Dent's Speech Against Trillion Dollar Health Overhaul

LV Congressman Charlie Dent is one of the House Republicans who unanimously opposed the trillion dollar health care overhaul passed last night. Because of the limitations on debate, he was unable to deliver a floor speech in person, but was permitted to submit a statement explaining his opposition.

Undeniably, health care reform is needed. Families and businesses are struggling to keep up with rising insurance premiums. Thousands of constituents in my district do not have access to affordable insurance because of skyrocketing costs. An increasing number of Americans are impacted by policies that preclude individuals with pre-existing conditions from securing insurance. Patients are frustrated with the difficulty of navigating the health care system and insurance bureaucracy. We have all experienced our doctors practicing defensive medicine – ordering unnecessary tests and procedures in an effort to ward off frivolous lawsuits. Poor reimbursement rates mean that doctors cannot afford to place an emphasis on prevention and wellness.

The consequences of reform are profound for families, our economy and the future of our country. Reform policies will have a direct impact on the lives of all Americans and the budgets of every household. These changes will affect one-sixth of our economy. Done right, we will lift burdens that are holding employers back from growing and revitalizing our economy. Done wrong, jobs will be lost and 10 percent unemployment will become the norm rather than the exception. Health care expenditures make up an increasing percentage of state and federal spending. Addressing health-care costs is vital to the long term economic health of the United States.

I support reform. I have advocated for deliberate policies that will reduce the cost and increase the quality of health care, provide all Americans with the opportunity to obtain affordable health insurance, give patients more control over their health care decisions, and promote innovations and wellness initiatives that lead to cures.

I oppose the bill before us today because it will increase health care costs for Americans and bend the curve of health care spending in the wrong direction; it will create a new trillion dollar entitlement program that the bill does not realistically address how we will afford; and it will impede economic growth, particularly in our district.

Above all else, health care reform must address the escalating health care costs that are crippling American families and overall, slow our nation’s healthcare spending. This bill does not accomplish those critical objectives. According to an analysis by the Congressional Budget Office (CBO), premiums will increase by 10 to 13 percent for families who are purchasing health insurance in the individual market. This amounts to more than $2,000 a year for a family. In addition, the CBO indicates that H.R. 3590, which will be the law of the land if we pass it today, will increase the federal budgetary commitment to health care by more than $200 billion over the next decade. If the reconciliation package (H.R. 4872) is also signed into law, the combined budgetary impact on health care spending will be $390 billion. American families can’t afford that increase and neither can our country.

Moreover, this bill creates an unsustainable new entitlement program at the expense of seniors who will be impacted by more than half a trillion dollars in Medicare cuts and all Americans who will pay higher health care costs and more than half a trillion dollars in increased taxes, fees and penalties. The bill uses ten years of taxes and Medicare cuts in order to pay for six years of programs. Overall, in the first ten years of full implementation (2014 to 2023), the health care package will result in more than $2.6 trillion in spending. Although the CBO estimated the overall deficit reduction will be $124 billion over ten years, in its analysis the CBO cautioned that its long-term deficit projections

“reflect an assumption that the key provisions of the reconciliation proposal and H.R. 3590 are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments, and legislation to do so again is currently under consideration by the Congress.”

House Leadership has already said it will consider a bill to address the physician payment issue. Just that policy alone will cost $200 billion, which is not reflected in the CBO score.

Finally, this bill will have an immediate impact on economic growth. New taxes and regulations will lead to lower wages, lost jobs and decreased investment. Employers with more than 50 employees who do not provide health insurance coverage that is deemed “acceptable” by federal standards will be saddled with a tax of up to $2,000 per employee. The bill will levy a tax of as much as 2.5 percent of household income on Americans who do not comply with the individual mandate, which requires all Americans to maintain acceptable coverage. Many investors will face a new tax of 3.8 percent that will be imposed on capital gains, dividends, interest, rents, royalties and other investment income. This tax coupled with scheduled rate increases will lead to a top rate of 23.8 percent for capital gains and 43.4 percent for dividends.

We will feel the impact close to home. A 2.3 percent medical device tax will increase the cost of medical devices – everything from tongue depressors to wheelchairs – and discourage the development of critical new medical innovations. Specifically, this tax will impact businesses in our district imperiling jobs; curtailing advanced research and innovation; reducing purchasing from Pennsylvania vendors; and hampering investment in capital equipment. The ripple effect on our economy and on working families will be far greater than the sum of the tax. And ultimately, patients will see increased costs as a result.

Just yesterday, I offered two amendments to the Rules Committee that would have reduced the negative impacts of H.R. 3590. The first amendment would have inserted common-sense medical liability reforms. Specifically, the amendment would enact nationwide reforms aimed at ending the costly practice of defensive medicine and encourage states to adopt effective alternative medical liability laws that will reduce the number of health care lawsuits that are litigated and the average amount of time taken to resolve lawsuits, and reduce the cost of malpractice insurance. The provisions would save our country billions of dollars and reduce national healthcare spending. The second amendment would have struck the ill-advised medical device tax that a company in my district has dubbed the “death tax” because it will increase their tax burden by 77 percent, raising their effective tax rate to over 73%. This is an innovation tax that will mean less investment in research and development that leads to medical innovations. Unfortunately the leadership of the House would not allow these important amendments to be debated on the House floor today.

I regret very much where we are today and wish that bipartisan efforts to address the shortcomings of our system – access and affordability – while building on our strengths – choice, quality and innovation had prevailed.