Health Care reform

This weekend, the U.S. House of Representatives will accomplish something first proposed by Harry Truman in 1947. We will take a historic vote on health care reform legislation. This legislation will make health care affordable for the middle class, provide security for seniors, and guarantee access to health insurance for the uninsured – while reducing the federal deficit by over $138 billion over the next decade.

The Congressional Budget Office, our national independent, non-partisan “referee” that by law examines each bill considered by Congress to assess the cost, released its “scoring” of the bill we will vote on Sunday. Based on an analysis from CBO, the legislation the bill:

• Cuts the deficit by $138 billion in the first ten years (2010 – 2019).
• Cuts the deficit by $1.2 trillion in the second ten years.
• Reduces annual growth in Medicare expenditures by 1.4 percentage points per year—while improving benefits and lowering costs for seniors.
• Extends Medicare’s solvency by at least 9 years.
• Expands health insurance coverage to 32 million Americans.
• Helps guarantee that 95 percent of Americans will be covered.
• $940 billion over a decade. (Americans spend nearly $2.5 trillion each year on health care now and nearly two-thirds of the bill is paid for by reducing health care costs).

But, let’s get specific to what this bill will do in our District. If passed the bill will:

• Improve coverage for 369,000 residents with health insurance.
• Give tax credits and other assistance to up to 171,000 families and 14,300 small businesses to help them afford coverage.
• Improve Medicare for 98,000 beneficiaries, including closing the donut hole.
• Extend coverage to 58,500 uninsured residents.
• Guarantee that 12,200 residents with pre-existing conditions can obtain coverage.
• Protect 1,500 families from bankruptcy due to unaffordable health care costs.
• Allow 49,000 young adults to obtain coverage on their parents’ insurance plans.
• Provide millions of dollars in new funding for 7 community health centers.
• Reduce the cost of uncompensated care for hospitals and other health care providers by $68 million annually.

Affordable High-Quality Health Care for the Middle Class

Essential health insurance reforms. Approximately 59% of the District (369,000 residents) receives health care coverage from an employer or through policies purchased on the individual market. Under the legislation, individuals with insurance can keep the coverage they have now, and it will get better. The insurance reforms in the bill prohibit annual and lifetime limits, eliminate rescissions for individuals who become ill while insured, ban coverage denials for pre-existing conditions, and reduce the cost of preventive care. To rein in soaring insurance costs, the reforms also limit the amount insurance companies can spend on administrative expenses, profits, and other overhead.

Historic health care tax cuts. Those who do not receive health care coverage through their employer will be able to purchase coverage at group rates through new health insurance exchange. To make this insurance affordable, the legislation contains the largest middle-class tax cut for health care in history, providing middle class families with incomes up to $88,000 for a family of four with tax credits to help pay for coverage in the exchange. For a family of four making $50,000, the average tax credit will be approximately $5,800. There are 171,000 households in the District that could qualify for these credits if they purchase health insurance through the exchange or, in the case of households with incomes below 133% of poverty, receive coverage through Medicaid.

Coverage for individuals with pre-existing conditions. There are 12,200 uninsured individuals in the District who have pre-existing medical conditions like cancer, heart disease, and diabetes. Under the bill’s insurance reforms, they cannot be denied affordable coverage.

Financial security for families. There were 1,500 health care-related bankruptcies in the District in 2008, caused primarily by the health care costs not covered by insurance. The bill caps annual out-of-pocket costs at $6,200 for individuals and $12,400 for families who purchase insurance through the exchange or who are insured by small businesses. It also eliminates annual and lifetime limits on all insurance coverage. These reforms ensure that no family will have to face financial ruin because of high health care costs.

Security for Seniors

Improving Medicare. There are 98,000 Medicare beneficiaries in the District. The legislation improves their benefits by providing free preventive and wellness care, improving primary and coordinated care, and enhancing nursing home care. The bill also strengthens the Medicare Trust Fund, extending its solvency from 2017 to 2026.

Closing the Part D donut hole. Each year, 9,300 Medicare beneficiaries in the District enter the Part D donut hole and are forced to pay the full cost of their prescription drugs. Under the bill, these beneficiaries will receive a $250 rebate in 2010, 50% discounts on brand name drugs beginning in 2011, and complete closure of the donut hole within a decade. A typical beneficiary who enters the donut hole will see savings of over $700 in 2011 and over $3,000 by 2020.

New Coverage Options for Young Adults

New lower-cost health care options for young adults. The legislation will allow young adults to remain on their parents’ policies until they turn 26. There are 49,000 young adults in the District who could benefit from this option. For individuals under age 30, the bill creates new, inexpensive policies that allow them to obtain protection from catastrophic health care costs.

Helping Small Businesses

Helping small businesses obtain health insurance. Under the legislation, small businesses with 100 employees or less will be able to join the health insurance exchange, benefiting from group rates and a greater choice of insurers. There are 16,400 small businesses in the District that could benefit from this provision.

Tax credits for small businesses. Small businesses with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 14,300 small businesses in the District that could qualify for these credits.

Covering the Uninsured

Coverage of the uninsured. The legislation would extend coverage to 95% of all Americans. If this level of coverage is reached in the District, 58,500 residents who currently do not have health insurance will receive coverage.

Relieving the burden of uncompensated care. In 2008, health care providers in the District provided uncompensated care to individuals who lacked insurance coverage and were unable to pay their bills.

Under the legislation, these costs of uncompensated care will be reduced by $68 million.

Recovery Act dollars to improve classrooms

I was pleased to announce this week with the U.S. Department of Treasury and the Department of Education that $16,274,000 in school construction bonds authority has been awarded to the Kansas City Missouri School District.

Nationally $11 billion was allocated for qualified school construction bonds under the American Recovery and Reinvestment Act of 2009 (Recovery Act). Qualified school construction bonds can be used to finance the construction, rehabilitation or repair of a public school facility or for the acquisition of land where a school will be built.

This is money to help our local school districts continue to repair and invest in our schools, despite the economic hard times we are facing. At a time when the Kansas City School District is consolidating half its schools, this allocation will allow for much needed building and classroom improvements necessary to accommodate shifting thousands of students. This is a zero-interest loan authority to invest in Kansas City’s students as they adjust to their new situation.

This announcement comes at a time when the Kansas City, Missouri School District is embarking on a radical transformation plan for Teaching and Learning for a New Millennium. “This funding is just what we need to upgrade many of our facilities and provide students with the 21st century learning environments they deserve,” said John Covington, Superintendent of the Kansas City, Missouri School District. “The bonds will assist us in providing a safe, nurturing and improved educational environment that enhances and supports academic achievement.”

Created by the Recovery Act, qualified school construction bonds help state and local governments obtain low-cost financing for much needed public school improvements and construction. Investors who buy these bonds receive Federal income tax credits at prescribed tax credit rates in lieu of interest. These tax credit bonds essentially allow state and local governments to borrow without incurring interest costs.

The Recovery Act provided for the issuance of $11 billion of qualified school construction bonds by states and large local educational agencies in 2009 and $11 billion in 2010. The 2010 allocations include $6.6 billion of bonding authority to the 50 states and the remaining $4.4 billion was allocated the nation’s 103 largest local educational agencies, including Kansas City, Missouri.

Our Mobile Office

Wow, after four years of using our Mobile Office in and around the District, have we ever got some attention! We are the third Member of Congress to serve the people of Missouri’s Fifth District to have a Mobile Office. Congressman Dick Bolling and Congressman Alan Wheat both leased Mobile Offices to help serve constituents.

I use the Mobile Office instead of renting another District office. It costs less than another office would.

It allows my staff to travel to nursing homes, senior centers, schools, fairs across the District. It is particularly helpful for those with disabilities because it has a wheel chair ramp.

It is outfitted with everything the staff needs to take care of constituents on the spot: printer, computer, Wi-Fi, scanner all inside.

Overall, our office spends less on operations than the surrounding Members, both Republicans and Democrats.

The Mobile Office is outfitted to run on recycled cooking grease and promotes alternative fuels as it tours the District.

It is an expensive lease compared to a personal vehicle, but this is not for personal use --- it is to help constituents and be accessible. It is unlike anything in the country.This is a unique approach which serves a unique need. A constituent suggested that we should have pictures of the Mobile Office serving people. I thought it was a great idea and we have put a link on our front page to a web page devoted to the Mobile Office. You can even request to have it come to your neighborhood from the page.

This is just a start, we have lots more pictures to add and we will keep updating the page. The Mobile Office webpage can be found here >>>

Check it out in person next week at our monthly "Coffee with Cleaver":
Saturday, March 27, 2010
Crossroads Coffeehouse
301 Southwest Blvd.
Kansas City, MO 64108
8-10 am

Google KC

I am an avid jazz fan. I suppose that is a bit like saying I am a Bar-B-Q fan. After all, I represent the world’s home of jazz, helped build the American Jazz Museum and spent a sleepless night on the phone to Paris securing Charlie Parker’s plastic sax for Kansas City. I love jazz.

Often my colleagues in New Orleans, New York and St. Louis speak fondly of their city’s jazz heritage. And each of them play a role in the history of jazz — none as important as Kansas City.
There are many reasons for that. I used to listen to the late great Jay McShann go on for hours about the differences. But, the key to Kansas City’s pivotal, preeminent and positively particular place in American jazz history is — the jam session.

Jazz became a collaborative community exercise here unlike anyplace before or since. Driven by the Great Depression, fueled by the wide-open atmosphere and mob money of the Pendergast machine, musicians from across the country gathered in Kansas City — and nowhere else. Count Basie, Duke Ellington, Ella Fitzgerald, Charlie Parker, Louis Armstrong, Jay McShann, Joe Turner, Mary Jo Williams, Lester Young and hundreds more were in one place, at one time, perfecting their craft together.

Collaboration was the key to creativity.

During the time surrounding the Depression, the jazz greats had to physically come together. It is no mistake the song goes “Going to Kansas City, Kansas City here I come!”

How times have changed. Today, a student in Kansas City can work with a student in Katmandu with the click of a mouse. What hasn’t changed is our unique rhythm and ability to come together to produce something singularly unique.

Friends, we have a chance to once again collaborate, to jam at a whole new kind of gig.

Google is planning to build and test ultra-high speed broadband networks in a small number of trial locations across the country. Their plan is to deliver Internet speeds more than 100 times faster than what most Americans have access to today with 1 gigabit per second connections.
As a first step, Google is asking communities to tell them what they would do with ultra-high speed internet.

A grassroots effort in Kansas City seeks to harness the power of Google's ultra high-speed broadband network to deliver the internet in a green way to close the digital divide — bridging the gap between those with the means to be connected and those who have been left behind on the information superhighway. This has always been the great promise of the internet: equality through universal access to information. Google’s ultra-high speed plan is an opportunity for every child in every home to have the world at their fingertips.

What is being developed is a plan that will leverage the Green Impact Zone and the unique talents and capabilities of the people of Kansas City to:

• Install broadband fiber as part of every city, federally-funded, or Recovery Act-related public infrastructure project in Kansas City.
  
• In addition to fiber to the home, deploy affordable, broadband connections to every library, research & bio-science institute, arts and cultural facilities, schools and educational facilities, community health care centers, public computing centers, and affordable housing developments in Kansas City’s center city.

Imagine the world’s fastest Internet in Kansas City. Imagine what our history of creativity through collaboration could do with these connections.

Now, do much more than just imagine…let’s make it happen.

Champion the cause, join the jam and sign the petition to bring Google ultra high-speed to Kansas City. Click here to take action>> http://www.googlekcmo.com/index.php?option=com_petitions&view=petition&id=7

Be sure to send your friends to www.googlekcmo.com

Mr. President

Yesterday afternoon, I joined several of my colleagues at the White House. I have been to the White House many times over the years. In fact, I was on President Clinton’s transition team. I say none of that to brag, only to say that I realize what a unique opportunity it is each and every time. For an American, walking into the West Wing is a privilege and, particularly when times are rough, I am struck by the awesome responsibility of the person who sits behind the Resolute Desk in the Oval Office.

I was there to talk with the President about job creation and concerns that I and others had about the pace and scope of efforts to put Americans back to work. As he always is, the President was thoughtful and serious about the matter and I think everyone came away from the meeting reminded of just how much work there is still left to do to turn the economy around.

As I said last week in this newsletter, the bill we just passed was much more a tax relief bill than it was a jobs bill. I expressed those concerns directly to the President. We are coming upon the summer months, when millions of high school students will be looking for summer work and finding none. A job market already flooded with unemployed workers looking for jobs will be joined by a tsunami of young people competing for much of the same work. It is a perfect storm.

There is a calm urgency about our President. His plate is full, the expectations are sky high and each of us, regardless of party needs him to succeed. The Washington Post wrote that I choked up a bit when I told them that, but it is true. Regardless of what you may hear, liberals are patriotic too. I want America to succeed no matter who sits in the Oval Office.

There may be special significance assigned to him because he is a historic first, but America needs him to succeed because the alternative is simply unfathomable. His programs have indeed brought us back from the brink, but the road ahead is still very long and dangerous. Now is not the time to let up.

Health Care Reform

New York Times columnist and winner of the Noble prize for economics, Paul Krugman, had a piece in the Post yesterday that lays out the need for health care reform and takes issue with several myths that plague our national conversation on the critical issue.

Health Reform Myths
By PAUL KRUGMAN

Health reform is back from the dead. Many Democrats have realized that their electoral prospects will be better if they can point to a real accomplishment. Polling on reform — which was never as negative as portrayed — shows signs of improving. And I’ve been really impressed by the passion and energy of this guy Barack Obama. Where was he last year?

But reform still has to run a gantlet of misinformation and outright lies. So let me address three big myths about the proposed reform, myths that are believed by many people who consider themselves well-informed, but who have actually fallen for deceptive spin.

The first of these myths, which has been all over the airwaves lately, is the claim that President Obama is proposing a government takeover of one-sixth of the economy, the share of G.D.P. currently spent on health.

Well, if having the government regulate and subsidize health insurance is a “takeover,” that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.

The only part of health care in which there isn’t already a lot of federal intervention is the market in which individuals who can’t get employment-based coverage buy their own insurance.

And that market, in case you hadn’t noticed, is a disaster — no coverage for people with pre-existing medical conditions, coverage dropped when you get sick, and huge premium increases in the middle of an economic crisis. It’s this sector, plus the plight of Americans with no insurance at all, that reform aims to fix. What’s wrong with that?

The second myth is that the proposed reform does nothing to control costs. To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.

Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.

And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first.

Furthermore, there’s good reason to believe that all such estimates are too pessimistic. There are many cost-saving efforts in the proposed reform, but nobody knows how well any one of these efforts will work. And as a result, official estimates don’t give the plan much credit for any of them. What the actuary and the budget office do is a bit like looking at an oil company’s prospecting efforts, concluding that any individual test hole it drills will probably come up dry, and predicting as a consequence that the company won’t find any oil at all — when the odds are, in fact, that some of the test holes will pan out, and produce big payoffs. Realistically, health reform is likely to do much better at controlling costs than any of the official projections suggest.

Which brings me to the third myth: that health reform is fiscally irresponsible. How can people say this given Congressional Budget Office predictions — which, as I’ve already argued, are probably too pessimistic — that reform would actually reduce the deficit? Critics argue that we should ignore what’s actually in the legislation; when cost control actually starts to bite on Medicare, they insist, Congress will back down.

But this isn’t an argument against Obamacare, it’s a declaration that we can’t control Medicare costs no matter what. And it also flies in the face of history: contrary to legend, past efforts to limit Medicare spending have in fact “stuck,” rather than being withdrawn in the face of political pressure.

So what’s the reality of the proposed reform? Compared with the Platonic ideal of reform, Obamacare comes up short. If the votes were there, I would much prefer to see Medicare for all.
For a real piece of passable legislation, however, it looks very good. It wouldn’t transform our health care system; in fact, Americans whose jobs come with health coverage would see little effect. But it would make a huge difference to the less fortunate among us, even as it would do more to control costs than anything we’ve done before.

This is a reasonable, responsible plan. Don’t let anyone tell you otherwise.