FAIRBANKS — On Christmas Eve, the Senate passed a health care bill by the narrowest of majority votes. I voted against the measure as did all of my Republican colleagues. At a price tag of $2.5 trillion, I could not support a partisan bill that would increase the role of the federal government in health care, worsen conditions for Medicare patients, raise taxes and insurance premiums and do nothing to reduce the cost of health care.
Hundreds of Alaskans contacted my offices in the days leading up to the vote, upset that the Senate was about to pass the bill. Constituents were confused by what was in the legislation and concerned about how the measure would affect them and their families. They had every reason to be worried.
Health insurance premiums would increase under the bill, according to the nonpartisan government scorekeeper, the Congressional Budget Office. CBO said that premiums for individuals without employer-sponsored coverage would increase between 10 and 13 percent, which in Alaska could affect up to 28,000 people. The University of Alaska at Anchorage’s Institute of Social and Economic Research, which reviewed the legislation at my request, concluded that premiums would rise roughly 12 percent, or a net increase of $1,160 for some individuals and $2,950 for some families in Alaska. Although subsidies would be available to help offset the cost, it is unclear from the bill who in Alaska would be eligible to receive them.
At 2,733 pages, no one can truly say they understand everything that is in this bill, but there are a few things that we do know. The Medicare program, which serves senior citizens and the disabled, will be slashed by nearly a half trillion dollars. Plundering Medicare to expand health care coverage is not reform.
ISER also said that Alaska Medicare seniors and the disabled would face even more severe restrictions in gaining access to primary care doctors and nurses than they do currently.
According to ISER, expanding Medicaid, the health care program for low income individuals, would create a surge of demand in Alaska that could send our Medicare beneficiaries to the back of the line due to Medicare’s low reimbursement rates compared to Medicaid’s rates. Unfortunately, the Democrats’ bill does nothing to fix the Medicare reimbursement rate inequity for Alaska.
There is also the $518.5 billion in tax increases under the bill that include a payroll tax hike of 0.9 percent for individuals earning $200,000 and couples earning $250,000, along with a mandate requiring all Americans to purchase health insurance or pay either $750 or 2 percent of taxable income, whichever is greater.
The bill also would impose a 40 percent excise tax on high value insurance plans. Because Alaska is a high cost state, ISER predicts that roughly 50 percent of health plans in the state would be subject to the tax by 2016 compared to only 19 percent on average in the Lower 48. Recently, I received a report from the Municipality of Anchorage Police and Fire Retiree Medical Trust saying that the insurance plans provided to its members would be subject to this 40 percent excise tax.
Throughout the debate, both sides stressed that any reform bill should first and foremost rein in the ever-escalating cost of health care. But this bill doesn’t bend down the health care cost curve as President Obama promised it would, according to the CBO analysis. While most of the tax and premium increases and Medicare cuts would begin upon enactment, many of the benefits would not kick in for three or four years. That’s like making mortgage payments on a new home but having to wait four years to move in.
Although the Senate passed the health care bill with no Republican support, that was not the final vote. There are significant differences between the House and Senate health care bills, and those differences will have to be reconciled before a vote for final passage occurs.
So the debate is not over. Democrats have not been listening, despite poll after poll that shows a majority of Americans oppose the bill. Perhaps that will change with lawmakers home for the holidays. Constituents will get an opportunity to express their views about the tax and premium hikes, Medicare cuts and sweetheart deals in this bill.
U.S. Sen. Lisa Murkowski is a Republican from Alaska. She has been a senator since 2002.