State Representative Garnet F. Coleman

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Health Care Reform: We Got it Done

noreply@blogger.com (Rep. Garnet F. Coleman) — Mon, 22 Mar 2010 02:54:00 +0000

Moments ago, the U.S. House passed historic health care legislation. With President Obama's signature, health care coverage will be the law of the land.

Thanks to the members of Texas' Democratic Congressional Delegation for providing the votes and the hard work that got reform across the finish line. Their votes will help clean up the health care crisis in Texas that Rick Perry and Republican leaders have refused to address.

After years of being victimized by the colossal abuses of the health care status-quo, Texans and Americans scored a victory. The health care legislation passed today will give health insurance access to 31 million Americans and most of our state's 6 million uninsured residents.

Today's accomplishments take the advantage away from the insurance companies and put it back in the hands of Texans and the American people. No longer will Americans be driven into debt by health care costs, be denied coverage based on a preexisting condition, and be indiscriminately dropped from their policy when they’re sick and need it most.

Because of our dismal health standings, Texas stands to gain the most from this legislation. I intend to work hard to ensure that this legislation is implemented effectively in our state, so that quality health care becomes more affordable and more accessible for all of our families.

This legislation moves Texas and America forward. Our country is back on the right path.

Statistics tell a sobering story in black and white

noreply@blogger.com (Rep. Garnet F. Coleman) — Sat, 20 Mar 2010 16:01:00 +0000

Cartoon by RJ Matson

The U.S. House is expected to vote on health care legislation tomorrow afternoon. As I've said before, Texas has the most to gain from reform given our dismal health standings. Today's Houston Chronicle ran an op-ed that I wrote on the subject. You can read it here, or below. You can also read a version of my op-ed in Spanish here.

The Congressional Hispanic Caucus (CHC) has endorsed the health care legislation because it will increase access to coverage to millions of Americans including 8.8 million Latinos. Texas Congressman Charlie Gonzalez, the First Vice Chair of the CHC, stated “We are ready to make the historic vote that will improve the health of all Americans, including Hispanic Americans.” To read the press release from the CHC in its entirety click here.

Statistics tell a sobering story in black and white
Dems’ health plan good for people and for business

By STATE REP. GARNET F. COLEMAN
HOUSTON CHRONICLE

Statistics tell a story, and when you look at the troubling health care numbers in our state, it's clear what that story is: Everything's bigger in Texas.

Whether you're looking at the 1.3 million uninsured residents of Harris County or the 7 million insured Texans who spend 10 percent of their income on health care, it's clear our state needs to head in a new direction. And when you see that a leading Texas economist says spending on health care has a short-term multiplier effect — meaning federal health care legislation would result in more than $400 billion in economic activity in Texas — it's clear our state could greatly benefit from federal health care legislation.

For the 18 years I've served in the Texas Legislature, I've worked on health care issues in our state. I've worked with Republicans and Democrats, suburban, rural and urban members, doctors, nurses, patients and all the insurance company bureaucrats in between. I've seen the best and the worst of our health care system, and I've come to the same conclusion as most Americans: The current system is unsustainable and in dire need of reform.

As I said, statistics tell a story, and being first in the nation for the number of uninsured says there are leaders in Texas who are hostile to reform and unwilling to ensure their constituents have health care. Enrollment in the Children's Health Insurance Program just recently reached the same level where we were in 2003 when Republican lawmakers slashed hundreds of thousands of children off the rolls. If we're fighting to remain competitive with 2003 levels, it's clear that it's up to the president and Congress to enact reform that will benefit all Americans, but most especially Texans.

Because the majority of Texas businesses are small businesses, it's necessary to remove the great burden they face under current law. Federal reform will ease the struggle for small businesses that have to choose between increasing health premiums on their employees or dropping their coverage altogether.

At times this whole Sisyphean endeavor can seem dismaying. Seven different times, seven different presidents have pushed this huge health care reform boulder to the top of a steep hill, only to see it roll back down again, sending us back to the beginning. I'm determined not to let this be the eighth time.

It's necessary to pull our heads out of the daily grindings of process stories and legislative minutiae and remember why we're in this fight. All Americans have fallen victim to our current health care system, not just the ones who are uninsured. We've all heard the stories about insurance companies not playing fair. At a time these companies are reaping record profits, they are unscrupulously raising their rates on customers.

Out-of-control costs are adding another load to the backs of families strapped for cash in a tough economy. Insured individuals are paying higher premiums, higher deductibles and out-of-pocket expenses, while receiving fewer benefits. Furthermore, they carry the additional burden of paying for the care of the uninsured who may be only one illness away from bankruptcy.

These sobering statistics emphasize the need to rewrite the rules in favor of the American people. The health care legislation in Congress is a carefully crafted package that will insure 32 million Americans, give unprecedented security and stability to those with insurance and cut the federal deficit by $1.3 trillion.

Health insurance reform will provide immediate relief to Texas families by preventing insurance companies from inexplicably and excessively raising their rates. It will cap the amount of money an individual can spend on out-of-pocket expenses, eliminate lifetime and unreasonable annual limits on benefits and ensure that families aren't driven into debt by health care costs. Additionally, it will stop insurance companies from denying coverage based on pre-existing conditions and prohibit insurance companies from kicking people off their policies when they're sick and need it most.

It's beyond clear that Texas needs federal health care reform. We'll continue to fight on a state level regardless of the outcome, but we can't really win the fight against the worst practices of the insurance industry without the help of our elected members of Congress and people of good will.

Let's get it done.

Coleman, a Houston Democrat, is a member of President Barack Obama's 32-member White House Working Group of State Legislators for Health Reform. He is also the chair of the County Affairs Committee in the Texas House of Representatives, chair of Progressive States Network, chair of the Legislative Study Group and senior ranking member of the Public Health Committee.

President Obama Committed to Immigration Reform

noreply@blogger.com (Rep. Garnet F. Coleman) — Fri, 19 Mar 2010 23:17:00 +0000

Please see below a note from Rebecca Acuna, a member of my staff.
-Garnet Coleman

As someone who holds immigration reform close to my heart, it has been an honor to work for a legislator who shares the urgency in the matter. I've been fortunate enough to closely monitor immigration policy under the leadership of Representative Coleman

Because of his constant advocacy and work on behalf of all communities, Representative Coleman was selected to serve as a member of the working group, State Legislators for Progressive Immigration Reform. As a co-chair of the Progressive States Network, Representative Coleman plays a hand at spearheading efforts to tackle immigration reform at the state level. His deep grasp of the matter has lead him to work closely with the American Jewish Committee on their Bridging American Project, a task force aimed at making immigration reform a reality.

For those of us determined to see comprehensive immigration reform tackled this year, it was encouraging to learn that President Obama is committed to the issue and will not put it on the back burner. Congressman Luis Gutierrez, a champion of immigration reform who was withholding his vote on health care, agreed to cast a vote in favor of health care after meeting with President Obama to discuss immigration reform. After the meeting, Congressman Gutierrez said the President was committed to moving forward on a comprehensive immigration reform package as soon as possible.

On Sunday, thousands of immigrant rights reformers will convene at our nation's capital to urge swift action of humane, and comprehensive immigration legislation. We stand with these supporters and applaud their actions.

We will keep you up to date, as this important issue continues to develop.

Latest from Washington: Health Care Reform a Deficit Reducer

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 18 Mar 2010 18:34:00 +0000

Cartoon by Mike Luckovich

I'm in Washington, D.C. meeting with our leaders in Congress as they prepare to take a final vote on health care reform. Today, the nonpartisan Congressional Budget Office reported that the health care bill passed by the Senate, along with the changes proposed in the reconciliation bill, will reduce the federal deficit by $1.3 trillion and insure 32 million Americans. These figures mean that this bill reduces the deficit by more than the versions already passed by the House and Senate, and insures more Americans than the Senate version. House Majority Leader Steny Hoyer correctly said that this health care legislation will be the largest deficit reducer in 17 years.

The current health care system is failing us. It's crippling family, state and federal budgets, and disproportionately hurting middle-income Texans. A report released yesterday by the Robert Woods Johnson Foundation showed that middle-income Texans are losing their health insurance at alarming rates. Between 2000 and 2008, 2.3 million middle-income Americans lost their health insurance. Texans accounted for 500,000 of that total, meaning that 1 in 5 middle-income Texans lost their health coverage. During the same time frame, family health insurance premiums in our state rose by 76 percent, although median incomes declined by 4 percent.

These final days are critical not only to the health care bill but also to Texans struggling under the current system. Please contact the following members of Congress and ask them to cast a final vote in support of health care reform.

Contact:
Representative Henry Cuellar	(202) 225-1640
Representative Lloyd Doggett	(202) 225-4865
Representative Charles A. Gonzalez	(202) 225-3236
Representative Al Green	(202) 225-7508
Representative Gene Green	(202) 225-1688
Representative Ruben Hinojosa	(202) 225-2531
Representative Sheila Jackson-Lee	(202) 225-3816
Representative Eddie Bernice Johnson	(202) 225-8885
Representative Solomon Ortiz	(202) 225-7742
Representative Silvestre Reyes	(202) 225-4831
Representative Ciro D. Rodriguez	(202) 225-4511

Houston Chronicle & Judson Robinson III: Pass Health Care Now

noreply@blogger.com (Rep. Garnet F. Coleman) — Wed, 17 Mar 2010 18:06:00 +0000

A Houston Chronicle editorial today urges Democrats in Congress to move at full speed to pass health care reform and lead us to a better, more secure future. The editorial highlights the risks that doing nothing would have on health care costs, individuals with pre-existing conditions, and our already unstable economy.

Also in today's Houston Chronicle is an op-ed by Houston Area Urban League President Judson Robinson III, in which he stresses the moral imperative of a just and equitable health insurance system and the necessity of being healthy to obtain and keep a job. He notes that health care reform legislation would be especially beneficial to our state, and even more so to Harris County, where more than half a million uninsured individuals reside.

I've included both pieces below.

Showdown: Congressional Democrats should stand tall and back health care reform

Copyright 2010 Houston Chronicle
March 17, 2010, 12:29AM

It's crunch time on health care reform for congressional Democrats, especially those in the House of Representatives in potential swing districts. After months of discussion, an up or down vote on reform is likely to come before the end of the week.

Or perhaps not: The House Democratic leadership is considering using a procedure that would bypass a direct vote and spare vulnerable members the risk of an up or down vote. This is wrongheaded. As strongly as we support reform, we believe Congress should have the courage to vote on it directly. An end run would only stoke the already deep public cynicism about Washington's ways.

We understand the temptation. As a showdown approaches, undecided Democrats are being warned by Republicans, in no uncertain terms, that supporting their president on reform will cost them their jobs in November.

It may. But the greater risk by far, we would submit, is to do nothing.

Doing nothing would keep some 30 million Americans in a costly health care limbo that also would ramp up costs for millions more citizens with full insurance.

Doing nothing would only guarantee that health insurance costs continue to skyrocket with no relief in sight and no effective means of controlling them.

Doing nothing would mean that millions with pre-existing conditions would still be unable to qualify for coverage.

Doing nothing would hinder the all-important jobs recovery that making health care mobile and universally available would strongly support.

The Republicans have made their choice. They are in lock step against passage of the president's plan. That is not a pretty picture. It does not speak well for the health of our supposedly collegial political system. But it is also their right.

The Republican refuseniks have their reasons. Some are philosophical. Many have honest disagreements on approach, as was made clear in the recent health care summit.

But other GOP motives are unabashedly calculating and political, having nothing to do with health care. These are aimed squarely at winning back congressional seats in the November elections and, two years hence, defeating Barack Obama. The Republican leadership is persuaded that Obama is vulnerable on health care and can be taken down with a loss on this major pledge of his 2008 campaign.

We believe this is a bad bet and a narrowly self-interested approach that will be seen through and rejected by informed voters.

We believe it's a smart bet for wavering Democrats to stand with their president and accomplish this major policy objective.

We strongly encourage members of the Democratic rank and file to stand with their president and support health care reform in this critical hour.

This is one of those votes that will shape the American future, for better or worse. We believe a better, more secure future will result from a decision to take this step of reform.

Health care reform: It's time to get the job done
By JUDSON W. ROBINSON III
March 17, 2010, 12:34AM

As president and CEO of the Houston Area Urban League, I personally experience the daily challenge of working with individuals seeking help in becoming more productive. We all benefit when these individuals seize opportunities to improve their status in life. At the Urban League, we focus on bringing personal and community economic empowerment to the most vulnerable Houstonians by hastening their pace toward self-sufficiency. The sooner people become self-sufficient, the more independent they become. The moral imperative of having a just and equitable health insurance system is one of the cornerstones of that empowerment.

There are many misconceptions about the intentions of the health care bill being debated in Washington, D.C. It is important to note the impact that passage of this legislation would have on real Houstonians, particularly those most in need.

The health care bill includes key, common-sense provisions that would ensure access to affordable coverage for Houstonians. These provisions include: prohibiting discrimination based on pre-existing conditions, ending the practice of dropping policyholders when they become seriously ill, ending lifetime caps on coverage, reducing out-of-pocket expenses and ensuring access to preventive care and expansion of Medicaid to many adults who live in poverty. Expanding Medicaid to low-income adults would be particularly beneficial to the health of our state, given that approximately 32 percent of Texas adults are uninsured. More than half a million of Texas' 6 million uninsured residents live in Harris County. Every day, 470 Texans lose their coverage as a result of rising premiums, obscene out-of-pocket expenses and being diagnosed with a catastrophic illness.

Certainly, the costs associated with coverage for the uninsured warrant close inspection, but so do the tremendous increases in premiums and the outrageous profits for some insurance companies. Long-term cost avoidance is critical to the public's welfare. According to the Congressional Budget Office, we will save approximately $118 billion over the next 10 years and another $600 billion over the second 10 years once health reform is enacted. The bills that have passed would cap consumer spending, ensuring that no one has to fear bankruptcy when paying for care. The bills passed by Congress would take great strides in providing Children's Health Insurance Program and Medicaid coverage to children from middle- and lower-income families while allowing small businesses affordable coverage for their employees. The legislation calls for expanding Medicaid eligibility to everyone who is living at or near poverty, which would increase access to affordable coverage and bring coverage to about a million low-income uninsured adults in Texas.

One of the issues we focus on at the Urban League is health education. We must do a better job of taking personal responsibility for our own health. Provisions of the health care reform legislation provide incentives for prevention of illness and for healthy eating.

This legislation is such a significant step forward that we must not lose sight of all the good it does. Never before has our country been this close to realizing the dream of health insurance reform. For 60 years, we have pursued a way to increase the likelihood of community wellness while enhancing the quality of life and care for our citizens. There is much work to be done in this country. Housing, education, the environment and, as we all know, jobs deserve a big slice of our focus. But to have a job, you have to be healthy. To keep a job, you must stay healthy. Let's get this done and move on to other pressing concerns facing Houstonians.

Affordable health care should not be the privilege of the fortunate few. It is the issue of our time, and Congress should deliver reform for the good of our country.

Robinson is president and CEO of the Houston Area Urban League.

Homeowner Insurance Rates Continue to Rise

noreply@blogger.com (Rep. Garnet F. Coleman) — Wed, 17 Mar 2010 14:49:00 +0000

State Farm Insurance announced that they are imposing a 4.5 percent rate hike on homeowners insurance a mere seven months after enacting an 8.8 percent rate increase. The Legislative Study Group, a House Caucus that I chair, compiled a policy update on homeowners insurance legislation in Texas and proposed solutions to the problem. You can also read a memorandum on the subject from Texas Watch here.

LSG Policy Update: Homeowner Insurance Rates Continue to Rise

State Farm Increases Homeowner Insurance Rates

State Farm has announced that they will raise homeowner insurance rates by 4.5 percent in May. This comes on the heels of an 8.8 percent increase in October.1 Texas homeowners already pay the second highest insurance premiums in the country; such a steep rate increase hurts Texas homeowners financially as they navigate through the worst recession in a generation.

Unfortunately, this is not the first time that Texas homeowners have been charged excessive premiums. In November, State Farm was ordered to repay its customers $310 million for overcharging homeowners for coverage dating back to 2003.2 This sum was actually $700 million less than what consumer advocates and the state's Public Insurance Counsel recommended.

In addition, the policies provided by State Farm and other companies have cut back on the level of coverage provided to Texas homeowners, meaning Texans are effectively paying more while getting less.

Background on Insurance Legislation in Texas

As a result of a dramatic increase in mold claims prior to 2003, homeowner insurance rates were pushed to record heights. In response, legislators in the 78th Legislature passed SB 14, which, among other things, moved Texas to a "file and use" system.

Previously, rates were established by the Commissioner of the Texas Department of Insurance, and companies had to petition the department for approval to raise their rates above the established level. However, a loophole allowed most companies to shift their policies outside of the regulations, meaning consumers still saw high premiums.

The "file and use" system passed in 2003 did little to alleviate the problem. Under the new system, insurance companies were simply required to inform the department of a rate change before they implemented it. The department had no mechanism to regulate insurance companies as they implemented premium rates.

Texas homeowners have failed to see any significant relief from the rates that were in place prior to 2003.

Texas Department of Insurance

The Texas Department of Insurance has not undergone a sunset review since 1993. As mentioned previously, there have been many significant developments in the insurance market in Texas during that time.

The department was slated to undergo its review during the past legislative session, but the Legislature failed to act before adjourning Sine Die. A special session was called to pass a safety net bill that extended the life of the Department of Insurance and five other agencies until 2011.

It is unfortunate that the TDI sunset bill did not reach the floor of the House for a vote. Since the 2003 session when lawmakers passed, and Governor Perry signed, the ineffective "file and use" system, lawmakers have proposed a "prior approval" system that could provide effective relief for Texas homeowners. Such legislation was drafted again this session as an amendment to be voted on by the House during floor debate on the sunset bill. Lawmakers that filed such amendments included Representative John Smithee and LSG members Representatives Jessica Farrar and Trey Martinez Fischer.

Similar bills were filed during the 81st session by LSG members Representatives Anchia, Coleman, Herrero, Martinez Fischer, Rose and Vaught. On the Senate side, Senators Van De Putte, Hinojosa, and LSG member Senator Ellis also filed legislation.

Ineffectiveness of Department

Since no legislation that gave such regulatory power to the Department of Insurance passed, insurance companies are free to continue raising rates. The Commissioner has been left only with the ability to write a disapproving letter to companies.

After State Farm informed the Department of Insurance that they would institute a 4.5 percent hike a mere seven months after an 8.8 percent hike, Mike Geeslin, the Commissioner of the Texas Department of Insurance, wrote in a letter to State Farm3:

"The timing of this filing causes me concern. State Farm Lloyds last rate change for its homeowners program was an increase of 8.8% effective September 1, 2009, for new business, and October 1, 2009 for renewal business. State Farm Lloyds has had this increase in effect for only seven months. Multiple rates increases within such a short period of time may indicate a lack of rate making discipline and lead to market instability.

Given that State Farm Lloyds is the market leader, writing nearly 30% of the homeowners market, other companies may follow suit which would lead to further market instability. It appears that the timing of this is not in the best interests of Texas consumers. Consumers deserve a stable and competitive market. It is my hope that State Farm Lloyds reconsider the timing of this filing and will voluntarily withdraw it."
(emphasis added)

Prior Approval

Currently, while acknowledging the damaging effect of multiple rate increases, the best that the Department of Insurance can do is ask State Farm to "voluntarily withdraw" their rate increase.

The Legislature should pass real insurance reform for Texas homeowners to rectify this disappointing lack of proper regulation. Included in such reform should be a "prior approval" provision, similar to the ones filed by lawmakers in past sessions. Such a system would require the Commissioner of Insurance to approve a rate increase before a company can implement it. This would ensure that insurance companies justify their rate increases, protecting policyholders from excessive charges.

Help Us Cross the Finish Line

noreply@blogger.com (Rep. Garnet F. Coleman) — Tue, 16 Mar 2010 16:09:00 +0000

The U.S. House of Representatives could cast its final vote on health care reform at the end of this week, and send it to the President's desk soon after. Thanks to the hard work of the Democratic leadership and members of the Texas delegation, millions of Texans are closer than ever to gaining access to affordable health coverage and having protection from some of the insurance industry's worst practices.

Please call the following members of Congress from Texas and thank them for supporting health care legislation which will improve the lives of Texans and Americans. Ask them to get us across the finish line and cast a final vote for health care reform.

Contact:
Representative Henry Cuellar	(202) 225-1640
Representative Lloyd Doggett	(202) 225-4865
Representative Charles A. Gonzalez	(202) 225-3236
Representative Al Green	(202) 225-7508
Representative Gene Green	(202) 225-1688
Representative Ruben Hinojosa	(202) 225-2531
Representative Sheila Jackson-Lee	(202) 225-3816
Representative Eddie Bernice Johnson	(202) 225-8885
Representative Solomon Ortiz	(202) 225-7742
Representative Silvestre Reyes	(202) 225-4831
Representative Ciro D. Rodriguez	(202) 225-4511

Lifelong Republican: Voting for Health Care Fiscally Disciplined

noreply@blogger.com (Rep. Garnet F. Coleman) — Mon, 15 Mar 2010 18:40:00 +0000

One in every six dollars in the U.S. economy is spent on health care. If we continue down our current path, one out of every three dollars will be spent on our health care system. This is not sustainable for our country's economy and for the budgets of American families. Transportation Secretary Ray LaHood, a lifelong Republican and fiscal conservative supports health care reform legislation "because it's a good bill." Calling it the fiscally disciplined thing to do, Secretary LaHood urges other Republicans to follow his lead.

Below, I've included Secretary LaHood's message to fiscal conservatives.

On health care reform: this is a good bill

Yesterday, I voiced my support for health care reform with an op-ed in the Chicago Tribune. I am grateful to those who saw my speaking-out for what it was: a former legislator reaching out to Congress to step up and solve one of our nation's greatest problems. As I told FoxNews, "It's a matter of voting for a good bill."

Look, if you take even one step beyond the partisanship and dig down into the numbers, you will find that most Americans want health care reform. And if you want to know why this is a good health care reform bill, I recommend a recent informative article by the Associated Press.

Here's what I wrote in the Tribune:

I've been a Republican all my life, when I served in the Illinois legislature, when I worked for members of Congress and when I served in Congress. During the 2008 presidential election, I supported Republican Sen. John McCain. I have always been — and still am — a fiscal conservative, an advocate for a smart, but restrained, government.

For those reasons and others, most people wouldn't expect me to be an advocate for comprehensive health care reform. But the truth is, I believe there is no bigger issue to solve and no better chance to solve it than now.

If I were still a member of Congress, I would proudly vote for the bill that President Barack Obama is championing and I would urge my colleagues to do the same, not because I don't believe in fiscal discipline, but because I do.

We do not need to look that far down the road to see the pain that failure to pass health care reform will cause. Americans of every background, class, race and political persuasion are suffering. We have the best health care system in the world, yet more than 40 million Americans lack access to it, a reality that is morally reprehensible. Health care is an essential, as important as food, water and shelter. Those who don't have it are left without the tools to survive.

In the coming days, Congress has a chance to change that. The bill that will be voted on will reduce the deficit by about $1 trillion over the next two decades, and will reduce waste, fraud and abuse in the health care system. It will slow the rate of growth in health care costs and put America back on the path toward fiscal sustainability.

The bill will give families and small business owners greater control over their own health care. It will expand coverage to more than 31 million Americans and will include tax credits to individuals, families and small businesses, giving them the same choices that members of Congress have to purchase private coverage. It will create state-based exchanges that will bring competition and transparency to insurance markets. And it will put in place common-sense rules of the road to hold insurance companies accountable and end some of the most outrageous practices of the insurance industry.

Never again will people be denied coverage because they have a pre-existing condition. Never again will insurance companies be able to raise rates unfairly — like the 60 percent hikes expected in Illinois.

While the ultimate vote on health care may not be bipartisan, the ultimate bill certainly is.

There are several Republican ideas in the bill. It allows Americans to buy health insurance across state lines. It increases the bargaining power of small businesses by allowing them to pool together — much like large corporations or labor unions — to bargain for a better insurance rate. It gives states the flexibility to come up with an alternate health care plan, and it gives them resources to reform our tort system by developing new ways to deal with medical malpractice.

I also feel compelled to remind my former colleagues that contrary to what many people have been saying, the bill explicitly prevents federal dollars from being used to fund abortion. It ensures not only that those seeking abortion coverage will be required to pay for it with their own money, but also that their personal money will never be commingled with federal funds. As a former congressman with a 100 percent pro-life voting record, I'm comfortable supporting this bill.

There isn't one member of Congress who represents a district that is without a health care crisis. There are good, hardworking men and women in every part of this country who work for a living, but not at a business that offers the opportunity to purchase health insurance. On their own, the cost of insurance is just plain out of reach.

During my time in Congress, I was known for reaching across the aisle. I did it not for the sake of bipartisanship alone, but in order to get important things done.

Now, my former colleagues have the opportunity to change the lives of their friends and neighbors for the better by voting for health care reform.

Senate Has Votes to Proceed Using Reconciliation

noreply@blogger.com (Rep. Garnet F. Coleman) — Mon, 08 Mar 2010 18:40:00 +0000

Senator Mark Begich, in a letter to a constituents, became the 50th Democratic Senator to signal that he was open to using reconciliation to clean up the health care reform bill already passed by the House and Senate. Speaker Pelosi will be able to use these developments to persuade her colleagues in the House to approve the health care bill already passed by the Senate. President Obama has urged the House to schedule a vote on health care by March 18.

Health care reform legislation already cleared both chambers, and with a 60-vote majority in the Senate. Reconciliation would be used only to amend the bill and ensure that all states are treated equitably. Although Republicans would like for you to think otherwise, reconciliation has been used 21 times since 1981, 16 times by Republicans. It was used by President Bush to pass his 2001 and 2003 tax cuts and his Medicare Part D plan. The New York Times chart below shows the major reconciliation bills passed by Congress.

I've also included an editorial from the New York Times that clearly outlines President Obama's health care plan, and the dire situation Americans will face if reform is not enacted.

March 7, 2010
EDITORIAL
If Reform Fails

As the fierce debate on President Obama’s plan for health care reform comes to a head, Americans should be thinking carefully about what happens if Congress fails to enact legislation.

Are they really satisfied with the status quo? And is the status quo really sustainable?

Here are some basic facts Americans need to know as Congress decides whether to approve comprehensive reform or continue with what we have:

HOW REFORM WOULD WORK: Let’s be clear, the changes Mr. Obama and Democratic leaders in Congress are proposing are significant. But, despite what the critics charge, this is not a government takeover. And the program is not only fully paid for, it should actually reduce the deficit over the next two decades.

Under the new system, all people would be required to have health insurance or pay a penalty. If you are poor or middle class you would also get significant help through Medicaid coverage or tax credits to pay the premiums.

The legislation would create exchanges on which small businesses and people who buy their own coverage directly from insurers could choose from an array of private plans that would compete for their business. It would also require insurance companies to accept all applicants, even those with a pre-existing condition. And it would make a start at reforming the medical care system to improve quality and lower costs.

46 MILLION AND RISING: If nothing is done, the number of uninsured people — 46 million in 2008 — is sure to spike upward as rising medical costs and soaring premiums make policies less affordable and employers continue to drop coverage to save money.

The Congressional Budget Office projects 54 million uninsured people in 2019; the actuary for the federal government’s Centers for Medicare and Medicaid Services projects 57 million.

It should be no surprise that people without insurance often postpone needed care, and many get much sicker as a result. That is morally unsustainable. It is also fiscally unsustainable for safety net hospitals — which foist much of the cost on the American taxpayer when the uninsured end up in the emergency room. As the number of uninsured rises, that bill will rise.

The Senate’s reform bill would reduce the number of uninsured by an estimated 31 million in 2019. The Republicans’ paltry proposals would cut the number by only three million.

BUT I HAVE INSURANCE: While most Americans have insurance, many pay exorbitant rates because they have no bargaining power with insurers.

That includes many of the tens of millions who buy their own insurance — the unemployed, the self-employed, and those whose employers do not offer insurance. The recently announced plan by Anthem Blue Cross in California to raise annual premiums by 35 to 39 percent for nearly a quarter of its individual subscribers is a chilling harbinger of what is to come if reform fails.

There are another 48 million people who work in relatively small firms that often cannot get the better rates of large-group coverage. All of these groups should be able to get a better deal if they can buy their insurance through new, competitive exchanges.

If current trends continue, the number of underinsured Americans — those who have coverage too skimpy to pay substantial medical bills or protect them from high out-of-pocket spending — will also rise from an estimated 25 million in 2007 to 35 million in 2011, according to the Commonwealth Fund, a respected research organization.

That will increase the risk that this group will forgo needed care and will expose many more of them to potential bankruptcy if they cannot pay huge medical bills. Some 72 million adults currently have medical debt or problems paying their bills even though most of them have insurance. Reform would help them by setting minimum standards of coverage and providing subsidies to tens of millions of low- and middle-income people to help pay their premiums.

BUT I LIKE MY INSURANCE: Most Americans get their insurance through large companies, with large group bargaining power. While they complain about premiums and paperwork, most seem satisfied with their coverage.

For them the real fear is what happens if they lose their jobs or decide to change jobs. Will they be shut out of coverage because of a pre-existing condition or forced to pay high rates to buy their own insurance?

For this group, the real advantage of reform is security. If they get laid off, decide to be self-employed or switch to a smaller employer that offers no insurance, they will still be guaranteed coverage — even if they are a cancer survivor or have heart trouble or any other pre-existing condition. And they will be able to buy insurance on the exchanges.

I’M JUST WORRIED ABOUT COSTS: You should be. The cost of medical care is rising far faster than wages or inflation. And despite all of the talk about reform “bending the curve,” no one is yet sure how to do that.
Many reforms that people instinctively believe should cut costs — computerization of medical records, paying doctors for quality not quantity of services, and prevention programs to promote healthy living and head off costly illnesses — cannot yet be shown to lower costs.

Pending reform legislation, specifically the Senate bill, would launch an array of pilot projects to test reforms in delivering and paying for care. It would also create a special board to accelerate the adoption of anything that seemed to work. That seems a reasonable way to go and a lot better than standing by as costs continue to spiral out of control. The Republicans’ proposals — including their call to cap malpractice awards — would make only a small dent in the problem.

WHAT ABOUT THE DEFICIT?: Republican critics of health care reform have done an especially good job of frightening Americans with their talk of bankrupting the Treasury. The truth of the matter is that the pending reform legislation has been designed to generate enough revenue and savings to more than offset the substantial cost of expanding Medicaid and providing subsidies to the middle class.

The Congressional Budget Office estimated that the Senate bill would reduce deficits over the first 10 years by $132 billion and even more in the second decade.

What critics certainly do not talk about is what happens to the deficit if Medicare costs continue their relentless rise. That is something that should keep Americans up at night.

The pending reforms would cut the growth in Medicare spending per beneficiary in half — from 4 percent a year to 2 percent — by demanding productivity savings from Medicare providers and cutting unjustified subsidies to the private plans in Medicare.

There is some skepticism that Congress will stick to its guns if health care providers say they cannot survive on the reduced rations. But Congress has stood by most previous Medicare cuts (physicians excepted) and should have its spine stiffened by new pay-go rules requiring that any Medicare increases be offset by other savings or taxes.

If reform is defeated, it seems likely that most of the proposed experiments designed to cut costs — first within Medicare and then throughout the rest of the health care system — will die as well. The legislation needs to be passed to establish a structure to force continuing improvement over the years. That is the best chance of restraining soaring medical costs that threaten the solvency of families, businesses and the federal government.

•

Any change as big as this is bound to cause anxiety. Republicans have happily fanned those fears with talk of “dangerous experiments” on the “best health care system in the world.” The fact is that the health care system is broken for far too many Americans. And the country cannot afford the status quo.

•

This editorial is a part of a comprehensive examination of the debate over health care reform. You can read all of these editorials at: nytimes.com/edhealthcare2009.

Texans Avert Medicare Crisis

noreply@blogger.com (Rep. Garnet F. Coleman) — Fri, 05 Mar 2010 18:14:00 +0000

I wanted to bring to your attention the damage that our economy, Texans, and Texas doctors avoided this week because of swift action by President Obama and Senate Democratic leaders. Earlier this week, President Obama signed legislation that delayed a scheduled 21.2% cut in Medicare reimbursement rates and extended unemployment insurance and COBRA health benefits to Americans who lost their jobs. These vital programs faced an unnecessary and unexpected roadblock caused by Republican Senator Jim Bunning, who was more concerned with making a political point than with the well being of the American people.

The personal and fiscal impact of these programs to our state is immeasurable. Repealing the Medicare cuts alone will prevent a $980 million a year loss for care of elderly and disabled patients in our state, and they will prevent annual cuts averaging $20,000 to each Texas physician. The President's actions to avert Medicare rate cuts helped 215,760 employees, 2,455,457 Medicare patients, and 852,625 TRICARE patients in Texas.

On Wednesday, President Obama urged Congress to finish their work on health care and schedule an up or down vote. The President anticipates a health care vote in the House by March 18.

Trade Secretary Ron Kirk Comments on States' Rights & Secession Talk

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 04 Mar 2010 23:02:00 +0000

As you know, in the past I've highlighted some of the troubling aspects of the new conservative movement sweeping our country - specifically the states' rights/secessionist rhetoric. The above picture was taken by a staff member of mine at a Tea Party at the Texas Capitol last year. People were marching in front of the State Capitol threatening bloodshed. I've said that leaders need to take responsibility for their words and actions, and refuse to associate in any way with others who seek to tear our country down by exploiting fear and hatred.

Unfortunately, some, like Governor Perry, have embraced language that caters to extremists to build support for their political campaigns. I've said before that states rights and secession have a history in our country that is negative; it is not something that befits our great country.

In that vein, I wanted to highlight comments made by former Dallas Mayor and current US Trade Representative, Ron Kirk. Kirk observes the same troubling root of states' rights/secession rhetoric, and is right to make these comments. I appreciate his frank statements, and encourage you to read the below article from the Dallas Morning News.

Ron Kirk is not amused by secession talk

Thursday, March 4, 2010
By JIM LANDERS / The Dallas Morning News

WASHINGTON – U.S. Trade Representative and former Dallas Mayor Ron Kirk tore into the Texas GOP fringe's flirtation with secession Wednesday, comparing such comments to a return to "the Jim Crow South."

"I know what it means for my parents' generation," Kirk, a black Democrat, said when asked about the issue. "And we fought too hard to get me to this point for me to be amused even a little bit by any of this states' rights, secession stuff."

During the Republican primary campaign, Gov. Rick Perry said he could understand why some anti-government Republicans spoke of returning Texas to its days as an independent republic because of a sense that Washington is intruding into state and private affairs.

Kirk compared such talk with the "states' rights" conservatism of the 1950s and 1960s that bridled against the federal government's efforts to desegregate the South.

Kirk, without mentioning Perry, said reporters should press the question of who would pay for the state's needs if it broke away.

"I wish those of you in the press would then ask, even though it's tongue in cheek, so what does this mean then, for a state that unfortunately ranks in the bottom, investment in education and health care for our kids, leads the nation in the number of people of unemployed, and you want to pull out of the country?" he said.

"Tell me where you're going to find the money to pay for Medicare with one of the highest-growing senior populations in the country," he said.

"In a state that's probably $2 billion underfunded in maintaining its own highways, and now you want to pull out of the United States and take away the billions of dollars you get from the federal [government] – how are you going to fix your infrastructure?"

Kirk, the highest-ranking Texan in the Obama administration, won two terms as Dallas mayor in the 1990s, then lost a race for U.S. Senate in 2002.

He was the Texas point man for Barack Obama's White House campaign in 2008.

Important Health Care Developments from the President

noreply@blogger.com (Rep. Garnet F. Coleman) — Wed, 03 Mar 2010 20:26:00 +0000

President Obama, promising to do everything in his power to make the case for reform, has urged Congress to finish their work on health care and schedule an up-or-down vote in the next few weeks. To reiterate what President Obama said, "Everything there is to say about health care has been said."

Health care reform legislation before Congress has already passed out of both chambers, and, with 60 votes in the Senate. The nonpartisan Congressional Budget Office reported that health care reform will reduce the federal deficit by $100 billion over the next ten years by cutting government overspending and reining in waste, fraud and abuse.

Last Monday, President Obama submitted his own health care proposal as a starting point for the health care summit last week. The President asked leaders of both parties to submit tangible policy ideas that will help the American people. Putting partisanship aside, President Obama embedded four health care ideas offered by Republicans at last week's summit into his proposal. They are:

Conducting undercover investigations of health care providers that receive Medicare reimbursements,
Investing $50 million in additional grants for pilot projects aimed at reforming the medical malpractice system,
Increasing Medicaid reimbursement rates to doctors, and
Expanding health saving accounts.

Members of both parties understand that our country is facing a serious problem. The proposal put forth by the President builds on and improves the current system. The plan ends some of the insurance industry's most despicable practices, reduces costs for people with insurance and makes coverage more affordable for people without coverage. It also sets up a new competitive insurance marketplace where small business owners and families can shop for the insurance plan that best fits their needs.

Health care legislation will give Americans more control of their health care, help provide coverage to 31 million Americans, and put our country on the path to a more sustainable economy. We can't waste more time. Congress needs to finish the job for the American people.

U.S. Senate Navigates Around Republican Roadblock

noreply@blogger.com (Rep. Garnet F. Coleman) — Wed, 03 Mar 2010 03:51:00 +0000

I know that tonight people are monitoring primary election results, but I wanted to forward you information that impacts Texans across the state. As you read in Chairman Dunnam’s email yesterday, Republican Senator Bunning, aided by some of his colleagues, was holding up unemployment benefits, health care for Americans who lost their jobs, transportation projects around the country, and was triggering a 21% cut in Medicare reimbursement rates to doctors. Because of Senator Bunning’s antics, 27,400 Texans and more than 200,000 Americans who are struggling in a tough economy, were at jeopardy of losing their much needed unemployment benefits.

Fortunately, moments ago the U.S. Senate passed legislation to navigate around the one man road block. President Obama just signed this legislation into law. Below, I’ve included an article from the New York Times with more details.

Senator Relents, and Jobless Bill Passes

By CARL HULSE

WASHINGTON — The Senate headed reached a resolution of an impasse over unemployment pay on Tuesday night after Senator Jim Bunning, Republican of Kentucky, dropped his objection to extending jobless benefits in exchange for a largely symbolic vote on paying for the aid.

Mr. Bunning’s agreement to relent essentially short-circuited an intensifying political battle that had already resulted in 2,000 workers at the Department of Transportation being furloughed without pay and in the temporary cutoff of benefits to thousands of out-of-work Americans.

It came after Mr. Bunning’s fellow Republicans began to air their own concerns about how the Senate blockade had the potential to damage their political brand while also having a direct impact on their constituents. The Senate later voted 78 to 19 to renew the programs.
While Democrats hailed the progress, they also said Mr. Bunning’s decision to delay the aid had caused serious disruptions in federal programs and could create bureaucratic problems as people tried to reclaim their federal aid.

“Sometimes just because we have the power to do things, we ought to think twice before we use that power,” said Senator Richard J. Durbin of Illinois, the No. 2 Democrat in the Senate.

With Mr. Bunning’s battle quickly becoming a national cause célèbre, Senator Mitch McConnell of Kentucky, the Republican leader and Mr. Bunning’s home-state colleague, made clear earlier that Republicans were trying to end the stalemate.

And Senator Susan Collins of Maine, a moderate Republican colleague of the conservative Mr. Bunning, joined Democrats in trying to force the measure through, calculating that perhaps a plea from a fellow Republican would get him to change his position.

“When I was home this weekend, I talked to constituents who expressed their utter bafflement that Congress could not proceed on something that has widespread support,” Ms. Collins said.

While trying to blame Democrats for mishandling the entire matter, other Republicans also distanced themselves from Mr. Bunning, whom Democrats were holding up as the embodiment of what they say has been a maddening pattern of Republican obstruction in the Senate.

“This is one senator,” said Senator John Cornyn of Texas, a chief political strategist for Senate Republicans. “This does not represent the position of the caucus.”

Other party officials said that while the Bunning fight was not helpful, it probably would not do serious damage as long as it ended rapidly.

Republicans were not just unhappy that the back-and-forth was allowing Democrats and editorial writers around the country to portray them as heartless curmudgeons, denying jobless aid to struggling Americans while Mr. Bunning complained that late-night debate was preventing him from watching a college basketball game.

The attention to the impasse was also cutting into Republican efforts to focus on the evolving Democratic strategy on the health care overhaul, which Republicans are trying to portray as an end-run around Senate rules. Instead, Democrats were having a field day citing Mr. Bunning’s repeated objections as evidence of how Republicans abuse the rules to delay needed legislation, helping them build a case in favor of using any available tools to overcome such opposition.

Complicating the situation was the fact that Mr. McConnell and Mr. Bunning have a tortured relationship because Mr. McConnell was instrumental last year in making it difficult for Mr. Bunning to seek a third term. The rift left Mr. McConnell with little leverage to apply to get his fellow Kentuckian to retreat.

Not all senators were engaged in Bunning-bashing. “He’s my hero this week,” said Senator Jim DeMint, the conservative Republican from South Carolina, who said Mr. Bunning was exposing Democratic hypocrisy of embracing budget controls but adding spending like the employment aid to the deficit. “We have to quit complaining about unsustainable debt and passing new spending programs every week.”

The fight spread to the House as well, with Representative John A. Boehner of Ohio, the Republican leader, saying Mr. Bunning has “got a legitimate argument that he’s making.”

At the same time, dozens of House Democrats sharply criticized Mr. Bunning, with Representative John Yarmuth of Kentucky saying he was “embarrassed that a senator from Kentucky is holding our government hostage.”

Last week the House passed the bill at issue, which provided a 30-day extension of unemployment benefits, health insurance subsidies for the jobless, the highway construction program and a handful of other expiring programs to allow Congress to work out more permanent legislation. Mr. Bunning almost immediately began lodging his objections, insisting that the unemployment help be offset by money from other sources.

As a result, the programs lapsed as of Sunday, forcing the Department of Transportation to furlough 2,000 workers without pay on Monday and shut down dozens of construction projects.

In addition, jobless benefits began running out for thousands of workers across the country, though a broader measure now before the Senate would restore them retroactively.

Even as negotiations toward a resolution continued, a parade of Senate Democrats kept up vigorous expressions of displeasure with Mr. Bunning.

“I come to the floor of the Senate to say to my colleague from Kentucky,” Senator Barbara A. Mikulski, Democrat of Maryland intoned Tuesday with a bit of biblical fervor, “let the unemployment bill go.”

Peter Baker and Robert Pear contributed reporting.

From the Desk of Representative Jim Dunnam

noreply@blogger.com (Rep. Garnet F. Coleman) — Mon, 01 Mar 2010 20:16:00 +0000

Please see the note below from my colleague in the Texas House, Representative Jim Dunnam of Waco.
- Garnet Coleman

March 1, 2010

As chair of the House Select Committee on Federal Economic Stabilization Funding, it's my job to monitor Washington, D.C. and keep Texas House members and Texans informed of federal actions that will impact them. Last week, the U.S. Senate was expected to pass legislation that would extend unemployment benefits, COBRA health insurance, as well as funds for the Highway Trust Fund and Medicaid reimbursements for physicians.

Because it's so urgent that the American people receive their unemployment benefits, the Senate was set to pass the bill through what's called "unanimous consent", which means everyone agrees to pass the bill. However, one Republican Senator from Kentucky, Jim Bunning, stood in the way and objected to its passage. Because of this one man roadblock, Texans and Americans across the country are set to lose their jobless aid today. Doctors are being instructed to not submit reimbursement claims under Medicaid for 10 days, to allow time to work around Senator Bunning's delays. Republican Senators have yet to reel in their colleague, and because of his publicity stunt, hundreds of thousands of Americans are feeling the pinch.

This epitomizes what it means to be from the Party of No, and shows how out of touch Senator Bunning and his Republican colleagues really are with the American people. Senate Democrats are scheduling a vote on the bill to go around the obstructionism and should be able to pass the legislation this week. In the meantime, this act of callous disregard will cause serious harm to Americans looking for work.

For your reference, below is an editorial from the New York Times, detailing the situation.

Clueless in Kentucky
Editorial February 27, 2010

Kentucky has lost about 60,000 jobs since the end of 2008. In December, its unemployment rate stood at 10.7 percent, the highest since 1983. So what exactly is going on in the minds of Kentucky's two Republican senators, Mitch McConnell and Jim Bunning?

This week, Mr. Bunning single-handedly shot down a one-month extension of unemployment benefits, along with a federal subsidy for the unemployed to maintain health coverage. Two weeks earlier, Mr. McConnell, the minority leader, objected to a one-week extension to give senators time to draft a longer-term package.

It should be a no-brainer to extend unemployment insurance when around 1 out of every 10 workers is unemployed. Standard unemployment benefits end at 26 weeks, yet 6.3 million workers have been out of work for more than 27 weeks. Congress has provided a series of extensions, and without another one, 400,000 people will lose their benefits in a matter of weeks.

Senator Bunning once cared about the unemployed. When the benefit was due to expire in November, he joined a unanimous vote to extend it until the end of February. "Kentucky has been hit hard by the current economic downturn," he said at the time. It still is, but Mr. Bunning refused to consider the extension unless it was paid for with funds from the fiscal stimulus plan. For years, Mr. Bunning didn't seem to have a problem with blowing up the deficit for the Iraq war and tax cuts. Now he's a deficit hawk when it comes to average Americans.

Maybe he's preoccupied. At one point during a debate on the issue Thursday night, he complained about missing the Kentucky-South Carolina basketball game.

Democrats must now defeat Republican attempts to lace the benefits extension with things like protecting the rich from the estate tax. To avoid a repeat of this nonsense every few weeks, unemployment benefits should be extended until the end of the year. Perhaps by Monday somebody can educate Senators Bunning and McConnell about Kentucky's unemployment rate.

Wrap-up of the Bipartisan Summit and Intro to Reconciliation

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 25 Feb 2010 22:24:00 +0000

The President's bipartisan healthcare summit has just wrapped up. What we saw today was the President and Congressional Democrats clearly lay out their vision and arguments for why the legislation they've passed should become law, and how it will help the American people. Unfortunately, for the most part, we heard the same song and a different verse from Congressional Republicans that simply want the President and proponents of health reform to give up.

Senator Cornyn put out a statement attacking the bill because of its cost to Texas. What he didn't note was that for every dollar the state will spend for Medicaid expansion, we'll receive $9 from the federal government to match it. Texas is clearly a winner under the President's plan, and we've reached the point where Senator Cornyn and his Republican obstructionist allies need to either lead or get out of the way.

The Congressional reconciliation process has made headlines lately as a possible track for Democrats to pass health care reform. Reconciliation is not a new concept, and it's not a "nuclear option". It's been used to pass significant legislation 21 times since 1981, 16 times by Republicans. President Bush used the budget reconciliation process to pass his 2001 and 2003 tax cuts and his Medicare Part D plan. This process was also used to pass COBRA- which lets individuals who lose their jobs continue employer sponsored coverage for 18 months- to enact most major Medicaid reforms, to pass the 1996 welfare reform, and to create the State Children's Health Insurance Program (CHIP).

Below, I've included an article from NPR that details the reconciliation process and some of the many instances it has been used to pass legislation.

Health Care No Stranger To Reconciliation Process
by Julie Rovner
February 24, 2010

To reconcile or not to reconcile — when it comes to a health overhaul bill, that seems to be the biggest argument of the moment.

At issue is a process called budget reconciliation. By writing Obama's health care plan as a budget bill, Democrats can prevent a Republican filibuster in the Senate and advance the bill with a simple majority instead of the 60-vote supermajority they no longer have.

Not surprisingly, that has Republicans crying foul. Budget reconciliation, Sen. John Kyl (R-AZ) told reporters Tuesday, "was never designed for a large, comprehensive piece of legislation such as health care, as you all know. It's a budget exercise, and that's why some refer to it as the 'nuclear option.'"

"The use of expedited reconciliation process to push through more dramatic changes to a health care bill of such size, scope and magnitude is unprecedented," Sen. Orrin Hatch (R-UT) wrote in a letter to President Obama on Monday, urging him to renounce the possibility of trying to pass a bill using the procedure.

But health care and reconciliation actually have a lengthy history. "In fact, the way in which virtually all of health reform, with very, very limited exceptions, has happened over the past 30 years has been the reconciliation process," says Sara Rosenbaum, who chairs the Department of Health Policy at George Washington University.

For example, the law that lets people keep their employers' health insurance after they leave their jobs is called COBRA, not because it has anything to do with snakes, but because it was included as one fairly minor provision in a huge reconciliation bill, she says.

"The correct name is continuation benefits. And the only reason it's called COBRA is because it was contained in the Consolidated Omnibus Budget Reconciliation Act of 1985; and that is how we came up with the name COBRA," she says.

COBRA, which confusingly did not become law until 1986, was actually a much larger bill, including many nonhealth provisions and many other important health provisions as well (see chart). Among them was the so-called Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals that accept Medicare or Medicaid payments to at least screen patients who arrive for emergency treatment, regardless of their ability to pay.

Children's Health

But the budget reconciliation process has been used for more far-reaching health policy changes as well, says Rosenbaum. The expansion of health insurance coverage for low-income children is a prime example.

"In 1980, children who were living at less than half the poverty level in the United States could not get a Medicaid card in half the states if they had two parents at home," she says.

But via a series of budget reconciliation bills, beginning in 1984, Congress began expanding Medicaid coverage. In 1997, also in a budget reconciliation bill, it created the Children's Health Insurance Program, known as CHIP. Today, says Rosenbaum, who helped write many of the children's health provisions in those bills, Medicaid and CHIP together cover 1 in every 3 children in the United States.

"So literally we've changed everything about insurance coverage for children and families, and we've changed access to health care all across the United States all as a result of reconciliation," she says.

Medicare Changes

Budget reconciliation has also been an important tool for changing the Medicare program.

"Going back even close to 30 years, if you start say in 1982, the reconciliation bill that year added the hospice benefit, which is very important to people at the end of life," says Tricia Neuman, vice president and director of the Medicare Policy Project for the Kaiser Family Foundation.

Over the years, budget reconciliation bills added Medicare benefits for HMOs, for preventive care like cancer screenings; added protections for patients in nursing homes; and changed the way Medicare pays doctors and other health professionals.

Because the point of budget reconciliation was usually to cut the deficit, the huge Medicare program was nearly always on the chopping block. But there's another reason it became the bill of choice for other far-reaching changes.

"This happened primarily because it was the only train leaving the station, so if policymakers wanted to make a change in health policy, the only way to do it would be to amend a reconciliation bill, and that's really why it happened," says Neuman, a former congressional health policy staffer.

In fact, over the past three decades, the number of major health financing measures that were NOT passed via budget reconciliation can be counted on one hand. And one of those — the 1988 Medicare Catastrophic Coverage Act — was repealed the following year after a backlash by seniors who were asked to underwrite the measure themselves.

So using the process to try to pass a health overhaul bill might not be easy. But it won't be unprecedented.

Visits with Biden, Sebelius, Duncan and Others in DC

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 25 Feb 2010 18:02:00 +0000

Yesterday afternoon I sat down with around 30 local and state officials from across the country at a three hour interactive briefing from senior White House staff, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan. Afterwards, I attended a reception and dinner hosted by Vice President Joe Biden and his wife at the Vice President’s Residence.

The issue briefing on the administration’s policy priorities was wide ranging, but focused on a common theme: strengthening America in tough times and creating a foundation for the future. As we heard about health care, public health, strengthening our education systems, economic policy, job creation and urban and rural initiatives it was clear that to remain competitive on the world stage we must continue to move America forward and build strength during one of the worst recessions in our nation’s history.

Secretary Sebelius gave a presentation on health care, focusing specifically on public health. Health intervention, reducing obesity, the general health of our nation’s people – across the board these priorities are key to advancing our country and rebuilding our economy.

Secretary Duncan stressed that education is paramount for our nation, education systems must empower our children to become productive adults and good parents. We as a nation must ensure that they have the education to compete globally.

The two Cabinet Secretaries said we have to make sure we're building the best America possible because we're losing our competitive edge with other nations. Other countries have invested in their health care and education systems, meaning they’ve invested in their future. We must do the same.

We heard from the President’s Council on Economic Advisors. They’ve been busy over the last year, working hard to save the economy in our country. Obviously, rescuing our struggling economy has been the most important item on the agenda because this affects all individuals. As any of my colleagues in the Texas Legislature could tell you, without the stimulus funds our state would have been over $12 billion in the hole. The stimulus served to create millions of jobs and stabilize the freefall that our businesses, and local and state governments were facing.

The administration has taken on wide ranging issues like health care, jobs and education, because taken as a whole, they will serve to move our country forward and keep us competitive across the globe. These issues filter down throughout every aspect of our lives – working together we can ensure that our future remains bright.

This was all capped off with a small reception of around 30 people hosted by Vice President Joe Biden and his wife, Dr. Jill Biden, at their home. Mayors, county commissioners and state legislators from around the country participated as we celebrated Black History Month.

It’s encouraging that the White House is reaching out so well to state and local officials to ensure they understand policies being worked on in Washington, D.C. and have a voice in the process. I’ll be in town for a couple more days, and I’ll continue to report back everything I hear.

We're Closer To Health Care Reform Than We've Been In Decades

noreply@blogger.com (Rep. Garnet F. Coleman) — Wed, 24 Feb 2010 18:51:00 +0000

Last night I landed in Washington, D.C. While I'm here, I'll be meeting with leaders to do whatever I can to aid in giving health care reform the push it needs to get over the finish line.

In part because of the work you and I have done, members of Congress have passed a health care bill out of both the House and the Senate. We've sent letters, made calls, met with leaders and voiced our support to anyone that will listen. Our efforts have had an effect. People are listening and are regrouping to close the deal.

To share our perspective on the health care challenges in our state, I sent a letter to the Secretary of Health and Human Services, Kathleen Sebelius. I wrote to ensure that the voices of Texans were heard above the din of Republican opposition from those like Governor Perry. Below you can read the letter I received in response from Secretary Sebelius. To view the full correspondence, click here.

Tomorrow, the President will convene a bipartisan summit on healthcare reform to break through the partisan logjam that has stalled us over the last few weeks. The meeting will be broadcast on national television Thursday at 9 a.m. I encourage you to tune in or watch it streamed live at WhiteHouse.gov. On Monday, the President laid out his vision for a health care reform bill that builds on the legislation passed by the Senate. You can read that plan here.

We've come too far to start over. Keep up the good work, and thank you for allowing me to serve you. I'll continue to keep you informed as we move forward.

Garnet

President Obama's Health Care Proposal

noreply@blogger.com (Rep. Garnet F. Coleman) — Mon, 22 Feb 2010 18:22:00 +0000

This morning, President Obama released a carefully crafted health care proposal that bridged the gap between the versions passed by the U.S. Senate and House. You can read that plan here. Understanding that we have come too far to start over, the President is pointing to his proposal as a starting point for the televised health care summit on Thursday.

The proposal would offer bigger subsidies to help working Americans purchase health coverage, and give billions in tax credits so small businesses could offer insurance to their employees. President Obama's plan would offer additional federal dollars to states for Medicaid expansion and ensure that all states are treated equally. It would stop deplorable insurance industry practices like denying coverage because of a pre-existing condition, and would give the federal government authority to stop egregious premium increases. Particularly during a recession, Americans understand the importance of this government oversight. Despite making massive profits, health insurance companies are enacting outrageous premium increases. Last week, Health and Human Services Secretary Kathleen Sebelius pressured a California health insurance company to delay a 39 percent premium increase it planned to implement on some of its customers.

President Obama has demonstrated his commitment to American families. His plan will help close the gap that has left millions of Americans uninsured and underinsured. It will also stabilize our economy by reducing the federal deficit by $100 billion over the next ten years.

Bipartisan Health Care Summit

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 18 Feb 2010 23:18:00 +0000

A week from today, the White House will host a televised health summit with top Democratic and Republican leaders, in hopes of coming up with a deal to move forward with health care reform. House and Senate Democratic leaders have been crafting a proposal, and President Obama is expected to release a single Democratic plan for reform on Monday. There is currently an effort on the part of Democratic Senators to allow a vote in the reconciliation process to pass a public option. As of now, 18 Democratic Senators have signed a letter requesting the vote, and more are expected to sign. So far, Republicans have not submitted proposals to move forward on health care.

While our families, hospitals, and state and local governments continue to struggle with out of control health care costs, health insurance companies are reaping massive profits. The profits of the 5 largest health insurance companies increased 56%.

If our broken health care system is not reformed, American families will continue to see staggering health care costs and will remain at risk of losing their health care. The head of the National Association of Insurance Commissioners predicts that consumers in several states are about to get hit with increases of “20, 25, 30 percent.” Hospitals will continue to be burdened with tens of billions of dollars of uncompensated care to uninsured and underinsured patients.

Insurers across the country are spiking their rates despite the recession:

In 2009, Blue Cross/Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market.
Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state.
In Maine, Anthem Blue Cross is seeking to raise rates by 23 percent this year---after jacking up their rates 32 percent last year.
Regency Blue Cross Blue Shield of Oregon requested a 20-percent premium increase.
UnitedHealth, Tufts, and Blue Cross requested 13- to 16-percent rate increases in Rhode Island.
And rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.

It is time to pass health insurance reform that will rein in insurance companies, provide more affordable options, protect Americans from abusive insurance company practices and restrict how much of your premium dollars can be spent on profits and overhead.

Anniversary of SCHIP Reauthorization

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 04 Feb 2010 19:31:00 +0000

Today marks the first anniversary of President Obama's reauthorization of the State Children's Health Insurance Program (CHIP). The expansion of the program was crucial to providing health insurance to children from working families, and is expected to cut the number of uninsured children in our country by half in the coming years.

The reauthorization of the program was one of President Obama's first orders of business upon taking office and was particularly meaningful after President George W. Bush twice vetoed similar legislation. President Obama called the expansion a down payment on quality, affordable health care for all Americans.

In Texas, 495,781 children rely on CHIP to access health care. January was the only month that Texas' enrollment levels exceeded 500,000 since 2003, when Republican lawmakers instituted enrollment barriers that purged hundreds of thousands of eligible children from the program. The federal government gives Texas $2.52 for every $1 we invest in the program.

During the 81st Legislative Session, I authored legislation to increase enrollment in and public awareness of CHIP. My bill would have insured an estimated 80,000 Texas children from working families by allowing their parents to buy in to the program. Despite bipartisan support in both the House and the Senate, political action by the Governor, conservative Republicans, and Senate leaders caused this bill to die in a Senate committee. As one of the original authors of CHIP in Texas, I will continue to work to eliminate the red tape that keeps eligible children from receiving health care.

Today, we have 495,781 reasons to thank President Obama.

DNC Appointment and Round-Up of Awards

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 04 Feb 2010 15:39:00 +0000

The Democratic Legislative Campaign Committee (DLCC), a national organization that works to elect Democratic majorities in state legislative chambers across the country, has appointed me to serve as a member of the Democratic National Committee (DNC). I was appointed by virtue of my position as a current board member of the DLCC, where I've been representing the interests of Democratic state legislators nationally by helping to develop state-specific strategies that will enable Democrats to win state legislative seats and chambers. My appointment to the DNC is a responsibility that I take seriously, and I look forward to working with fellow members to continue to build on the successes of the Democratic Party. As a member of the DNC I'll have the opportunity to vote on party rules, work on the party platform, and, as a superdelegate, re-nominate President Obama and Vice President Biden in 2012.

Some of my colleagues in the Legislature were elected as DNC members through the Texas Democratic Party process. They include Senator Royce West, Representative Yvonne Davis, Representative Senfronia Thompson, and Council Member Sue Lovell.

Additionally, Speaker Straus has nominated me to serve on the Minority Health Advisory Committee of the National Conference of State Legislatures. Today, I'm flying to Tampa to meet with this committee and review and strategize on objectives that will move us toward health equity. I consider it a privilege that Speaker Straus has entrusted me with this duty, and will represent our state to the best of my abilities.

It is because of your support and participation that I have been able to best execute my responsibilities. This past year, I was deeply honored to receive the acknowledgment of many statewide organizations. Some of those recognitions include:

Texas Medical Association's 2009 Friend of Medicine Award
Texas Academy of Family Physicians' 2009 Patient Advocacy Award
Texas Hospital Association's 2009 Advocacy Tribute Award
Texas Association of Counties 2009 Champion of County Government Award
Capitol Inside Honorable Mention in Best of the Legislature 2009
Named 2009 People's Friend by the Texas Observer
Mental Health America of Greater Houston 2009 Legislative Award
Cenikor's Annual Elected Official Award, September 2009
Harris County Medical Society's Patient Care Champion Award
The Gathering Place's Founder's Award

Thank you for all the support you have given me throughout the years. Together, we can continue to work to move Texas forward.

Health Care and the Federal Budget

noreply@blogger.com (Rep. Garnet F. Coleman) — Tue, 02 Feb 2010 22:29:00 +0000

Yesterday, President Obama submitted his 2011 federal budget proposal to Congress. Included in the budget proposal are some critical investments to health care.

Because of today's tough economic times, more people are enrolling in Medicaid. President Obama's budget proposal allocates $25.5 billion for Medicaid assistance to help states maintain their Medicaid programs as they increase enrollment rates. Community health centers, which currently help millions of uninsured Americans access health care, will receive an infusion of $290 million to continue their work. Additionally, $995 million dollars will be allocated to increase the number of doctors and nurses in rural and underserved areas.

The administration proposed to extend the federal COBRA health insurance premiums that are currently provided to Americans who have been involuntarily terminated. Under the proposed budget, the federal government would subsidize 65% of health care premiums for individuals laid off through December 31, 2010.

Some other key provisions include:

$110 million for continuing efforts to strengthen health IT policy, coordination, and research activities.
$286 million for research that compares the effectiveness of different medical options, building on the expansion of this research begun under Recovery Act.
New Medicare demonstration projects that evaluate reforms to provide higher quality care at lower costs, improve beneficiary education and understanding
$20 million to fund a new effort in up to 10 of the largest U.S. cities to reduce the rates of morbidity and disability due to chronic disease.
$10 million to improve workforce capacity of state and local health departments.
$10 million for the federal employee workplace wellness initiative. This initiative will implement prototype wellness programs in select locations that will be rigorously evaluated for their ability to produce a healthier workforce and lower health care costs.

President Obama and his administration are committed to expanding access to coverage for those without insurance, and to provide security and stability to those who have it.

Texas and the Federal Budget

The President's budget also allocates funds to benefit Texas and Texas families. Some of the key investments for our state include:

Tax cuts for 8.4 million families.
$5 billion for schools, students, and teachers.
$4.2 billion to fix and expand the state’s network of roads and highways, modernize airports, and expand water and sewer infrastructure.
$2.5 billion in new funding for Pell Grants to help families pay for college.
$1.5 billion for housing assistance.
Extend for another year the broadest tax cut in American history – the Making Work Pay Tax Credit – for 8.4 million families in Texas.
Increase the child care tax break by providing a 35 percent credit for middle-class families earning up to $85,000 a year and at least some additional credit to families earning up to $113,000. Families could claim up to $3,000 in expenses for one child or $6,000 for two children. Many middle-class families with two children will see value of the credit nearly double, from $1,200 to $2,100.
Expand child care funding for working parents by adding $1.6 billion to the Child Care Development Fund, the largest one-year increase in 20 years, to serve an additional 235,000 children. For Texas, the Budget includes $603.1 million in child care assistance.
Deploy future TARP funds to assist homeowners threatened with foreclosure and small businesses needing access to affordable credit.

Click here to learn more about the federal budget and its investments in Texas.

"Finish the Job for the American People"

noreply@blogger.com (Rep. Garnet F. Coleman) — Thu, 28 Jan 2010 20:08:00 +0000

"Do not walk away from [health care] reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people. Let's get it done. Let's get it done."
-President Obama, State of the Union Address, 1/27/2009

Last night, the President called for Congress to finish the job. We're now on the 2 yard line, we just need a final push to score a win for the American people.

Separately, Speaker Nancy Pelosi indicated she has the votes for the Senate's health care bill if the Senate pursues reconciliation to pass a clean up bill.

It's important to ensure that members from Texas and in the leadership hear our message: Pass the bill and get it done.

If any of the below members of Congress represent you, call their offices and tell them you support swift passage of the bill. If you don't live in their districts, call the offices of Senate Majority Leader Harry Reid and Speaker Nancy Pelosi to tell them that this legislation would improve the lives of all Americans, and ask them to move forward and pass the bill.

Contact:

House Speaker Nancy Pelosi	(202) 225-0100
Senate Majority Leader Harry Reid	(202) 224-3542
Representative Henry Cuellar	(202) 225-1640
Representative Lloyd Doggett	(202) 225-4865
Representative Chet Edwards	(202) 225-6105
Representative Charles A. Gonzalez	(202) 225-3236
Representative Al Green	(202) 225-7508
Representative Gene Green	(202) 225-1688
Representative Ruben Hinojosa	(202) 225-2531
Representative Sheila Jackson-Lee	(202) 225-3816
Representative Eddie Bernice Johnson	(202) 225-8885
Representative Solomon Ortiz	(202) 225-7742
Representative Silvestre Reyes	(202) 225-4831
Representative Ciro D. Rodriguez	(202) 225-4511

No Surrender

noreply@blogger.com (Rep. Garnet F. Coleman) — Tue, 26 Jan 2010 15:31:00 +0000

With the Republican victory in the Massachusetts special election last week, many politicians and pundits have begun to preemptively write the obituary for health care reform.

After a year of legislative wrangling, it's frustrating to watch as momentum for health care reform seems to wane. At times this whole sisyphean endeavor can seem dismaying. Seven different times, seven different Presidents have pushed this huge boulder to the top of a steep hill, only to see it roll back down again, sending us back to the beginning. I'm determined to not let this be the eighth time. As a black man, I don't want President Obama's only legacy to be that he was just the first black president.

It's necessary to pull our heads out of the daily grindings of legislative minutiae and remember why we're in this fight. There are six million uninsured Texans, living each day in fear of getting sick. There are millions more underinsured Texans that are one catastrophic illness away from being shoved off their insurance. Runaway health insurance costs are putting the hurt on budgets of families, businesses, and local and state governments.

It's beyond clear that the status quo, the system we deal with, has run amok. This is no time to shirk from the fight and kick the can down the road.

This month in Texas, enrollment in the Children's Health Insurance Program finally reached back to 500,000 after hundreds of thousands of children were slashed from the rolls by Republican lawmakers. This is the same level of enrollment that our state was at in 2003. If we're fighting in Texas to remain competitive with 2003 levels, it's clear that the governing philosophy of Governor Perry and his allies is to place the lowest possible priority on the health of their constituents.

Texas needs federal health care reform. We'll continue to fight on a state level regardless of the outcome, but we can't really win the fight against the worst practices of the insurance industry without the help of the federal government.

I'm reaching out to our members of Congress, Senators, and the White House, to urge them to press on. I encourage you to do the same. Surrender is not an option, we need to fight on.

Click here to look up your member of Congress and get their contact information.

For your reference, below is an article on the options available to Congress and the President to move forward.

New York Times

January 26, 2010

Decision Looms on Advancing Health Care Bill

By DAVID M. HERSZENHORN and ROBERT PEAR

WASHINGTON — Seeking to avert the collapse of major health care legislation, the White House and Democratic leaders in Congress face a crucial decision about whether to use a procedural maneuver that would allow them to advance the bill despite the loss of their 60-vote majority in the Senate.

The maneuver, known as budget reconciliation, could allow President Obama and his party to muscle the legislation through Congress with a simple majority vote in the Senate. But it carries numerous risks, including the possibility of a political backlash against what Republicans would be sure to cast as parliamentary trickery.

The procedure is also subject to complex rules that could make it difficult for Democrats to include all the provisions needed to win approval of the bill, especially among rank-and-file House Democrats. For instance, it might be difficult to include provisions related to insurance coverage for abortions.

Still, for Mr. Obama, it may be the only route available to win passage of the sort of ambitious overhaul that he has pressed as his top domestic priority. And the White House and Congressional leaders have known all along that they might need to employ the tactic to finish a health bill.

“The idea that at any given time the Senate would have 60 votes was not what we would call the most ironclad assumption,” the House speaker, Nancy Pelosi, said at a news conference on Thursday. “We have always thought, what if? You know, what if the policy decisions are such that they can’t get 60 votes for it?”

Senior Congressional aides said that lawmakers and the White House were increasingly focused on a plan by which the House would adopt the health care bill approved by the Senate on Dec. 24, with any changes made in a separate bill using the budget reconciliation maneuver.

But Democratic leaders are no longer confident that rank-and-file House Democrats would be willing to go along. The victory by the Republican, Scott Brown, in Massachusetts last Tuesday not only denied Democrats their 60th vote, but raised a specter of fear for Democrats over the midterm elections.

Some Democrats said that regaining the support of the caucus could depend heavily on what Mr. Obama says in his State of the Union speech on Wednesday.

Republicans, however, have made clear that they will portray Mr. Obama and Democrats as trying to use a hardball tactic to win passage of the health care legislation.

“Less than a week after the Massachusetts special election, the Obama administration is vowing to ‘stay the course’ and double down on the same costly, job-killing policies that are leaving America’s middle-class families and small businesses high and dry,” said the House Republican leader, Representative John A. Boehner of Ohio.

Some Democrats seem prepared to give up on a health care bill or to put it off for several weeks. Others have begun calling for a sharply scaled-back measure that they hope could win bipartisan support. But it is unclear if Republicans would cooperate even on a modest bill.

In the meantime, aides have been trying to devise a process by which the Senate could make changes to its health bill on a reconciliation measure even before the House voted on the Senate-passed health bill. Some lawmakers said House Democrats might have to vote first.

The House could approve the Senate bill and send it directly to Mr. Obama, eliminating the need for any more votes. But House Democrats have refused to do so because they oppose numerous provisions in the Senate measure, including one that provided extra federal aid solely for Nebraska.

Some House Democrats have also voiced opposition to an deal that the White House and labor unions reached on a proposed tax on high-cost, employer-sponsored insurance plans.

Passing even a modest reconciliation bill to make changes to the Senate health measure would not be easy. The mere mention of reconciliation infuriates many Republicans, even though they occasionally used the tactic when they were in the majority.

At least one Democrat who opposed the maneuver earlier in the heath care debate, Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, said he could go along with its limited use, depending on the specific changes to the health bill.

“If you had another one of the bills that’s in play pass and then you used reconciliation to improve it, to fix it, that’s certainly possible,” Mr. Conrad said. “But it’s important to understand the limitations of reconciliation.”

Mr. Conrad said provisions could be stricken from the measure if they were judged not to have direct budgetary impact, potentially limiting the scope of the legislation.

Mr. Conrad said he was not concerned about the likely Republican accusations of trickery. “They are going to say that, whatever,” he said.

The senior Republican on the Budget Committee, Senator Judd Gregg of New Hampshire, said Democrats would have trouble executing their strategy. “It would be a very hard lift,” Mr. Gregg said. “We would make it an extraordinarily difficult exercise.”

Democrats positioned themselves to potentially use reconciliation by including a provision for it in last year’s budget.

Under the Congressional Budget Act of 1974, reconciliation bills were given special Senate protection and allowed to pass by simple majority votes, after limited debate, to let senators make the tough decisions required to cut the deficit.

But Senator Robert C. Byrd, Democrat of West Virginia and a longtime defender of Senate precedents, created complex rules to deter lawmakers from using reconciliation to make new policy rather than to achieve budget savings.

Sheryl Gay Stolberg contributed reporting.