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Tom Perriello | Fifth District Report

Last week, a new version of health-care reform legislation was unveiled in the U.S. House. I was pleased to see major changes in the bill that move us in the right direction. Though I was unsatisfied with the original bill, I’ve been working hard for reforms that I can support, because doing nothing would mean that premiums would double over the next decade for the middle class and small-business owners. I argued that we could reduce skyrocketing premiums, bring the uninsured into the system, and reduce the federal deficit through an emphasis on prevention and increasing competition. 

When congressional leaders tried to force a vote on health care reform on July, I fought to delay it so we could spend a month in dialogue with the American people. Taking our time and listening to constituents has paid off in the form of a stronger set of reforms. I took ideas from my 100 hours of town-hall meetings and dozens of other consultations and combined them with ideas other freshmen colleagues had heard to produce a letter that set out our guidelines for real reform.

I’m pleased to see that the new version of the bill addresses many of our requests, such as extending the life of Medicare, addressing tort reform, and not just holding the deficit neutral but actually reducing it over the next two decades. Here are some of the biggest victories we gained in the new version of the legislation:

· Protecting Medicare: Begins closing the Medicare Part D “donut” hole immediately (January 1, 2010) by $500 and institutes a 50 percent discount for brand-name drugs; requires the Secretary of HHS to negotiate drug prices on behalf of Medicare beneficiaries; and extends the life of the Medicare Trust Fund. Phases out the donut hole completely by 2019.

· Deficit Neutrality: The new health-care bill cuts over $300 billion from the original bill, and reduces the federal deficit; the independent Congressional Budget Office has also confirmed that the legislation cuts the deficit by about $104 billion with the CLASS Act ($32 billion without the CLASS Act) in the first ten years and reduces the deficit in the second ten years.

· Tort Reform: Establishes new voluntary state grant programs designed to encourage states to implement alternatives (“early offer” and “certificate of merit” approach) to traditional medical-malpractice litigation.

· Wellness and Prevention: Provides for the research and inclusion of proven healthy behaviors in the essential benefits package and in community-wellness programs; establishes a new grants program to prevent overweight and obesity among children. The cheapest health care is the illnesses we avoid by staying healthy in the first place.

· Protecting Small Business: Doubles the threshold of small-business exemption from $250,000 of payroll to $500,000; decreases obligations for employers with payrolls between $500,000 and $750,000. Increases the size of small employers automatically allowed to purchase coverage through the Exchange to at least 100 employees within the first three years, making it cheaper for small businesses to insure their workforce.

· Helping Rural Hospitals: For decades, Medicare and Medicare have reimbursed rural hospitals and doctors at a lower rate than other areas. The new bill is a major step forward towards fixing this problem by directing the Institute of Medicine (IOM) to study geographic inequities in Medicare reimbursement rates and revising payment rates based on the IOM’s findings. It also provides a 10 percent incentive payment for primary-care doctors practicing in underserved areas, such as rural areas.

I am reading the bill and looking for stronger provisions to increase competition – particularly competition across state lines – before I make a decision. I have fought tirelessly for these changes that my constituents wanted to see in the bill. If we do nothing, premiums will continue to rise, small businesses will continue to get crushed by skyrocketing health-care costs, and Medicare will be endangered. I will continue to push for meaningful reform because we can and must bring down the cost of health care.

The full text of the health-care legislation, along with the analysis by the Congressional Budget Office and other helpful fact sheets can be found on my website:

Please feel free to contact me to share your concerns and ideas. You may call 1-888-4-TOM4US (1-888-486-6487); write to 1520 Longworth House Office Building, Washington, DC 20515; or visit to sign up for my weekly e-newsletter.


Tom Perriello represents the Fifth District in the United States House of Representatives.

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