Health Care

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Health Care

As a physician with more than 30 years of experience—and co-chairman of the GOP Doctors Caucus—taking care of patients has been my life’s work. That’s why my top priority in Congress is repealing ObamaCare and replacing it with patient-centered health reforms that will improve access to care, lower costs, and improve quality.


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.

This flawed law has proven to be a disaster, resulting in less choice and skyrocketing costs for patients. For the 2017 plan year alone, individuals who purchased insurance through an ACA-compliant plan saw their premiums increase an average of 56 percent, with additional rate hikes requested for 2018.

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.

The American Health Care Act

I supported H.R. 1628, the American Health Care Act (AHCA), which passed the House on May 4, 2017 by a vote of 217 to 213. AHCA repeals ObamaCare and replaces it with patient-centered, free-market reforms designed to spur competition, lower costs, and improve the quality of care –  all while maintaining consumer protections such as for pre-existing conditions. While the Senate failed to act on this legislation, I will continue working with the Trump administration and my colleagues in the Senate to find a path forward to repeal and replace ObamaCare.

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.

To address these challenges, in the 115th Congress I introduced H.R. 277, the American Health Care Reform Act. This bill, supported by a majority of House Republicans, puts free-market competition to work for patients and their families. Specifically, H.R. 277 would:

  • Fully repeal President Obama's health care law, eliminating billions in taxes and thousands of pages of unworkable regulations and mandates that are driving up health care costs. 
  • Spur competition to lower health care costs by allowing Americans to purchase health insurance across state lines and enable small businesses to pool together and get the same buying power as large corporations.
  • Reform medical malpractice laws in a commonsense way that limits trial lawyer fees and non-economic damages while maintaining strong protections for patients.
  • Provide tax reform that allows families and individuals to deduct health care costs, just like companies, leveling the playing field and providing all Americans with a standard deduction for health insurance.
  • Expand access to Health Savings Accounts, increasing the amount of pre-tax dollars individuals can deposit into portable savings accounts to be used for health care expenses.
  • Safeguard individuals with pre-existing conditions from being discriminated against purchasing health insurance by bolstering state-based high risk pools and extending HIPAA guaranteed availability protections.
  • Protect the unborn by ensuring no federal funding of abortions.

I was pleased many of these reforms were included in the American Health Care Act.

Independent Payment Advisory Board (IPAB)

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 reintroduced bipartisan legislation in the 115th Congress to repeal the authority of the IPAB to be empaneled. H.R. 849, the Protecting Seniors’ Access to Medicare Act of 2017, would repeal the IPAB’s authority and make it so there is no opportunity for an unelected body to make cuts to Medicare without Congressional oversight and approval. This is a bipartisan, bicameral issue. On October 4, 2017, the House Ways and Means Committee marked up this bill, and I will continue working with my colleagues in order to get the whole House of Representatives to consider this bill on the floor.

I also requested that the House Appropriations Committee rescind any funding for the IPAB in Fiscal Year 2018, and I was pleased that this rescission was included in H.R. 3354, the Make America Secure and Prosperous Appropriations Act, which passed the House by a vote of 211 to 198. This is an important step toward repealing the IPAB authority and protecting Medicare for our nation’s seniors.

Medicare Physician Payments

Beginning in 2001, Medicare was 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.


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