     percent FPL and 7.5 percent of income for beneficiaries with 
     income between 300 percent-500 percent FPL. There is no cost 
     sharing for children, pregnant women and low-income 
     individuals (below 200 percent FPL). Sliding scale subsidies 
     are in place for cost-sharing for individuals between 200 
     percent and 300 percent FPL.
       Financing: At April 15 tax filing each year, individuals 
     either demonstrate equivalent coverage through their employer 
     or pay the AmeriCare premium based on cost of coverage and 
     class of enrollment (individual, couple, unmarried individual 
     with children, or married couple with children). Employers 
     may either pay 80 percent of the AmeriCare premium or provide 
     equivalent benefits through a group health plan (the 
     contribution for part-time workers is pro-rated). AmeriCare 
     does not affect contracts or collective bargaining agreements 
     in effect as of the date of enactment, and employers may 
     choose to provide additional benefits. Employers with fewer 
     than 100 employees have until January 1, 2014 to comply 
     (employees of small businesses would still only pay 20 
     percent of the premium).

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