Washington, D.C. — The status quo in health care is unacceptable. American families and small businesses are crippled by the staggering costs of premiums. We can not afford inaction. Health care reform will immediately start lowering the cost of health care to make coverage more affordable for families and ensure small businesses no longer have to choose between health care and hiring.

Health care reform is about instilling common-sense rules of the road to hold insurance companies accountable. We will immediately put an end to their abusive practices like arbitrarily hiking premiums, denying people coverage due to pre-existing conditions, and dropping patients from their plans when they get sick.

Health care reform will lower the cost of health care and give the power back to the American consumer. It preserves choice and creates competition in the insurance market. If you like your plan, you can keep your plan. If you like your doctor, you can keep your doctor. If you change jobs, you can keep your coverage.

The skyrocketing cost of health care is forcing small businesses to choose between health care and hiring. This bill will provide much-needed financial relief to small business owners by offering them tax credits when they purchase coverage for their employees. Small businesses are the engine of job growth in this country and in this economy we need them to use their dollars to fuel payrolls—not out-of control premiums.

Health reform means that the Medicare trust fund will be around so seniors can count on their benefits for years to come. This bill will improve their coverage and ensure access to Medicare prescriptions by beginning to close the donut hole this year.

The nonpartisan Congressional Budget Office (CBO) confirms that this bill is fiscally responsible and will reduce the deficit by $138 billion in this decade and by $1.2 trillion in 20 years. This bill will help us build a foundation for long-term growth by tackling the unsustainable cost of health care and providing much-needed financial relief for families and businesses.

After reading through your emails and letters, I have noticed several common questions and concerns about health care reform. I have prepared this Frequently Asked Questions document to help answer some of your questions and concerns. I hope that you will find it helpful.

HOW WILL THIS AFFECT ME?

Q: What is in this bill?

The health insurance bill will expand access to quality, affordable health insurance options. It sets up Health Insurance Exchanges, which will provide one-stop, comparison shopping for individuals and small businesses to purchase affordable coverage. The bill provides affordability credits to make insurance premiums more affordable for low- and middle-income families.

The bill will establish common-sense rules of the road to hold insurance companies accountable. It will immediately put an end to their abusive practices like arbitrarily hiking premiums, denying people coverage due to pre-existing conditions, and dropping patients when they get sick.

It creates shared responsibility among individuals, employers and government to ensure all Americans have affordable health coverage. Except in cases of hardship, individuals will be responsible for obtaining and maintaining health insurance. Those who choose not to obtain coverage will pay a penalty, and those who cannot afford to obtain coverage will get help to do so. The proposal builds on the employer-sponsored coverage that exists today: large employers will have the option of providing health insurance coverage for their workers or contributing funds on their behalf.

Recognizing the special needs of small businesses which are the engine of our economy, small businesses with less than 50 employees will be exempted from any penalties for not providing health insurance. In addition, a new small business tax credit will be available for those firms who want to provide health coverage to their workers, but cannot afford it today.

Health reform will strengthen Medicare. It lengthens the solvency of the Medicare trust fund so seniors can count on their benefits for years to come. This bill will improve their coverage and ensure access to Medicare prescriptions by beginning to close the donut hole this year.

Q: When does this bill take effect?

Some provisions take effect immediately. In 6 months, insurance companies will be prohibited from dropping people from coverage when they get sick, denying coverage to children with pre-existing conditions, and placing lifetime limits on coverage. Health insurance plans will be required to allow young people up to their 26th birthday to remain on their parent’s insurance. Small businesses will have access to tax credits to help them purchase health insurance for their employees. And seniors who hit the donut hole this year will receive a $250 rebate.

Most of the major provisions of the bill – the health insurance exchanges, the individual and employer responsibility provisions, and the prohibition against discriminating based pre-existing conditions – take effect in 2014.

Q: Why do we need health care reform? I already get great health insurance from my employer and I am afraid health care reform will mess up what I already have.

We need health care reform because the status quo is unacceptable. Business as usual is unacceptable for small business owners who cannot afford coverage for their employees. The status quo does not work for families who are worried about their jobs and sky-high health costs. The current system must be reformed for taxpayers who have seen health care costs explode the federal budget deficit. Discrimination must stop for my constituents who are denied coverage, or charged through the roof, because of their age or gender, or because they have a preexisting condition such as diabetes or cancer.

If you like the status quo, if you like your health insurance, nothing will change for you. If anything, your health insurance will improve and be more affordable to you. If you get sick, you will be able to get care without worrying that your premiums are going to skyrocket the next year or that your health insurer will drop your coverage. The bill requires your employer coverage to cap your out-of-pocket costs and prohibits annual or lifetime limits on benefits, so if you have unexpected medical needs you don’t have to worry about going bankrupt due to unexpected costs. If you change jobs, you can take your health insurance with you. And because millions of people without coverage today will have coverage in the future, your premiums will be lower.

Q: Will I be forced to give up my current health care coverage and take something that is going to be forced on me?

No. No one will be forced to give up their current health insurance if they like it. If you have employer-sponsored health care today – as most people do – then little to nothing will change. If anything, your health care benefits will be improved: the bill mandates minimum standards that all health insurance plans will have to meet. Most employer-based plans already meet these minimum standards. If you buy your health insurance on the individual insurance market, then you can keep your plan permanently and it will be considered acceptable coverage. Health care plans that have been negotiated through collective bargaining agreements will remain the same.

Q: I’m uninsured – how will health care reform help me now?

Although most of the major provisions of the bill go into effect in 2014, some of the reforms will happen right away. Immediate help for the uninsured will be available until the Health Insurance Exchange is up and running – the bill creates a temporary insurance program for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions. And if you’re young, this bill will require insurance companies to allow young people through age 26 to remain on their parents’ insurance policy.

Q: I have health insurance – how will I benefit under this bill?

If you get sick, you will be able to get care without worrying that your premiums are going to skyrocket the next year or that your health insurer will drop your coverage. The bill requires your employer coverage to cap your out-of-pocket costs and prohibits annual or lifetime limits on benefits, so if you have unexpected medical needs you don’t have to worry about going bankrupt due to unexpected costs. If you have a pre-existing condition like cancer or diabetes, health insurers will no longer be able to deny you coverage. And because millions of people without coverage today will have coverage in the future, your premiums will be lower.

If you have insurance, but it’s unaffordable to you, you may be eligible to purchase cheaper coverage in a Health Insurance Exchange. You may also be eligible for affordability credits to help you afford your premiums and co-pays.

Q: What are Health Insurance Exchanges?

The Exchanges will provide one-stop, comparison shopping for individuals and small businesses to purchase affordable coverage. The Exchanges would not be insurers; they would provide eligible individuals and small businesses with access to insurers’ plans in a comparable way. Think of an Exchange as a Travelocity or Expedia for health insurance plans.

Beginning in 2014, individuals and small businesses with up to 100 employees can purchase health care coverage through an Exchange. In 2017, states can allow businesses with more than 100 employees to purchase coverage.

The Exchanges will make coverage more affordable for individuals and small businesses because they will be pooled together with other individuals in the Exchanges. This means that people can get the benefits of large-group rates normally enjoyed only by large employers, lower administrative costs, greater transparency, and increased price competition.

Q: Will I have to buy health insurance?

Under health care reform, all individuals who can afford it have a responsibility to obtain health insurance. If individuals do not obtain health insurance, then they pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount per family or 2.5% of household income. If you believe that your premiums are unaffordable, you may apply for a hardship waiver to exempt you from purchasing health insurance.

Fixing our broken healthcare system will provide real benefits for every part of our society – patients and consumers, businesses, hospitals, physicians and nurses. Fixing this will have a cost. I believe that everyone must take some responsibility to fix the system. That means that individuals must take personal responsibility to obtain health insurance, and employers must take responsibility to support the health coverage needs of their workers. Otherwise, everyone pays if individuals without health coverage end up in the emergency room.

Q: What is the public option?

The House health care reform would have established a public health insurance option that would be available through the Health Insurance Exchange. However, the final health care reform bill does not contain a public health insurance option.

Q: Will health care reform destroy the employer-based health care system? Will it lead to single payer health care?

No. The employer-based health care system will remain strong. Health care reform builds on the current system and improves it by making health care more affordable for families and businesses.

Q: Can I get YOUR health care plan? That’s what I want – the same health care Members of Congress get.

As a member of Congress, I get the same choice of health care insurance plans as all other federal employees. I have a choice of insurance providers with different benefits and different premiums. My family chooses to receive coverage from CareFirst, a Blue Cross Blue Shield plan.

I want all American to get to choose their insurance the same way that federal employees and Member of Congress do – that’s why I support establishing a health insurance exchange. A health insurance exchange would be a place for individuals and small businesses to comparison shop among insurers.

Q: Can I keep my health savings account (HSA), flexible spending account (FSA), or health reimbursement account (HRA)?

Yes. Employees may still receive benefits under employer-provided HSAs, FSAs and HRAs. Nothing in the bill would eliminate these options.

I support HSAs and believe they should continue to be an affordable health insurance option for individuals and small businesses.

Q: Are you going to tax my employer-provided benefits?

The health care reform bill enacts an excise tax on very high-cost health insurance policies ($10,200 annual premium for individual coverage and $27,500 for family coverage), but it does not go into effect until 2018.

Q: Will health care reform increase my taxes?

If you choose not to obtain health insurance coverage for you and your family – either by declining your employer-provided health insurance or by not purchasing coverage from an Exchange – then you will have to pay a penalty. If you believe that your premiums are unaffordable, you may apply for a hardship waiver to exempt you from purchasing health insurance.

Q: Will health care reform result in rationing?

No. Health care reform is about putting in place common-sense rules of the road to hold insurance companies accountable. We will immediately put an end to their abusive practices like arbitrarily hiking premiums, denying people coverage due to pre-existing conditions, and dropping patients from their plans when they get sick. These abusive practices ration care right now.

Q: My premiums are going to skyrocket with this bill.

Your premiums are going to increase whether or not Congress passes health insurance reform. However, the best estimates show that for most people, premiums won’t change significantly with health insurance reform. The nonpartisan Congressional Budget Office (CBO) estimated that for those in the group market – those who get insurance through their employers – premiums would largely stay the same. The change in the average premium in the large group market would be between 0 percent and a 3 percent decrease compared to where they’d be under current law in 2016.

Average premiums for families who buy insurance on the individual market would go up by 10 to 13 percent. The reason is that benefits would be a lot better for families buying coverage on their own under the bill. But most people buying their own coverage would receive affordability subsidies that will make their actual costs substantially lower than they otherwise would be.

Q: How will health care reform affect rural communities?

The health care reform bill includes numerous provisions dedicated to addressing health care access issues in rural America by bolstering the health care workforce and improving rural Medicare reimbursement. The bill provides rural physician training grants; loan repayment assistance for doctors who agree to practice in rural areas; and increases reimbursement for rural doctors, hospitals, and pharmacies.

Q: Is tort reform in this bill?

Medical malpractice reform is not part of this bill. Right now there is no agreement on how reform could be achieved. Setting caps on non-economic damages in medical malpractice suits has produced varied results. Some states with caps have seen their malpractice insurance rates increase more slowly than states without caps, but some states with caps have seen their rates increase faster than in states without caps. Until there’s consensus on how to address medical malpractice reform, it’s hard to move forward.

The health care reform bill establishes a new voluntary state program designed to encourage states to implement alternatives (“early offer” or certificate of merit approach) to traditional medical malpractice litigation.

Q: Does this bill allow health insurance to be sold across state lines?

The health care reform bill permits states to enter into agreements to allow for the sale of insurance across state lines when the state legislatures of the states in question agree to do so. Insurers selling policies through a compact would only be subject to the laws and regulations of the state where the policy is written or issued.

MEDICARE

Q: Will Medicare change under this bill?

The only changes Medicare beneficiaries will see are two significant improvements to the program that seniors have long asked for. First, the bill will cover 100 percent of the cost of preventative care, such as regular check ups, mammograms and other preventive tests. Second, the bill ensures that millions of seniors will save money on their prescription drugs by immediately beginning to close the “donut hole” in the Medicare prescription drug benefit.

Also:

• Nothing in the health care reform bill would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.
• This bill will begin closing the Medicare Part D “donut hole” immediately, and close it completely by 2020. Seniors who reach the donut hole this year will receive a $250 rebate.
• Health care reform will reduce the cost of preventive services so patients stay healthier.
• Health care reform will reduce costly, preventable hospital readmissions, saving patients undue harm and Medicare money.
• Health care reform will reduce hospital acquired infections, also protecting seniors.
• The non-partisan Congressional Budget Office (CBO) has shown that health care reform will slow the growth of Medicare costs by 1.4 points per year.
• According to the Department of Health and Human Services, this bill will lengthen the solvency of the Medicare program by almost a decade, protecting both beneficiaries and taxpayers.

Q: Is the Medicare geographic inequity agreement in the final bill?

The final bill includes an agreement to address the long-standing Medicare reimbursement problems that have hurt access to health care in Washington state. I have been fighting to protect access to health care for Washington state seniors by ensuring that Washington state is rewarded, not penalized, for providing high-quality, low-cost patient care.

The agreement includes changes to the reconciliation bill to immediately provide $800 million in additional funding for efficient providers and hospitals, including doctors and hospitals in Washington state. This funding is a short-term fix to the Medicare geographic payment inequity issue until long-term changes can be implemented by the Administration. It will reward Washington state medical providers for providing high-quality, low-cost patient care.

My colleagues and I also secured an agreement with the Secretary of Health and Human Services to study and implement changes to the Medicare reimbursement and payment system. The Secretary will commission the two Institute of Medicine studies that were included in the House health care reform bill and implement the recommendations of the studies. The studies will begin in April and will be completed within two years.

Q: Why is Washington state reimbursed so low?

Under the current system, Washington state is penalized for providing higher-quality, lower-cost care. The average federal Medicare payment per patient in Everett, Washington is $6,905 a patient. In McAllen, Texas the average is $14,946. But while the quality of care in Everett is the same if not better compared to McAllen, medical providers there get paid more than twice as much, costing taxpayers more than twice as much and punishing Washington providers. This inequity makes Washington physicians less likely to accept patients on Medicare, making it more difficult for local seniors to find a doctor who will accept their insurance.

Q: I heard that you are cutting over a half trillion dollars out of Medicare. Is that true?

The health care reform does cut about $450 billion out of the Medicare program. However, none of these cuts are to Medicare benefits. About $140 billion of this amount comes from reducing overpayments to private insurance companies that offer Medicare Advantage plans. About $200 billion comes from making changes to the way Medicare pays doctors and hospitals. These changes will make the health care delivery system more efficient, which also makes it less costly to taxpayers. About $35 billion comes from reducing payments that hospitals currently receive for providing care to uninsured patients. Since these patients will be insured under health care reform, these payments will no longer be necessary. And finally, about $80 billion comes from other changes to the Medicare program, including rooting out waste, fraud and abuse.

Q: How does the bill cut waste, fraud and abuse?
The bill improves payment accuracy to ensure that the right amount is paid, and expands funding and authority to fight waste, fraud and abuse. It strengthens existing compliance and enforcement tools for Medicare, increases funding to support these efforts and creates new, tougher penalties for individuals who submit false claims to Medicare. The Congressional Budget Office (CBO) has estimated that for every $1 we invest in fighting waste, fraud, and abuse we will produce $1.75 in savings.

Q: Are my Medicare benefits going to decrease?

No. In fact, the health care reform bill improves your Medicare benefits. It fills the Medicare Part D drug program “donut hole” which currently leaves a gap in your prescription drug benefits when you need help the most. It will make preventive care free for Medicare beneficiaries. It will lower the cost of prescription drugs by finally allowing the government to negotiate with drug companies to get cheaper drugs. It improves the low-income subsidy programs in Medicare so that more seniors get the financial help they need to make sure Medicare is affordable for them. And this bill will lengthen the solvency of the Medicare program, protecting both beneficiaries and taxpayers.

Q: What are you doing to fix the Medicare Prescription Drug Program donut hole?

The bill will begin closing the Medicare Part D “donut hole” immediately, and close it completely by 2020. Seniors who reach the donut hole this year will receive a $250 rebate. [The donut hole is the coverage gap in the Medicare Prescription Drug Program (Part D). Under Part D, Medicare does not contribute toward the cost of drugs when some individuals’ annual drug expenses fall into a certain range.] I strongly support fixing the donut hole so that Washington state seniors are no longer faced with paying thousands of dollars in out-of-pocket drug costs.

Q: I’ve heard that this bill will get rid of my Medicare Advantage plan. Is that true?

No. The health care reform bill does not eliminate Medicare Advantage plans – instead, it simply phases out the overpayments going to these plans. Currently, the private insurance companies that offer Medicare Advantage plans are paid an average of 14 percent more than it costs to provide traditional Medicare. Since most Medicare Advantage plans simply offer standard Medicare benefits at a higher cost to the federal government and U.S. taxpayers, the bill eliminates the extra subsidies. Most private Medicare Advantage plans will still continue to operate once the current overpayments are phased out.

Q: I’ve heard that Medigap plans will no longer be available. Is that true?

No. Nothing in the bill will affect Medigap plans. Medigap plans will continue to be available to Medicare beneficiaries.

EMPLOYERS

Q: How will the House health care reform bill help small businesses?

This legislation will bring down costs for small businesses and families. Because they lack bargaining leverage, small businesses pay 18 percent more than larger businesses for the same health insurance. Insurance market reforms will make coverage more affordable. Small businesses (employers with less than 100 employees) will have new options to purchase affordable health insurance that are not available to them now. Through new Health Insurance Exchanges, small business owners and employees can comparison shop for a plan that offers lower rates that large groups and large employers get, stable pricing from year to year and lower administrative costs. The bill also offers tax credits to small businesses with less than 25 employees to help them purchase health insurance for their employees. Small businesses can receive these tax credits beginning this year.

Q: I’m a small business owner - will I be required to provide health care to my employees?

The health care reform bill exempts employers with 50 or fewer employees from any penalties for not providing health care coverage to their employees. 96% of small businesses would be exempt from penalties for not providing coverage.

For small businesses with less than 25 employees that want to offer health insurance coverage, a tax credit help them provide health benefits to their employees – paying up to 50% of their costs based on size and average wages. 60% of small businesses will be eligible for a tax credit.

Q: I’m a business owner - will I be required to provide health care to my employees?

If your business employs 50 or more full time employees, you will be subject to a penalty if you do not provide insurance and one of more or your employees is receiving an affordability credit in the exchange. The fee is $2,000 per full-time employee, with the first 30 full time employees subtracted from the payment calculation. (e.g. a firm with 51 workers that does not offer coverage will pay an amount equal to 51-30, or 21 times the fee).

If you have more than 50 employees and you currently offer coverage that is considered “affordable,” you can continue proving that coverage without penalty. Affordable coverage means an employer plan with an actuarial value of at least 60% and the employee share of the premium does not exceed 9.8% of income.

Fixing our broken healthcare system will provide real benefits for every part of our society – patients and consumers, businesses, hospitals, physicians and nurses. Fixing this will have a cost. I believe that everyone must take some responsibility to fix the system. That means that individuals must take personal responsibility to obtain health insurance, and employers must take responsibility to support the health coverage needs of their workers. Otherwise, everyone pays if individuals without health coverage end up in the emergency room.

COSTS

Q: How much is this health care bill going to cost?

The total cost of the health care reform bill is $940 billion over ten years. According to the nonpartisan Congressional Budget Office (CBO), the bill will reduce the deficit by $138 billion over 10 years and $1.2 trillion in two decades.

The bill is fully paid for. Much of the bill is paid for by achieving significant efficiencies and savings in the health care system – using the money we are already spending more effectively by rewarding high-quality, efficient care and expanding coverage to bring down emergency costs.

Q: Our country is in a serious economic recession. Shouldn’t Congress focus on that first?

Insurance companies are not going to wait until the recession is over – they are still hiking premiums by 40 percent and denying people coverage for pre-existing conditions.

Health care reform is a critical part of our economic recovery. If we don’t act now, skyrocketing health care costs will only get worse – threatening the budgets of families, businesses, and the nation. Health care reform will improve our nation’s fiscal health and put us on the road to economic recovery: the nonpartisan Congressional Budget Office (CBO) estimates that this bill will reduce the deficit by $1.2 trillion over the next two decades.

Q: How are you going to address the increases in government spending?

Health care reform will be fully paid for – and it will reduce the deficit by $138 billion in the next 10 years and $1.2 trillion in the next 20 years. Moreover, making our health care system more efficient will decrease government spending and our federal deficit in the future. Moving forward, we must do even more to restore fiscal discipline to Washington, D.C.

VETERANS

Q: Is there any provision related to veteran’s coverage in the health care reform bill? Will this bill affect my VA health care?

The health care reform bill would not significantly affect the VA health system or service members and their families covered by TRICARE. Veterans in the VA system and service members and their families covered by TRICARE will be allowed to continue seeing your doctor and your care will not be affected.

The bill contains provisions to ensure that those covered by VA health care, TRICARE, or TRICARE for Life meet the individual responsibility requirement, and therefore exempts veterans and service members and their dependents from any penalty. The House has also passed separate legislation, HR 4887, the TRICARE Affirmation Act, to ensure that TRICARE is considered adequate coverage and affirm that TRICARE beneficiaries do not have to purchase additional insurance. I was an original cosponsor of this legislation, which passed unanimously.

Veterans, service members and their families have access to the Health Insurance Exchange to obtain additional health insurance if they choose.

LEGISLATIVE PROCESS

Q: Have you read this bill? Are you going to read it?

Yes, I have read the bill.

Q: Why are you trying to jam this bill through the House? Why not take your time and properly debate this bill? Why is the House in such a hurry to get things done?

I agree that reforming health care is a major undertaking, and Congress needs to take the time to do it right. Congress has held more than 100 hearings on health care since 2007. Democrats in Congress have held close to 3,000 health care events in our districts. Three committees in the House have spent 160 hours on hearings and markups of health care legislation. Much of the new health care reform bill has been available for review and comment for more than six months. And the full text of the bill will be publicly available for at least 72 hours before Members of Congress are asked to vote.

I believe that it is important to get as much feedback as possible from my constituents before I vote on health care reform. I have been holding town halls and meetings with folks back in the district during the past several months – including meetings with local doctors, patients, small business and hospitals. Since July, I have held two in-person town halls attended by over 3,000 people, and one telephone town hall listened to by over 3,500 people. I participated in a League of Women Voters health care forum in Coupeville that was attended by over 300 people. I have held nearly 30 meetings on health care reform in the district. I have responded to over 20,000 constituent letters about health care reform.

Q: Why does Congress need to pass the bill using the reconciliation process?

I support taking an up or down vote on health care reform. Congress is using a legitimate process to get us to the finish line on health care reform. Health care reform already passed in the House with a majority and in the Senate with a super-majority. The American people deserve an up or down vote on final health care reform legislation. This process is not overly controversial, nor has it been rarely used: it has been used 22 times since 1980, by both parties.

Q: Is the “Cornhusker kickback” in the bill?

No. The final health care reform bill strips out the “Cornhusker kickback” and other special deals.

CONGRESSMAN LARSEN’S POSITIONS ON HEALTH CARE REFORM

Q: Do you support the final health care reform bill? If so, why?

After a full review of the final health care reform bill, I will support this important legislation. The status quo in health care is unacceptable. American families and small businesses are crippled by the staggering costs of premiums. We can not afford inaction.

This health care reform bill will immediately start lowering the costs of health care to make coverage more affordable for families and to ensure small businesses no longer have to choose between health care and hiring.

Since the House of Representatives began crafting health care reform legislation, we have made great progress for Washington state. I brought local concerns to the attention of leadership in Washington, D.C. and fought hard to make sure the health care reform bill includes a fair deal for Washington state. Specifically, I pushed to protect access to health care for Washington state patients by ensuring that Washington state is rewarded, not penalized, for providing high-quality, low-cost patient care.

I believe that a vote in favor of the Affordable Health Care for America Act is the right vote for Washington’s 2nd Congressional district.

Q: What do you like about the bill?

This bill implements common-sense rules of the road for insurance companies that will protect consumers from abusive practices and bring more choice and competition to our health care system.

Under the current system, small businesses pay 18 percent more in premiums than large firms and their deductibles are more than double. Our health care reform package will immediately work to eliminate these inequities by offering tax credits to business owners who purchase coverage for their employees. Small businesses are the engine of job growth in this country and in this economy we need them to use their dollars to fuel payrolls—not skyrocketing premiums.

Finally, this bill strengthens and improves Medicare for seniors by closing the donut hole, rooting out waste, fraud and abuse from the system and making sure seniors continue to have access to the doctors they choose.

As we work our way out of this recession, we need to pass legislation that will make health care more affordable for consumers and our nation. By immediately lowering costs for families and business and by reducing the deficit by $1 trillion over the next two decades this bill is fiscally responsible and will help us create a sustainable economic environment for the future.

Q: Do you support a public option?

I supported the public option that was included in the House health care reform bill. It would have worked for Washington state. It would have been subject to the same rules that private insurance plans are subject to and it would not be subsidized by the government. Unfortunately, the public option is not included in the final health care reform bill.

Q: Do you support single-payer health care?

I do not support HR 676, legislation that would create a single-payer system by expanding Medicare, because I believe in preserving patient choice and competition, which creates incentives for doctors to provide a high level of care. I would vote against an amendment to create a single-payer system if it came up for a vote in the House.

I want health care reform to happen – and that’s why I’m working to reform health care and get reform that works for Washington state.

Reforming health care will mean no discrimination for pre-existing conditions. No dropping your coverage because you get sick. No more job or life decisions made based on loss of coverage. No need to change doctors or plans. No co-pays for preventive care. No excessive out-of-pocket expenses, deductibles, or co-pays. No yearly or lifetime cost caps on what insurance companies cover.

HEALTH CARE REFORM MYTHS

Q: Does this bill mandate government funding of abortion? Will my taxpayer dollars be paying for abortions?

The bill does not mandate government funding of abortion. In fact, the bill was amended to specifically ensure that no federal funds go towards abortion services. The bill maintains current law by prohibiting federal funds from being used to pay for abortion (except in cases of rape, incest, and to save the life of the woman). No health insurance plan in the Exchanges would be required to cover abortion services. If a health insurance plan does cover abortion services, funds for this purpose must be segregated from other funds, including affordability credits. Only private premium dollars can be used to provide abortion coverage.

In addition, President Obama issued an executive order providing additional safeguards to ensure that current law prohibiting federal funding of abortion services is upheld and enforced. This executive order will help ensure that the health care reform bill’s restrictions against federal funding of abortion services cannot be circumvented.

Q: Will illegal aliens get government-funded health care?

No. The health care reform bill specifically prevents illegal aliens from receiving government-funded health care. Only U.S. citizens and legal immigrants are eligible to receive premium credits through the Exchanges.

Q: Isn’t it unconstitutional to require citizens to have health insurance? Where in the Constitution does say that people must have health insurance?

There is no explicit clause within the Constitution that states health care is a fundamental right, or that states that citizens must have health coverage.

However, Congress has historically provided funding to pay for the health services provided under law (Medicare, Medicaid, CHIP). Most of these statutes have been enacted pursuant to Congress's authority to "make all Laws which shall be necessary and proper" to carry out its mandate "to … provide for the … general Welfare." The power to spend for the general welfare is one of the broadest grants of authority to Congress in the U.S. Constitution. The Supreme Court allows considerable latitude to a legislative decision by Congress that a particular health care spending program provides for the general welfare.

Specifically, the Necessary and Proper Clause (commonly referred to as the Elastic Clause) grants the federal government of the United States the flexibility to create laws or otherwise to act where the Constitution does not give it the explicit authority to act. The Taxing and Spending Clause (commonly referred to as the General Welfare clause) grants the federal government of the United States its power of taxation. This is open to interpretation, but the broader view of Alexander Hamilton that spending is an enumerated power that Congress may exercise independently to benefit the general welfare, such as to assist national needs in agriculture or education, provided that the spending is general in nature and does not favor any specific section of the country over any other.

Q: This bill contains sweetheart deals for unions.

No, it does not. This rumor came from the deal that the Administration made with House Democrats and labor unions in January. The deal would have delayed the excise tax on high-cost insurance plans for five years, but only for collectively bargained plans (until 2018). The final health care bill delays the excise tax until 2018 for all plans. It also raises the thresholds so that significantly less people are subject to the tax.

Q: Is health care reform going to lead to socialized medicine?

Health care reform will not socialize our health care system. To me, socializing health care means making our health care system more like Great Britain, where the government owns hospitals and employs physicians; or like Canada, where the government pays for every citizen’s health care. To be clear, President Obama and Congress are not proposing anything like this. Under the House health care reform bill, if you like your doctor, you will be able to keep your doctor. If you like the health care coverage you have, you will be able to keep it.

I share some of your concerns about the role of the federal government. I’m a strong believer in free market economy, and I believe that the government should step in to pass rules and regulations or legislation only when it’s needed, and particularly when doing so levels the playing field for consumers.

I believe that reforming health care is a critical priority. Today, our health care system is broken, and it needs to be fixed. The status quo is unacceptable. Families and business are faced with skyrocketing costs. Since 2001, health care premiums have grown four times faster than wages. Health care costs are breaking the bank for families, for small businesses and governments.

Reforming health care will mean no discrimination for pre-existing conditions. No dropping your coverage because you get sick. No more job or life decisions made based on loss of coverage. No need to change doctors or plans. No co-pays for preventive care. No excessive out-of-pocket expenses, deductibles, or co-pays. No yearly or lifetime cost caps on what insurance companies cover.