People should judge health care reform legislation on its whole rather than its parts, according to U.S. Rep. Bruce Braley, D-Waterloo.
During a Quad-Cities visit Monday, Rep. Braley said the health care legislation that passed the House 220-215 late Saturday night has many good elements that should not be lost in Senate action.
"You hear a lot of posturing going on right now," Rep. Braley said, noting the critical time for the bill will be when the House and Senate reach a compromise on health care reform.
"Then it's going to be a time for Democrats in the House and the Senate to decide whether they're going to stand for meaningful health care reform or they're going to buckle into these special interests,"he said.
Rep. Braley is living that stance. A recognized pro-choice lawmaker, he voted for the House bill Saturday despite language The Associated Press says clearly prohibits federal dollars from going to pay for abortions.
"You can't just carve out single issues and say, 'This is going to be a deal breaker for me or not,'"Rep. Braley said. "One of the things I will look at is whether the totality of the Senate bill, in my opinion, accomplishes meaningful health care reform."
Such reform, he said Monday, includes closing the "doughnut hole" in Medicare coverage and enabling small businesses either to offer health coverage for employees or help those employees qualify for a public option. Small businesses' concerns, he noted, were made clear to him during his summer town hall meetings on health care reform.
"One of the best things that happened is that we heard those concerns," he said. "The bill has been changed to improve not only the availability of income tax credits for small businesses that want to provide health insurance to their employees, but also to limit the employer-mandate to a higher income level for small businesses.
"The bill exempts small business owners up to a certain level – but it also allows them to pay into a special fund based on a percentage of their employees' wages," Rep. Braley said. "A lot of those employees would then be eligible for affordability credits to go into the exchange by a private insurance policy or a public option and be able to finally get the kind of coverage they don't have right now.
"By developing a national health insurance exchange from Day 1 that will eliminate discrimination due to pre-existing conditions, it's going to help small businesses enormously."
Rep. Braley also praised the House bill's effort to make Medicare a "quality-based payment system in two years." Medicare would be required to conduct a two-year study on a value-based system, he said, after which time the program would adopt the approach unless Congress specifically voted against the move.
"These provisions represent a major breakthrough in health care reform," Rep. Braley said, that would save billions of dollars and reduce costly, unneeded procedures. The changes, he said, will give states with lower levels of quality of care the "incentive to improve."
He cautioned people not to misinterpret $400 billion in proposed Medicare spending cuts. People don't realize, Rep. Braley said, that a great deal of money is being wasted. Through the House-passed health care reform legislation, Medicare Part D participants immediately would receive $500 in additional benefits, he said, while lower prescription drug costs helped shrink and eventually phase out the hole in coverage.
Rep. Braley said he hopes a compromise health care reform bill will reach the president's desk by Christmas, adding "we're prepared to stay" as long as necessary "to improve the quality of care for every American."
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