Tuesday, December 1, 2009

Senator Brown's Response on Health Care Reform

Dear Ms. Hottinger:

Thank you for sharing your views on health reform.

With health care costs rising to a breaking point and access to health coverage rapidly eroding, our health care system is in need of reform. We must reduce the long-term growth of health care costs for patients, taxpayers, and businesses; protect families from bankruptcy or debt because of health expenditures; guarantee a choice of doctors and health plans; invest in prevention and wellness; improve patient safety and quality of care; assure affordable, quality health coverage for all Americans; and end barriers to coverage for people with pre-existing conditions.

One promising solution to the problems of cost, quality, and access that plague our health care system is to increase competition in the health insurance market. If the private insurance industry was truly competitive, then there would be strong incentives to provide coverage to as many Americans as possible and to build customer loyalty through cost savings and quality improvements. Unfortunately, insurers do not truly compete against one another; instead, they make use of the same basic strategies to earn significant profits. These tactics include selectively insuring the lowest risk enrollees, slow-walking claims payments so they can earn interest on every premium dollar, and denying as many claims as possible.

What the insurance industry needs is some healthy competition from a public insurance option. This option would not replace employer-sponsored coverage and no one would be forced into it; the public option would simply give uninsured or underinsured Americans the choice of enrolling in a quality, affordable health insurance plan that does not engage in the same cost-avoidance tactics that some private insurance plans do. The public health insurance option would also be a vehicle for improvements in quality, coverage, and provider-access that sets the bar higher for private insurance plans. This option would be available to all Americans: both private and government employees, including members of Congress and their staffs.

Since Congress began debating health reform, an overwhelming number of people in Ohio have contacted me. I appreciate this input and am carefully considering the thoughts, questions, and concerns that you and other Ohioans have shared with me.

One question I am often asked is whether I would enroll in the public insurance option. Since first coming to Congress in 1993, I have refused to enroll in the coverage offered to members of Congress until every American has access to high-quality, affordable health insurance. Should a health care reform bill pass that offers a public insurance option, I would be pleased to enroll.

I have also heard from Ohioans concerned about proposals to tax employer-sponsored benefits. I am opposed to taxing these benefits, which would unjustifiably increase the cost of health insurance for working families in Ohio.

Several Ohioans have also questioned whether Americans should be required to purchase coverage. They have expressed concerns over establishing fines intended to increase participation in the health insurance system.

It is important to clarify that these fines would not affect anyone who is currently insured. One of the key principles of the reform effort is that Americans who are satisfied with their coverage today should be able to keep it without being subject to additional costs. However, without a mechanism that encourages the purchase of insurance, some individuals will continue to forego coverage, resulting in uncompensated care costs that inflate insurance premiums and increase the costs of Medicare and Medicaid.

Unfortunately, too many Americans today forego health insurance not by choice, but by circumstance. Many Americans are left without health insurance because their employers don’t offer it, and because it is too expensive to buy in the individual market. That’s why I am working to ensure that individuals who cannot afford the high costs of coverage are provided with federal subsidies to help them purchase insurance. I recognize that, even with federal help, some individuals will still not be able to afford health insurance and I firmly believe that those individuals should not have to pay any fines because they are unable to afford health insurance.

A consolidated Senate health reform bill, the “Patient Protection and Affordable Care Act,” was released on November 18, 2009, and will be considered by the Senate over the next few weeks. According to the Congressional Budget Office (CBO), this bill would extend coverage to an additional 31 million Americans, would cost approximately $848 billion to implement, and would reduce the national deficit by $130 billion over the next decade. The bill is available online at http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf.

On November 7, 2009, the House of Representatives passed legislation, the Affordable Health Care for America Act (H.R. 3962), by a vote of 220 to 215. For more information on the House of Representatives’ health reform bill, please visit http://www.speaker.gov/newsroom/legislation?id=0327.

I am currently reviewing the Senate bill, but am pleased we are one step closer to passing health reform legislation beneficial to health care consumers, businesses, and taxpayers alike. I also support giving every member of Congress, and every member of the public, time to review the bill.

As Congress moves forward on health reform, I will certainly work to address the issues contained in your letter. If you wish to learn more about my work on health reform as well as the most Frequently Asked Questions (FAQs) that Ohioans have posed to my office, please visit my website at:


Thank you again for getting in touch with me on this important matter.


Sherrod Brown
United States Senator

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