The health reform bill passed late Saturday night won't fix a fiscally unsustainable system, says U.S. Rep. Collin Peterson.
Peterson, DFL-7th District, was the lone Minnesota Democrat to vote against the House bill in a narrow 220-215 vote late Saturday night. Minnesota's other northern representative, Rep. Jim Oberstar, DFL-8th District, voted for the measure.
"We need health care reform and we need to control and reduce health care costs -- I know it and most Minnesotans know it," Peterson said in a statement late Saturday night. "We also need everyone - Democrats and Republicans - to work together to make coverage more affordable for individuals and families, and to bring current and future costs under control."
But Peterson said both parties have put politics ahead of bipartisanship, forcing Congress to struggle to find solutions.
"In my view, the bill that passed the House of Representatives on Saturday fell well short of those objectives and so I voted against it," he said. "Don't get me wrong - I think the bill was trying to tackle the right problems and generally was going in the right direction, so I'm hopeful that as the process goes forward and the Senate does its work we will soon see a bill that Democrats and Republicans will be willing to vote for. But we're not there yet."
Democrats hailed the bill as it provides health insurance coverage for 96 percent of Americans. It requires most Americans to carry insurance and provides federal subsidies to those who can't afford it. Large companies would have to offer coverage, and both consumers and companies would face penalties if they don't get or offer coverage.
Insurance companies would no longer be able to bar coverage based on pre-existing conditions, or be able to charge higher premiums on the basis of gender or medical history. The insurance industry would also lose its exemption from federal antitrust restrictions.
The House bill would have the government sell insurance, but a federally regulated marketplace would be created.
"Although the bill was full of good intentions, our current system is fiscally unsustainable and this bill won't change that," said Peterson, chairman of the House Agriculture Committee. "Medicare's current unfunded liabilities are some $37 trillion, and Medicaid is close behind at around $35 trillion. This is money we don't have, money we'll have to borrow from foreign countries or raise here at home through tax increases. We have to tackle this problem and fix the underlying structural problems in both Medicare and Medicaid."
Peterson also questioned the viability of the proposed insurance marketplace.
"The House bill also commits the government to provide billions in subsidies to help people buy insurance in the marketplace," he said. "Subsidies only shift the cost of care from individuals to government and doing this leaves us promising to spend more money that we don't have. Adding it all up, I don't think our country can afford to add another trillion-plus dollar health care delivery plan."
It was also a flawed bill, Peterson said. "It did nothing to control costs and offered nothing to expand coverage."
The Congressional Budget Office said that the Republican's bill would create even larger numbers of uninsured Americans, he said. "We need to expand coverage, get more people insured and reduce costs."
The Detroit Lakes Democrat also outlined what he thought should be in a bill.
"I'm in favor of expanding coverage, creating market-based insurance exchanges, establishing portability of coverage, and eliminating the ability of insurance companies to exclude pre-existing conditions from coverage," he said.
"I think we should have tort reform, allow people to buy coverage across state lines, and restructure our payment systems so that we reward care that delivers high quality at lower costs instead of simply spending money for treatments that do little for the patient," he added.
Oberstar, chairman of the House Transportation and Infrastructure Committee, waited until making a House floor statement Saturday evening that he would support the bill.
"I am very pleased that the House health care bill includes many essential reforms that will improve health care," Oberstar said in a statement after the vote. "The health insurance provisions to ensure that Americans will not be denied coverage due to a pre-existing condition, the requirement for guaranteed issue and renewal, and the limit on out-of-pocket spending are much needed reforms that will make health insurance more available and affordable. For seniors, I strongly support the funding to close the donut hole in the Medicare Part D prescription drug program."
He also praised provisions to address "the historic disparities in Medicare reimbursement that have long penalized Minnesota and other high-quality, low-cost states."
Oberstar said he was disappointed the bill did not contain policy reforms for longstanding payment inequities that affect rural care. He also hopes the Senate bill and final conference report will include Critical Access Hospital designation for Cass County and the proposed facility near Walker.
"I strongly believe that Minnesota's leadership in health care reform should serve as a model for national reform," Oberstar said. "Minnesota is unique in requiring all health maintenance organizations to be non-profit as a condition of licensure. Minnesota extended health care coverage to lower-income children long before the enactment of the federal SCHIP program, and Minnesota has done a better job in expanding access to care through its MinnesotaCare program than the rest of the nation.
"Minnesota has led the nation on integrated health systems to coordinate care, and a new partnership between Fairview Health and the Medica health insurance company that provides payment incentives to invest in health care rather than paying for 'sick care' demonstrates Minnesota's continued leadership that is far ahead of national policymakers," he added.