Barbara Lee on Health Care Democratic Representative (CA-9)

Increase funding for AIDS treatment & prevention.

HIV/AIDS Initiatives
The CBC’s Minority HIV/AIDS Initiative will focus on those areas hardest hit by the epidemic, many of which are in districts that we represent. The initiative will focus on prevention and treatment and we will also seek to re-direct and/or increase funding levels based on a detailed review of the implementation of the initiative. In addition, the CBC recognizes the devastating impact of HIV/AIDS on the global workforce, specifically in Africa, and on the allocation of resources of developing countries. Therefore, the CBC will continue its efforts to support a comprehensive global policy aimed at ending the scourge of HIV/AIDS around the globe.

More funding for Rx benefits, community health, CHIPs.

The Congressional Black Caucus is committed to improving America’s health care system by focusing on, among other items, the following issue areas:
• Eliminating Health Care Disparities.The CBC will emphasize the importance of eliminating health care disparities as it relates to access, treatment and availability in communities of color and other disadvantaged communities. The CBC will also ensure that America keeps its promise to our veterans, and will support funding for the best health care programs at our veterans’ hospitals.
• Patients’ Bill of Rights. The CBC will support a strong and enforceable Patients’ Bill of Rights that puts medical decisions back in the hands of doctors, and gives patients the right to seek damages when they are harmed by decisions influenced by non-medical professionals.
• Medicare Prescription Drug Benefit. The CBC supports a prescription benefit program for the Medicare program. The price of prescription drugs is too high for most seniors, and many seniors go without the necessary medication they need, or have to choose between conflicting priorities.
• Support for Health Providers in Underserved Communities. The CBC will support the development of networks of providers, community hospitals and health centers in underserved communities to increase the quality of care provided to patients. We will also seek funding and technical assistance to assist Community Health Centers in developing a system of comprehensive health services in both urban and rural communities.
• Healthy Children. The CBC will work to expand the Children’s Health Insurance Program. We will also focus on increasing immunization rates, better dietary and physical fitness programs, prevention of teenage pregnancies and anti-drug and smoking initiatives. In addition, we will support efforts to ensure that mental health is covered under basic health plans.

MEDS Plan: Cover senior Rx under Medicare.

Summary of the Medicare Extention of Drugs To Seniors Act (Meds)

Coverage:

• First-dollar 80%/20% benefit (may charge beneficiary less for generics)
• Catastrophic coverage begins at $2000 out-of-pocket.
• No beneficiary would have to spend more than $2288 for prescription drugs (including premium)

Prescription Drug Prices:

• (Reimportation) Beginning 2003, all FDA-approved prescription would be allowed for importation at world market prices after being tested for safety. Once fully implemented, Medicare could set fee schedules based on imported drug prices.
• (Allen Bill) To eliminate price discrimination, manufacturers would charge Medicare and its beneficiaries the price equal to the lower of either the lowest price paid for the drug by other Federal Government agencies or the manufacturer’s best price for the drug.
• (Reasonable Prices) Drugs developed with taxpayer funds would be subject to “reasonable price” agreements when patents are transferred to pharmaceutical companies.

Premiums and Low-income Assistance:

The Government would subsidize low-income beneficiaries to the following levels:
• 100% of the premium and cost sharing for beneficiaries below 135% of poverty.
• Partial subsidy on a sliding scale for those between 135% and 150%

Employer Incentive Program:

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

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.

Require insurers to cover breast cancer treatment.

Congressional Summary: Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require coverage and radiation therapy for breast cancer treatment.

• Prohibits restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection; or
• Prohibits requiring that a provider obtain authorization from the plan for prescribing any such length of stay.

Congressional Findings:

1. According to the American Cancer Society, excluding cancers of the skin, breast cancer is the most frequently diagnosed cancer in women.
2. An estimated 40,480 women and 450 men died from breast cancer in 2008, and an estimated 182,460 new cases of invasive breast cancer were diagnosed in women, plus 1,990 cases in men.
3. Most breast cancer patients undergo some type of surgical treatment.
4. Treatment for breast cancer varies according to type of insurance coverage and State of residence.
5. Currently, 20 States mandate minimum inpatient coverage after a patient undergoes a mastectomy.
6. Breast cancer patients have reported adverse outcomes, including infection and inadequately controlled pain, resulting from premature hospital discharge following breast cancer surgery. Source: H.R.111 11-HR111 on Jan 5, 2011

   Establish a public insurance option via healthcare Exchanges.

   Lee co-sponsored Public Option Deficit Reduction Act

   Amends the Patient Protection and Affordable Care Act [PPACA, known as ObamaCare] to require Exchanges to offer a public health insurance option that ensures choice, competition, and stability of affordable, high-quality coverage throughout the United States. Declares that the primary responsibility is to create a low-cost plan without compromising quality or access to care. Sets forth provisions related to the establishment and governance of the public health insurance option, including that such plan:

   1. may be made available only through Exchanges;
   2. must comply with requirements applicable to other health benefits plans offered through such Exchanges; and
   3. must offer bronze, silver, and gold plan levels.
   Requires the Secretary of Health and Human Services to:
   1. establish an office of the ombudsman for the public health insurance option;
   2. collect such data as may be required to establish premiums and payment rates;
   3. establish geographically adjusted premiums at a level sufficient to fully finance the costs of the health benefits provided and administrative costs related to the operation of the plan; and
   4. establish payment rates and provide for greater payment rates for the first three years.
   Requires repayment of start-up costs for the public health insurance option. Authorizes the Secretary to utilize innovative payment mechanisms and policies to determine payments for items and services under the public health insurance option. Source: H.R.191 11-HR191 on Jan 5, 2011

   Sponsored merging Alzheimers diagnosis and care benefit.

   Lee co-sponsored HOPE for Alzheimer's Act

   Congressional Summary:The purpose of this Act is to increase diagnosis of Alzheimer`s disease and related dementias, leading to better care and outcomes for Americans living with Alzheimer`s disease and related dementias. Congress makes the following findings:

   1. As many as half of the estimated 5.2 million Americans with Alzheimer`s disease have never received a diagnosis.
   2. An early and documented diagnosis and access to care planning services leads to better outcomes for individuals with Alzheimer`s disease.
   3. Combining the existing Medicare benefits of a diagnostic evaluation and care planning into a single package of services would help ensure that individuals receive an appropriate diagnosis as well as critical information about the disease and available care options.

   Proponent`s argument for bill: (The Alzheimer`s Association, alz.org). The `Health Outcomes, Planning, and Education (HOPE) for Alzheimer`s Act` (S.709/H.R. 1507) is one of the Alzheimer`s Association`s top federal priorities for the 113th Congress. The HOPE for Alzheimer`s Act would improve diagnosis of Alzheimer`s disease and increase access to information on care and support for newly diagnosed individuals and their families. It would also ensure that an Alzheimer`s or dementia diagnosis is documented in the individual`s medical record.

   Source: S.709/H.R. 1507 13-H1507 on Apr 11, 2013

   Religious exemption from ObamaCare individual mandate.

   Lee co-sponsored H.R.631 & S.352

   Congressional Summary: To provide an additional religious exemption from the individual health coverage mandate. This Act may be cited as the `Equitable Access to Care and Health Act` or the `EACH Act`. The `Religious Conscience Exemption` exempts individuals who are members of a recognized religious sect which relies solely on a religious method of healing, and for whom the acceptance of medical health services would be inconsistent with their religious beliefs.

   Supporters reasons for voting YEA: (TheHill.com weblog, April 29, 2013): `We believe the EACH Act balances a respect for religious diversity against the need to prevent fraud and abuse,` wrote Reps. Aaron Schock (R-IL) and William Keating (D-MA). `It is imperative we expand the religious conscience exemption now as the Administration is verifying the various exemptions to the individual mandate,` they wrote. Religious exemption from ObamaCare has come up before, including contraception. The EACH Act, however, deals only with exemptions from the insurance mandate.

   Opponents reasons for voting NAY: (CHILD, Inc. `Children`s Healthcare Is a Legal Duty`, Dec. 2014): The Christian Science church is pushing hard to get another religious exemption through Congress. The EACH Act exempts everyone with `sincerely held religious beliefs` from the mandate to buy health insurance. We are particularly concerned about uninsured children: hundreds of American children have died because of their family`s religious objections to medical care. The EACH Act increases the risk to children in faith-healing sects and the cost to the state if the children do get medical care. Some complain that their church members should not have to pay for health care that they won`t use. But insurance works on the assumption that many in the pool of policyholders will not draw from it. Most people with fire insurance don`t have their homes burn, for example.

   Source: EACH Act 15_H631 on Jan 30, 2015

   Expand the National Health Service Corps.

   Lee 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

   Make health care a right, not a privilege.

   Lee adopted the Progressive Caucus Position Paper:
   The Progressive Caucus is united in its goal of making health care a right, not a privilege. Every person should have access to affordable, comprehensive and high-quality medical care. We must use our health care dollars efficiently and ensure public accountability in all medical decisions. Based on this goal, we support the following principles:
   1. All Americans, including the 44 million currently without health insurance, deserve to have the health care they need, regardless of ability to pay.
   2. Medicare must remain solvent and available for the millions of seniors and individuals with disabilities who rely on the program. The Progressive Caucus supports expanding the program to cover prescription drugs and other needed products and services for beneficiaries. We support a Medicare buy-in for individuals age 55 and older. We support lowering out-of-pocket costs for seniors who currently pay, on average, 20% of their income for health care.
   3. Proposals should be rejected to change traditional Medicare from a defined benefit to a defined contribution or voucher system.
   4. Balanced Budget Act cuts that are negatively affecting patient access to hospitals, nursing homes, and home health agencies must be restored.
   5. Medicaid must have the resources to continue to provide coverage and care for low-income individuals, including children in the CHIP program.
   6. Individuals with disabilities should retain their health benefits when they return to work and to have access to rehabilitative and other needed services.
   7. Funding and outreach and other programs serving low-income Americans should be expanded. Examples of such programs are the Children’s Health Insurance Program (CHIP); Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB), and Qualified Individuals programs; transitional funds for Medicaid recipients who are also welfare-to-work recipients; and for HHS for mental health outreach for the elderly.
   Source: CPC Position Paper: Health Care 99-CPC2 on Nov 11, 1999

   Supported funding women's health needs.

   Lee adopted the Women's Caucus policy agenda:
   The teams of the Women’s Caucus are charged with advancing action on their designated issues in a bipartisan manner. Legislation from Team 2A: WOMEN’S HEALTH:
   • HR49—Treatment of Children’s Deformities Act—require coverage for congenital or developmental deformity or disorder due to trauma, infection, tumor, or disease. (Kelly)
   • HR306—Genetic Information Nondiscrimination in Health Insurance Act—prohibit discrimination against individuals on the basis of genetic information. (Slaughter)
   • HR1285—Cancer Screening Coverage Act —require coverage of breast, cervical, prostate, and colorectal cancer screening. (Maloney/Kelly)
   • HR1388—Medicare Cancer Clinical Trial Coverage Act—officially expand Medicare coverage to clinical trials (N.Johnson/Cardin)
   • HR116—Breast Cancer Patient Protection Act—and HR383—Women’s Health and Cancer Rights Act—and HR1070—require coverage for a minimum hospital stay for mastectomies and treatment of breast cancer. (DeLauro/Kelly/Eshoo)
   • HR1816—Eliminate Colorectal Cancer Act—require coverage for colorectal cancer screenings. (Slaughter/McIntosh)
   • HR961—Ovarian Cancer Research and Information Amendments—provide for programs regarding ovarian cancer. (Mink)
   • HR845—Beneficiary Health Coverage Notification Rights Act—require notification of impending termination of coverage resulting from the failure of a group health plan to pay premiums. (Thurman)
   • HR1966—Asthma Awareness, Education and Treatment Act—carry out programs regarding the prevention and management of asthma and allergies. (Millender-McDonald)
   • H. Con. Res. 64—Cervical Cancer Public Awareness Resolution—recognizing the severity of the issue of cervical health. (Millender-McDonald)
   • H.Res. 19—expressing the seriousness of mental illness. (Roukema)
   • HR1899—The Health Care Worker Needlestick Prevention Act—require regulations to minimize the risk of needlestick injury to health care workers. (Roukema/Stark)
   Source: Women's Caucus Agenda-106th Congress 99-WC2 on Jul 15, 1999

   Supported funding older women's health.

   Lee adopted the Women's Caucus policy agenda:
   The teams of the Women’s Caucus are charged with advancing action on their designated issues in a bipartisan manner. Legislation from Team 2B: OLDER WOMEN’S HEALTH:
   • HR762—Lupus Research and Care Amendments of 1999—A bill to provide for research and services with respect to lupus. (Meek)
   • HR925—Osteoporosis Early Detection and Prevention Act of 1999—A bill to require that health insurance plans provide coverage for qualified individuals for bone mass measurement. (Maloney/Morella)
   • HR933—Osteoporosis Federal Employee Health Benefits Standardization Act of 1999—A bill to ensure that coverage of bone mass measurement is provided under the health benefits program for federal employees (Morella)
   • HR1187—Medicare Medical Nutrition Therapy Act of 1999—A bill to provide for coverage under part B of the Medicare Program of medical nutrition therapy services furnished by registered dietitians and nutrition professionals. (N. Johnson)
   • HR2294—Osteoporosis Education and Prevention Act of 1999—A bill to amend the Older Americans Act of 1965 to help prevent osteoporosis. (Berkley/Roukema/DeLauro/Maloney)
   • HR2471—Public Health Osteoporosis Screening, Diagnosis, and Treatment Act of 1999—A bill to amend the Public Health Service Act to provide for screenings, referrals, and education regarding osteoporosis. (E.B. Johnson/Kelly)
   Source: Women's Caucus Agenda-106th Congress 99-WC3 on Jul 15, 1999

   Supported funding Prenatal and Postpartum Care.

   Lee adopted the Women's Caucus policy agenda:
   The teams of the Women’s Caucus are charged with advancing action on their designated issues in a bipartisan manner. Legislation from Team 3B: Prenatal and Postpartum Care:
   • HR 1843—Mothers and Newborns Health Insurance Act—improve prenatal care and delivery of healthy babies by enrolling pregnant women under state CHIP programs and allowing the option of automatically enrolling the babies born to those women in CHIP. (Hyde/Lowey)
   • HR2538—Folic Acid Promotion and Birth Defects Prevention Act—provide for a national folic acid education program to prevent birth defects. 70% of neural tube birth defects could be prevented if women of childbearing age consumed 400 micrograms of folic acid daily. The problem is that a majority of women are still not aware of the benefits of folic acid, nor are they consuming the recommended daily amount. (Roybal-Allard/Emerson)
   • H. Res. 163—raise awareness of post partum depression. Approximately 400,000 women experience post partum depression each year. More than just the “baby blues,” the more extreme cases of post partum depression can result in sadness, fatigue, anxiety, irritability, and low self esteem in new mothers. The resolution provides statistics, and provides recommendations on how the US can work to reduce its incidence, including providing information, training of medical providers, and screening of new mothers for symptoms for early detection of the problem. Additionally, the resolution calls on the U.S. to begin to collect data on post partum depression, so that we can measure its extent. (Capps-Kingston)
   • HR1848—Right to Breastfeed Act—ensure a woman’s right to breastfeed her child on any part of federal property (federal parks, federal buildings, and national museums) where she and her child have a right to be. (Maloney/Morella/Roybal-Allard) [STATUS: enacted as part of the FY2000 Treasury-Postal Appropriations bill]
   Source: Women's Caucus Agenda-106th Congress 99-WC5 on Jul 15, 1999

   Supported funding Family and Children's Coverage.

   Lee adopted the Women's Caucus policy agenda:
   The teams of the Women’s Caucus are charged with advancing action on their designated issues in a bipartisan manner. Legislation from Team 3D: Family Planning and Children’s Coverage:
   • HR 1806—Access to Women’s Health Care Act —provide women in managed care plans with direct access to ob/gyn services and the option of choosing their ob/gyn provider (including non-physicians specialists) as their primary care provider. (Lowey/Lazio)
   • HR 1636—Teen Pregnancy Reduction Act—The federal government spends more than $200 million annually specifically for teen pregnancy programs or services. These amounts demonstrate a significant investment in a national effort to prevent teen pregnancy. However, we know very little about the effectiveness of teen pregnancy prevention programs because adequate evaluation is not taking place. In an effort to bolster evaluation of teen pregnancy prevention programs of every type, the bill would provide for both a substantial investment in rigorous, scientific evaluation as well as the dissemination of information on programs, models and processes that have proven effective in preventing teen pregnancy. (Lowey/Castle)
   • HR 827—Improved Maternal and Children’s Health Coverage Act of 1999—expand health coverage for uninsured children by improving the outreach to an enrollment of children into Medicaid and the State Children’s Health Insurance Program (S-CHIP). (DeGette)
   • HR 1085—Healthy Kids Act 2000—improve health care for pregnant women and newborns by ensuring direct access to obstetric and gynecological care for women and pediatric care for children, by giving states greater flexibility by allowing them to enroll income-eligible pregnant women in State Children’s Health Insurance Program (CHIP) and by increasing enrollment of Medicaid-eligible women. This bill also includes sections for pediatric medical education, public health promotion, and research. (Emerson)
   Source: Women's Caucus Agenda-106th Congress 99-WC6 on Jul 15, 1999

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