Mazie Hirono on Health Care

	Mazie Hirono on Health Care Democratic challenger; Representative (HI-2)

Single-payer plans are viable starting points

Q: What measures do you propose to ensure adequate health care for all Americans?

A: There is no magic bullet when it comes to solving this critical problem. Models such as Hawaii's and Massachusetts', as well as proposed single-payer plans, are all viable starting points. While there are legitimate debates, the goals are clear: we must bring all parties together and immediately begin the process of providing real options for the 45 million Americans currently without health insurance.

Source: 2006 Senate campaign website, mazieforcongress.com, "Issues" , Nov 7, 2006

MEDS Plan: Cover senior Rx under Medicare.

Hirono 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.

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:

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.

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

Establish a national childhood cancer database.

Hirono co-sponsored establishing a national childhood cancer database

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.

Legislative Outcome: House version H.R.1553; became Public Law 110-285 on 7/29/2008. Source: Conquer Childhood Cancer Act (S911/HR1553) 07-S911 on Mar 19, 2007

Require insurers to cover breast cancer treatment.

Hirono 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.

Congressional Findings:

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.

Hirono 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.

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.

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

Religious exemption from ObamaCare individual mandate.

Hirono 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_S352 on Feb 3, 2015

Keep healthcare mandate, according to CC survey.

Hirono opposes the CC survey question on healthcare mandate

The Christian Coalition Voter Guide inferred whether candidates agree or disagree with the statement, 'Repealing the Nationalized Health Care System that Forces Citizens to Buy Insurance ' Christian Coalition's self-description: "Christian Voter Guide is a clearing-house for traditional, pro-family voter guides. We do not create voter guides, nor do we interview or endorse candidates."

Source: Christian Coalition Surve 18CC-5 on Jul 1, 2018

Expand the National Health Service Corps.

Hirono signed Access for All America Act

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.

Source: S.486&HR1296 2009-S486 on Mar 4, 2009

Make health care a right, not a privilege.