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Breaking Down the Health Care Bill with Congresswoman Tammy Baldwin

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Last week, when HuffPost Eyes & Ears citizen reporter Charlotte Robinson secured an interview with her Congresswoman, we sent out a call for questions about the controversial House health care bill. Readers sent in questions about the effect the bill could have on their lives. Our Eyes & Ears team selected several of the best questions and forwarded them to Robinson, who asked for Congresswoman Tammy Baldwin's (D-WI) responses.

What does your Congressperson think about the America's Affordable Health Care Choices Act (H.R. 3200), which could introduce a government-run health insurance option for all Americans? If you'd like to get involved with our citizen-powered health care coverage by interviewing your Congressperson, shoot us an email at mattandadam@huffingtonpost.com. And click here for more information about joining the Eyes & Ears Health Care Investigative Unit, our team of citizen journalists who have been keeping an eye on the health care reform process.

In this exclusive interview, Congresswoman Tammy Baldwin (D-WI), who sits on the Energy and Commerce Committee and its Health Subcommittee, discusses the landmark health care reform bill moving through the house. The virtual deluge of often-confusing and overwhelming information makes a tricky issue even more difficult to talk about. Congresswoman Baldwin explains this bill in comprehensive language we can all understand.

Charlotte Robinson: Do you support a single-payer plan?

Congresswoman Tammy Baldwin: I have been a single-payer advocate for as long as I've had an opinion on health care, which goes back to my childhood -- because that's really how other countries have achieved universal health care. The most important element of the bill before us relating to single-payer is making sure that we have a very strong public option available among the choices that Americans will have, competing toe-to-toe with private health insurance to keep the private health insurance options honest. And, I have set as a bottom line the health care reform that we produce in the Congress must have a robust public plan.

As a member of Congress, will you have the same health care coverage as every other citizen once this bill takes effect?

Let me describe how it is designed. A lot of the new choices and options are made specifically to be available for the 47 million people who have no insurance and for the many more who are under-insured or in small businesses that for example won't be able to keep on providing health care because it's gotten unaffordable and out of reach. And so the first phase of the bill sets up what we're calling an "exchange." I know it's not a sexy name, but an exchange whereby someone who's uninsured or under-insured or unhappily insured can come in and compare the plans and compare their prices and compare what they cover. And that's precisely where this public option needs to be available as one of the choices to the people who will now be able to get health insurance; some of them for the first time in many, many years.


One thing I might note is the kind of health insurance that I have as a member of Congress. I participate in the Federal Employees Health Benefit plan. What that is, is a series of options and every year we have an open-enrollment period where every federal employee in the country and frankly across the globe, because we have Federal employees overseas too, receive a catalog and it shows and reviews the health care options, prices, what it covers, etc.


That's exactly what we're setting up right now for the uninsured and for the underinsured. So, this Exchange is very much like the system that's available for federal employees or state employees across the nation. It will be a series of choices where you can compare benefits, compare prices and enroll in the program of your choice.

If the bill will not take effect for 4 years what will you tell the people who need help now?

I have been in Congress ten and a half years and I ran for Congress so we could reform health care, so I could work on providing universal access. I get letters and I have conversations on a daily basis of what happens to people in our current system. People with pre-existing conditions who are being turned away and so can't get any insurance at all because we don't cover people who had cancer a decade ago or who had certain illnesses and so the pain is very, very real. I wish we could put together a bill that had a light switch attached to it so that as soon as it got signed by the President, we turn on the light and all of a sudden everybody would be able to enroll.


But as you can imagine when you're setting up a new system in the first phases, probably 80-100 million people would be enrolled. That does take a little bit of time and it's just a tragedy to me that there will be more heartbreak before this is set up. Frankly, that's why we need to act with some sense of urgency. The longer we wait, the longer it will take for these options and choices to be available to American citizens.

How can any congressman take money from lobbyists from the health care industry and then tell the people who put them in office that he or she is acting in our best interest?

Well, that's a great question and it's sort of also a call to action. I think that people really do need to be aware of where their elected officials and their candidates are getting their money. There are a lot of sources of accurate information on the internet where you can see on a quarterly basis every calendar year -- what, where, who and when your members of Congress, or the candidates who are opposing your members of Congress, are taking money. I think that's important knowledge for voters to have. Not everyone can do that research so there are clean government organizations out there that do some of that for you. You really can learn a lot more than what you hear when you go to a debate or listen to a candidate give a speech.


I would add that I think another important element not only to making good policy in health care, but to making good policy in all areas is if we were to move at the Federal level to a public financing type of program for campaigns. Then voters would look at how their candidates raise money and say they're not beholden to anyone but me and that would be very refreshing. That's a political debate that may be as tough as getting universal health care, but one worth having.

Women are charged 1.5 times more for health care than men and that 41% of women receive their health care through their husband's plans -- so are not free to leave an abusive relationship. How you are going to insure that all health care is equitable if it's not provided to everyone through a single payer system?

One of the things that is very, very frustrating for people today with regard to health care is what is known as the individual market. If you don't get health care through your employer or through your spouse who is employed then that's one of the most difficult ways to get health insurance. Sometimes it's way overpriced and there's no way you can afford it. Sometimes you're disqualified for pre-existing conditions, etc. and as the journalist notes, sometimes the rates are based upon factors, over which you have no control, that are discriminatory. So the creation of the Exchange where there is no such discrimination is such a critical step for people who are uninsured. Also the insurance market reforms that are contained in this bill are critical. We will mandate that insurance companies can no longer refuse to cover someone because of a pre-existing condition or a disease or injury that they had years ago.


We also will protect people from being trapped in a job or trapped in a relationship because of the lack of portability of health insurance. It will be completely portable. And, individuals will control that. And on the issue of the discrimination that women face in the health care system, this is an area that is very, very important to me and there's a number of different ways in which we're confronting this in health care reform.

How will the bill going through the house effect temporary staffing agencies?

We have the group market. So if you're an employer who has say, 2000 employees, you bargain with an insurance company. You say, I want to be able to enroll all of my 2000 employees, and I want a good price for the premium and you do the best to hold the prices down (although I hear complaints from big business just as I do from small business). So that's the group market where you're insuring a large group of people. But when you have temporary employees, part-time employees, when you're a small business, you don't have the group bargaining power and so most of those folks end up in a small group or individual market and that is where you have no leverage, no bargaining power and so people sometimes experience the highest prices.


The individual market and the small group market are the biggest reforms occurring with the creation of the Exchange. The creation of the Exchange will stop the discriminatory practices that private insurance now engages in by telling them they can't refuse people who have pre-existing conditions, telling them that there's a yearly and lifetime limit on out-of-pocket and deductible expenses that people experience and saying if the person presents and can pay the premium, you have to cover them. These, combined with a strong public option in the Exchange, I believe, is going to drive down the premium costs for precisely the people that are employed by this temp firm.

Who are the three percent that will not be covered by the plan?

The plan is intended to be mandatory. That will be a part of the law. But, we know there's always some risk-takers, some people who say "Yeah, I know they're telling me I have to get health care, but I'm just not going to." And that's estimated to be roughly 3% of the population. I don't know how they actually test that and figure that out. It may be based on the plan they have in Massachusetts, where there is an insurance mandate on everybody in Massachusetts and maybe they found that after a couple of years of that program that it's about 3% who just haven't shown up and enrolled.


There may be other reasons why people fall between the cracks. Say they have health insurance provided by their employer, but they leave their job or choose to return to school or whatever it is, they might forget to sign up right away. So I think at any time they're saying it's not going to be 100% even though we want it to be.

Hear the full interview, including LGBT language added to the bill at OUTTAKE VOICES.