Senate Resolution 13 - Introduced PAG LIN S.R. ________ H.R. ________ 1 1 SENATE RESOLUTION NO. 1 2 BY HATCH, HORN, BOLKCOM, RAGAN, McCOY, 1 3 APPEL, DANIELSON, QUIRMBACH, JOCHUM, OLIVE, 1 4 SCHOENJAHN, HECKROTH, BEALL, SODDERS, SCHMITZ, 1 5 DOTZLER, GRONSTAL, DVORSKY, WARNSTADT, WILHELM, 1 6 SENG, DEARDEN, BLACK, STEWART, COURTNEY, KIBBIE, 1 7 FRAISE, KREIMAN, HOGG, and DANDEKAR 1 8 A Resolution encouraging a federal state collaboration 1 9 to achieve quality, affordable health care for all. 1 10 WHEREAS, the United States is facing a worsening 1 11 health care crisis of ever=higher costs, inconsistent 1 12 quality, and lack of access to necessary coverage and 1 13 medical care for tens of millions of uninsured and 1 14 underinsured residents; and 1 15 WHEREAS, reforming the United States' health care 1 16 system to achieve a high=performing, affordable, and 1 17 quality system covering all residents is central to a 1 18 sustainable economic recovery and the health and 1 19 financial security of all residents, businesses, and 1 20 governments; and 1 21 WHEREAS, reform of the United States' health care 1 22 system is a paramount and immediate priority for 1 23 President Barack Obama, his administration, and the 1 24 111th Congress; and 1 25 WHEREAS, each state has unique economic, social, 1 26 geographic, and demographic factors that must be 1 27 accommodated to reach quality and affordable health 1 28 care for all; and 1 29 WHEREAS, states play a vital role in health care 1 30 for tens of millions of Americans by administering and 2 1 funding public programs such as Medicaid and the State 2 2 Children's Health Insurance Program (SCHIP) that 2 3 improve access to quality and affordable health care; 2 4 and 2 5 WHEREAS, states can help improve health care for 2 6 all residents of the United States by using public 2 7 programs and regulatory power to influence, guide, and 2 8 direct the broader health care system toward improved 2 9 and less costly care; and 2 10 WHEREAS, the federal government looks to states for 2 11 guidance in improving health care, and federal health 2 12 care reform is informed by state initiatives; and 2 13 WHEREAS, since the current health care system is 2 14 unsustainable and the cost of doing nothing would be 2 15 far greater than the cost of health care reform; and 2 16 WHEREAS, all states and the federal government 2 17 share a common mission to protect and provide for the 2 18 general welfare of all the people of the United 2 19 States; NOW THEREFORE, 2 20 BE IT RESOLVED BY THE SENATE, That the Iowa Senate 2 21 urges both state governments and the federal 2 22 government to collaborate with one another to reach 2 23 the goal of providing quality and affordable health 2 24 care to all Americans; and 2 25 BE IT FURTHER RESOLVED, That each state exercise 2 26 its inherent responsibility to assist in providing 2 27 access to quality health care; and 2 28 BE IT FURTHER RESOLVED, That all of the following 2 29 guiding principles be incorporated into a national 2 30 health care policy: 3 1 1. Stabilize financing through payment reform. 3 2 a. Implement a patient=centered medical home. 3 3 This practice emphasizes reimbursement of services 3 4 based on patient needs, with effective financial 3 5 incentives for coordinated care among 3 6 multispecialties. 3 7 b. Prioritize payments for primary and preventive 3 8 care. This prioritization will steer patients to 3 9 cost=effective treatments that promote wellness and 3 10 health. Equally important is to end Medicare's 3 11 regional reimbursement discrimination, whereby states 3 12 receive considerably more or less for the same 3 13 procedure based upon geographic location. 3 14 c. Support value=based purchasing efforts. 3 15 Value=based purchasing uses transparent quality and 3 16 cost data and patient incentives to steer care toward 3 17 high=quality, cost=effective providers. 3 18 d. Restructure national financing for long=term 3 19 care. As baby boomers age, long=term care needs will 3 20 skyrocket. A comprehensive financing strategy that 3 21 takes into account states' financial capabilities is 3 22 critical. 3 23 2. Improve cost containment policies. 3 24 a. Advance cost containment strategies. To ensure 3 25 a financially stable system, national standards for 3 26 cost containment should be advanced in areas such as 3 27 chronic care management and medical homes, pay for 3 28 performance, electronic health records, administrative 3 29 efficiency, public health measures, drug and medical 3 30 device negotiations, and sunshine laws to increase 4 1 transparency of financial arrangements among industry 4 2 stakeholders. 4 3 b. Establish national electronic medical record 4 4 standards. National standards should be established 4 5 for the states controlling the use and distribution of 4 6 electronic medical records. 4 7 c. Provide financial and technical assistance for 4 8 the creation and utilization of electronic medical 4 9 records. Modernizing medical records using current 4 10 technology will improve care and lower costs. 4 11 d. Facilitate the confidential sharing of patient 4 12 data within and across state borders. A national 4 13 interoperational standard will allow providers to 4 14 access patient records anywhere. 4 15 3. Increase access to affordable health insurance 4 16 coverage. 4 17 a. Expand coverage to everyone. Using private 4 18 market and publicly financed plans, affordable 4 19 coverage must be guaranteed to every resident. Total 4 20 health care costs for individuals, families, and 4 21 employers must be limited to an affordable percentage 4 22 of household income or payroll. 4 23 b. Allow for greater flexibility in state 4 24 regulation of federal Employee Retirement Income 4 25 Security Act (ERISA)=regulated insurance plans. ERISA 4 26 precludes effective state oversight of self=insured 4 27 employer=offered insurance coverage. This unintended 4 28 consequence of ERISA distorts policy and interferes 4 29 with a state's ability to provide for consistency in 4 30 coverage. 5 1 c. Eliminate preexisting conditions exemptions and 5 2 require guaranteed issue of insurance. Permitting 5 3 insurers to reject applicants based on health status 5 4 leaves those who most need coverage without any 5 5 affordable options, defeating the purpose of health 5 6 insurance. 5 7 d. Strengthen the health care safety net. 5 8 Increase the investments in public programs 5 9 administered by states and the federal government, 5 10 such as Medicaid, community health centers, and SCHIP. 5 11 e. Support state innovation by creating robust 5 12 national standards that serve to raise the floor for 5 13 state action, rather than limit state efforts to 5 14 achieve the goal of quality and affordable health care 5 15 for all. 5 16 f. Invest in increasing the number of primary care 5 17 providers, midlevel practitioners, direct care 5 18 workers, and laboratory and community health workers. 5 19 g. Carefully monitor the supply of specialists. 5 20 Certain specialists are in short supply, and 5 21 policymakers need to be attentive to these shortages. 5 22 4. Increase quality. 5 23 a. Develop evidence=based standards using robust 5 24 clinical and cost comparative=effectiveness findings. 5 25 Care options need to take into account both 5 26 effectiveness and price. Comparative=effectiveness 5 27 research that evaluates treatments in terms of 5 28 efficacy and price will allow for the greatest value 5 29 in health improvement. 5 30 b. Require the use of informed, shared decision 6 1 making between the provider and patient. Patients 6 2 need to bring their preferences and values to the 6 3 medical decision=making process, just as providers 6 4 bring their experience and knowledge of medicine. 6 5 Informed joint decision making has been shown to 6 6 improve outcomes and increase patient and family 6 7 satisfaction. 6 8 c. Eliminate disparities and inequality. Numerous 6 9 social factors lead to widespread racial and ethnic 6 10 disparities in health care. The health care system 6 11 needs to systematically address these disparities if 6 12 the promise of health care for all is to be honored. 6 13 d. Invest in proven prevention programs and health 6 14 promotion activities. Public health activities such 6 15 as promoting healthy behaviors and teaching disease 6 16 management can improve overall health and lower costs. 6 17 e. Reduce unwarranted variation in care. Wide 6 18 variations in care, not matched by improved health 6 19 outcomes, show that much superfluous care is being 6 20 provided. Rooting out unnecessary care will both 6 21 improve health and save money. 6 22 f. Demand more effective public quality reporting 6 23 by all providers. Reporting allows consumers to 6 24 choose high=quality providers and encourages providers 6 25 to improve care; and 6 26 BE IT FURTHER RESOLVED, That a copy of this 6 27 resolution be transmitted to: 6 28 President Barack Obama; Vice President Joe Biden; 6 29 Speaker of the United States House of Representatives, 6 30 Nancy Pelosi; the Secretary of Health and Human 7 1 Services; Senator Edward Kennedy, Chair, Senate 7 2 Health, Education, Labor and Pensions Committee; 7 3 Representative Henry Waxman, Chair, Oversight and 7 4 Government Reform; Senator Max Baucus, Chair, Senate 7 5 Finance Committee; Senator Harry Reid, Senate Majority 7 6 Leader; Representative Steny Hoyer, House Majority 7 7 Leader; Senator Mitch McConnell, Senate Minority 7 8 Leader; Representative John Boehner, House Minority 7 9 Leader; the members of Iowa's congressional 7 10 delegation; Iowa Governor Chet Culver; and Dr. Jeanne 7 11 Lambrew, Deputy Director, White House Task Force on 7 12 Health Care Reform. 7 13 LSB 2640SS 83 7 14 pf/rj/8.1