Statement of Senator Patrick Leahy
On Vermont’s Contribution to Health Insurance Reform Legislation
November 4, 2009

Today, we as Members of Congress have the opportunity to complete an effort that began decades ago.  The status quo has a powerful lobby, and the sentries of the status quo have killed health insurance reform before.  They are pouring all their energy not into offering constructive solutions but into erecting new pillars of obstruction at every turn.

Each of the various reform plans that have been brought forward by now has its strengths and weaknesses, but radical reforms they are not.  As President Obama asked, these proposals are based on the existing system of employer-based private insurance.

But in the absence of comprehensive national reform, several States have helped fill the void by crafting some of their own solutions.   

Vermont’s Trailblazing Reforms

I am proud that my home state of Vermont has been a leader and innovator on several issues that are now being wrapped into the reform packages.  One such provision mirrors a pilot program in Vermont, the “Blueprint for Health,” which coordinates care among patients to prevent costly hospitalizations and procedures.  Patients participating in the program have their care monitored to ensure they are receiving the kinds of preventative services and disease management they need.  The Blueprint rewards physicians for keeping their patients healthy, and the program has already slowed costs and reduced emergency room visits. 

Vermont has also coordinated patient care as one of the States at the forefront of the movement toward electronic medical records, a reform I also have long promoted.  Recently I visited Montpelier Pharmacy in our capital city to announce a grant I secured to help small pharmacies across Vermont adopt a system for electronic prescriptions. Electronic prescribing will include safeguards to prevent dosages from being too large or from conflicting with other prescriptions.  This system will also offer physicians and pharmacists a concrete medication history that does not rely on a patient’s memory alone.  When a patient does not, or cannot, remember what medications have been taken, this can be lifesaving.    

Vermont has also been a national leader on children’s health care and in expanding coverage for low income Vermonters through the Medicaid program.  Because of our early action, 96 percent of Vermont’s children have health insurance, and we also have one of the lowest rates for uninsured adults in the country, making Vermont a leader and a model for the rest of the Nation.  It is no surprise that Vermont has been ranked the healthiest state in the Nation by the American Public Health Association and the Partnership for Prevention and ranked number one in health care by the Commonwealth Fund. 

While Vermont has been a model in coordinating care and offering wider health coverage through public programs, a provision to expand Medicaid coverage nationwide threatens to penalize states like Vermont that have acted early to do the right thing.  Instead of rewarding states that have taken the initiative to expand their Medicaid programs early, one of the Senate bills would require States that have been leaders in expanding coverage to accept less federal assistance than other States that have only offered the bare minimum of coverage.  Taxpayers in “early leader” states like Vermont would be forced to sustain programs in States around the country in that have traditionally ignored these needs of its citizens.  To address this disparity, I recently joined with 13 other Senators from “early leader states” to offer a proposal that would treat all states fairly.  We can all share the goal of increasing access to essential medical services by expanding Medicaid coverage nationwide.  I look forward to working with others to do that in a way that does not misguidedly harm our “early leader” States.

Competition And Choice

Even though Vermont has long recognized the importance of a health care system that includes all Vermonters and all Americans, individual States cannot make enough progress without comprehensive health insurance reform. Tens of thousands of Vermonters still lack health insurance.  Workers nationwide are losing insurance for their families when they change or lose jobs. Insurance companies can and do discriminate against sick people. 

I hear heartbreaking stories daily from constituents who call or write to tell of the trouble they have getting, paying for or keeping health insurance.  Like the woman from Winhall, Vermont, who spends $500 a month on prescriptions but who would be uninsured if not for her husband’s job.  She is working two jobs just to make ends meet and to afford their health care costs.  Or the small business owner in Vermont who has three full time employees and one part time worker and works six and seven days a week -- but still can’t afford the blood tests her doctor recommended.  If she becomes sick she will lose her business and her home.  Or the man from central Vermont who told me of his sister-in-law who lost parts of both her feet because she did not have health insurance. When she needed medical attention, she waited hoping things would get better.  By the time her family was able to step in, she had to be rushed to the emergency room for amputations.

It is real-life stories like these that serve as fresh reminders every day about why we must work to pass health insurance reform.  We remain the only industrialized nation in the world that lacks health insurance for its citizens.  That is shameful, and we owe it to all Americans to pass meaningful reform that will assure that all Americans have affordable access to health care coverage, that will reduce costs for families, businesses and taxpayers, and that will protect everyone’s choice of doctors, hospitals and insurance plans.

I believe strongly that the best way to meet these goals is to include a public health insurance option in health insurance reform.  A public option would give consumers more choices to purchase an affordable and quality health insurance plan and will help drive down overall health care costs by introducing real competition into the health care market.  I welcome the Majority Leader’s announcement last week that the bill the Senate considers will include a public option.  I look forward to working with Senate leaders as we begin to carefully review the proposals and to debating the issue on the Senate Floor in the coming weeks. 

In order to introduce true competition in the insurance industry we must also end the exemption from antitrust scrutiny that has been carved out of our laws for the benefit of health insurers and medical malpractice insurance companies. The antitrust laws exist to protect consumers and promote competition, and we should no longer allow the insurance industry to hide behind its special, statutory exemption from the antitrust laws.  During the Senate’s debate on health insurance reform, I will offer as an amendment the Health Insurance Industry Antitrust Enforcement Act, which I introduced last month, to end the health insurance industry’s exemption from our antitrust laws. 

We know our current health system is unsustainable and that threatens not only our health security but also our economic security.  Doing nothing has been seen as an option before, but it’s no option now.  We have tried doing nothing for years, and the situation has only grown worse.  I look forward to debating and passing a health insurance overhaul in the coming weeks that gives the American people the competition and choice they deserve.   

# # # # #