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Jim Costa on Health Care

Democratic Representative (CA-20)

 


Helped enact low cost health care insurance for children

He greatly improved Valley medical services, helped cut prescription drugs costs for seniors on Medicare, made sure employees can use sick leave to care for a sick family member and helped enact low cost health insurance for children in the families of working poor.
Source: 2004 House campaign website, CostaforCongress.com , Nov 2, 2004

Voted NO on the Ryan Budget: Medicare choice, tax & spending cuts.

Proponent's Arguments for voting Yes:

[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-OR]: 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.

Reference: Ryan Budget Plan; Bill HCR34&SCR21 ; vote number 11-HV277 on Apr 15, 2011

Voted NO on repealing the "Prevention and Public Health" slush fund.

Congressional Summary:Amends the Patient Protection and Affordable Care Act (PPACA) to repeal provisions establishing and appropriating funds to the Prevention and Public Health Fund (a Fund to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs). Rescinds any unobligated balanced appropriated to such Fund.

Proponent's Argument for voting Yes:
[Rep. Pitts, R-PA]: Section 4002 of PPACA establishes a Prevention and Public Health Fund, which my bill, H.R. 1217, would repeal. The PPACA section authorizes the appropriation of and appropriates to the fund from the Treasury the following amounts:

We have created a slush fund from which the Secretary of HHS can spend without any congressional oversight or approval. I would suggest to my colleagues that, if you wanted more funding to go towards smoking cessation or to any other program, the health care law should have contained an explicit authorization. By eliminating this fund, we are not cutting any specific program. This is about reclaiming our oversight role of how Federal tax dollars should be used.

Opponent's Argument for voting No:
[Rep. Waxman, D-CA]: This bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation.

Reference: To repeal the Prevention and Public Health Fund; Bill H.1217 ; vote number 11-HV264 on Apr 13, 2011

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

Better and immediate funding for Medicare & Medicaid.

Costa adopted 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.

Costa 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

GOP can't beat ObamaCare, so they pretend it's a "disaster".

Costa voted NAY Full Repeal of ObamaCare

Heritage Action Summary: This vote would fully repeal ObamaCare.

Heritage Foundation recommendation to vote YES: (2/3/2015): ObamaCare creates $1.8 trillion in new health care spending and uses cuts to Medicare spending to help pay for some of it. Millions of Americans already have lost, and more likely will lose, their coverage because of ObamaCare. Many Americans have not been able to keep their doctors as insurers try to offset the added costs of ObamaCare by limiting the number of providers in their networks. In spite of the promise, the law increases the cost of health coverage.

Secretary of Labor Robert Reich recommendation to vote NO: (robertreich.org 11/22/2013): Having failed to defeat the Affordable Care Act, Republicans are now hell-bent on destroying the ObamaCare in Americans' minds, using the word "disaster" whenever mentioning the Act, and demand its repeal. Democrats [should] meet the Republican barrage with three larger truths:

  1. The wreck of private insurance: Ours has been the only healthcare system in the world designed to avoid sick people. For-profit insurers have spent billions finding and marketing their policies to healthy people--while rejecting people with preexisting conditions, or at high risk.
  2. We could not continue with this travesty of a healthcare system: ObamaCare is a modest solution. It still relies on private insurers--merely setting minimum standards and "exchanges" where customers can compare policies.
  3. The moral imperative: Even a clunky compromise like the ACA between a national system of health insurance and a for-profit insurance market depends, fundamentally, on a social compact in which those who are healthier and richer are willing to help those who are sicker and poorer. Such a social compact defines a society.

Legislative outcome: Passed House 239-186-8; never came to a vote in the Senate.

Source: Congressional vote 15-H0132 on Feb 3, 2015

Expand the National Health Service Corps.

Costa signed Access for All America Act

    A bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs. Amends the Public Health Service Act to:
  1. increase and extend the authorization of appropriations for community health centers and for the National Health Service Corps scholarship and loan repayment program for FY2010-FY2015, and provide for increased funding for such programs in FY2016 and each subsequent fiscal year; and
  2. revise and expand provisions allowing a community health center to provide services at different locations, adjust its operating plan and budget, enter into arrangements with other centers to purchase supplies and services at reduced cost, and correct material failures in grant compliance.
Source: S.486&HR1296 2009-S486 on Mar 4, 2009

2021-22 Governor, House and Senate candidates on Health Care: Jim Costa on other issues:
CA Gubernatorial:
Antonio Villaraigosa
Caitlyn Jenner
Carly Fiorina
David Hadley
Delaine Eastin
Doug Ose
Eric Garcetti
Eric Swalwell
Gavin Newsom
Hilda Solis
Jerry Brown
Jerry Sanders
John Chiang
John Cox
Kamala Harris
Kevin Faulconer
Kevin Paffrath
Larry Elder
Laura Smith
Neel Kashkari
Travis Allen
Xavier Becerra
CA Senatorial:
Dianne Feinstein
Duf Sundheim
Greg Brannon
Kamala Harris
Kevin de Leon
Loretta Sanchez
Michael Eisen
Rocky Chavez
Tom Del Beccaro
Republican Freshman class of 2021:
AL-1: Jerry Carl(R)
AL-2: Barry Moore(R)
CA-8: Jay Obernolte(R)
CA-50: Darrell Issa(R)
CO-3: Lauren Boebert(R)
FL-3: Kat Cammack(R)
FL-15: Scott Franklin(R)
FL-19: Byron Donalds(R)
GA-9: Andrew Clyde(R)
GA-14: Marjorie Taylor Greene(R)
IA-2: Mariannette Miller-Meeks(R)
IA-4: Randy Feenstra(R)
IL-15: Mary Miller(R)
IN-5: Victoria Spartz(R)
KS-1: Tracey Mann(R)
KS-2: Jake LaTurner(R)
LA-5: Luke Letlow(R)
MI-3: Peter Meijer(R)
MI-10: Lisa McClain(R)
MT-0: Matt Rosendale(R)
NC-11: Madison Cawthorn(R)
NM-3: Teresa Leger Fernandez(D)
NY-2: Andrew Garbarino(R)
NY-22: Claudia Tenney(R)
OR-2: Cliff Bentz(R)
PR-0: Jenniffer Gonzalez-Colon(R)
TN-1: Diana Harshbarger(R)
TX-4: Pat Fallon(R)
TX-11: August Pfluger(R)
TX-13: Ronny Jackson(R)
TX-17: Pete Sessions(R)
TX-22: Troy Nehls(R)
TX-23: Tony Gonzales(R)
TX-24: Beth Van Duyne(R)
UT-1: Blake Moore(R)
VA-5: Bob Good(R)
WI-5: Scott Fitzgerald(R)
Incoming Democratic Freshman class of 2021:
CA-53: Sara Jacobs(D)
GA-5: Nikema Williams(D)
GA-7: Carolyn Bourdeaux(D)
HI-2: Kai Kahele(D)
IL-3: Marie Newman(D)
IN-1: Frank Mrvan(D)
MA-4: Jake Auchincloss(D)
MO-1: Cori Bush(D)
NC-2: Deborah Ross(D)
NC-6: Kathy Manning(D)
NY-15: Ritchie Torres(D)
NY-16: Jamaal Bowman(D)
NY-17: Mondaire Jones(D)
WA-10: Marilyn Strickland(D)

Republican takeovers as of 2021:
CA-21: David Valadao(R) defeated T.J. Cox(D)
CA-39: Young Kim(R) defeated Gil Cisneros(D)
CA-48: Michelle Steel(R) defeated Harley Rouda(D)
FL-26: Carlos Gimenez(R) defeated Debbie Mucarsel-Powell(D)
FL-27: Maria Elvira Salazar(R) defeated Donna Shalala(D)
IA-1: Ashley Hinson(R) defeated Abby Finkenauer(D)
MN-7: Michelle Fischbach(R) defeated Collin Peterson(D)
NM-2: Yvette Herrell(R) defeated Xochitl Small(D)
NY-11: Nicole Malliotakis(R) defeated Max Rose(D)
OK-5: Stephanie Bice(R) defeated Kendra Horn(D)
SC-1: Nancy Mace(R) defeated Joe Cunningham(D)
UT-4: Burgess Owens(R) defeated Ben McAdams(D)

Special Elections 2021-2022:
CA-22: replacing Devin Nunes (R, SPEL summer 2022)
FL-20: replacing Alcee Hastings (D, SPEL Jan. 2022)
LA-2: Troy Carter (R, April 2021)
LA-5: Julia Letlow (R, March 2021)
NM-1: Melanie Stansbury (D, June 2021)
OH-11: Shontel Brown (D, Nov. 2021)
OH-15: Mike Carey (R, Nov. 2021)
TX-6: Jake Ellzey (R, July 2021)
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