Policy over Politics: Op-Ed from Congressman Kratovil

The discussion of health care reform has been one of the most partisan and heated public debates our country has seen in years. As a freshman lawmaker, it has certainly been an eye-opening experience. What has struck me the most, however, wasn’t the anger and unruliness that grabbed so many headlines during August, but rather the number of people I would encounter who believed that I should commit to voting one way or the other before even knowing what would be included or excluded from the legislation. This was perhaps the only aspect of the health care debate that was truly bipartisan; I heard from many Republicans who demanded that I oppose any health care reform package, regardless of its contents, while some Democrats have told me I had a duty to unquestioningly support the bill simply because it was a priority for my party’s leadership.

It’s unfortunate that this debate – on one of the most important challenges facing our nation today – has been reduced to such a black-or-white oversimplification. The need for reform is clear: Without reform, premiums and out-of-pocket expenses continue to rise rapidly for both middle class families and employers. But the pathway for achieving reform is far more complex. The goals of reform must be two-fold: expanding coverage and reducing long-term costs by significantly slowing the rate of health care inflation. This health care reform debate offers us a historic opportunity, but passing a bill that does not truly achieve these goals would waste this historic moment.

Since the introduction of H.R. 3200 in July, I have voiced a number of concerns about the legislation. Chief among these were the bill’s failure to curb long-term costs, it’s potential to increase the deficit, and its inadequate protections for small employers, which I fear may have an adverse impact on job creation. Following the August recess, I also led a group of my fellow freshman in sending a letter to House Leadership urging them to include additional reform proposals in this bill, such as allowing insurance companies to compete across state lines and promoting policies to reduce medical errors, lawsuits, and medical malpractice rates.

While the revised H.R. 3962 made progress toward these goals, I am not convinced that the final bill is a fiscally sustainable approach to reforming health care. The non-partisan Congressional Budget Office (CBO) indicates that the bill does not reduce long-term health care costs, and that it drastically increases federal health care spending in the near-term and long-term. Furthermore, while the bill is projected to decrease the deficit over the first 10 years, the CBO said this reduction is largely due to the removal of a $210 billion provision to correct the formula by which doctors are paid under Medicare. That “Doc Fix” language was moved into a companion bill, which Congress will consider later this month. Taken together, these bills will increase the deficit substantially in the years ahead.

To be successful, health care reform must both expand coverage and reduce long-term costs. Unfortunately, this health care reform legislation will significantly increase long-term spending, is unlikely to reduce the deficit, and even costs several hundred billion dollars more than the $900 billion target for which President Obama has advocated. As the debate moves to the Senate, both parties would be well advised to dial back the propaganda, put down the talking points, and focus instead on the substance of legislation before them. I’m hopeful that a better bill is still possible, one that more effectively bends the cost curve while going further to protect small businesses, increase competition, and decrease the deficit. If and when a bill does come back from the Senate, it will be policy, not politics, that will determine my support.