Congressman Rick Boucher’s statement on not voting for House health care bill

9th District Congressman Rick Boucher, a Democrat, voted against the House of Representatvies health care reform plan over the weekend.  The plan was championed by the House’s Democratic leadership, and Congressman Boucher was one of two Virginia Democrats who voted against the bill.

Boucher held a news conference in Bristol Monday morning to talk about why he voted against the bill.  Here is a statement from his office about his “no” vote:

Health care reform is needed.

More than 36 million American citizens do not have health insurance, and millions more are underinsured and cannot afford to pay for the medical care they need.  As those without insurance are treated in emergency rooms, the high cost of that care is borne by those who have insurance, driving up health insurance costs for everyone. The typical family pays an extra $1,100 each year in health insurance premiums as a cost of treating the uninsured.  Health insurance premiums are increasing 3.5 times as fast as the rate of increase in family incomes.

This status quo is unsustainable, and finding a way for everyone to afford health insurance is necessary to benefit both the uninsured and those who have insurance. I hope that following a House-Senate conference on the legislation, we will be able to send to the White House the needed reform measure.

But reform legislation must ensure that Southwest Virginia residents continue to have access to the high quality health care services now delivered locally.

I opposed the health care reform legislation recently debated by the U.S. House of Representatives for several reasons including the continued existence of disparities in Medicare reimbursements between urban and rural areas under the House bill. Rural areas have traditionally received less under Medicare than urban areas, and while the bill makes some improvements in this regard, I would like to see more done to increase the payments to rural health care providers.  Higher Medicare reimbursements would enable the attraction of more doctors to serve our medically underserved region.

I also opposed the bill because of my concern that a government operated health insurance plan could place at risk the survival of our region’s hospitals. Most of our hospitals are operated on a non-profit basis for the benefit of the community. While most of their receipts are from Medicare and Medicaid payments, they lose money on each Medicare or Medicaid patient they treat. These programs reimburse hospitals at rates below the actual cost of providing patient care.

The financial viability of our hospitals comes from the payments they receive from privately insured patients. A government operated health insurance plan competing with private insurance will attract patients who are privately insured today, with the result that the hospitals would treat less privately insured patients and lose the critical revenues that are essential to their survival.

A government operated plan would reimburse health care providers at rates approximating Medicare rates, and hospitals would lose money on each of their patients insured under the government plan. 
I am concerned that for these reasons the creation of a government operated insurance plan as envisioned in the House bill could result in the closure of hospitals in our region. Families depend on our community hospitals for health care services, and financially healthy hospitals are essential to the health of Southwest Virginians.

Many of our hospitals are financially stressed in normal times, and two hospitals in the district I represent closed for periods of time in recent years for financial reasons. The government owned insurance plan as outlined in the House bill could push many more over the edge. I cannot support legislation that could lead to that result.

I also believe that bipartisan participation is needed on a measure of this scope which affects every American. The best ideas of Democrats and Republicans alike should be drawn upon to fashion the final legislation. That did not happen as the House bill was constructed.

In July, I opposed the health care reform measure when it was considered by the House Energy and Commerce Committee and expressed my concerns at that time. The bill passed by the House did not address those concerns.

Passage of the House bill is but a first step in a long legislative process to final enactment of a reform. I look forward to future steps in that process offering an opportunity for my concerns to be resolved.
Reform is needed, and I hope to support the final passage of legislation that emerges from a House-Senate conference that creates affordable access to health care for all Americans and does so in a way that enables the continued delivery of the excellent care now offered in our region.