I voted against the Patient Protection and Affordable Care Act (ObamaCare) in the 111th Congress, and have since been leading the charge to repeal the law and replace it with commonsense reforms.
In just a short period of time, this flawed law has proven to be a disaster. There have been numerous technical problems with the ObamaCare website, millions of Americans have been forced out of insurance plans they liked, and patients are finding it harder to keep their doctors—just to name a few of the many problems. In 2016 alone, BlueCross BlueShield of Tennessee sought, and was granted, a 62 percent premium increase for 2017, only to pull out of providing coverage to three major metropolitan areas in Tennessee just a couple weeks later.
Though supporters of the law claimed it would lower health care costs, give more choice to Americans regarding their care, and offer a higher quality of services, year after year ObamaCare has proven to do just the opposite. When Tennessee adopted TennCare—a proposal similar to ObamaCare—in the 1990s, it failed both to keep costs under control and to extend universal coverage. The cost of the program tripled within 10 years, putting an unbearable strain on the state budget. Additionally, access to health care for TennCare beneficiaries was poor.
My top priority in Congress will continue to be the full repeal of this law, and its replacement with patient-centered health reforms. I am excited about Speaker Paul Ryan’s Better Way Health Care Reform agenda, which is a bold set of reforms to put patients back in charge of their healthcare. I look forward to working with the Trump administration and my colleagues in the House to replace this disastrous law.
The American Health Care Reform Act
ObamaCare is a disaster for the American people. But we must also remember that there were serious challenges in American health care even before the president’s law came into effect.
Among the worst parts of ObamaCare is the Independent Payment Advisory Board (IPAB). The IPAB is an unelected, unaccountable bureaucracy that has been granted sweeping powers to “reduce the per capita rate of growth in Medicare spending.” Medicare cuts proposed by the IPAB are to be considered using “fast track” procedures and—absent a three-fifths vote of the Senate—Congress can only modify the type of cuts, not the amount. Should Congress fail to act on the board’s recommendations, they automatically go into effect. To make matters worse, the IPAB is exempt from administrative or judicial review.
I have grave concerns that the IPAB will function as a denial-of-care board that will slash Medicare payments just to meet an arbitrary budget. It is likely that the IPAB’s proposed cuts will include reduced payments to physicians and other health care providers. Given that Medicare currently pays physicians only 80% of what private insurers do, any additional cuts could severely limit patients’ access to care.
I have introduced legislation in the past three Congresses that would repeal the IPAB, and will do so again in the 115th Congress. I will be working diligently to ensure it never has the chance to make any cuts.
Medicare Physician Payments
Since 2002, Medicare has been scheduled to cut payments to physicians annually because of the payment update formula known as the Sustainable Growth Rate, or SGR. Thankfully, in the 114th Congress, we were able to pass legislation that repealed the SGR and instituted a new way to pay physicians for seeing Medicare patients.
In 2015, I proudly voted for and helped urge passage of the Medicare Access and CHIP Reauthorization Act (MACRA),which repealed the SGR while instituting a new process to pay Medicare physicians that would not require yearly fixes. In 2017, MACRA will begin its implementation and I look forward to working with the Centers for Medicare and Medicaid Services (CMS) to get this law fully implemented. Already, I have been actively engaged in pushing for more flexibility to protect small practice groups and to encourage as much innovation amongst physicians as possible.