U.S. Rep. Anna Eshoo, D-Palo Alto, talked about the need for health care reform, the status of the current proposals and the legislative process of getting the bills passed during a "telephone town hall" with her constituents last week.
While other members of Congress interacted with their constituents in face-to-face meetings, occasionally featuring heated exchanges, Eshoo opted for a series of telephone conferences with residents from the 14th Congressional District.
The next such meeting is scheduled to take place Monday at 6:40 p.m. District residents can sign up to participate by filling out a form on her Web site. They are asked to choose the "Telephone Town Hall" option from the drop-down box on the form and submit their contact information by noon Monday.
Eshoo is a member of the House Energy and Commerce Committee -- one of three House committees charged with drafting portions of the health care reform bill.
For residents who missed the Wednesday meeting, including those who registered but didn't hear back from Eshoo's office, below is a review of some of the issues discussed. (An online recording of the meeting can be heard by clicking here.)
The status of the health care bill:
"There are three House committees that have responsibility over the issue of health care. Each committee wrote its own section of legislation and passed it. Now these three versions have to be melded into one bill to be considered by the full House when the House reconvenes next month."
The "public option" -- a government-run plan that would compete with private insurance plans:
"As I helped write the bill and put the public option in it, I'm four-square for it and let me tell you why. I believe that in the reforms that need to be done, the public option will bring about competition -- competition between private health plans and the government-run but nonprofit health care plan. The public option will be government-run, but it is a nonprofit plan that will be available to people by the Exchange.
"Like Medicare, it will not be funded by government subsidies, but solely by premiums it collects, like private plans do. I think it will bring about real competition -- will bring about cost savings. It will give people a choice and the public option will be required to follow the same regulations that are placed on private insurance companies, including staying financially solvent.
"The whole issue of lowering health care costs and improving efficiencies and driving costs down are absolutely essential. If we don't bring the costs down that are part of the overall health-care system in our country, it could bankrupt our country.
"I'm as committed as any member of the House or the entire Congress on the public-option piece and I think it would be a march to folly if in fact the public option were dropped. It would really hollow out the bill and, not only weaken it, but make it a bill that might not be worth voting for.
"So I am 100 percent for it and I hope listeners, as I spoke about the public option, have hopefully a clearer idea of what it actually is."
The practice of insurance companies to exclude customers with pre-existing medical conditions:
"The legislation rewrites the rules of the private-insurance industry. At the top of the hit list is eliminating pre-existing conditions. I want those words "pre-existing conditions" to be the phrase of the distant past. We all know what they are, we all know what insurers have done and continue to do and the legislation eliminates it."
"Recisions," the insurance companies' practice of dropping customers after they get sick:
"This is a widespread practice and the legislation prohibits recision. ... I think this is an area absolutely crying out for reform. It's not fair, it has hurt hundreds of thousands of people. It has taken whole families down to where they had to file bankruptcies because of insurance practices. These (practices) are banned in the legislation."
The "doughnut hole" in the Medicare Part D prescription-drug plan, which requires seniors to pay out of pocket for medication after the cost reaches a certain amount:
"The legislation eliminates the doughnut hole in the Medicare Part D, which has forced more than 4 million seniors to fork over costs from their own pockets or go without the drug. ...
"What we're doing is eliminating this. You should not be forced to be placed in that position. This is a very important reform. We have heard from many seniors who have fallen into a dark hole and it had a negative impact on their lives. They had to choose between paying rent, buying groceries or paying for prescription drugs."
The impact of the House legislation on small businesses:
"Will small business (under the proposed legislation) be forced to provide coverage for employees? The answer is 'No.' The bill exempts all small businesses with payrolls of less than $500,000 from the employer-responsibility requirement.
"Above that, there will be a payroll tax that will be charged that will gradually increase with the size of the business's payroll. The proceeds will be used to offset the costs of affordability credits used in what's called the Exchange.
"The bill would significantly cut the costs for health care coverage for small businesses.
We worked very hard on this section because small businesses are heavily effected by health care coverage."
Whether she would be willing to sign up for a health care plan offered through the House legislation:
"Absolutely. The legislation really mirrors very, very closely what federal employees have, which members of the Congress are considered. There are hundreds of thousands of federal employees that receive health care options with a choice of private plans that vary by benefits and costs as well as the public option."
"If I can't stand next to the legislation that I helped write and support and vote for, then you're not going to have confidence in it."
"The Health Insurance Exchange":
"There will be a 'Health Insurance Exchange.' What that is, very simply, is an online clearing house for all insurance plans. To participate, an insurance plan must contain basic minimum benefits as determined by a Health Choices Commission, which is established by the legislation. This would include preventive care, inpatient and outpatient hospital services, maternal care and mental-health services. Coverage-of-benefits information must be listed in clear and easy to understand language. ...
"The Exchange will bring together information that is currently really scattered all over the place. ... No one will be required to join the public plan, but if you lose your insurance, you will be able to shop for a new plan on the Exchange and you are the person who will determine which plan best suits you and your family's needs."
Responding to a caller who said the the government is "rushing too fast" through health-care reform:
"We didn't get to where we are in five minutes, and we're not going to get out of its as quickly as we would like to. ...
"I share your concerns about that and I don't blame you for being hesitant. But I do think the time has come. We don't need to rush it, we need to do it very carefully because it effects every one of us."
Whether the proposed legislation would allow customers to keep their current doctors:
"There's absolutely nothing in the legislation that would come between you and your doctor. If you're happy with the insurance you have and the doctor you have, there's nothing in the legislation that would disrupt that."
How the House bill will be reconciled with the Senate bill:
"In the Senate, one committee -- The Health Education and Labor Committee -- produced one bill. There's another committee in the Senate -- the Finance Committee -- that hasn't completed its work.
"The regular process is each body, the House and the Senate, comes up with its own bill and passes it in the respective body. Then there's a Conference Committee with representatives from the House and the Senate. They go into a big room with a big table and they have to hash out the differences between the two bills and come up with one bill that the whole Congress votes on and then sends to the president. We have a long journey ahead of us on this."
The "single-payer system," which is not a part of the current proposals:
"Most Americans really like choice. Some people in our congressional district and elsewhere in the country believe the single-payer system is the best way to contain costs and cover everyone. I think if we were starting from scratch, that probably would be set up, but we're not starting from scratch. We already have about 85 percent of Americans covered – they have health-insurance coverage through the employer.
"We're building on that, fixing what needs to be fixed, eliminating the abuses of the insured, but also making sure the private sector has competition without anyone being forced to move away from their private insurance if they like it and their doctor, or be forced into a public option.
"There may very well be a vote on the floor of the House -- in the form of the amendment -- to establish a single-payer system. I think it's important that it is debated. I could very well cast a vote for it. I don't think it will pass, but I think there may be an amendment offered on the floor, so stay tuned for it."
Whether the bill will cover illegal immigrants:
"The answer to that is an unequivocal no. The bill explicitly prohibits any undocumented aliens from receiving any federal dollars to subsidize health insurance."
Why the meetings are conducted over telephone:
"We will keep doing them because constituents have told me they really like the telephone Town Hall meetings. They don't have to leave their homes -- they can be having dinner or doing whatever they're doing in the house and still participate."