Health Care Reform Bill Includes Major Cantwell Initiatives to Control Costs, Improve Quality of Care

Cantwell pledges to continue improving the bill as health care reform moves to historic Senate floor debate

WASHINGTON, DC  – The U.S. Senate Finance Committee today approved sweeping health care reform legislation that includes major initiatives authored by Senator Maria Cantwell (D-WA) to reform Medicare, aid seniors in need of long-term care, promote coordinated care between patients and doctors, cut insurance costs, and help cover the country’s uninsured. The bill, America’s Healthy Future Act of 2009, will be combined with legislation previously passed by the Health, Education, Labor and Pensions Committee, and this melded legislation will then go to the Senate floor for debate.


“I am a mountain climber, and to reach the summit, you need a good foothold; this legislation gives us that foothold,” said Cantwell, who voted with the majority to pass the bill by a vote of 14-9. “We are now one step closer toward historic and long-sought reform of our health care system. I will be working with my colleagues on the Senate floor to ensure that the many strong provisions in this legislation remain, to improve it where necessary, and to emerge with a bill that controls health care costs, improves the quality of health care, and looks after the people that our system has left behind.”


Over the past two weeks the Senate Finance Committee made numerous improvements to the health care reform bill but defeated amendments supported by Cantwell to add a public health insurance option to the bill.  Subsequently, the Committee approved a Cantwell amendment that would establish a nation-wide version of Washington state’s Basic Health system. Under the Cantwell plan, states that opt-in could use federal funding to negotiate with health insurance providers for affordable coverage of hardworking Americans – up to a family of four earning $44,000.


“Uncontrolled health care costs are wreaking havoc on American lives,” Cantwell continued. “What does it say if we don’t step up at this critical point in history and help American families get the coverage and the quality care they need? Doing nothing is not an option.  In floor debate, I will be pushing for the most robust plan possible to cover the uninsured and to put pressure on private insurance companies to lower rates.”


Five Cantwell amendments included in the bill approved today aim to increase access to quality care while reining in out-of-control health care and health insurance costs. The following is a summary of Cantwell’s key amendments included in the Senate Finance Committee bill:




·        Basic Plan: For the first time, states that opt-in would have the ability to negotiate directly with health insurers to provide high quality health care coverage at a lower cost.  Rather than handing tax subsidies to insurance companies, Cantwell’s amendment directs money to the states, and lets them use their purchasing power to negotiate with private insurance carriers. The measure, modeled after Washington state’s Basic Health Plan, which has a 20-year track record of reducing costs and providing quality care, Cantwell’s plan could provide health insurance to as many as 75 percent of the nation’s uninsured.


·        Medicare reform: Establishes a “value-based index” to reward doctors for providing high quality, efficient, and coordinated care. The amendment is designed to fix flaws in the current system that rewards practitioners for ordering often redundant or unnecessary tests and procedures.  Currently, Medicare wastes $120 billion a year, or 30 percent of all Medicare spending.  This waste is due, in part, to incentives in the Medicare physician payment structure.  Cantwell’s amendment provides incentives to doctors to work toward the best outcomes, instead of paying them for ordering more services and spending more money.


·        Long Term Care: Cantwell’s amendment increases matching federal Medicaid funding to states that implement home- and community-based health care programs.  America’s aging population is increasing demand for long-term care and assistance with day-to-day activities. States now struggling with rising Medicaid costs will be able to expand their range of long-term care services to enable seniors to remain in their homes and communities. Studies have shown that providing long-term care in the home can save nearly 70 percent over institutionalized care. 


·        Primary Care: With the nation experiencing a shortage of primary care doctors, the Finance Committee bill includes concepts championed by Cantwell to expand the nation’s graduate medical education training capacity to more suburban and rural hospitals, and to provide incentives for medical students to opt for a career in primary care. Primary care physicians play the vital role of coordinating care so that patients have a single doctor looking over all of their health care needs, supervising their medications and the specialists they see.


·        Pharmacy Benefit Managers (PBMs):  Serving as the middlemen between health insurance plans (including both private health insurance plans and Medicare Part D), pharmaceutical manufacturers and pharmacies, PBMs manage most of the prescriptions filled in the United States but are the only unregulated area of the health insurance industry.  Cantwell’s proposal requires reporting by PBMs to ensure that savings from drug price negotiations are being passed on to consumers and not contributing more to pharmaceuticals’ bottom lines.