Howard Berman on Health Care

Democratic Representative (CA-28)

Voted NO on the Ryan Budget: Medicare choice, tax & spending cuts.

Proponent's Arguments for voting Yes:

[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.

[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.

Opponent's Arguments for voting No:

[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.

[Sen. Merkley, D-TK]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.

Reference: Ryan Budget Plan; Bill HCR34&SCR21 ; vote number 11-HV277 on Apr 15, 2011

Voted NO on repealing the "Prevention and Public Health" slush fund.

Congressional Summary:Amends the Patient Protection and Affordable Care Act (PPACA) to repeal provisions establishing and appropriating funds to the Prevention and Public Health Fund (a Fund to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs). Rescinds any unobligated balanced appropriated to such Fund.

Proponent's Argument for voting Yes:
[Rep. Pitts, R-PA]: Section 4002 of PPACA establishes a Prevention and Public Health Fund, which my bill, H.R. 1217, would repeal. The PPACA section authorizes the appropriation of and appropriates to the fund from the Treasury the following amounts:

$500 million for FY 2010
$750 million for FY11
$1 billion for FY12
$1.25 billion for FY13
$1.5 billion for FY14
and for FY15 and every fiscal year thereafter, $2 billion.

We have created a slush fund from which the Secretary of HHS can spend without any congressional oversight or approval. I would suggest to my colleagues that, if you wanted more funding to go towards smoking cessation or to any other program, the health care law should have contained an explicit authorization. By eliminating this fund, we are not cutting any specific program. This is about reclaiming our oversight role of how Federal tax dollars should be used.

Opponent's Argument for voting No:
[Rep. Waxman, D-CA]: This bill represents the Republicans' newest line of attack to disrupt, dismantle, and to ultimately destroy the Affordable Care Act. For many years, Republicans have joined with Democrats in supporting programs to prevent disease, to promote health and, in turn, to cut health care costs. But today, the House will vote to end funding for the first and only Federal program with dedicated, ongoing resources designed to make us a healthier Nation.

Reference: To repeal the Prevention and Public Health Fund; Bill H.1217 ; vote number 11-HV264 on Apr 13, 2011

Voted YES on regulating tobacco as a drug.

Congressional Summary:Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to provide for the regulation of tobacco products by the Secretary of Health and Human Services through the Food and Drug Administration (FDA). Defines a tobacco product as any product made or derived from tobacco that is intended for human consumption. Excludes from FDA authority the tobacco leaf and tobacco farms.

Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.

Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.

Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.

Reference: Family Smoking Prevention and Tobacco Control Act; Bill HR1256&S982 ; vote number 2009-H187 on Apr 2, 2009

Voted YES on expanding the Children's Health Insurance Program.

Congressional Summary:

Reauthorizes State Children's Health Insurance Program (SCHIP) through FY2013 at increased levels.
Gives states the option to cover targeted low-income pregnant women
Phases out coverage for nonpregnant childless adults.

Proponent's argument to vote Yes:

Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.

Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.

Reference: SCHIP Reauthorization Act; Bill H.R.2 ; vote number 2009-H016 on Jan 14, 2009

Voted YES on overriding veto on expansion of Medicare.

Congressional Summary:

Extends Medicare to cover additional preventive services.
Includes body mass index and end-of-life planning among initial preventive physical examinations.
Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.

Pres. GEORGE W. BUSH's veto message (argument to vote No):

It would harm beneficiaries by taking private health plan options away from them.
It would undermine the Medicare prescription drug program.
It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.

In addition, H.R. 6331 would delay important reforms like the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies competitive bidding program. Changing policy in mid-stream is also confusing to beneficiaries who are receiving services from quality suppliers at lower prices. In order to slow the growth in Medicare spending, competition within the program should be expanded, not diminished.

Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.

Reference: Medicare Improvements for Patients and Providers Act; Bill HR.6331 ; vote number 2008-H491 on Jul 15, 2008

Voted YES on giving mental health full equity with physical health.

CONGRESSIONAL SUMMARY:

Paul Wellstone Mental Health and Addiction Equity Act of 2008: Requires group health plans to apply the same treatment limits on mental health or substance-related disorder benefits as they do for medical and surgical benefits (parity requirement).
Genetic Information Nondiscrimination Act of 2008: Prohibits a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information.

SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. PALLONE. This is a comprehensive bill which will establish full mental health and addiction care parity. The Mental Health Parity Act of 1996 authorized for 5 years partial parity by mandating that the annual and lifetime dollar limit for mental health treatment under group health plans offering mental health coverage be no less than that for physical illnesses. This bill requires full parity and also protects against discrimination by diagnosis.

OPPONENT'S ARGUMENT FOR VOTING NO:Rep. DEAL of Georgia: I am a supporter of the concept of mental health parity, but this bill before us today is not the correct approach. This path will raise the price of health insurance, and would cause some to lose their health insurance benefits and some employers to terminate mental health benefits altogether.

The bill's focus is also overly broad. Our legislation should focus on serious biologically-based mental disorders like schizophrenia and bipolar disorder, not on jet lag and caffeine addiction, as this bill would include. There are no criteria for judicial review, required notice and comment, or congressional review of future decisions.

I would ask my colleagues to vote "no" today so that we can take up the Senate bill and avoid a possible stalemate in a House-Senate conference on an issue that should be signed into law this Congress.

LEGISLATIVE OUTCOME:Bill passed House, 268-148

Reference: Mental Health and Addiction Equity Act; Bill H.R.1424 ; vote number 08-HR1424 on Mar 5, 2008

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

It terminates the coverage of childless adults.
It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Reference: Children's Health Insurance Program Reauthorization Act; Bill H.R. 3963 ; vote number 2007-1009 on Oct 25, 2007

Voted YES on requiring negotiated Rx prices for Medicare part D.

Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.

Reference: Medicare Prescription Drug Price Negotiation Act; Bill HR 4 ("First 100 hours") ; vote number 2007-023 on Jan 12, 2007

Voted NO on denying non-emergency treatment for lack of Medicare co-pay.

Vote to pass a resolution, agreeing to S. AMDT. 2691 that removes the following provisions from S 1932:

Allows hospitals to refuse treatment to Medicaid patients when they are unable to pay their co-pay if the hospital deems the situation to be a non-emergency
Excludes payment to grandparents for foster care

Reference: Reconciliation resolution on the FY06 budget; Bill H Res 653 on S. AMDT. 2691 ; vote number 2006-004 on Feb 1, 2006

Voted NO on limiting medical malpractice lawsuits to $250,000 damages.

Vote to pass a bill that would limit the awards that plaintiffs and their attorneys could be given in medical malpractice cases. The bill would limit non-economic damages, including physical and emotional pain to $250,000. The bill would also limit punitive damages to $250,000 or double economic damages, whichever amount is greater. Punitive damages would be banned against makers and distributors of medical products if the Food and Drug Administration approved those products. The bill would call for all states to set damage caps but would not block existing state statutory limits. The bill would cap attorneys' contingency fees to 40% of the first $50,000 in damages; 33.3% of the next $50,000; 25% of the next $500,000; and 15% of any amount in excess of $600,000. Reference: Medical Malpractice Liability Limitation bill; Bill HR 4280 ; vote number 2004-166 on May 12, 2004

Voted NO on limited prescription drug benefit for Medicare recipients.

Medicare Prescription Drug and Modernization Act of 2003: Vote to adopt the conference report on the bill that would create a prescription drug benefit for Medicare recipients. Starting in 2006, prescription coverage would be made available through private insurers to seniors. Seniors would pay a monthly premium of an estimated $35 in 2006. Individuals enrolled in the plan would cover the first $250 of annual drug costs themselves, and 25 percent of all drug costs up to $2,250. The government would offer a fallback prescription drug plan in regions were no private plans had made a bid.Over a 10 year time period medicare payments to managed care plans would increase by $14.2 billion. A pilot project would begin in 2010 in which Medicare would compete with private insurers to provide coverage for doctors and hospitals costs in six metropolitan areas for six years. The importation of drugs from Canada would be approved only if HHS determines there is no safety risks and that consumers would be saving money. Reference: Bill sponsored by Hastert, R-IL; Bill HR.1 ; vote number 2003-669 on Nov 22, 2003

Voted NO on allowing reimportation of prescription drugs.

Pharmaceutical Market Access Act of 2003: Vote to pass a bill that would call for the Food and Drug Administration to begin a program that would permit the importation of FDA-approved prescription drugs from Australia, Canada, the European Union, Iceland, Israel, Japan, Lichtenstein, New Zealand, Norway, Switzerland and South Africa. Reference: Bill sponsored by Gutknecht, R-MN; Bill HR.2427 ; vote number 2003-445 on Jul 24, 2003

Voted NO on small business associations for buying health insurance.

Vote to pass a bill that would permit the creation of association health plans through which small companies could group together to buy insurance for their employees. Association health plans that cover employees in several states would be excused from many individual state insurance regulations but would be regulated by the Labor Department. Reference: Small Business Health Fairness Act; Bill HR 660 ; vote number 2003-296 on Jun 19, 2003

Voted NO on capping damages & setting time limits in medical lawsuits.

Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2003: To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system. Limits the availability of punitive damages, and sets a 3-year limit for suing. Reference: Bill sponsored by Greenwood, R-PA; Bill HR 5 ; vote number 2003-64 on Mar 13, 2003

Voted NO on allowing suing HMOs, but under federal rules & limited award.

Vote to adopt an amendment that would limit liability and damage awards when a patient is harmed by a denial of health care. It would allow a patient to sue a health maintenance organization in state court but federal, not state, law would govern. Bill HR 2563 ; vote number 2001-329 on Aug 2, 2001

Voted NO on subsidizing private insurance for Medicare Rx drug coverage.

HR 4680, the Medicare Rx 2000 Act, would institute a new program to provide voluntary prescription drug coverage for Medicare beneficiaries through subsidies to private plans. The program would cost an estimated $40 billion over five years and would go into effect in fiscal 2003. Reference: Bill sponsored by Thomas, R-CA; Bill HR 4680 ; vote number 2000-357 on Jun 28, 2000

Voted NO on banning physician-assisted suicide.

Vote on HR 2260, the Pain Relief Promotion Act of 1999, would ban the use of drugs for physician-assisted suicide. The bill would not allow doctors to give lethal prescriptions to terminally ill patients, and instead promotes "palliative care," or aggressive pain relief techniques. Reference: Bill sponsored by Hyde, R-IL; Bill HR 2260 ; vote number 1999-544 on Oct 27, 1999

Voted NO on establishing tax-exempt Medical Savings Accounts.

The bill allows all taxpayers to create a tax-exempt account for paying medical expenses called a Medical Savings Account [MSA]. Also, the measure would allow the full cost of health care premiums to be taken as a tax deduction for the self-employed and taxpayers who are paying for their own insurance. The bill would also allow the establishment of "HealthMarts," regional groups of insurers, health care providers and employers who could work together to develop packages for uninsured employees. Another provision of the bill would establish "association health plan," in which organizations could combine resources to purchase health insurance at better rates than they could separately. Reference: Bill sponsored by Talent, R-MO; Bill HR 2990 ; vote number 1999-485 on Oct 6, 1999

Rated 89% by APHA, indicating a pro-public health record.

Berman scores 89% by APHA on health issues

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Source: APHA website 03n-APHA on Dec 31, 2003

Improve services for people with autism & their families.

Berman co-sponsored improving services for people with autism & their families

Amends the Public Health Service Act to require the Secretary of Health and Human Services to:

convene, on behalf of the Interagency Autism Coordinating Committee, a Treatments, Interventions, and Services Evaluation Task Force to evaluate evidence-based biomedical and behavioral treatments and services for individuals with autism;
establish a multi-year demonstration grant program for states to provide evidence-based autism treatments, interventions, and services.
establish planning and demonstration grant programs for adults with autism;
award grants to states for access to autism services following diagnosis;
award grants to University Centers of Excellence for Developmental Disabilities to provide services and address the unmet needs of individuals with autism and their families;
make grants to protection and advocacy systems to address the needs of individuals with autism and other emerging populations of individuals with disabilities; and
award a grant to a national nonprofit organization for the establishment and maintenance of a national technical assistance center for autism services and information dissemination.
Directs the Comptroller General to issue a report on the financing of autism services and treatments.

Source: Promise for Individuals With Autism Act (S.937 & HR.1881) 07-HR1881 on Apr 17, 2007

Establish a national childhood cancer database.

Berman co-sponsored establishing a national childhood cancer database

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.

Legislative Outcome: House version H.R.1553; became Public Law 110-285 on 7/29/2008. Source: Conquer Childhood Cancer Act (S911/HR1553) 07-S911 on Mar 19, 2007

Require insurers to cover breast cancer treatment.

Berman co-sponsored Breast Cancer Patient Protection Act

Congressional Summary: Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require coverage and radiation therapy for breast cancer treatment.

Prohibits restricting benefits for any hospital length of stay to less than 48 hours in connection with a mastectomy or breast conserving surgery or 24 hours in connection with a lymph node dissection; or
Prohibits requiring that a provider obtain authorization from the plan for prescribing any such length of stay.

Congressional Findings:

According to the American Cancer Society, excluding cancers of the skin, breast cancer is the most frequently diagnosed cancer in women.
An estimated 40,480 women and 450 men died from breast cancer in 2008, and an estimated 182,460 new cases of invasive breast cancer were diagnosed in women, plus 1,990 cases in men.
Most breast cancer patients undergo some type of surgical treatment.
Treatment for breast cancer varies according to type of insurance coverage and State of residence.
Currently, 20 States mandate minimum inpatient coverage after a patient undergoes a mastectomy.

Breast cancer patients have reported adverse outcomes, including infection and inadequately controlled pain, resulting from premature hospital discharge following breast cancer surgery. Source: H.R.111 11-HR111 on Jan 5, 2011

Expand the National Health Service Corps.

Berman signed Access for All America Act

increase and extend the authorization of appropriations for community health centers and for the National Health Service Corps scholarship and loan repayment program for FY2010-FY2015, and provide for increased funding for such programs in FY2016 and each subsequent fiscal year; and
revise and expand provisions allowing a community health center to provide services at different locations, adjust its operating plan and budget, enter into arrangements with other centers to purchase supplies and services at reduced cost, and correct material failures in grant compliance.

Source: S.486&HR1296 2009-S486 on Mar 4, 2009

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