House Passes Health Care Legislation

March 22, 2010

Dear Friend,

Today, the House of Representatives passed comprehensive health care reform legislation.  I voted in favor of this legislation because I believe it is a crucial step in our effort to reduce the cost of health care for families and small businesses, as well as provide access for those who currently do not have insurance. 

A key consideration for me was the tremendous relief this bill will bring to millions of small business owners and employees across the country.  Recently, I have been walking the main streets of my district, talking to small business owners who have been hit hard by this tough economy.  They worry that, even as things begin to turn the corner, the cost of health care will hamstring their ability to make a full recovery.  We depend on small businesses to be the engine of our economy.  The health care bill we passed today will finally make it possible for small business owners and their employees to access health care coverage at affordable group rates and benefit from targeted tax credits.

My vote was also based on the recognition that Americans are literally sick and tired of being pushed around by powerful health insurance companies.  This bill fights back against that industry and says enough is enough.

Admittedly, the bill is not perfect. I would have much preferred the version passed by the House of Representatives last November. The version developed by the Senate and placed before us only became palatable after we secured several important changes that increased affordability credits for low-income and middle-class Americans, strengthened provisions that benefit traditional Medicare for our seniors, and ensured that the bill was fully paid for without creating a new tax burden for middle income families.  We also removed egregious provisions that were previously added at the request of individual Senators and disproportionately benefited their home states.  They should never have been included in the first place. 

Your Input

As a member of the Health Subcommittee of the Energy and Commerce Committee, I have been fully engaged in the health care reform debate since the beginning of last year.  During that time, many of you have written to me, called my office or emailed through my website.  I have heard from passionate advocates of health care reform, committed opponents, and many who have sincere and often complex questions about the policies being proposed.  Your input was invaluable to me in this process.

Reining in Insurance Industry Abuses

On the merits, I believe we have crafted a good bill that addresses the accumulated frustrations of millions of Americans.  It is a measured approach that will preserve what works in the current system and fix what does not.  The comprehensive health care legislation will ensure that you are treated fairly in return for the premiums you pay every month.  For example, when fully implemented, the bill will prohibit insurance companies from denying coverage for pre-existing conditions.  It will cap annual out of pocket expenses and do away with lifetime limits on how much insurance companies will pay to cover.  And it will prohibit the arbitrary termination of your policy at the precise moment when you need it the most.

A Stronger Medicare Program for Our Seniors

For our seniors who depend on Medicare, the bill will do away with co-pays and deductibles for key aspects of preventive care.  It will lower the cost of prescription drugs by gradually closing the dreaded “donut hole” in the Medicare Part D prescription drug plan.  And it will strengthen the solvency of the Medicare program by cracking down on fraud, abuse and waste and reinvesting the savings in enhanced models of care.

Better Coverage for Small Businesses and Individuals

For those who do not have health insurance, are looking to change plans, or are worried that they will lose their coverage because of their job, there will be a new framework in place to give you options.  The bill creates a system of state-based health care exchanges governed by national quality standards. Uninsured individuals and small businesses can choose from multiple private plans, thereby benefiting from access to the kind of group rates that are now available only to large employers.  This legislation also requires standardized formats and definitions to allow for easy comparison of prices, benefits and performance of health plans.  This approach will make health insurance more “portable” and give real relief to the millions of Americans who currently have nowhere to turn. 

While many of these reforms will be phased in over the next several years, there are a number of key changes that will take effect immediately.
  • Beginning this year, the bill will provide tax credits to small businesses that choose to offer health insurance coverage to their employees. 
  • This fall, Medicare beneficiaries who hit the “donut hole” will receive a $250 rebate.  In 2011, this bill institutes a 50 percent discount on brand-name drugs in the donut hole.  It also eliminates co-payments and deductibles for preventive services under Medicare. 
  • Six months after enactment, insurance companies will be banned from nullifying or rescinding a patient’s policy when they file a claim for benefits and health insurance companies will be prohibited from placing lifetime caps on coverage. 
  • The bill will require health plans to allow young people through age 26 to remain on their parents’ insurance policy and discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases. 
  • Ninety days after enactment, this bill will provide $5 billion in immediate federal support to state high risk pools which provide affordable coverage to uninsured Americans with pre-existing conditions.

Workforce Reforms

I also wanted to take a moment to talk about an issue that I worked hard to include in the overall health care reform bill: ensuring that we have an adequate supply of doctors and nurses, especially in preventive care so we can save money by catching health problems before patients become very sick.

A strong, well-trained workforce is critical to supporting a high-quality health care delivery system.  That is why I introduced legislation to establish an advisory committee on health workforce policies, which will review health care workforce capacity and projected needs and make recommendations directly to Congress concerning workforce priorities, goals and policies. This idea was included in the health reform bill.  I also pushed for incentives for medical students entering fields of shortage, including scholarships and loan forgiveness programs that will help medical professionals manage the substantial educational debt that they accumulate during their training.

These are only a few of the provisions of the bill that will make a positive difference in the lives of American families.  I encourage you to visit  the Majority Leader's Health Care Reform Clearinghouse if you would like more detailed information about the health care legislation. 

A Long Road

Beginning in January 2009, the House committees of jurisdiction held more than 20 hearings on health care reform.  In May of last year, the committees released a public discussion draft for comment and revision.  In July, a formal bill was introduced and three committees considered the bill in open markup sessions.  My committee conducted a five day markup ending on July 31st when we reported the bill to the full House.  The House passed their version of the bill, the Affordable Health Care for America Act (H.R. 3962), on November 7th by a vote of 220 to 215.  The Senate then passed a bill, H.R. 3590, on December 24th by a vote of 60 to 39.  After discussions between the two chambers and with the President, we are now voting to approve a final product that will become law. 

I am mindful of the fact that, while very thorough, the process that got us here has been convoluted at times and that many Americans became worn out by the debate.  But when we brought people back to the content of the bill and the specific changes it would achieve, the dominant message was that we should continue to press forward.  

When the Senate passes this bill in the coming days and it is signed into law, it will expand health coverage and improve quality of care.  It will reduce cost by eliminating waste and making our system more efficient. But more than anything, it will mark a new direction for the country – away from the influence of powerful special interests and towards common sense solutions for America’s families.  As we implement important changes to our health care system, your input will be invaluable and I ask that you continue to provide me with your comments and suggestions in the weeks and months ahead.


Congressman John P. Sarbanes
Maryland's Third Congressional District