The House of Representatives voted 220-215 late Saturday night to approve legislation that includes mandates to insurance providers and consumers and creates a public option for the provision of insurance coverage.
One Republican, Joseph Cao of Louisiana, joined 219 Democrats in voting for the bill; 176 Republicans and 39 Democrats voted against the legislation, which next goes to the Senate. It can be expected that whatever health-care bill makes it to the Senate floor will have some differences in language with the House version, so if and when the Senate were to pass similar legislation, it would be up to a House-Senate conference committee to work out differences and present a compromise bill for additional consideration by the two legislative chambers.
Which is to say, it’s not over yet, not by a long shot.
But the Saturday vote was historic nonetheless, and no matter as to what side of the political or ideological aisle you happen to be on.
We collected on-the-record comments from Virginia’s congressional delegation on the legislation from yesterday and late last night. Here’s what your congressional delegation had to say.
Rob Wittman, R-1st:
“Today, we’ve witnessed what continues to be a flawed legislative process in Washington when it comes to providing common ground and common-sense solutions to the problems facing the Commonwealth and nation. Throughout the process of crafting health-care legislation I’ve formed a First District Healthcare Advisory Council, held town-hall and telephone town-hall meetings, and received thousands of e-mails, phone calls, and letters with an overwhelming message not to vote for a reform package that included a government takeover of our health-care system. With my vote, I brought the message from my constituents directly to Congress.
“While this bill has passed today, there is still much in the way to go of the legislative process. I remain optimistic as the Senate works on their legislation and as Congress meets to craft a final bill that we will focus on the true tenets of reform: allowing the sale of insurance across state lines, enacting meaningful tort reform, and allowing those with preexisting conditions to purchase affordable coverage. We owe it to the American people to get it right when it comes to reforming something that affects every single American and encompasses nearly 1/5 of our economy. We need reform that will truly lower costs, not create more bureaucracy and new government programs at the price of further debt upon an already bloated budget.”
Glenn Nye, D-2nd:
“Health-care costs are crippling our small businesses and forcing families into bankruptcy, and any reform plan needs to reduce those costs. Although this version of the bill takes important steps to lower the deficit in the short term, the CBO has said that it does not address the fundamental problem of reducing skyrocketing health-care costs. Small businesses are facing increases of 10 to 20 percent in their health-care premiums each year, and I am not convinced that this bill would fix that problem next year or the year after.
“It’s more important to pass the right bill, one that will reduce costs and help families and small businesses, than to pass this bill right now. From all my conversations with small businesses, doctors, nurses, and families across Hampton Roads and the Eastern Shore, it’s clear that we need meaningful health-care reform, and I’m going to keep working until we get this right.”
Bobby Scott, D-3rd:
“I am proud to vote in favor of historic health-insurance reform legislation that gives Americans more choice in their health insurance options and gives security to those who have currently have coverage. Since 1987, the average family health insurance policy has risen from 7 percent of median family income to 17 percent. Skyrocketing health-care costs are hurting families and forcing businesses to cut or drop health benefits. Americans are losing coverage at a rate of 14,000 a day. Continuing on this path is not an option.
“Both Democrats and Republicans agree that expanding coverage and lowering costs are central tenants of reform. We also agree that people should not be denied coverage because of pre-existing conditions. But implementing these changes requires us to make tough choices, including mandates and subsidies and other measures that will actually make affordable health care available for millions of Americans. And though Republicans support expanding coverage and bringing down health-care costs, they are not willing to offer a bill that will actually achieve these goals or address these priorities. They have been unable to provide a viable alternative that reduces the number of uninsured, increases accessibility of health care, controls skyrocketing costs, or addresses the denial of coverage based on pre-existing conditions. The Affordable Health Care for America Act makes the tough choices and addresses all the priorities that we know are essential to expanding care and lowering costs. This legislation will put us on a new path where health care will be affordable to all and not just a luxury for some.”
Randy Forbes, R-4th:
“Ironically and sadly, I believe history will judge this 2,000-page bill more for what it is missing than what it contains: the missing care for those that will wait on long lists for rationed health services; the missing jobs that will result from the legislation’s crushing taxes and regulations; the missing voice of our doctors who will be increasingly controlled by Washington bureaucrats; the missing ideas of reasonable, impactful, and bipartisan alternatives proposed by Republicans and moderate Democrats; the missing integrity of an institution marred by months of infighting and political maneuvering; and most importantly – the missing voice of the American people.”
Tom Perriello, D-5th:
“Whether for or against health-care reform, most people in the district asked me to fight for deficit reduction, a fair shake for rural doctors, and no federal funding for abortions. I helped to score major victories on all three fronts. Today’s vote on health-care legislation came down to a simple choice for me: Do we sit back and let premiums skyrocket for middle-class families and small businesses, and watch the cost of prescription drugs bankrupt seniors and the cost of health care bankrupt the federal government? Or do we take this step today to support middle-class families and small businesses by encouraging competition to bring down premiums?
“The time to act is now, because Virginians deserve a competitive health-care market. They deserve access to affordable health care, and they deserve better choices when purchasing insurance.
“Our work on this bill is not over. As health-care legislation advances through Congress, I will work with my colleagues in the Senate to push for better interstate competition. But I am proud of the changes I fought for. After hearing from my constituents during over 100 hours of town-hall meetings in August, and by continuing those conversations in the months since, I worked to include their ideas in the bill, pushing for legislation that now protect Medicare, ensure deficit neutrality, encourage wellness and preventive care, and protect small businesses.
“We can – and should – have the best health-care system in the world. I am proud to support this profound shift away from the status quo towards progress and better, cheaper health care for more Americans.”
Bob Goodlatte, R-6th:
“Americans from across the country are concerned about their health care. Americans want the ability to be able make health-care decisions that are in the best interests of their loved ones, without worrying that the cost of quality care will lead them to financial ruin. I know Americans are frustrated by rising health-care costs, and that is why we in Congress must act in order to cut health-insurance costs and make health care better, more available, and more affordable for all Americans.
“House Democrats, led by Speaker Nancy Pelosi, have introduced legislation that will not make health care better for your family. Speaker Pelosi’s 2,000-page bill, with over $1 trillion in new spending, is defined by more than 120 new government agencies and programs and a myriad of new federal regulations, mandates, and a significant increase in federal spending and debt. This amounts to a government takeover of your health care, and Washington would have ultimate control over what is best for you, the patient, what treatments are acceptable, and how long you must wait for needed care. This is the wrong approach for health care and what is worse, the over $800 billion in new taxes will kill as many as 5.5 million jobs primarily in small businesses. I believe you kno w what is best for you and your family and that is why I oppose any proposal that will allow Washington to make your health care decisions for you.
“I support a better approach to improving the quality of your care. Republicans have offered solutions that I support that will empower patients with choices, make high quality coverage more affordable, and protect and preserve the doctor-patient relationship. Unlike the Democrats’ plan, the nonpartisan Congressional Budget Office has confirmed that the plan offered by House Republicans will lower premiums by up to 10 percent and reduce the deficit by $68 billion over 10 years, all without imposing any tax increases on families and small businesses and while improving the quality of your health care. This legislation, that I support, allows for the purchase of health insurance across state lines, allows individuals and small businesses to join large pools to get more competitive rates, provides tort reform to cut down the high cost of defensive medicine, allows full tax deductibility of health insurance premiums, portability of health insurance and protection against pre-existing condition exclusions. These are the reform the American people want and need.”
Eric Cantor, R-7th:
“Republicans believe there is a better way. We have proposed an alternative approach that offers a stark contrast to the majority’s plan. It is a fiscally responsible and reasoned approach. The majority’s proposal overturns the whole system. We keep what works and then try to fix what’s wrong. Their bill puts the government between families and their doctors, ours doesn’t. Their plan cuts Medicare benefits to seniors, ours retains them. Their proposal blows a hole in the deficit, ours actually saves money. Their bill imposes penalties and mandates on our small businesses that costs jobs, ours does not. Specifically Mr. Speaker, our bill will help you access health care if you lose or change your job. And it will ensure that you have access to medical care if you have a pre-existing condition. And we also, Mr. Speaker, deliver on something that the majority refuses to even talk about, and that’s real meaningful medical liability reform. And most importantly Mr. Speaker, we produce cost savings for workers, families, and small businesses.
“The Congressional Budget Office says that the Democrat’s new government-run system won’t reduce costs. CBO says our legislation lowers health care costs. In fact, CBO says that the Republican plan cuts premiums by up to 10 percent for employees covered by small businesses, up to 8 percent for those not covered by employers, and up to 3 percent for employees covered by large businesses. Mr. Speaker in the face of 10.2 percent unemployment, Americans want jobs. They want less government spending and more economic security. The majority’s bill shows they have not listened, ours shows we have. Interestingly Mr. Speaker, the only bipartisanship on Capitol Hill today will be in opposition to Speaker Pelosi’s trillion-dollar-plus government overhaul of America’s health-care system.”
Jim Moran, D-8th:
“We are a great nation, a prosperous and compassionate one. But our health-care system doesn’t measure up to that greatness.
“In fact we pay twice what every other industrialized nation pays for health care, and yet 71 nations have enabled their people to live longer and healthier lives.
“The difference is that they have decided that the health of their people is a higher priority than the profit of their insurance companies.”
“Today we will have the opportunity to bring our health care system up to a standard deserving of the greatness of this nation. By controlling our costs, by covering all of our people and by improving the quality of the care that they receive, this bill is deserving of the greatness of our nation. It must pass today.”
Rick Boucher, D-9th:
“Health care reform is needed. More than 36 million American citizens do not have health insurance, and millions more are underinsured and cannot afford to pay for the medical care they need. As those without insurance are treated in emergency rooms, the high cost of that care is borne by those who have insurance, driving up health insurance costs for everyone. The typical family pays an extra $1,100 each year in health insurance premiums as a cost of treating the uninsured. Health-insurance premiums are increasing 3.5 times as fast as the rate of increase in family incomes.
“This status quo is unsustainable, and finding a way for everyone to afford health insurance is necessary to benefit both the uninsured and those who have insurance. I hope that following a House-Senate conference on the legislation, we will be able to send to the White House the needed reform measure.
“But reform legislation must ensure that Southwest Virginia residents continue to have access to the high quality health care services now delivered locally.
“I intend to oppose the health-care reform legislation recently debated by the U.S. House of Representatives for several reasons, including the continued existence of disparities in Medicare reimbursements between urban and rural areas under the House bill. Rural areas have traditionally received less under Medicare than urban areas, and while the bill makes some improvements in this regard, I would like to see more done to increase the payments to rural health care providers. Higher Medicare reimbursements would enable the attraction of more doctors to serve our medically underserved region.
“I also intend to oppose the bill because of my concern that a government-operated health-insurance plan could place at risk the survival of our region’s hospitals. Most of our hospitals are operated on a nonprofit basis for the benefit of the community. While most of their receipts are from Medicare and Medicaid payments, they lose money on each Medicare or Medicaid patient they treat. These programs reimburse hospitals at rates below the actual cost of providing patient care.
“The financial viability of our hospitals comes from the payments they receive from privately insured patients. A government-operated health-insurance plan competing with private insurance will attract patients who are privately insured today, with the result that the hospitals would treat less privately insured patients and lose the critical revenues that are essential to their survival.
“A government-operated plan would reimburse health-care providers at rates approximating Medicare rates, and hospitals would lose money on each of their patients insured under the government plan.
“I am concerned that for these reasons the creation of a government-operated insurance plan as envisioned in the House bill could result in the closure of hospitals in our region. Families depend on our community hospitals for health-care services, and financially healthy hospitals are essential to the health of Southwest Virginians.
“Many of our hospitals are financially stressed in normal times, and two hospitals in the district I represent closed for periods of time in recent years for financial reasons. The government-owned insurance plan as outlined in the House bill could push many more over the edge. I cannot support legislation that could lead to that result.
“I also believe that bipartisan participation is needed on a measure of this scope which affects every American. The best ideas of Democrats and Republicans alike should be drawn upon to fashion the final legislation. That did not happen as the House bill was constructed.
“In July, I opposed the health-care reform measure when it was considered by the House Energy and Commerce Committee and expressed my concerns at that time. The bill passed by the House did not address those concerns.
“Passage of the House bill is but a first step in a long legislative process to final enactment of a reform. I look forward to future steps in that process offering an opportunity for my concerns to be resolved.
“Reform is needed, and I hope to support the final passage of legislation that emerges from a House-Senate conference that creates affordable access to health care for all Americans and does so in a way that enables the continued delivery of the excellent care now offered in our region.
Frank Wolf, R-10th:
“Our nation is going broke.”
Gerry Connolly, D-11th:
“Teddy Roosevelt first called for comprehensive health care in the early 1900s. Some rush.
“A hundred years after that Republican’s vision, T.R. has been vindicated. Americans need the reform he endeavored to achieve.
“Today’s vote will mark an epic turning point for our country, for it enshrines national principles far more important than legislative pages:
“The principle of universal access and affordability;
“The principle of protection for American families against bankruptcy from the cost of catastrophic illness;
“The simple justice of shielding millions, including our children, from the caprice and devastation of health care benefits denied because of a pre-existing medical condition.
“If we have common American values that include compassion and economic common sense, if we have some sense of commonwealth in which your need is also mine, if we can rise above partisan advantage and understand our responsibilities to our fellow countrymen, here in this place, then we will seize this moment, this one transformative moment to make America a better place.”
– Story by Chris Graham