THE PATIENT PROTECTION AND AFFORDABLE CARE ACT

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. The law is popularly referred to as the Affordable Care Act (ACA). The ACA has been termed “the most important law since Medicare” (Harkin, 2011). The law provides new protections for health care consumers and strengthens existing protections. The law addresses the Patient’s Bill of Rights which has been needed for many years. The ACA is designed to overhaul the crumbling health care system in this country and provide affordable care, reasonable insurance premiums, prevent chronic illness, increase accessibility to health care, and improve public health programs. The ACA proposes to reward quality of health care rather than quantity through changing the ways we pay for services. The Congressional Budget Office (CBO) projects that the first decade following the passage of the law the deficit will decrease by $210 billion and more than one trillion dollars by the end of the second decade.
Senator John McCain (R- Arizona), a former presidential candidate in 2008, did not support the ACA (New York Times, 2009). Senator McCain is a very vocal advocate of reforming health care but objected to many aspects of the ACA that he felt would not accomplish the goal of improving health care. Senator McCain does not support universal health care, mandated insurance coverage, or government-funded public health care. Instead, he endorses tax credits for individuals and families who do not have access to health insurance from an employer that will allow them to purchase the coverage they need. He also thinks that people should be allowed to purchase insurance nationwide and not be limited to their state of residence, thereby encouraging competition and a free-market economy. Senator McCain is a staunch supporter of prosecuting people who commit Medicare fraud and waste (McCain, 2011). Senator McCain released a press statement on March 29, 2011 announcing his co-sponsorship of a bill entitled The Health Care Bureaucrats Elimination Act. This bill seeks to repeal a measure of the ACA called the Independent Payment Advisory Board (IPAB). The IPAB allows unelected, unaccountable officials the power to make decisions that affect senior citizen's Medicare. Senator McCain said, “The IPAB is another one of the many flawed provisions in the health reform law that empowers government rather than patients and their doctors and it must be repealed along with the entire law,” said Senator John McCain. “The IPAB will steer our health care toward a European-style system where government bureaucrats’ decisions are put before medical care decisions that should only be between patients and their doctors. “
I stand with Senator McCain in his belief that the ACA and many of its' provisions such as the IPAB should be repealed. The ACA is well-intentioned and addresses many issues that effect our health care system, but I believe it was not thoroughly examined before the passage of the bill into law. Certain aspects of the current health care system have yet been addressed such as mandates for purchase of health insurance. Many families are struggling to put food on the table and gas in their cars in today's economy. Millions are unemployed, including nurses. Forcing citizens to buy insurance they cannot afford is bordering on the extreme. Fining those who do not or cannot afford to purchase insurance, while not requiring illegal immigrants to do the same is discrimination. The law does not address the legal right to health care either (ANA, 2010). Until the government puts the reins on insurance companies that make huge profits at the expense of Americans, I can not support the legislation. While the enactment of the ACA is a positive step forward as opposed to nothing, the state of our economy must be a major concern. The current political agenda to repeal the ACA is costing our country many months of valuable time that could be used to focus on other issues such as improving public health.

WHAT HAPPENS TO BILLS AFTER THEY REACH THE COMMITTEE?

The process of enacting legislation is tedious and time-consuming. The first thing which must happen is the writing, or drafting, of the bill. The bill will have a sponsor, someone who introduces the bill to the Congress, and sometimes a co-sponsor. The sponsor must be a member of Congress, of either the House of Representatives or the Senate. The text of the bill must cover every conceivable aspect of the bill in order to avoid being deadlocked in committee for months or years. The bill will have an official name as well as a short name and a popular name. When the bill has been formally introduced, it will also be assigned a number and officially printed in the Congressional Record.

 All bills, or resolutions, must then be referred to a House or Senate Committee. After the bill is considered by a committee, or maybe a sub-committee depending on the type of bill, it will either be approved and will move forward to the full House or Senate for a vote or it will be allowed to die. The majority of bills die by never being passed on by a committee to the respective branch of Congress. Bills that do survive the scrutiny and debate of the committee or sub-committee will be sent to the Congress to be placed on a voting schedule which is chronologically ordered. Then the bill will be discussed and debated by both chambers of Congress and then, when the bill is decided on favorably, it is sent to the President who has the power to veto, or not sign the bill into law.

COMMITTEE VACANCIES

At the present moment, there are no identifiable vacancies on the HELP committee. Several staff members have been appointed, most notably, Jenelle Krishnamoorthy will serve as Health Policy Director for the Committee. She served as Senator Harkin’s health policy director until this appointment and has extensive experience in prevention and wellness policy (Harkin, 2009). The last vacancy noted in the literature was that of Senator Edward Kennedy (D- Massachusetts) who passed away in the autumn of 2009.

COMMITTEE MEMBERS, PARTY AFFILIATIONS, HOME STATE

 List of Committee Members, Party Affiliation, Rank, and State

Senator Tom Harkin (D- Iowa)

Senator Barbara Mikulski (D- Maryland)

Senator Jeff Bingaman (D- New Mexico)

Senator Patty Murray (D- Washington)

Senator Bernard Sanders (D- Vermont)

Senator Robert P. Casey, Jr. (D- Pennsylvania)

Senator Kay R. Hogan (D- North Carolina)

Senator Jeff Merkley (D- Oregon)

Senator Al Franken (D- Minnesota)

Senator Michael F. Bennet (D- Colorado)

Senator Sheldon Whitehouse (D- Rhode Island)

Senator Richard Blumenthal (D- Connecticut)

Senator Michael B. Enzi (R- Wyoming)

Senator Lamar Alexander (R- Tennessee)

Senator Richard Burr (R- North Carolina)

Senator Johnny Isakson (R- Georgia)

Senator Rand Paul (R- Kentucky)

Senator Orrin G. Hatch (R- Utah)

Senator John McCain (R- Arizona)

Senator Pat Roberts (R- Kansas)

Senator Lisa Murkowski (R- Alaska)

Senator Mark Kirk (R- Illinois)

SUBCOMITTEES OF THE SENATE HELP COMMITTEE

Subcommittees:

Subcommittee on Children and Families / Chair- Patty Murray (D-WA)

Subcommittee on Employment and Workplace Safety / Chair -Barbara Mikulsky (D-MD)

Subcommittee on Retirement and Aging / Chair- Bernie Sanders (I-VT)

HISTORY AND COMPOSITION OF THE SENATE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS

The United States Senate Committee on Health, Education, Labor, and Pensions (HELP) was officially formed in 1999 by the U.S. Senate. It has a long history of service, under different names, which initially began after the end of the Civil War in 1869 and was focused solely on education. The committee was renamed the Committee on Education and Labor in 1884 and continued to be known by that name until the middle of the 1990s when it was assigned the additional oversight of health and pensions issues. A committee is defined by the Senate as a subsidiary organization of the Senate established for the purpose of considering legislation, conducting hearings and investigations, or carrying out other assignments as instructed by the parent chamber (U.S. Senate, 2011). The HELP committee is designated as a standing committee which means that it is a permanent entity as compared to a select, or special, committee which is organized for a temporary length of time. There are 16 standing committees currently empowered by the senate. The HELP committee is composed of 22 senators, currently 12 Democrats and 10 republicans, although the party ratio may change with mid-term elections and new nominees (U.S. Senate Committee on Health, Education, Labor, and Pensions, 2011). “Rule 25, of the Standing Rules of the Senate, States the Committee's Jurisdiction to be the following: Committee on Health, Education, Labor and Pensions, to which committee shall be referred all proposed legislation, messages, petitions, memorials, and other matters relating to health, education, labor, and pensions” (U.S. Senate, 2011). It also has a reputation for being one of the most contentious standing committees (Enzi, 2011).