Patients Bill of Rights | The Uninsured | Children’s Health | Fighting HIV/AIDS | Medicare/Medicaid

Today, millions of Americans live without health insurance. This is unacceptable and an issue I am working diligently to address. I believe that everyone should have access to affordable health coverage, for themselves, as well as for their families, and that this health care should be comprehensive and of good quality. As we work to improve the affordability, accessibility and quality of healthcare, we must increase consumer health care options. Patients and their doctors should make critical medical decisions rather than insurance companies. As a State Senator, I played a pivotal role in passing California's landmark HMO Patient's Bill of Rights. In Congress, I am proud to continue my efforts to reform our national healthcare system, and have been an original cosponsor of the bipartisan Patients Bill of Rights. I am also working to increase health care access for children and to strengthen immunization programs.

Patients Bill of Rights

Both the Senate and the House of Representatives passed Patient's Bill of Rights legislation in 2001. I cosponsored the original Bipartisan Patient Protection Act, H.R. 2563 (107th), a fiscally responsible plan to ensure HMO patients receive the medical treatment their doctor recommends. Under this plan, patients would be assured that their doctors would make medical decisions involving their medical care. Although this bill never became law, I am hopeful that Congress will revisit this important issue, and I am committed to continuing the fight for a Patient's Bill of Rights.

The Uninsured

Extending COBRA Coverage

I have introduced the COBRA Coverage Act of 2003, to help laid-off workers maintain health coverage. Under current law, commonly referred to as COBRA, workers who are laid off are allowed to remain in their employer-based health insurance plan for up to 18 months, provided they pay the full premium for the plan (their share plus the employer share) plus a small administrative fee. The problem is that the full premium for employment-based coverage averages almost $2,500 per year for self-only coverage and about $6,500 per year for family coverage.

Since COBRA coverage is very expensive, many laid-off workers let their insurance lapse, gambling they won't get sick or injured before they find another job. This bill, H.R. 3040, makes sure that unemployed workers have access to affordable health care coverage when they need it most.

My bill would provide laid-off workers with a 50% refundable tax rebate toward the cost of COBRA coverage, up to a maximum of $110 for an individual and $290 for a family per month. The COBRA Coverage Act provides immediate relief to workers because the tax credit would be administered through the employer. This would help workers afford health insurance right away, instead of waiting for a tax credit at the end of the year.

To read more about this legislation, please click here.

Health Coverage in Times of Economic Hardship

I am also a cosponsor of H.R. 816 (108th), the State Budget Relief Act. In these trying economic times, this bill would temporarily increase Medicaid’s Federal medical assistance percentage. This legislation will assist in paying for rising Medicaid enrollment resulting from growing unemployment.

Insurance for All Americans

H.Con.Res. 99 (108th), which instructs Congress to implement legislation guaranteeing health coverage for every person in America, has also earned my support. This would extend health care coverage to every individual, irrespective of income, age, health condition, or employment. Among other goals, this legislation seeks to ensure access to quality affordable care, to provide comprehensive benefits (including preventive care and early detection), and to guarantee continuity of coverage and care, while being cost efficient and reducing paperwork.

Mental Health Benefits

I am also a cosponsor of H.R. 953 (108th), the Mental Health Equitable Treatment Act. As many Americans are afflicted by mental illness, we need to eliminate discrimination and inequality in its treatment. Therefore, this bill states that those employer-based group health plans, which provide both medical-surgical and mental health benefits, cannot place limitations on mental health coverage unless comparable restrictions are placed on medical-surgical benefits.

Children's Health

As the proud parent of two young children, ensuring the health of America's youth is a priority of mine.

Making SCHIP Enrollment Easier

I have introduced H.R. 1633 (108th), the SCHIP Web-Based Enrollment Act. This bill provides a simple, targeted method for expanding access to children's health care by giving States the flexibility they need to implement web-based enrollment programs for SCHIP. First, it would allow States to use unused, “retained” (redistributed from the Federal Government back to the State) SCHIP money for this effort. Under current law, a State may use up to 10 percent of these retained allotments for outreach activities approved by the Secretary of Health and Human Services. The bill also allows States to use any amount of their retained funds for web-based enrollment outreach. Second, the bill establishes a separate grant program for web-based enrollment efforts. The grant program would make $50 million available over 5 years. Finally, this legislation provides assistance to States from the Department of Health and Human Services for development and implementation of the web-based enrollment system by providing information and technical assistance.

To read more about this legislation, please click here.

Expanding SCHIP

At a news conference at Huntington Memorial Hospital in Pasadena, I called on the Bush Administration to expand Children’s Health Insurance Programs (SCHIP) in California. Currently the State of California provides state funds to draw down the federal matching dollars available through the federal SCHIP program. Because of the state’s budget deficit, California is unable to pull down the maximum federal allowance of SCHIP matching dollars; meaning crucial federal funding for children’s health insurance remains unused. To address this problem, the California Legislature introduced Assembly Bill 495, legislation authorizing California Counties to work with the State to use local funds to draw down federal SCHIP funds. To fully implement AB 495, the Bush Administration’s Centers for Medicare and Medicaid Services must approve a State Plan Amendment allowing the use of non-state funds to draw down federal SCHIP funds. California’s State Plan Amendment was submitted on March 31, 2003. This plan will help give health insurance to thousands more children who are currently uninsured.

To read more about Schiff’s efforts to expand SCHIP, please click here.

Providing Vaccines to California Children

I cosponsored H.R. 2701(108th) to clarify federal law so that all children enrolled in SCHIP will receive free immunizations through the Vaccines for Children program, which supplies federally purchased vaccines to low-income children who are uninsured or enrolled in Medicaid. This bill is needed because some states (like California) administer their SCHIP program though innovative non-Medicaid programs.

Improving Children's Dental Health

I also cosponsored H.R. 3649 (107th), the Children's Dental Health Improvement Act. This legislation will improve access to dental care to millions of children across America who lack dental coverage by allowing states the flexibility to cover dental care through SCHIP and Medicaid.

Improving Child Survival and Maternal Health

I also supported H.Con.Res 404 (107th), a resolution which illustrates that an increased commitment to improving the health of mothers and children all over the world has an impact on political, economic, and social stability of developing nations. According to the World Health Organization, the lifetime risk of dying from pregnancy-related complications or during childbirth in developing countries is 1 in 48; in developed countries, the ratio is drastically reduced to 1 in 1,800.

I also cosigned a letter to the Labor-HHS Appropriations Chairman Regula and Ranking Member Obey to include $150 million in FY2003 funding for the Healthy Start program. This program works to reduce the incidence of infant mortality and low birth weight in communities where the infant mortality exceed 150% of the national average. Previous program cuts have seriously hampered the program’s mission to assist expectant mothers with a healthy and successful childbirth.

I also joined an effort with the March of Dimes to support $25 million for newborn screening programs. Screening detects disorders in newborns that, if left untreated, can cause death, mental retardation, and other serious illnesses. Currently, the number and quality of tests vary widely among states.

Promoting Pediatric Drug Safety

I cosponsored H.R. 4730 (107th), which would establish a standardized pediatric rule requiring pharmaceutical companies to test the safety and efficacy of drugs intended for use by children.

Finding a Cure for Juvenile Diabetes

I am a cosponsor of H.Con. Res. 107 (107th), urging federal funding for diabetes research. Hopefully, funding this research will culminate in a cure or improved treatments for juvenile diabetes.

Fighting HIV/AIDS

Currently, millions throughout the world are plagued by the HIV/AIDS epidemic. As this is a problem not just of today, but of tomorrow as well, I have worked diligently to obtain access to services, medication, and research for the treatment of AIDS. As the world's only superpower, the United States has a global responsibility to take a prominent leadership role in the struggle against the AIDS epidemic. AIDS is not only a global health danger, but a destabilizing force that presents a grave threat to international security.

To date, more than 25 million people have died of AIDS worldwide, including more than 3 million in 2002. Life expectancy in Africa has been cut in half by the pandemic, and by the year 2010, 80 million persons could be dead of AIDS. This is simply unacceptable.

Funding Global AIDS Efforts

I am a cosponsor of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and have recently urged the House International Relations Committee to support this important piece of legislation. This legislation would authorize $15 billion to combat HIV/AIDS, tuberculosis, and malaria over the next five years.

To read more about this bill, please click here.

Supporting Medicaid Coverage for those with HIV

I cosponsored H.R. 2063 (107th), the Early Treatment for HIV Act, introduced by House Democratic Leader Nancy Pelosi, to allow low-income individuals with HIV to qualify for Medicaid coverage earlier in the course of their disease. Currently, many uninsured and underinsured Americans still do not have access to these life-saving medications because HIV-positive individuals generally do not meet Medicaid requirements until they are disabled by full-blown AIDS.

Preventing Mother-to-Child HIV/AIDS Transmission in Sub-Saharan Africa and India

I cosponsored H.R. 684 (107th), which authorizes $15 million for three years for pilot programs for sub-Saharan Africa and India to prevent mother-to-child transmission of HIV/AIDS through effective partnerships with nongovernmental organizations and university-based research facilities. H.R. 864 limited the pilot programs to prenatal volunteer counseling, voluntary testing, and use of nevarapine and replacement feeding.

Supporting the Global AIDS Fund

I voted for H.R. 2069 (107th), the Global Access to HIV/AIDS Prevention, Awareness, Education and Treatment Act, during the House International Relations Committee mark-up. This compromise international AIDS funding proposal of $1.36 billion, included $750 million for an international AIDS trust fund. H.R. 2069 also authorized the Agency for International Development to undertake a comprehensive program of HIV/AIDS prevention, education and treatment with $560 million in FY 2002. An additional $50 million was authorized for treatment in developing countries by assisting in procuring pharmaceuticals and anti-viral therapies.

Medicare/Medicaid

Opposing Medicare Cuts to Doctors

When the Center for Medicare and Medicaid Services issued its final Medicare Physician Fee Schedule for 2002, it resulted in a reimbursement rate cut of 5.45 %, applying to chiropractors, optometrists, nurse practitioners, therapists and other doctors. The cut will have immediate negative consequences for patient access to physician services because many physicians are holding off on accepting new Medicare patients. Reducing their fees will only exacerbate this problem.

I support H.R. 41 (108th), the Medicare Physician Payment Fairness Act, which would prevent cuts in Medicare physician payments and ensure physicians' continued ability to provide high quality care under the Medicare program.

Special Needs Medicaid Coverage

I cosponsored H.R. 600 (107th), the Family Opportunity Act, which would allow middle-income families of children with special needs to purchase Medicaid coverage. This bill would allow states to create a Medicaid buy-in for low and middle-income families of special needs children, just as the Workforce Investment Act allows states to create a Medicaid buy-in for adults with disabilities.

Covering Cancer Therapies under Medicare

I supported H.R. 1624 (107th), the Access to Cancer Therapies Act, legislation that would have enhanced access to new life-extending anti-cancer treatments for Medicare beneficiaries. H.R. 1624 extended Medicare coverage to innovative oral therapies that are expected to revolutionize cancer care.

Currently Medicare covers the vast majority of drugs available to treat beneficiaries diagnosed with cancer because physicians can administer these therapies through injection. However, as science has progressed, so too have cancer treatments and their future lies in the oral administration of these therapies not covered by Medicare.

Support for Medicare coverage of Mammography

I am opposed to the Center for Medicare and Medicaid Services' (CMS) proposed reduction of Medicare payment rates for diagnostic mammography. There is a direct relationship between Medicare payment rates and access. I supported the Assure Access to Mammography Act of, H.R. 1354 (107th), which sought to raise the payment rates for routine mammography screening.

Prescription Drugs for Seniors

I strongly believe that our nation's seniors should have access to a meaningful prescription drug benefit. Medical care has changed dramatically since the Medicare program was created in 1965 and prescription drugs were covered only during hospital stays. Seniors, in particular, are now heavily dependent on prescription medication, and often pay more in drug costs than they do for their doctor. Moreover, because of the spiraling costs of prescription drugs, many seniors must choose between buying their food, paying their rent, or purchasing their medicine.

In July 2003, I hosted a Medicare Town Hall at the Pasadena Senior Center with representatives from the AARP, Older Women's League (OWL) and National Committee to Preserve Social Security and Medicare (NCPSSM). We discussed efforts to provide seniors with a prescription drug benefit that is voluntary, available to everyone and guaranteed under Medicare.

In the summer of 2003, the House of Representatives debated Medicare reform and passed a controversial bill (H.R. 1) by one vote. H.R. 1 forces Medicare beneficiaries to go outside the current Medicare program to private health plans in order to obtain a prescription drug benefit and eventually will force Medicare beneficiaries out of traditional Medicare and into Health Maintenance Organizations (HMO) or Preferred Provider Organizations (PPO). In adopting H.R. 1, the House unwisely agreed to provide no guaranteed minimum prescription drug benefit, to turn Medicare into a voucher program, to provide for no guaranteed monthly premium and no fallback prescription drug plan, and to raise the Medicare Part B deductible.

This plan is unacceptable and I voted against it. The alternative which I supported, the Medicare Prescription Drug Benefit and Discount Act of 2003 (H.R. 1199), would have added a new "Part D" to the Medicare program with voluntary prescription drug coverage for all Medicare beneficiaries. Participating seniors would pay a set $25 per month premium and a $100 per year deductible for Medicare to cover 80% of all drug costs up to $2,000 a year. Once a senior reached the $2,000 out-of-pocket limit, Medicare would then cover 100% of all drug costs after that point. A senior with $4,000 in annual drug costs would pay $1,180 -- a savings of 71%. Every drug would be covered under this proposal. The Secretary of Health and Human Services would also have the authority to use the cumulative bargaining power of Medicare's 40 million beneficiaries to negotiate with pharmaceutical companies for lower drug prices.

The House also passed a bill, which I supported, that allows for the reimportation of American-made drugs from 25 foreign countries, thus allowing seniors to buy prescription drugs at a greatly reduced cost. The final Medicare bill will be debated in a conference committee later in the year. I support a Medicare prescription drug benefit that is: affordable, reducing the exorbitant prices of drugs; with guaranteed benefits; within Medicare; and available to all seniors, regardless of where they live.

On July 30, 2003 – Medicare’s 38th birthday, I hosted a town hall meeting at the Pasadena Senior Center to discuss efforts in Congress to provide seniors with a prescription drug benefit under Medicare.

To read more about this town hall meeting, please click here.