I appreciate your past support and for that reason would like to share with you the thoughts behind my vote on the House health care reform bill. This was one of the most difficult decisions I have had to make since being in Congress.  The decision was both gut-wrenching and conscience-driven.

 

Knowing that health care reform is critical, I am hopeful that we will reach consensus on a bill that is fiscally responsible and that will move our country forward towards affordable, accessible, sustainable health care.  This was only one vote in an ongoing process, and I look forward to a fiscally sound bill that I can proudly support and that the President will sign into law.

 

The President has identified the unsustainable level of rising health care costs as an impending economic crisis for our nation. The fact that the House bill does not rein in costs to address this crisis is a core issue for me. If we don’t get costs under control, all other admirable and necessary reforms we are working for might be in vain.

 

In 2007 the U.S. spent 16.2% of GDP on health costs, nearly twice the average of other developed nations, and costs are projected to rise to 25% of GDP in 2025. Small businesses have seen their premiums rise 129% over the last nine years.  We are on an unsustainable path that is hurting job growth, overwhelming the federal budget, and creating debt for future generations.

 

While the House health care reform bill has many positive elements, I believe that it does not do enough to slow the growth of health care costs or to rein in spending on care. That is why, after careful consideration and with great difficulty, I decided that I could not in good conscience support this bill.

 

According to the Congressional Budget Office, the House health care bill will actually increase federal health care spending over the long term, while proposals being considered by the Senate would have a net decrease.  Furthermore, the total cost of the House bill is nearly $1.2 trillion, significantly more than the President’s stated goal.  Because it is our obligation to be fiscally responsible, I cannot support a plan that spends so much, but doesn’t significantly slow the growth in health care costs.

 

As I said, this vote was an extremely difficult decision for me. I have long been a champion for efforts to improve health care, including the expansion of health coverage for children of working families, protecting seniors from an increase in Medicare Part B premiums, and working to secure the funding for the new Orlando VA Medical Center to improve care for Central Florida’s veterans.

 

While I believe fiscally responsible health care reform is attainable, we must improve upon the House bill.  We need reform that truly rewards quality outcomes and moves us away from the fee-for-service system that rewards quantity alone.  We need reform that gives real incentives to maintain healthy lifestyles.  We need reform that makes a serious effort to control waste, fraud, and abuse.  And we need reform that leads to health insurance plans that are more cost-effective.
 
Though I voted against the House plan, the bill does have promising aspects.  It begins to hold insurance companies accountable by preventing them from denying coverage based on preexisting conditions, by eliminating life-time caps on coverage, and by taking steps to lower premiums. The bill also establishes health insurance exchanges that will help provide additional options for many individuals and small businesses. 

 

Hopefully, health care reform legislation will include these positive changes for everyone, but, in the long run, these reforms will not be attainable or sustainable if we don’t take significant steps to rein in rising costs.
 
I truly appreciate your views on this important issue and I hope that you will take the time to share your thoughts with me as the process moves forward.
 
Sincerely, 


SUZANNE M KOSMAS
Member of Congress