Senator Collins to vote against health care legislation

Says bill fails to reduce costs and will hurt Maine's seniors, health care providers, and small businesses

U.S. Senator Susan Collins announced today her decision to vote against the final health care bill unveiled by Majority Leader Harry Reid on Saturday. Following is her statement:

"Our nation’s health care system requires substantial reform. The status quo of soaring health care costs, families struggling, millions uninsured, and health care provider shortages is unacceptable. That is why I am so disappointed that the partisan legislation before the Senate falls far short of what should be the goals of reform. This bill will actually increase health care costs, impose billions in new taxes, fees, and penalties, and hurt our seniors, health care providers, and small businesses. I simply cannot support such a bill.

"It is particularly disappointing that the bill does not do enough to rein in the cost of health care and to provide consumers with more affordable choices. Whether I am talking to a self-employed fisherman, a laid-off worker, the owner of a struggling small business, or the human resource manager of a large company, the soaring cost of health insurance is a primary concern. Yet, the government's own actuary projects that health care costs will be higher as a result of this bill than under current law.

"I am deeply opposed to the nearly $500 billion in cuts to Medicare – a program that already has long-term financing problems. It is fiscally irresponsible to raid Medicare to pay for a new entitlement program at a time when the number of Medicare beneficiaries is on the rise.

"It makes no sense that the bill would slash more than $47 billion in payments to home health and hospice providers. That is completely contrary to the goal of controlling health care costs because home care and hospice services have consistently proven to be cost-effective alternatives to institutional care.

"According to the Centers for Medicaid and Medicare Actuary, these deep cuts could push one in five hospitals, nursing homes, and home health providers into the red. Many of these providers would simply stop taking Medicare patients, which would jeopardize access to care for millions of seniors.

"The comments of the Chief Executive Officer of Central Maine Healthcare, reflect what I have heard from many of Maine's health care providers about this bill. He told me that its passage would be 'disastrous' for Maine and would saddle our hospitals with some $800 million in Medicare cuts over the next ten years.

"Aside from the devastating cuts in Medicare, additional financing for this bill comes through an array of new taxes, penalties, and fees on individuals, employers, insurance providers, and medical device and pharmaceutical manufacturers. The Congressional Budget Office and Joint Committee on Taxation have testified that these costs will simply be passed on to consumers, further increasing the costs of health care for many Americans – the opposite of what health care reform should produce.

"And there is a four-year gap between when billions of new taxes and fees are imposed and when the new subsidies go into effect. The bill would provide fewer and more expensive insurance choices for many self-employed individuals who will not qualify for subsidies.

"The detrimental impact of this bill on small businesses, our nation's job creators, concerns me greatly. This bill would discourage small businesses from hiring more employees and paying them better. It could lead to onerous financial penalties on small businesses that are already struggling to provide health insurance for their employees.

"Small businesses want to provide health insurance for their employees, but many simply cannot afford to absorb double-digit increases in their health insurance premiums year after year. The National Federation of Independent Businesses (NFIB), the nation’s leading small business association, says this bill does too little to reduce insurance costs, imposes new taxes, establishes new entitlement programs, and creates new mandates that will burden small business owners and their employees. In short, the NFIB says, 'the Senate bill fails small business.' I agree.

"To remedy some of these fundamental problems, I worked with my colleagues on both sides of the aisle to offer significant bipartisan amendments aimed at containing costs, helping small businesses, increasing affordability, and providing more choices for consumers. Unfortunately, we were precluded from offering our amendments due to procedural roadblocks.

"It is unfair that Republicans were allowed to offer only seven amendments to a bill that affects every single citizen and one-sixth of our nation’s economy.

"The health care legislation before the Senate has enormous consequences for our economy and our society. The Senate missed the opportunity to produce true, bipartisan health reform. Unfortunately, the process became too divisive and partisan, and the result is a bill that takes us in the wrong direction and will do more harm than good. Keeping in mind the oath every physician takes to 'first, do no harm,' I will cast my vote against this legislation."

Collins, Wyden introduce amendments to hold down premiums and expand health care choices

Bipartisan amendments offered to Senate health care bill

Washington, D.C.-. U.S. Senators Ron Wyden (D-Ore.) and Susan Collins (R-Maine) today filed three bipartisan amendments to the “Patient Protection and Affordable Care Act.” If adopted, the amendments will improve the Senate bill by doing more to hold down premium increases for all Americans while expanding health care choices for more Americans and their employers.

“At the end of the day, Americans don’t care if a health reform proposal originated with a Democrat or a Republican, what matters to them is that it works,” Senator Wyden said. “I’m proud to join forces with Senator Collins to offer common-sense amendments that will hold down premium costs and make health care more affordable for American families and their employers. As I have long said, the best way to hold down health care costs and make insurance companies accountable is to put Americans in the driver’s seat and empower them to pick the plan that best fits their needs.”

Senator Collins said; “Health care reform should give Americans more choices of affordable health insurance options. That is why I am pleased to have worked closely with Senator Wyden on this bipartisan amendment that would help keep costs down and provide individuals, employers and employees with more health care choices.”

Senators Wyden and Collins are proposing as amendments to the “Patient Protection and Affordable Care Act” the following three amendments:

MORE CHOICES FOR EMPLOYERS AND WORKERS: While the current Senate legislation will eventually make it possible for employers to insure their workforce in the new health insurance exchanges, the legislation does not contain a mechanism to make it possible for employers to offer their workers the ability to choose any plan offered in the exchange. This Wyden-Collins amendment would correct that by making it possible for employers – who want to offer their employees the full range of choices in the exchange – to do just that while increasing competition in the new marketplace:

Under the amendment, any employer that sponsors a health plan would have the option to offer tax-free vouchers to its workers equal to the amount the employer contributes to its own health plan. Workers could then use that voucher to purchase the exchange plan that works best for them and their family. If a worker decides to purchase a less-expensive plan the worker would keep the savings as added income just as workers wanting to purchase more generous plans in the exchange will be able to pay the additional cost out of pocket. Whatever employers pay for vouchers will remain tax deductible for employers and tax free for employees; and while no employer will be required to offer vouchers under the new system, in order to encourage participation, employers who want to offer their employees tax-free vouchers will be given accelerated access to the new health insurance exchanges. Under the amendment, any employer offering its workers vouchers would have access to the exchange in 2015 rather than 2017, which is the schedule for employer access in the bill.

OFFERING MORE CHOICES IN THE EXCHANGE: This amendment will make it possible for individuals, who are not eligible for a subsidy, to purchase a catastrophic plan, regardless of age. Catastrophic plans will typically have much lower premiums than other plans offered through the exchange but subscribers will pay for most of their health care expenses “out-of pocket” up until they exceed their plan’s catastrophic limit.

Americans should have the choice to purchase more affordable coverage, if that is what works best for them. Under the Patient Protection and Affordable Care Act, individuals up to the age of 30 are eligible to purchase these plans. The Wyden-Collins amendment will extend that option to individuals – not receiving government subsidies – over the age of 30. This amendment would give consumers more choice and help ensure that more people can purchase coverage that fits their needs and is affordable to them.

The amendment includes aggressive disclosure requirements that will require catastrophic subscribers to certify that they understand the terms of the coverage and know that they are purchasing the lowest level of coverage available.

III. HOLDING DOWN PREMIUMS FOR CONSUMERS: Starting in 2010, the Patient Protection and Affordable Care Act will impose an annual fee on insurance companies based on the number of premiums written each year. This amendment will modify that fee to create an incentive for insurers to hold down rates. So, for example, insurance companies that hold down premium increases will pay lower fees, while insurers who jack-up their premiums will pay much higher fees. Starting in 2010 the fee will be varied by as much as 50% based on how aggressively insurers control costs which will give them a strong incentive to hold the line on overhead, executive salaries, provider payments and inefficiency. As under the bill, the total amount of the annual fee will be $6.7 billion per year.

Health Care Reform Must Not Hurt Small Businesses

Weekly column by Senator Susan Collins

While the national unemployment rate has fallen ever so slightly to ten percent, the fact remains that far too many Americans are still without jobs, and their families continue to struggle during this economic crisis. Government at all levels must do everything possible to help revive the economy by creating and preserving jobs.

Small businesses remain our nation’s job-creation engine. Here in Maine, more than 97 percent of employers are small business, and nearly 120,000 Mainers work for firms with fewer than 20 employees. That is why I am so concerned about the effect the Senate health care bill will have on small businesses, and in turn, on jobs in our State and nation.

The rapidly escalating cost of health care has been particularly burdensome for small businesses, the backbone of our economy. Small businesses want to provide health insurance for their employees, but many simply cannot afford to absorb double-digit increases in their health insurance premiums year after year. The cost is simply too high.

A small business owner in Maine recently e-mailed me to say that: “I just received our renewal proposals for our company. Of course, the plans are all up anywhere from 12 percent to 32 percent on the three plans that we offer. Each year, we increase the deductibles to try to keep premium increases to less than five percent, and this year is no exception.

“You are right when you say that we need to address the cost of health insurance, NOT create another vehicle to deliver the services. The current legislation, as I understand it, totally misses the mark.”

How does this bill help small businesses? On balance, it doesn't. This is the analysis of many, including the National Federation of Independent Businesses, the nation's leading small business association. In a statement on the health care bill, the NFIB says "this kind of reform is not what we need. “ “New taxes . . . new mandates . . . new entitlement programs . . . paid for on the backs of small business . . . equals disaster,” the NFIB says.

In short, as the title of the NFIB’s statement’s indicates, "The Senate Bill Fails Small Business."

Even where this proposal tries to help small business, it misses the mark. I support the providing tax credits for small businesses to help cover employee health insurance costs, but the credits for small business in the proposal are poorly structured.

Only businesses with no more than ten workers, paying an average of wage of $20,000, can get the maximum tax credit. If a business hires more workers, or pays higher salaries, its credit is phased-out. In other words, this bill discourages small businesses from adding jobs or raising pay. This just doesn’t make sense.

Small businesses want to provide health insurance to their employees as a way to attract and retain good employees. But they are far too often unable to do so because of the high cost.
Not only does this bill do little to address this problem, the bill makes matters worse by imposing $28 billion in new taxes levied on employers with more than 50 employees that cannot afford to offer health insurance.

There is no question that our health care system is broken and in need of reform. I continue to believe that the American public would like to see a bipartisan bill that brings together the best ideas that achieves the goal of lower health care costs, higher value, and better outcomes. That is why I am continuing to work with my colleagues on both sides of the aisle on bipartisan amendments that would make tax credits available to more businesses while eliminating some of the disincentives to hire more workers, as the current bill would do.

Along with Senator Joe Lieberman, I have introduced a package of amendments that would help to constrain costs by improving the health care delivery system. For example, our proposal would penalize hospitals that don’t work to reduce preventable infections, which results in a cost each year of $30 billion to our health care system, not to mention much avoidable suffering. We are also working to create more transparency and more incentives for better health care outcomes, which will in turn, help lower health care costs.

It is critical that the Senate keep working toward an alternative health care reform proposal that reduces health care costs, improves outcomes, and equally important, enhances, not hinders the ability of small businesses to succeed.

Senator Collins on Fox- health care reform

Senator Collins was on Fox and Friends discussing the health care reform debate:

Senator Collins on Hardball

Senator Collins discusses the health care reform debate on Hardball with Chris Matthews:

Senator Collins' statement on health care reform debate

As the U.S. Senate moves forward in the health care reform debate, Senator Susan Collins (R-ME) today released this statement:

“There simply is no question that our nation’s health care system requires substantial reform. The status quo of soaring health care costs, families struggling, millions uninsured, and health care provider shortages is unacceptable. Maine families and small businesses are paying ever higher premiums, increased deductibles and greater co-pays.

“Due, in large measure, to the efforts of Senator Olympia Snowe, who has worked tirelessly, the legislation passed by the Senate Finance Committee represents a substantial improvement over the costly and flawed alternative approved by the Senate Health Committee as well as the House bills.

“Nevertheless, the Senate Finance Committee’s bill falls short of the goal of providing access to more affordable health care for all Americans. The goal of health care reform must be to rein in costs and provide consumers with more affordable choices. Yet, many individuals and families would be forced to pay more for their health care under the Finance Committee bill, and they would have fewer choices. Our health care reform efforts should give Americans more, not fewer, choices of affordable coverage options.

“This bill also could lead to onerous financial penalties for small businesses that are already struggling to provide affordable health insurance to their employees. As structured, the bill actually could discourage small businesses from adding more jobs.

“I am troubled that the legislation would cut nearly $500 billion from Medicare, which provides care for our oldest Americans and our most vulnerable citizens. These cuts would adversely affect the ability of Maine’s hospitals and other health care providers to provide essential services to Medicare patients. Medicare, which is so critically important to our nation’s seniors, is already in financial trouble. It should not be the piggy bank for new spending programs when revenues are needed to shore up the current program.

“Finally, I am disappointed that the Finance Committee did not focus more on cost containment, which should have been one of the most important goals of this bill. For example, the legislation contains no meaningful medical liability reforms to reduce frivolous lawsuits and reduce the costly practice of defensive medicine. The Congressional Budget Office estimates that medical liability reform could save $54 billion in health care costs over the next decade. And the bill should do more to reform the health care delivery system in ways that would curb costs and improve the quality of care.

“I share the goal of passing responsible health care reform and, working with members on both sides of the aisle who share these concerns, I am hopeful that many improvements will continue to be made to produce a bill that can achieve bipartisan support. Our goal should be legislation that protects affordable health care choices, safeguards Medicare, and reduces costs to the consumer and the taxpayer especially at a time when we simply cannot afford to pay more.”

Senator Collins' statement on President's health care address

WASHINGTON, D.C. – U.S. Senator Susan Collins tonight released this statement following the President’s address to Congress.

“The problem of providing affordable access to quality health care for all Americans is one of the most significant domestic challenges facing our country. It affects every American and one-sixth of our economy.

“I continue to believe that addressing growing health care costs must be at the center of any health care reform legislation. The high cost is the major barrier to coverage for the uninsured and the reason why so many small businesses and middle-income families are struggling with the escalating cost of health insurance. Soaring costs also are a major burden for the federal and state budgets.

“Any reforms must also take into account our country’s exploding national debt. I remain deeply concerned about the high price tags associated with House bill and the Senate Health Committee legislation. The nonpartisan Congressional Budget Office (CBO) has estimated that these plans could cost as much as $1.6 trillion over the next decade. These costs may be borne by middle-income families and small businesses in the form of increased taxes at a time when they can least afford it.

“The Senate Finance Committee continues to work to come up with bipartisan legislation that addresses these concerns. I look forward to seeing what its negotiations produce.”

Audio: Senator Collins on health care reform

Senator Collins discusses health care reform with Ric Tyler and George Hale on WVOM: