Thank you for contacting my office regarding health care reform. I appreciate you taking the time to share your thoughts with me. I value your views on the important issues facing our Commonwealth and the Nation.
Like you, I am concerned about rising health care costs and the increasing number of Americans who do not have health insurance, have trouble keeping it, or are unable to find affordable health care. I also believe that those in Washington should not interfere with your relationship and confidentiality with your doctor, limit your right to seek better care, or raise your taxes.
As you may know, Representative John Dingell introduced H.R. 3200, the America's Affordable Health Choices Act of 2009, on July 14, 2009. This legislation would create a government-run health plan, mandate health plan benefits, impose employer and employee payroll taxes and establish the Health Benefits Advisory Committee. Furthermore, it would create a national health insurance exchange in which insurance plans would be offered for purchase. A federal commissioner would govern the exchange and would be charged with determining which plans could enter and compete in the marketplace with the government-run option.
H.R. 3200 would automatically enroll all Medicare-participating physicians in the government-run plan. This bill would also allow the Secretary of Health and Humans Services (HHS) to require physicians to deny services to patients with private insurance as a condition of participation in the government-run plan.
Additionally, H.R. 3200 would establish a Health Benefits Advisory Committee to recommend minimum federal benefits standards and cost-sharing levels. The Committee, in conjunction with the Secretary of Health and Human Services (HHS), would define what is 'acceptable' health insurance and impose new mandates on individuals and insurance carriers. Under the bill, all Americans would be required to have health insurance, a so-called 'individual mandate', with a few exceptions.
This legislation also includes many tax increases to pay for health care reform including an 8 percent payroll surcharge, or 'pay-or-play' provision, for businesses that cannot afford to purchase coverage for their employees. Most economists agree that the cost of health insurance is passed on to workers in the form of lower wages.
A 'pay-or-play' provision is particularly harmful to small businesses. Under this provision, businesses that opt out of the government-run system will be subject to an indexed payroll tax. A small business with a payroll of $350,000 to $400,000 would be subject to a 6 percent payroll tax which increases to 8 percent for a payroll over $400,000. This legislation would also impose a 2.5 percent tax on individuals who opt out of a government-approved health plan. The Congressional Budget Office (CBO) also noted that a "pay-or-play provision could reduce the hiring of low-wage workers, whose wages could not fall by the full cost of health insurance or a substantial pay-or-play fee if they were close to the minimum wage."
Moreover, this legislation increases the federal government's long-term spending obligations and fails to slow the growth of health care costs. CBO Director Doug Elmedorf testified before the Senate Budget Committee that "we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the Contrary, the legislation significantly expands the federal responsibility for health care costs." The CBO estimates that H.R. 3200 would increase the federal deficit by approximately $239 billion over ten years. This cost would be in addition to annual projected budget deficits expected to reach $1.8 trillion this year alone.
There is no doubt that real health care reform is critically needed. It is important that Congress support legislation that provides access to quality medical care for Americans without health care coverage. I support a consumer-driven system in which key decisions are made by you, your family and your physician. Competition is critically important in health care as in every facet of our economy. Unfortunately, I believe H.R. 3200 would have devastating consequences for families and small businesses. Moreover, I believe a government-run option would inevitably raise taxes, lead to rationed health care and let bureaucrats, not doctors, make decisions about your care.
Please rest assured, I will continue to support health care reform legislation that promotes quality, accessibility and affordability in the provision of health care. Thank you again for sharing your views and opinions with me. I am committed to serving you to the best of my abilities. If I can ever be of assistance to you or your family, please do not hesitate to call me at (202) 225-4261 or contact me online at: www.wittman.house.gov.
Robert J. Wittman
Member of Congress