Thank you for contacting me regarding health care reform.  I welcome the opportunity to update you about what is contained in the Senate health care bill and clear up some wide-spread misinformation. 

According to independent analyses of the bill, including the non-partisan Congressional Budget Office, the recently-passed Senate health care reform legislation will reduce the deficit, protect Medicare, and stabilize healthcare costs for over 90% of Americans.  This reform is necessary because the soaring cost of medical care is crippling our economy, bankrupting our nation's families, and becoming an unsustainable financial burden for American employers.  In the last eight years, health care premiums have grown four times faster than wages, and insurance companies have made millions of dollars in profits while routinely denying coverage. 

On November 18, 2009, Senate Majority Leader Reid introduced The Patient Protection and Affordable Care Act.  On December 24, 2009, after five weeks of debate, I voted for the Patient Protection and Affordable Care Act, embodied in H.R. 3590, which passed by a vote of 60 to 39.  The Senate bill (H.R. 3590) and the previously passed House bill (H.R. 3962) must now go through a reconciliation process.

I want you to know that I have read The Patient Protection and Affordable Care Act thoroughly and plan to read all of the provisions in a final, reconciled health reform bill before casting my vote on final passage.  If you would also like to read the full text of the legislation, you can find the complete text of the Patient Protection and Affordable Care Act at http://democrats.senate.gov/.  While there has been an unprecedented amount of transparency during this debate, including hundreds of televised hours of committee work and debate, I disagree with the decision not to have a conference committee to resolve the differences between the House and Senate legislation. I believe that those negotiations should be open to the public.

I supported the Patient Protection and Affordable Care Act because it would expand health care coverage to more than 94 percent of Americans, curb skyrocketing healthcare costs, and ensure patient choice of care, all while significantly reducing the government deficit.  The bill would also stop insurance company abuses that prevent people from getting the health care they need, such as denying coverage based on pre-existing conditions.  In addition to consumer protections, the bill establishes state-based health insurance exchanges where individuals and small businesses can compare and purchase insurance plans online at more competitive prices.  

I have heard from some Missourians who have concerns regarding certain provisions in the Senate bill.  The Senate bill not only upholds current federal law which requires that no federal funds can be used to pay for an abortion except in the case of rape, incest, or danger to the life of the mother, but further requires insurance plans to keep federal funds completely separate from private premium dollars, and that anyone purchasing abortion coverage do so with a separate private payment.  I will continue to monitor the crafting of this language in the final bill to both ensure that no federal dollars are used to pay for any abortion, while also upholding women's access to critical medical care.

The bill also expressly exempts illegal immigrants from any of the health care programs and the ability to participate in the health insurance exchange.  Some non-citizens who lawfully reside in the United States and pay taxes on their earnings may be eligible to purchase health insurance in the exchange, provided they meet prescribed eligibility requirements. 

In addition, there are provisions that will strengthen seniors' Medicare benefits and significantly reduce fraud, abuse, and inefficiencies in the program, which could extend the life of the Medicare Trust Fund beyond 2022.  Let me emphasize that none of these changes would reduce the guaranteed benefits that seniors are entitled to under the Medicare program.

Finally, the bill requires that Members of Congress and their staffs buy their insurance on the same exchange that will be available to those who don't get insurance from their employer.  In other words, Members of Congress will be required to be part of the new insurance exchange that we are creating.

I am opposed to any special deals in this bill for particular states.  This earmarking process is an ingrained culture in Washington, where every year members go into back rooms and negotiate special deals for their states.  This is a problem on both sides of the aisle and I find it hypocritical that some of the same Senators who are criticizing the earmarks in the health care bill were in line for special deals for their states in the annual spending bills passed just a few weeks ago.  I'm proud that I am one of the few Senators of either party that refuses to participate in this flawed earmarking process.  I'm hopeful that some of these special earmarks will be removed from the bill before our final vote.

This bill is not perfect, but in the end, I supported this legislation because it will reduce the federal deficit and contain health care costs.  With one out of every six dollars in our economy going toward health care in the United States, it is imperative that our government work to rein in the soaring cost of health care.  The bill will not only reduce the cost of insurance for families but also decrease the national deficit in the long term.  In fact, the Congressional Budget Office estimates that the bill would reduce the federal deficit by $130 billion over the next decade, followed by another $650 billion cut in the deficit in its second decade.

Health care reform holds the promise of lowering government budget deficits, curbing unsustainable health care costs, and expanding access to health coverage.  As the health care debate continues, I will continue to work with my colleagues on both sides of the aisle to find meaningful solutions to these difficult and complex problems.