Barbara Lee on Health Care
Democratic Representative (CA-9)
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;
; 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.
- $500 million for FY 2010
- $750 million for FY11
- $1 billion for FY12
- $1.25 billion for FY13
- $1.5 billion for FY14
- and for FY15 and every fiscal year thereafter, $2 billion.
Opponent's Argument for voting No:
Reference: To repeal the Prevention and Public Health Fund;
; vote number 11-HV264
on Apr 13, 2011
[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.
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;
; vote number 2009-H187
on Apr 2, 2009
Voted YES on expanding the Children's Health Insurance Program.
Proponent's argument to vote Yes:
- Reauthorizes State Children's Health Insurance Program (SCHIP) through FY2013 at increased levels.
- Gives states the option to cover targeted low-income pregnant women
- Phases out coverage for nonpregnant childless adults.
Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.
Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7):
This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.
Reference: SCHIP Reauthorization Act;
; vote number 2009-H016
on Jan 14, 2009
Voted YES on overriding veto on expansion of Medicare.
Pres. GEORGE W. BUSH's veto message (argument to vote No):
- Extends Medicare to cover additional preventive services.
- Includes body mass index and end-of-life planning among initial preventive physical examinations.
- Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.
I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it because: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.
- It would harm beneficiaries by taking private health plan options away from them.
- It would undermine the Medicare prescription drug program.
- It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.
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;
; vote number 2008-H491
on Jul 15, 2008
Voted YES on giving mental health full equity with physical health.
- Paul Wellstone Mental Health and Addiction Equity Act of 2008: Requires group health plans to apply the same treatment limits on mental health or substance-related disorder benefits as they do for medical and surgical benefits (parity requirement).
- Genetic Information Nondiscrimination Act of 2008: Prohibits a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information.
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;
; 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.
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
- It terminates the coverage of childless adults in 1 year.
- It prohibits States from covering children in families with incomes above $51,000.
- It contains adequate enforcement to ensure that only US citizens are covered.
- It encourages securing health insurance provided through private employer.
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]:
- It terminates the coverage of childless adults.
- 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.
- 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:
- On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
- On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
- On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.
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
- Allows hospitals to refuse treatment to Medicaid patients when they are unable to pay their co-pay if the hospital deems the situation to be a non-emergency
- Excludes payment to grandparents for foster care
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;
; 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;
; vote number 2003-445
on Jul 24, 2003
Voted NO 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
Voted NO on subsidizing private insurance for Medicare Rx drug coverage.
HR 4680, the Medicare Rx 2000 Act, would institute a new program to provide voluntary prescription drug coverage for Medicare beneficiaries through subsidies to private plans. The program would cost an estimated $40 billion over five years and would go into effect in fiscal 2003.
Reference: Bill sponsored by Thomas, R-CA;
Bill HR 4680
; vote number 2000-357
on Jun 28, 2000
Voted NO on banning physician-assisted suicide.
Vote on HR 2260, the Pain Relief Promotion Act of 1999, would ban the use of drugs for physician-assisted suicide. The bill would not allow doctors to give lethal prescriptions to terminally ill patients, and instead promotes "palliative care," or aggressive pain relief techniques.
Reference: Bill sponsored by Hyde, R-IL;
Bill HR 2260
; vote number 1999-544
on Oct 27, 1999
Voted NO on establishing tax-exempt Medical Savings Accounts.
The bill allows all taxpayers to create a tax-exempt account for paying medical expenses called a Medical Savings Account [MSA]. Also, the measure would allow the full cost of health care premiums to be taken as a tax deduction for the self-employed and taxpayers who are paying for their own insurance. The bill would also allow the establishment of "HealthMarts," regional groups of insurers, health care providers and employers who could work together to develop packages for uninsured employees. Another provision of the bill would establish "association health plan," in which organizations could combine resources to purchase health insurance at better rates than they could separately.
Reference: Bill sponsored by Talent, R-MO;
Bill HR 2990
; vote number 1999-485
on Oct 6, 1999
Increase funding for AIDS treatment & prevention.
Lee adopted the CBC principles:
Source: Congressional Black Caucus press release 01-CBC5 on Jan 6, 2001
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.
Lee adopted the CBC principles:
The Congressional Black Caucus is committed to improving America’s health care system by focusing on, among other items, the following issue areas:
Source: Congressional Black Caucus press release 01-CBC6 on Jan 6, 2001
- 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.
Lee adopted the Progressive Caucus Position Paper:
Summary of the Medicare Extention of Drugs To Seniors Act (Meds) MEDS establishes an 80/20 outpatient prescription drug benefit under a new Medicare Part D that will be administered by the Health Care Financing Administration. The plan will cost similar to figures for the Bush prescription drug plan due to this plan’s emphasis on lowering the price of pharmaceuticals.
- 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: Premiums would be $24/month in the first year and indexed to a pharmaceutical Sustainable Growth Rate, which will ensure that premiums or drug costs do not increase arbitrarily.
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: Employers providing drug coverage equal to or better than the Medicare coverage receive an incentive payment to maintain such coverage.
Source: CPC Press Release, MEDS Plan 01-CPC3 on Jan 31, 2001
Rated 100% by APHA, indicating a pro-public health record.
Lee 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
Require insurers to cover breast cancer treatment.
Lee co-sponsored Breast Cancer Patient Protection Act
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.
- According to the American Cancer Society, excluding cancers of the skin, breast cancer is the most frequently diagnosed cancer in women.
- 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.
- Most breast cancer patients undergo some type of surgical treatment.
- Treatment for breast cancer varies according to type of insurance coverage and State of residence.
- Currently, 20 States mandate minimum inpatient coverage after a patient undergoes a mastectomy.
- 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:
- may be made available only through Exchanges;
- must comply with requirements applicable to other health benefits plans offered through such Exchanges; and
- must offer bronze, silver, and gold plan levels.
Requires the Secretary of Health and Human Services to: 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
- establish an office of the ombudsman for the public health insurance option;
- collect such data as may be required to establish premiums and payment rates;
- 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
- establish payment rates and provide for greater payment rates for the first three years.
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:
- As many as half of the estimated 5.2 million Americans with Alzheimer's disease have never received a diagnosis.
- An early and documented diagnosis and access to care planning services leads to better outcomes for individuals with Alzheimer's disease.
- 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:
Source: S.486&HR1296 2009-S486 on Mar 4, 2009
- 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
- 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.
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:
Source: CPC Position Paper: Health Care 99-CPC2 on Nov 11, 1999
- All Americans, including the 44 million currently without health insurance, deserve to have the health care they need, regardless of ability to pay.
- 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.
- Proposals should be rejected to
change traditional Medicare from a defined benefit to a defined contribution or voucher system.
- Balanced Budget Act cuts that are negatively affecting patient access to hospitals, nursing homes, and home health agencies must be restored.
- Medicaid must have the resources to continue to provide coverage and care for low-income individuals, including children in the CHIP program.
- Individuals with disabilities should retain their health benefits when they return to work and to have access to rehabilitative and other needed services.
- 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.
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:
Source: Women's Caucus Agenda-106th Congress 99-WC2 on Jul 15, 1999
- 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)
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:
Source: Women's Caucus Agenda-106th Congress 99-WC3 on Jul 15, 1999
- 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)
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:
Source: Women's Caucus Agenda-106th Congress 99-WC5 on Jul 15, 1999
- 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]
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:
Source: Women's Caucus Agenda-106th Congress 99-WC6 on Jul 15, 1999
- 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)
2021-22 Governor, House and Senate candidates on Health Care:
Barbara Lee on other issues:
Kevin de Leon
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)
Rayburn HOB 2444, Washington, DC 20515
Page last updated: May 23, 2022; copyright 1999-2022 Jesse Gordon and OnTheIssues.org