Deciding health care reform: Why I voted no

Posted: Sunday, January 03, 2010

Usually by this time of year, members of Congress stop hearing from their constituents because they've got other things on their minds Christmas cards and presents and family gatherings to celebrate the holidays. But not this year.

Christmas week, my offices in Alaska and Washington were bombarded with hundreds of calls, faxes and e-mails from constituents. The overwhelming majority were upset, even outraged, that the Senate was about to pass a partisan $2.5 trillion health care bill that increases the role of the federal government in health care, worsens conditions for Medicare patients, raises taxes and insurance premiums and does nothing to reduce the cost of health care.

The Senate passed the health care bill on Christmas Eve and I voted against the measure, as did all of my Republican colleagues. Many of the Alaskans who contacted me in recent weeks are confused by what this bill does and are concerned about how the legislation will impact them directly. They should be.

In fact, the non-partisan government scorekeeper, the Congressional Budget Office, said just before the vote that a large share of the savings from Medicare was double counted and thus overstated the improvement in the government's fiscal position. This further illustrates how the fatigued CBO staff is unable to produce accurate and verifiable information while adhering to harsh deadlines to pass a bill before Christmas.

Health insurance premiums would rise under the bill, according to the CBO, which said that premiums for individuals without employer-sponsored coverage would increase between 10 and 13 percent, which in Alaska could affect up to 28,000 people.

The University of Alaska at Anchorage's Institute of Social and Economic Research, which reviewed the legislation at my request, concluded that premiums would rise roughly 12 percent, or a net increase of $1,160 for some individuals and $2,950 for some families in Alaska. Although subsidies would be available to help offset the cost, it is unclear from the bill who in Alaska would be eligible to receive them.

At 2,733 pages, no one can truly say they understand everything that is in this bill, but there are a few things that we do know. The Medicare program, which serves senior citizens and the disabled, will be slashed by nearly a half trillion dollars. Plundering Medicare to expand health care coverage is not reform.

According to ISER, expanding Medicaid, the health care program for low income individuals, would create a surge of demand in Alaska that could send our Medicare beneficiaries to the back of the line due to Medicare's low reimbursement rates compared to Medicaid's rates. Unfortunately, the Democrats' bill does nothing to fix the Medicare reimbursement rate inequity for Alaska.

There is also the $518.5 billion in tax increases under the bill that include a payroll tax hike of 0.9 percent for individuals earning $200,000 and couples earning $250,000, along with a mandate requiring all Americans to purchase health insurance or pay either $750 or 2 percent of taxable income, whichever is greater.

The bill also would impose a 40 percent excise tax on high value insurance plans. Because Alaska is a high cost state, ISER predicts that roughly 50 percent of health plans in the state would be subject to the tax by 2016, compared to only 19 percent on average in the Lower 48.

Throughout the debate, both sides stressed that any reform bill should first and foremost rein in the ever-escalating cost of health care. But this bill doesn't bend down the health care cost curve as President Barack Obama promised it would, according to the CBO analysis.

While most of the tax and premium increases and Medicare cuts would begin upon enactment, many of the benefits would not kick in for three or four years. That's like making mortgage payments on a new home but having to wait four years to move in.

A poll was released bears out the hundreds of e-mails and phone calls I have received from constituents who are opposed to the health care bill. The statewide Dittman Research poll of 393 registered voters in Alaska showed that 57 percent of respondents oppose congressional health care legislation; 64 percent expect costs to increase and 60 percent expect the quality of care to decline if the bill becomes law; and 59 percent want the congressional delegation to oppose the bill. Those are pretty convincing numbers.

Although the Senate passed the health care bill by the narrowest of majorities and with no Republican support, that was not the final vote. There are significant differences between the House and Senate health care bills, and those differences will have to be reconciled before a vote for final passage occurs.

So the debate is not over. Democrats have not been listening, despite poll after poll that shows a majority of Americans oppose the bill. Perhaps that will change as lawmakers return home this holiday season and constituents get an opportunity to express their views about the tax and premium hikes, Medicare cuts and sweetheart deals in this bill.

• Lisa Murkowski is a Republican U.S. senator from Alaska.

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