Jay Inslee Responds To My Question

2+ weeks ago I emailed Representative Inslee the question If a government run health care plan is passed, will you pledge to sign up for that as your health care insurance? Here is his reply:

Thank you for contacting me regarding potential health care reforms. I appreciate hearing from you.



As you may know, Members of Congress and retired Members are entitled to participate in the Federal Employees Health Benefits Program (FEHBP) under the same rules as other federal employees. The Federal Government and enrollees of FEHBP jointly pay for the cost, or premiums, of the FEHBP plans. Participants pay an average of 28 percent, but no less than 25 percent of premiums. Members of Congress must also pay the same payroll taxes as all other workers for Medicare Advantage Part A coverage.



I would like you to know that I share your concern for reducing the tax burden of the American public. As a father of three, I know how hard it is to pay the mortgage, save for retirement, send our children to college, and pay taxes. I firmly believe that any increases in spending or changes to our tax code should simplify the system, increase our nation's savings rate, and fairly tax individuals of varying income.



While this is true, I am deeply concerned as the cost of medical care has risen over the years. Inflation within the medical sector has risen at an alarming rate, and we have seen health care spending rise from an average of $348 per person in 1970 to $7,026 in 2006. There are multiple factors for this and it is one of the reasons I believe the time for health care reform is now. I believe we must continue to work to expand affordable, high quality coverage, and contain medical costs. Critics of the reform process have claimed that attempts to limit cost will necessarily limit services and lead to rationing. On the contrary, funding in H.R. 3200 is directed towards comparative effectiveness research that will help doctors decide what treatments will be most effective for their patients, thereby promoting high quality care as opposed to simply high quantity care. This research will also help to combat overutilization practices, or so-called "defensive medicine," another driver of high costs in the system.



You may be interested to know that throughout the process of consideration of H.R. 3200 in the Energy & Commerce Committee I have voiced my concern that the initial version of the bill did not do enough to address the high cost of health care, and I have worked diligently with my colleagues to add additional cost containment measures to the bill. Our Nation spent over $2 billion dollars on health care in 2007, or more than $7,000 per person. If the inefficiencies in the system aren't addressed, by the year 2025 it is estimated that one of every four dollars in our national economy will be consumed by the health care system. One of my focuses in the reform process has been addressing inequities in the Medicare reimbursement process. I worked hard for the inclusion of two studies in the reform bill that, when implemented, will lead to the creation of a value index to guide reimbursement rates, and address the geographical disparities that have long affected physicians in Washington state. Under the current Medicare reimbursement formula, payment for services rewards the quantity of services, rather than the effectiveness of those services. For this reason, Washington state physicians have historically been reimbursed at a lesser rate compared to their peers in other parts of the country, due to the efficient, high-quality service they provide. Implementation of the two IOM studies will rectify this historic inequity and provide real cost-containment by incentivizing and reimbursing for the quality, not the quantity, of medical care across the United States. This reform will also benefit Washington state's senior citizens, who suffer from limited access to providers as a result of the reimbursement inequality that affects low-cost areas. The Congressional Budget Office has estimated that these Medicare reforms will save more than $500 billion in the next decade.



I would also like to take a moment to address one of the most common misconceptions related to the health care reform effort. Many voices critical of reform have pointed to a section that addresses seniors' consultations with their physicians as cause for concern. The provision in question, found in Part 3, Section 1233, simply allows for Medicare coverage of "advanced care planning consultations," sessions in which a physician can offer details as to what options the patient has for end-of-life care. These sessions would be in no way mandatory, and the purpose of this section is to merely to extend Medicare coverage to a common medical practice, making physicians more likely to be available to patients who are interested in the service but couldn't otherwise afford it, protecting the doctor patient relationship.



I believe that it is important to protect the interest of the consumer by providing choices so that people may decide what solution is best for them and their family. As you may know, H.R. 3200 promotes choice through the creation of a public health insurance option that would include sliding scale affordability credits to assist those with low and moderate incomes. H.R. 3200, includes language that explicitly affirms that the public option will remain just that, optional, and will be offered alongside private health insurance plans in a Health Insurance Exchange. Any individual who is satisfied with their current plan would be allowed to remain with that provider. While some express concern that this public option will lead to the disappearance of private plans, the nonpartisan Congressional Budget Office has estimated that the number of Americans with private health insurance will grow, rather than shrink, under the House bill. Additionally, the CBO projects that two-thirds of consumers who purchase insurance through the Health Insurance Exchange will opt for one of the private plans, and they further estimate that only 3% of our country will select the public insurance option in the first decade after it is implemented. Perhaps most importantly, this public option is entirely budget neutral, financed primarily through its own premiums.



Finally, as you know, most federal assistance programs are meant for citizens and legal residents only. Standing federal laws bar any illegal immigrant from receiving any direct federal assistance such as Social Security, Medicare, or housing assistance. H.R. 3200 expressly prohibits the payment of the public plan's affordability credits to individuals who are not legally documented residents. It would also create a small business health tax credit to make it easier for small businesses to cover their employees and assist in lowering premium costs for businesses. This bill also seeks to improve Medicare and Medicaid and prevent waste, fraud and abuse in the programs. These are just a few components of the proposed legislation. Knowing your interest in this issue, I encourage you to visit the Energy and Commerce website for a more comprehensive look at this bill. I hope you will find the following summary of interest: http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf.



At this time, H.R. 3200 has been approved by the Energy and Commerce Committee and reported to the full House of Representatives. In the interest of allowing for ample consideration of such a hugely important issue, the House will not vote on the bill until after the August recess. I will keep your thoughts in mind as the bill moves through the legislative process.



Please continue to contact me about the issues that concern you, as I both need and welcome your thoughts and ideas. I encourage you to contact me via email, telephone, or fax, because security measures in the House cause delays in receiving postal mail. For more information on my activities in Congress, and for information on services that my office can provide, please visit my website at http://www.house.gov/inslee. If you would like to subscribe to my email updates, please visit http://www.house.gov/inslee/signup.htm.


Very truly yours,

JAY INSLEE
Member of Congress

Is that yes or no?

I called the Shoreline office letting them know he did not answer the question. They said they would submit it again and I should hear back in about 2 weeks.