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Begich Focuses on Fixes to Health Care Bill

Medicare, Veterans Care, Rural Hospitals need more attention

With the U.S. Senate expected to begin vigorous debate on health care legislation after the Thanksgiving holiday, Sen. Mark Begich is focused on several proposals to ensure Alaskans can get quality, affordable health care.

One of the key amendments Begich is supporting is outlined in S. 1776 which would provide a permanent fix for Medicare payments, by repealing the flawed sustainable growth rate (SGR) formula that determines physician payments for Medicare and TRICARE. Several Democrats including Begich are co-sponsoring a bill, S.1776, which contains this change.

"This reimbursement fix is necessary to make sure veterans and seniors can find a doctor. We know the reimbursement uncertainty and cuts are what lead to doctors in Alaska saying no to Medicare patients," Begich said. "Because of underpayments, doctors are not taking new Medicare patients and some are opting out of the program altogether. We owe it to our veterans and seniors to do better."

The current Medicare formula cuts doctors' payments in the future if today's physician spending exceeds a target based on the growth of the economy.  This has led to scheduled payment cuts over each of the last eight years - and each time the Senate has voted at the last minute for a temporary fix.  The planned cuts are cumulative over time, producing massive payment cuts such as next year's scheduled 21 percent reduction, and a cumulative 40 percent cut anticipated over the next decade.  S. 1776 lays the foundation for real payment reform and allows Congress to truly redesign Medicare physician payments to align them with quality and performance.

Begich is also looking at how to improve the TRICARE system for veterans. Currently, many civilian specialists in Alaska do not participate in the TRICARE network which results in certain health care needs of military members and their families in Alaska not being met. As part of the reform bill Begich would like to add language that sets up a mechanism in the Department of Defense to examine the gaps in the TRICARE network in Alaska.

Begich said he will also support language in the health care bill to allow consumers to purchase health insurance across state lines, as well as reauthorization of the Indian Health Care Act and support for hospitals in smaller communities that don't currently qualify for major federal support.

The Rural Community Hospital Demonstration Program funds up to 15 demonstration hospitals in a handful of small states, including three in Alaska (Soldotna, Juneau, Sitka), but the program is set to expire. Begich is co-sponsoring an amendment with Sen. Ben Nelson to extend the demonstration project for five years, recalculate the reimbursement formula, and allow 30 hospitals to participate from any rural location in any state.

Reauthorization of the Indian Health Care Act is 10 years overdue and is critical for 120,000 Alaska Natives. Reauthorization will modernize IHS and allow for American Indians and Alaska Natives to finally have access to care that other groups take for granted. This includes treatment for substance abuse, increased coverage for mental health care and long-term care facilities coverage.

Recognizing the key role prevention and wellness play in reducing health care costs, Begich plans to introduce an amendment to encourage parents to enroll their children in physical activities by offering a $500 a year tax deduction. This amendment would be offset through ending a tax emption for drug company advertising.

"America's families deserve a break well before the drug companies who make millions a year off of advertising," Begich said. "If we're giving a tax   deduction to anyone, it should go to parents trying to keep their children active and healthy."

The Patient Protection and Affordable Care Act now on the Senate floor has many key provisions designed to bring health care costs down and make health insurance more affordable and accessible including:

·         Ends discrimination for pre-existing conditions and you can't get dropped because you are sick. No more higher costs due to gender;
·         No lifetime caps allowed on individual insurance coverage;
·         Seniors benefit from strengthened Medicare as Medicare overpayments to insurance companies will be cut and new investments will fight waste, fraud and abuse. Prescription drug discounts on brand-name drugs and biologics;
·         Health insurance exchange will expand choice, increase completion and lower prices;
·         Dependents will continue to be eligible for family coverage until age 26;
·         Employers with 50 or fewer workers are exempt from employer responsibility provisions. Businesses with fewer than 25 employees who want to provide health insurance get tax credits.

·         Sliding scale tax credits will limit the amount people have to spend on health care premiums. Credits available for people earning up to 400 percent of the federal poverty level, which in Alaska is $110,000 for a family of four.
·         Legislation focuses on promoting good health and preventing chronic disease by funding preventive care;
·         The non-partisan Congressional Budget Office estimates the bill will cut the budget deficit by $127 billion over ten years.

For more information, go to www.begich.senate.gov.

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