I want to thank Mr. Waxman for yielding to me at this time. I rise in opposition to H.R. 5, brought to the floor by my Republican colleagues. It does two things. It repeals IPAB as created in the Affordable Care Act, and it enacts a…
I want to thank Mr. Waxman for yielding to me at this time.
I rise in opposition to H.R. 5, brought to the floor by my Republican colleagues. It does two things. It repeals IPAB as created in the Affordable Care Act, and it enacts a medical malpractice reform long sought by my Republican friends as a way to protect pharmaceutical companies, medical device companies, and health care providers from any liability or full liability when they cause harm or death.
The medical malpractice part of this bill is so bad that the California Medical Association rejects the bill and says to vote ``no'' unless they had a decent medical malpractice reform part in it. And when the doctors will reject medical malpractice reform issues, you know it's got to be bad.
This extreme proposal is really not needed. I happen to agree with the part of the bill that repeals IPAB. We refused to include it in the House version of health reform. And Congress has always stepped in in its congressional manner to strengthen Medicare's finances when needed, and I see no need for us to relinquish that duty. We only have to look at the health reform law. It has extended solvency; it has slowed spending growth; it has lowered beneficiary costs; it has improved benefits, modernized the delivery system, created new fraud-fighting tools. We've done a good job. In fact, the CBO projects that IPAB won't even be triggered until the next 10 years, proving we've already done our job here in Congress of strengthening Medicare's finances.
Today's Republican support to repeal IPAB isn't a sincere interest in providing Medicare for all. They still want to give us an unfunded or underfunded voucher, slash and burn funding. And despite my opposition to IPAB, it's far less dangerous to Medicare than the Republican voucher plan put forth in the House Republican budget this week. IPAB doesn't undermine Medicare's guaranteed benefits and its ability to reduce Medicare spending. It has guardrails to prevent it. It doesn't permit costs to come from reducing Medicare and increasing costs on beneficiaries. It prohibits rationing, and it has annual limits on the cuts. The Republican voucher plan has none of these protections.
The Republicans are continuing their march begun by Newt Gingrich to have Medicare ``wither on the vine.'' I urge my colleagues to vote ``no'' on yet another political stunt, which really, thankfully, is not destined to become law at this time.
Sacramento, CA, Mar. 15, 2012.
RE. H.R. 5 Protecting Access to Healthcare Act.
CMA Position. Oppose Unless Amended.
Hon. John Boehner,
Speaker, House of Representatives,
Washington, DC
Hon. Nancy Pelosi,
Minority Leader, House of Representatives,
Washington, DC.
Dear Speaker Boehner and Leader Pelosi: The California
Medical Association has adopted a position of Oppose Unless
Amended on H.R. 5 the ``Protecting Access to Healthcare
Act.'' While we strongly support the repeal of the Medicare
Independent Payment Advisory Board (IPAB) and appreciate the
state preemption of medical liability laws that will preserve
California's successful MICRA law, we have serious concerns
with two additional medical liability provisions that will
expose California physicians to even greater liability
despite the bill's stated legislative intent to reduce health
care costs and insurance premiums.
Support Repeal of the Medicare Independent Payment Advisory Board
(IPAB)
CMA strongly opposes the Medicare Independent Payment
Advisory Board (IPAB) which thwarts Congress' stewardship of
the Medicare program and gives fifteen unaccountable
individuals the power to make significant cuts to Medicare.
We believe it is Congress' responsibility to ensure the
Medicare program meets the needs of their communities. The
IPAB is mandated to make draconian cuts if Medicare spending
exceeds unrealistic budget targets in 2014. While we
appreciate the necessity to control the growth in health care
spending, the IPAB mandate does not leave room to actually
reform the program, particularly because hospitals and other
providers are exempt from the cuts until 2020. It
disproportionately harms physicians who are already
challenged to provide care to Medicare patients with limited
resources. As you know, physicians are facing large Medicare
SGR payment cuts over the next decade as well.
These measures are already forcing more California
physicians to limit the number of Medicare patients they can
accept. If additional cuts take effect, physicians will be
forced to leave the program--harming timely access to quality
care for California's seniors and military families.
The IPAB was not part of the House Health Care Reform bill
because most of the leaders in the California delegation
opposed it. Please continue to stand against an IPAB that
takes important decisions out of your hands.
Medical Liability: Oppose Unless Amended
For the last several decades, California's medical
liability law--MICRA--has successfully protected patients and
physicians. It has kept medical liability insurance
affordable and thus, protected access to care for California
patients while reducing health care costs. CMA appreciates
the provisions in H.R. 5 that allow state preemption and the
preservation of California's important MICRA law. While we
agree with the intent of H.R. 5--to provide MICRA-like
protections for physicians in other states--we have serious
concerns with two provisions that will increase physician
liability costs not only in California but across the
country. We believe these provisions are inconsistent with
the stated intent of the legislation to reduce insurance
premiums and overall health care costs.
1. Fair Share Rule
California has a joint and several liability law that
governs economic damages and allows claimants to recover the
full amount of economic damages from any defendant. The Fair
Share Rule in H.R. 5 will preempt California's law and put
full recovery by injured patients at risk. As written, the
Fair Share Rule will dramatically increase the potential for
physicians to face enforcement proceedings against their
personal assets. This will force physicians to purchase
increased medical professional liability insurance coverage,
which will significantly increase liability premiums in
California for physicians.
Therefore, CMA requests the following amendment that would
allow states with joint and several liability laws to
maintain those important laws.
Page 23, line 4 Add: (b) Protection of States' Rights and
Other Laws.
(1) Any issue that is not governed by any provision of law
established by or under this title (including State standards
of negligence) shall be governed by otherwise applicable
State or Federal law.
(2) This title shall not preempt or supersede any State or
Federal law that imposes greater procedural or substantive
protections for health care providers and health care
organizations from liability, loss, or damages than those
provide by this title or create a cause of action or any
State law that governs the allocation or recovery of damages
among joint tort feasors.
2. No Punitive Damages for Medical Products and Devices
that Comply with FDA Standards
The CMA has serious concerns with granting complete
immunity from punitive damages to medical product and device
manufacturers, distributors and suppliers. We believe this
will force plaintiffs to look only to physicians and other
providers to seek relief and will significantly increase
physician exposure and liability costs. CMA believes that the
United States Supreme Court decision on this issue in Levine
v Wyeth was correct and should remain the law because the
alleged benefits of providing immunity to pharmaceuticals
companies through preemption are far outweighed by the harm
to patient care and physicians.
Therefore. CMA urges that subdivision (c) of Section 106 of
Title I of the Protecting Access to Healthcare Act be
stricken in its entirety.
At the very least, if Title I, Section 106(c) remains in
the bill, the CMA requests the following amendments to
protect physicians from punitive damages liability that would
otherwise be that of the manufacturers and suppliers of
medical products and devices.
Page 10, line 14: (c) No punitive damages for products that
comply with FDA standards
(1) In General (A) No punitive damages may be awarded
against the manufacturer, distributor, or prescriber of a
medical product, or a supplier of any component or raw
material of such medical products, based on a claim that such
product caused the claimant's harm where--
Page 16. Lines 24 25: ``. . . or the manufacturer,
distributor supplier, marketer, promoter, [or] seller, or
prescriber of a medical product, . . .''
Page 17, Lines 15 16: ``. . . or the manufacturer,
distributor supplier, marketer, promoter, [or] seller, or
prescriber of a medical product, . . .''
Page 17, Line 25: ``44. . . or the manufacturer,
distributor supplier, marketer, promoter, [or] seller, or
prescriber of a medical product, . . .''
The CMA urges you to accept these important amendments. We
appreciate the efforts to repeal the IPAB, to protect
California's MICRA law with a state preemption, and to bring
liability relief and lower health care costs to the rest of
the nation.
Thank you for this important work.
Sincerely,
James T. Hay, MD,
President.