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Jane Harman on Health Care

Democratic Representative (CA-36)


Supports More Federal Funding for Health Coverage

Source: http://www.janeharman2000.net/home/issues/healthcare.htm , Oct 26, 2000

Voted YES on regulating tobacco as a drug.

Congressional Summary:Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to provide for the regulation of tobacco products by the Secretary of Health and Human Services through the Food and Drug Administration (FDA). Defines a tobacco product as any product made or derived from tobacco that is intended for human consumption. Excludes from FDA authority the tobacco leaf and tobacco farms.

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.

Reference: Family Smoking Prevention and Tobacco Control Act; Bill HR1256&S982 ; vote number 2009-H187 on Apr 2, 2009

Voted YES on expanding the Children's Health Insurance Program.

Congressional Summary:

Proponent's argument to vote Yes:

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.

Reference: SCHIP Reauthorization Act; Bill H.R.2 ; vote number 2009-H016 on Jan 14, 2009

Voted YES on overriding veto on expansion of Medicare.

Congressional Summary:Pres. GEORGE W. BUSH's veto message (argument to vote No):In addition, H.R. 6331 would delay important reforms like the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies competitive bidding program. Changing policy in mid-stream is also confusing to beneficiaries who are receiving services from quality suppliers at lower prices. In order to slow the growth in Medicare spending, competition within the program should be expanded, not diminished.

Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.

Reference: Medicare Improvements for Patients and Providers Act; Bill HR.6331 ; vote number 2008-H491 on Jul 15, 2008

Voted YES on giving mental health full equity with physical health.

CONGRESSIONAL SUMMARY:

SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. PALLONE. This is a comprehensive bill which will establish full mental health and addiction care parity. The Mental Health Parity Act of 1996 authorized for 5 years partial parity by mandating that the annual and lifetime dollar limit for mental health treatment under group health plans offering mental health coverage be no less than that for physical illnesses. This bill requires full parity and also protects against discrimination by diagnosis.

OPPONENT'S ARGUMENT FOR VOTING NO:Rep. DEAL of Georgia: I am a supporter of the concept of mental health parity, but this bill before us today is not the correct approach. This path will raise the price of health insurance, and would cause some to lose their health insurance benefits and some employers to terminate mental health benefits altogether.

The bill's focus is also overly broad. Our legislation should focus on serious biologically-based mental disorders like schizophrenia and bipolar disorder, not on jet lag and caffeine addiction, as this bill would include. There are no criteria for judicial review, required notice and comment, or congressional review of future decisions.

I would ask my colleagues to vote "no" today so that we can take up the Senate bill and avoid a possible stalemate in a House-Senate conference on an issue that should be signed into law this Congress.

LEGISLATIVE OUTCOME:Bill passed House, 268-148

Reference: Mental Health and Addiction Equity Act; Bill H.R.1424 ; vote number 08-HR1424 on Mar 5, 2008

Voted YES on Veto override: Extend SCHIP to cover 6M more kids.

OnTheIssues Explanation: This vote is a veto override of the SCHIP extension (State Children's Health Insurance Program). The bill passed the House 265-142 on 10/25/07, and was vetoed by Pres. Bush on 12/12/07.

CONGRESSIONAL SUMMARY: This Act would enroll all 6 million uninsured children who are eligible, but not enrolled, for coverage under existing programs.

PRESIDENT'S VETO MESSAGE: Our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. My Administration strongly supports reauthorization of SCHIP. [But this bill, even with changes, does not meet the requirements I outlined].

It would still shift SCHIP away from its original purpose by covering adults. It would still include coverage of many individuals with incomes higher than the median income. It would still result in government health care for approximately 2 million children who already have private health care coverage.

SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill protects health insurance coverage for some 6 million children who now depend on SCHIP. It provides health coverage for 3.9 million children who are eligible, yet remain uninsured. Together, this is a total of better than 10 million young Americans who, without this legislation, would not have health insurance.

The bill makes changes to accommodate the President's stated concerns.

  1. It terminates the coverage of childless adults in 1 year.
  2. It prohibits States from covering children in families with incomes above $51,000.
  3. It contains adequate enforcement to ensure that only US citizens are covered.
  4. It encourages securing health insurance provided through private employer.
LEGISLATIVE OUTCOME:Veto override failed, 260-152 (2/3rds required)
Reference: SCHIP Extension; Bill Veto override on H.R.3963 ; vote number 08-HR3963 on Jan 23, 2008

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

  1. It terminates the coverage of childless adults.
  2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
  3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Reference: Children's Health Insurance Program Reauthorization Act; Bill H.R. 3963 ; vote number 2007-1009 on Oct 25, 2007

Voted YES on requiring negotiated Rx prices for Medicare part D.

Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.

Reference: Medicare Prescription Drug Price Negotiation Act; Bill HR 4 ("First 100 hours") ; vote number 2007-023 on Jan 12, 2007

Voted NO on denying non-emergency treatment for lack of Medicare co-pay.

Vote to pass a resolution, agreeing to S. AMDT. 2691 that removes the following provisions from S 1932:
Reference: Reconciliation resolution on the FY06 budget; Bill H Res 653 on S. AMDT. 2691 ; vote number 2006-004 on Feb 1, 2006

Voted NO on limiting medical malpractice lawsuits to $250,000 damages.

Vote to pass a bill that would limit the awards that plaintiffs and their attorneys could be given in medical malpractice cases. The bill would limit non-economic damages, including physical and emotional pain to $250,000. The bill would also limit punitive damages to $250,000 or double economic damages, whichever amount is greater. Punitive damages would be banned against makers and distributors of medical products if the Food and Drug Administration approved those products. The bill would call for all states to set damage caps but would not block existing state statutory limits. The bill would cap attorneys' contingency fees to 40% of the first $50,000 in damages; 33.3% of the next $50,000; 25% of the next $500,000; and 15% of any amount in excess of $600,000.
Reference: Medical Malpractice Liability Limitation bill; Bill HR 4280 ; vote number 2004-166 on May 12, 2004

Voted NO on limited prescription drug benefit for Medicare recipients.

Medicare Prescription Drug and Modernization Act of 2003: Vote to adopt the conference report on the bill that would create a prescription drug benefit for Medicare recipients. Starting in 2006, prescription coverage would be made available through private insurers to seniors. Seniors would pay a monthly premium of an estimated $35 in 2006. Individuals enrolled in the plan would cover the first $250 of annual drug costs themselves, and 25 percent of all drug costs up to $2,250. The government would offer a fallback prescription drug plan in regions were no private plans had made a bid.Over a 10 year time period medicare payments to managed care plans would increase by $14.2 billion. A pilot project would begin in 2010 in which Medicare would compete with private insurers to provide coverage for doctors and hospitals costs in six metropolitan areas for six years. The importation of drugs from Canada would be approved only if HHS determines there is no safety risks and that consumers would be saving money.
Reference: Bill sponsored by Hastert, R-IL; Bill HR.1 ; vote number 2003-669 on Nov 22, 2003

Voted YES on allowing reimportation of prescription drugs.

Pharmaceutical Market Access Act of 2003: Vote to pass a bill that would call for the Food and Drug Administration to begin a program that would permit the importation of FDA-approved prescription drugs from Australia, Canada, the European Union, Iceland, Israel, Japan, Lichtenstein, New Zealand, Norway, Switzerland and South Africa.
Reference: Bill sponsored by Gutknecht, R-MN; Bill HR.2427 ; vote number 2003-445 on Jul 24, 2003

Voted YES on small business associations for buying health insurance.

Vote to pass a bill that would permit the creation of association health plans through which small companies could group together to buy insurance for their employees. Association health plans that cover employees in several states would be excused from many individual state insurance regulations but would be regulated by the Labor Department.
Reference: Small Business Health Fairness Act; Bill HR 660 ; vote number 2003-296 on Jun 19, 2003

Voted NO on capping damages & setting time limits in medical lawsuits.

Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2003: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. Limits the availability of punitive damages, and sets a 3-year limit for suing.
Reference: Bill sponsored by Greenwood, R-PA; Bill HR 5 ; vote number 2003-64 on Mar 13, 2003

Voted NO on allowing suing HMOs, but under federal rules & limited award.

Vote to adopt an amendment that would limit liability and damage awards when a patient is harmed by a denial of health care. It would allow a patient to sue a health maintenance organization in state court but federal, not state, law would govern.
Bill HR 2563 ; vote number 2001-329 on Aug 2, 2001

Better and immediate funding for Medicare & Medicaid.

Harman signed the Blue Dog Coalition letter to Congressional leadership:

We are writing on behalf of the House Blue Dog Caucus to request that bipartisan legislation be crafted for passage before the end of this Congress that adequately addresses the funding of the Medicare, Medicaid, and SCHIP programs. As you know, over 39 million seniors and the disabled rely on the Medicare program for their health care. A further 43 million Americans rely on the Medicaid and SCHIP programs. The Balanced Budget Act of 1997 has produced cuts in spending far beyond what Congress and the Congressional Budget Office anticipated when the legislation was enacted. These greater-than- expected cuts threaten to jeopardize the health care of seniors and the disabled all across the country. While the Balanced Budget Refinement Act of 1999 did provide some relief, it is clear that we need to do more. As we approach the end of the 106 Congress, it is impossible to th overstate the need for us to work on a bipartisan basis to write meaningful legislation that can be signed by the President.

We strongly believe there is a need to separate the provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protections Act from H.R. 2614 and that bipartisan negotiations should be undertaken to improve this package so that it better provides for the critical needs of vulnerable patients. We respectfully submit that by working in a bipartisan basis, the 106 Congress can take th significant actions to help alleviate the current problems being faced by health care providers and patients that must be addressed. Waiting until next year to address this problem may be too late.

Source: Blue Dog Coalition press release 00-BDC1 on Dec 5, 2000

Prescription drug benefit within Medicare.

Harman adopted the Blue Dog Coalition press release:

We strongly believe that Congress should enact a Medicare prescription drug benefit that is available, affordable, dependable and voluntary for all seniors. The Blue Dog Coalition supports proposals to provide prescription drug coverage through a defined Medicare benefit that is available to all Medicare beneficiaries. Given the shortcomings of existing private plans, we believe that relying on private sector insurance plans will leave many beneficiaries without adequate coverage.

    An effective prescription drug benefit must:
  1. provide a benefit which is available to all seniors, including those in rural areas;
  2. provide equal treatment for all seniors, without disparities in coverage between rural, urban and suburban regions;
  3. use market power of seniors to reduce costs through competition;
  4. help low and middle-income seniors afford prescription medicine costs;
  5. allow participation by local pharmacists, not just mail order pharmacies; and
  6. be consistent with Medicare modernization.
Providing prescription drug coverage as a Medicare defined benefit ensures that all seniors, regardless of where they live, will have access to the same benefit plan. The Coalition opposes H.R. 4680, unless it is modified to provide all seniors with the option of prescription drug coverage.

Relying on private sector plans to deliver prescription drug coverage will not achieve the goals outlined above. It will not be cost effective for private plans to offer coverage in rural areas, which will result in expensive government subsidies to attract plans to rural areas. Rural seniors should not be forced to pay higher premiums or have less generous benefits, simply because they live in areas that are not financially attractive to private insurance companies.”

Source: Blue Dog Coalition press release 00-BDC2 on Jun 28, 2000

Establish "report cards" on HMO quality of care.

Harman adopted the manifesto, "A New Agenda for the New Decade":

Promote Universal Access and Quality in Health Care
That more than 40 million Americans lack health insurance is one of our society’s most glaring inequities. Lack of insurance jeopardizes the health of disadvantaged Americans and also imposes high costs on everyone else when the uninsured lack preventive care and get treatment from emergency rooms. Washington provides a tax subsidy for insurance for Americans who get coverage from their employers but offers nothing to workers who don’t have job-based coverage.

Markets alone cannot assure universal access to health coverage. Government should enable all low-income families to buy health insurance. Individuals must take responsibility for insuring themselves and their families whether or not they qualify for public assistance.

Finally, to help promote higher quality in health care for all Americans, we need reliable information on the quality of health care delivered by health plans and providers; a “patient’s bill of rights” that ensures access to medically necessary care; and a system in which private health plans compete on the basis of quality as well as cost.

Source: The Hyde Park Declaration 00-DLC5 on Aug 1, 2000

Rated 100% by APHA, indicating a pro-public health record.

Harman scores 100% by APHA on health issues

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Source: APHA website 03n-APHA on Dec 31, 2003

Supported funding women's health needs.

Harman adopted the Women's Caucus policy agenda:

Source: Women's Caucus Agenda-106th Congress 99-WC2 on Jul 15, 1999

Supported funding older women's health.

Harman adopted the Women's Caucus policy agenda:

Source: Women's Caucus Agenda-106th Congress 99-WC3 on Jul 15, 1999

Supported funding Prenatal and Postpartum Care.

Harman adopted the Women's Caucus policy agenda:

Source: Women's Caucus Agenda-106th Congress 99-WC5 on Jul 15, 1999

Supported funding Family and Children's Coverage.

Harman adopted the Women's Caucus policy agenda:

Source: Women's Caucus Agenda-106th Congress 99-WC6 on Jul 15, 1999

2012 Governor, House and Senate candidates on Health Care: Jane Harman on other issues:
CA Gubernatorial:
Antonio Villaraigosa
Jerry Brown
Jerry Sanders
CA Senatorial:
Barbara Boxer
Dianne Feinstein
Elizabeth Emken
Gail Lightfoot

Retiring to run for other office:

Running for President:
TX-14:Ron Paul(R)

Running for Mayor:
CA-51:Bob Filner(D)

Running for Governor:
IN-6:Mike Pence(R)
WA-1:Jay Inslee(D)

Running for Senate:
AZ-6:Jeff Flake(R)
CT-5:Chris Murphy(R)
FL-14:Connie Mack(R)
HI-2:Mazie Hirono(D)
IN-2:Joe Donnelly(D)
MO-2:Todd Akin(R)
MT-0:Dennis Rehberg(R)
ND-0:Rick Berg(D)
NM-1:Martin Heinrich(D)
NV-1:Shelley Berkley(D)
NY-9:Bob Turner(R)
WI-2:Tammy Baldwin(D)
Lost Primary 2012:
IL-16:Donald Manzullo(R)
NJ-9:Steven Rothman(D)
OH-2:Jean Schmidt(R)
OH-9:Dennis Kucinich(D)
PA-4:Jason Altmire(D)
PA-17:Tim Holden(D)
TX-16:Silvestre Reyes(D)

Retiring 2012:
AR-4:Mike Ross(D)
AZ-8:Gabby Giffords(D)
CA-2:Wally Herger(R)
CA-6:Lynn Woolsey(D)
CA-18:Dennis Cardoza(R)
CA-24:Elton Gallegly(D)
CA-26:David Dreier(R)
CA-41:Jerry Lewis(R)
IL-12:Jerry Costello(D)
IL-15:Timothy Johnson(R)
IN-5:Dan Burton(R)
KY-4:Geoff Davis(R)
MA-1:John Olver(D)
MA-4:Barney Frank(D)
MI-5:Dale Kildee(D)
NC-9:Sue Myrick(R)
NC-11:Heath Shuler(D)
NC-13:Brad Miller(D)
NY-5:Gary Ackerman(D)
NY-10:Ed Towns(D)
NY-22:Maurice Hinchey(D)
OH-7:Steve Austria(R)
OK-2:Dan Boren(D)
PA-19:Todd Platts(R)
TX-20:Charles Gonzalez(D)
WA-6:Norm Dicks(D)
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