Q: Why do we need health care reform?
A:  First, I believe every American should have comprehensive health care. A report in The Institute of Medicine said tens of thousands of people die every year for a lack of health care.  We can and must do better.  It is a moral imperative.  

Second, it is a fiscal imperative. We currently spend 16% of our gross domestic product on health care, and programs like Medicare, Medicaid and Social Security are unsustainable in their current form.  If we do nothing, by 2012, America's credit will be seriously damaged.

Q: What is the current status with the health care bill?
A:  Both the Senate and the House have passed different versions of a health care bill.

On November 7th, the House passed HR 3962,The Affordable Health Care for America Act.  Click here to see the full text. 

On December 24th, the Senate passed The Patient Protection and Affordable Care Act.  Click here to see the full text.

In the coming weeks, the House and Senate will merge both bills together to create one final bill.   After the final bill passes through both chambers, it will be sent to the President. 

Q: I feel sorry for those who don't have health insurance, but why should I care if I like my coverage?
A: You are already paying for people who don't have coverage through higher premiums and added-on costs. Currently, if a person without insurance goes to the doctor, they get treated, but, by the time uninsured people receive treatment, the costs are much higher than they would have been. Since we are already paying their bills on the back end, why don't we try to prevent their illness on the front end and save money?

Likewise, you may be satisfied with your current plan. However, more and more employers say they are less competitive due to rising health care costs.  That means less jobs with fewer health benefits. 

Also, if you have been covered by your employer and you lose your job, what will happen to your health care?  For a limited time, you may pay for COBRA, but you may have a hard time finding adequate, affordable coverage once your COBRA expires.  Or you may know someone with a pre-existing health condition such as diabetes, heart disease or cancer who is unable to get any coverage.

Q: What does this mean for small businesses?
A: Small business owners could greatly benefit from health care reform if it is done right, as insurance costs weigh heaviest on this group. Small businesses that provide health care to their employees are forced to pay higher premiums because they do not have the benefit of spreading out their insurance risk over a larger pool of people. For example, health care reform could allow their employees to join larger risk pools and have the same benefits that larger companies have. Small businesses create jobs, and stimulate economic growth and we need to encourage their success. Removing the burden of health care is a big step in the right direction for small businesses.

Q:  Will reform change my Medicare benefits?
A: No.  In fact, one of the reasons we need health reform is to make sure that the Medicare program can continue to provide benefits.  Medicare is currently $34 trillion in the hole; without reform, benefits will be cut in half in the coming decades.  Health reform offers ways to slow or eliminate wasteful Medicare spending like subsidies for insurance companies.  In addition, requiring the pharmaceutical industry to help pay for prescription drugs by closing the "donut hole" could make Medicare less expensive for many seniors. 

Q: Do you support a public option?
A: Yes, I support a public option.  We need to keep insurance companies honest, and their recent efforts to block reform only reinforce the importance of a public plan.  There are many different types of public options, and I think the public option on a level playing field designed by Senator Chuck Schumer of New York is the best approach.

Q: How would a public option affect my current health care?
A:  If the public option is on a level-playing field, it should help bring your premiums down. 

I think we should also be talking about a robust exchange at the same time we're talking about a robust public option.  As the House bills are currently written, only 10% of people would have access to choose the public option. 

Q: What is an "exchange"?
A: An exchange is a marketplace that would allow you to shop your health coverage based on what's best for you and your family.  Federal employees have "shopped" for their health insurance plans for decades.  Sen. Ron Wyden has a proposal that gives everyone this opportunity.  Click here to visit Sen. Wyden's website for more information. 

Q: Are there any other health care bills in Congress that meet all of the guidelines?
A: Yes, there is one bill that meets all of the guidelines, but it is not gaining momentum.  It's HR 1321, The Healthy Americans Act, and I've been a co-sponsor for the last 2 years.  It has been analyzed by the Congressional Budget Office and meets all three of the President's goals.  It is deficit neutral for the next ten years, lowers costs of health care over the long-term, and covers every American.  It's also bipartisan, unlike any other bill in Congress.

With the HAA, every American is eligible for the same type of benefits that Congress and federal employees have enjoyed for 40 years.  The HAA does not affect seniors or our military personnel.  They will continue to be covered by Medicare and TRICARE. 

Q: Why isn't everyone on board with HAA?
A: It's the bill that some say is too conservative and others say is too much reform. That's why it appeals to both Democrats and Republicans. It changes the role of employers in health care.  It also requires everyone to have health insurance - much like the current requirement for everyone to have automobile insurance. 

Q: What about a single-payer system? 
A: There are some people who really just want a single-payer system. That's fine. President Obama has said if we were starting with a clean slate, he'd be for single-payer. But he's not starting with a clean slate. So basically there's no serious single-payer legislation in the Congress.  Their supporters are very committed, but none of the bills moving through any of the committees resemble a single-payer plan.

Q: I've heard that the government will fund abortions.  Is this true?
A: No.  Current law, through a provision known as the Hyde amendment, states that no federal funds can be used to pay for abortions. I do not think Congress will change current law.

Q: How is this different from when we tried to pass reform in ‘93/94?
A: I believe that the majority of Americans are in support of sensible health reform, and the battle is over what type of change will be best, not whether we actually need it.  That wasn't the case in ‘93.  People weren't convinced that any reform was necessary, and public support was needed to get the bill passed. We have much more support now, and we won't allow health care industry lobbyists to stand in the way of strengthening America's future.

Q: I hear you don't support President Obama's plan for reform.
A. I do support the President and his principles for health reform.  But Congress has to do its job and provide President Obama with good bills that meet his guidelines.  He has laid out three main principles of health reform; it must cover everyone, it must be deficit neutral, and it must lower future health care costs.  These are all principles that I agree with. We cannot have a successful health care system without addressing these three issues. 

Q: What is your role as a Blue Dog Democrat?
A: The Blue Dog Coalition is a group of 52 fiscally conservative Democrats in the House.  I have studied health care for decades and teach health policy at Vanderbilt.  Therefore, I am one of the more knowledgeable Blue Dogs on health care, despite not serving on a committee with health care jurisdiction. Blue Dogs believe that President Obama is correct to demand that health reform legislation meet his budget guidelines, both in the short and long-run.  We are trying to work with the President and the Congress to improve the legislation so that it meets his standards.

Q: What do you say to people who are calling you an obstructionist?
A: I don't have the ability or the interest in stopping health care reform. I am 100% in support of health care reform this year. I have been fighting for a long time to get this done. I was one of the earliest supporters of then-candidate Obama, and I have stood behind President Obama's health care principles since the very beginning.  Like the President, I want to make sure we are being fiscally responsible with health care reform.

Q: What happens if we do nothing?
A: Tens of thousands could lose health care due to rising costs and accessibility.  And thousands more could die due to a lack of care. 

In addition, the U.S. could lose its AAA credit rating.  That would mean higher interest rates for everyone and inflation. That is not an option.  Health care costs are rising at a rate of 2.5 percent faster than inflation. At that rate, what we spend on health care will soon double.  Premiums will double; co-pays will double. 

We must act, and we must act now.