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Mike Pence on Health Care

Republican Representative (IN-6)

 


Medicaid is not just broke, it is broken

Most Hoosiers didn't like Washington intruding on our healthcare long before it became a reality. Now, more people than ever know why we were right to stand up to the federal government on the Affordable Care Act.

There's been a lot of talk about Medicaid. The sad truth is that traditional Medicaid is not just broke, it is broken. Research shows that the program does not lead to better health outcomes and in some cases hurts the very people it is supposed to help. One analysis found 2/3 of the children on Medicaid who needed to see a specialist, couldn't. Traditional Medicaid is not a system we need to expand. It's a system we need to change. The Healthy Indiana Plan is the right place to start.

The Healthy Indiana Plan is consumer-driven healthcare that moves people from emergency rooms to primary care and encourages low-income Hoosiers to take more ownership of their own healthcare decisions.

Source: 2014 State of the State Address to Indiana legislature , Jan 14, 2014

Voted YES 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 YES 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 NO 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 NO 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 NO 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 NO 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 NO 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 NO 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 NO 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 YES 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 YES 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 NO 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 YES 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 YES 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

Rated 11% by APHA, indicating a anti-public health voting record.

Pence scores 11% 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

Repeal any federal health care takeover.

Pence signed Club for Growth's "Repeal-It!" Pledge

The Club for Growth's "Repeal-It!" Pledge for incumbents states, "I hereby pledge to the people of my district/state to sponsor and support legislation to repeal any federal health care takeover passed in 2010, and replace it with real reforms that lower health care costs without growing government."

Source: Club for Growth's "Repeal-It!" Pledge 10-CfG-inc on Jul 4, 2010

Deauthorize funding for Obamacare.

Pence signed H.R.5882

To deauthorize appropriation of funds to carry out the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA). Notwithstanding any other provision of law, no funds are authorized to be appropriated to carry out the provisions of the Patient Protection and Affordable Care Act (Public Law 111-148), the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendment made by either such Act.

[OnTheIssues Note: these two bills are the core of the Democratic healthcare plan, known as "Obamacare." Deauthorizing funding for Obamacare means almost the same as repealing it, except that the laws would still stay on the books so perhaps it's a little more likely to get votes. This bill is an exercise of "the power of the purse", over which the House has sole control.]

Source: PPACA and HCERA Deauthorization 10-HR5882 on Jul 27, 2010

Repeal the Job-Killing Health Care Law.

Pence co-sponsored Repealing the Job-Killing Health Care Law Act

Repeals the Patient Protection and Affordable Care Act, effective as of its enactment. Restores provisions of law amended by such Act.

Repeals the health care provisions of the Health Care and Education and Reconciliation Act of 2010, effective as of the Act's enactment. Restores provisions of law amended by the Act's health care provisions.

Source: H.R.2 11-HR002 on Jan 5, 2011

Other governors on Health Care: Mike Pence on other issues:

IN Senatorial:
Joe Donnelly

Gubernatorial Debates 2017:
NJ: Fulop(D) vs.Lesniak(D)
VA: Gillespie(R) vs.Wittman(R) vs.Northam(D)
Gubernatorial Debates 2016:
DE: Bonini(R) vs.Carney(D)
IN: Pence(R) vs.Gregg(D)
MO: Hanaway(R) vs.Brunner(R) vs.Kinder(R) vs.Greitens(R)
MT: Bullock(D) vs.Perea(R) vs.Johnson(R)
NC: McCrory(R) vs.Cooper(D) vs.Spaulding(D)
ND: Dalrymple(R) vs.Stenehjem(R) vs.Heitkamp(D) vs.Pomeroy(D)
NH: Hassan(D) vs.Bradley(R) vs.Sununu(R) vs.Lavoie(R)
OR: Brown(D) vs.Bell(D) vs.Niemeyer(R) vs.Pierce(R)
UT: Herbert(R) vs.Johnson(R) vs.Matheson(D)
VT: Shumlin(D) vs.Minter(D) vs.Dunne(D) vs.Scott(R) vs.Smith(D)
WA: Inslee(D) vs.Bryant(R)
WV: Kessler(R) vs.Cole(D)
Newly-elected governors (first seated in Jan. 2015):
AK-I: Bill Walker
AR-R: Asa Hutchinson
AZ-R: Doug Ducey
IL-R: Bruce Rauner
MA-R: Charlie Baker
MD-R: Larry Hogan
NE-R: Pete Ricketts
OR-D: Kate Brown
PA-D: Tom Wolf
RI-D: Gina Raimondo
TX-R: Greg Abbott

Lame ducks 2015-16:
DE-D: Jack Markell
(term-limited 2016)
KY-D: Steve Beshear
(term-limited 2015)
LA-R: Bobby Jindal
(term-limited 2015)
MO-D: Jay Nixon
(term-limited 2016)
VT-D: Peter Shumlin
(retiring 2016)
WV-D: Earl Ray Tomblin
(term-limited 2016)
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