Mike Johanns on Health Care Secretary of Agriculture; previously Republican NE Governor

Didn’t phase out adult mental health care services

Johanns said that Kleeb was “simply wrong” and that neither he nor state lawmakers would have allowed that to happen.

Kleeb quickly took aim at Johanns during his opening statement, criticizing the former governor for his role in phasing out the state’s regional centers. In 2004, Johanns supported a proposal to develop more community-based programs for the mentally ill. As part of that plan, lawmakers lessened the roles of the regional centers and spent the money from institutional treatment on community-based mental health services.

Johanns responded that more than $26 million was budgeted to help with the transition. “We would never have gotten a bill passed with that idea. It would (have been) just cruel beyond cruel,” said Johanns.

Giving all taxpayers federal coverage would cost $480B

Johanns said that was a “nice sound bite,” but said it would cost the nation $480 billion.

Kleeb responded that at a time when government was spending billions to rescue Wall Street, he thought the federal government could help insure the uninsured. It is estimated that about 200,000 Nebraskans lack health insurance, Kleeb said.

Kleeb also argued that Nebraskans already pay for the uninsured, whose medical bills are passed down by hospitals and doctors to other consumers. “We actually can afford it because we’re paying it,” Kleeb said.

Alternative community hospitals got 9000 more people treated

Johanns said Kleeb made a “major mistake” by calling the Beatrice center a “mental health” facility because it treats the developmentally disabled. He said the policy change allowed Nebraska to access millions in additional federal dollars, allowing 9,000 more people to receive mental health services.

Opposes a single-payer government run program

Use tobacco settlement for biomedical research

We are so close to solving once and for all the riddles of many diseases with this research. These funds can offer a new day and a new life for Nebraskans and people around the world.

In addition to this research, there are many needs to be funded with the remaining portion of the tobacco settlement. You know as I do that there are many health care needs in Nebraska that are not being met. I would submit, however, that there is no, and I repeat, no greater priority for funding than in the area of mental health.

$6M increase in funding for mental health

Second, let’s join together to increase general fund support for mental health. Including the tobacco settlement funds, I propose increasing mental health aid from $28.5 million in the current fiscal year to $33.6 million dollars in fiscal year 2002 and to $38.7 million dollars in fiscal year 2003. This represents a more than 35% increase over the biennium.

I recognize that even more needs to be done and so I pledge to do what I can to help Senator Jensen and the Health and Human Services Committee and Senator Wehrbein and the Appropriations Committee to identify mental health needs, prioritize them, and fund them. Maybe we can do more than what I propose today.

Voted YES on the Ryan Budget: Medicare choice, tax & spending cuts.

[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.

[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.

Opponent's Arguments for voting No:

[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.

[Sen. Merkley, D-TK]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Status: Failed 40-57

Voted YES on regulating tobacco as a drug.

Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.

Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.

Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.

Voted NO on expanding the Children's Health Insurance Program.

• Reauthorizes State Children's Health Insurance Program (SCHIP) through FY2013 at increased levels.
• Gives states the option to cover targeted low-income pregnant women
• Phases out coverage for nonpregnant childless adults.

Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.

Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.

No federal pre-emption of employee health plan regulation.

The Issue

NGA’s Position

The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.

States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.

More federal funding for rural health services.

1. Western Governors want rural areas to have an adequate and able workforce to deliver needed health care services. The governors call on the federal government to provide necessary funding for programs such as the National Health Service Corps (NHSC) that have a state-based component, and the Health Professions programs that help health professionals serve in rural and frontier areas.
2. Western Governors believe that rural health care providers should be paid fairly by Medicare in order to ensure access to health care for rural citizens. The governors encourage the federal government to take further steps to ensure equity in Medicare reimbursement for urban and rural areas.
3. Alaska, Hawaii, America Samoa, the Northern Mariana Islands and Guam face extraordinary geographic barriers in providing healthcare services and they should be designated for special consideration and adequate funding to overcome their frontier barriers.
4. Federal programs like the Rural Health Outreach Grants and the Rural Hospital Flexibility program need to continue to provide funds to states and communities to experiment with new programs, integration of services and coalition building to develop new types of providers, facilities, and services.
5. Western Governors believe in strengthening the existing health care system. Support for home health agencies, rural health clinics, public health nursing and critical access hospitals are partial solutions.
6. Western Governors support the elimination of barriers to the use of telemedicine as outlined in the WGA’s 1998 report. In particular, we request that the federal efforts to increase reimbursement for telemedicine consultations, to protect the privacy of patient-identifiable medical information and to support rural health provider telecommunication costs with universal service funds continue.

Establishment of Office of Health Care Fraud Prevention.

CONGRESSIONAL SUMMARY:
• There is hereby established, in the Department of H, the Office of the Deputy Secretary for Health Care Fraud Prevention.
• The Office shall provide contracts for the design, development, and operation of a predictive model antifraud system, based on the risk level assigned to claims activity, and develop a comprehensive antifraud database for health care activities carried out or managed by Federal health agencies.
• The Office shall promulgate and enforce regulations relating to the reporting of data claims to the health care antifraud system.

SPONSOR'S INTRODUCTORY REMARKS:

Sen. LeMIEUX. The current proposal for health care is a $1 trillion proposal. If we spent as much time caring about the money we are spending now, as opposed to the money some in this Chamber want to spend, I suspect we could find plenty of money to either return to the people or to find money for these new programs.

Today, I wish to talk about just such an idea, an idea to recover some of the waste, fraud, and abuse that is currently happening in our current provision of health care--in Medicare and Medicaid. Estimates are that some $60 billion to a staggering $226 billion a year to waste, fraud, and abuse.

This health care proposal that we are discussing in the Senate is $1 trillion over 10 years. That is about $100 billion a year. We may be wasting $226 billion a year. If we captured just half of that, we might be able to pay for this program.

Why can't we do the same thing the credit card companies are doing for health care? Why can't we use a predictive modeling system that says a health care claim is not going to be paid when a red flag comes up? Right now we are on a pay-and-chase system. If we put this predictive modeling system in, it stops the fraud before it happens. The credit card industry benchmark is 0.1% while fraud losses in the health care business run from 3% to 14%.

Reforms should slow the long-term growth of health costs.

• Whereas health care spending has risen close to 2.4 percentage points faster than gross domestic product (GDP) since 1970; and
• Whereas the Centers for Medicare & Medicaid Services projects health care spending to be 17.6% of GDP in 2009 and 20.4% of GDP by 2018:

Now, therefore, be it Resolved, That it is the sense of the Senate that--
1. any health care reform proposal should reduce total spending on health care in the United States during the next decade to below current projections by the Centers for Medicare & Medicaid Services; and
2. any health care reform proposal should reduce the growth rate of Federal health care spending.

Protect state tobacco settlement funds from federal seizure.

As you know, preserving and protecting the state tobacco settlement funds is the nation’s Governors’ highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on states’ ability to tailor spending to meet the needs of their citizens.

We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.