Rep. Lois Capps, D-Santa Barbara, celebrated the House passage of comprehensive health insurance reform, the Affordable Health Care for America Act (H.R. 3932), on Saturday. For the first time, the House of Representatives has passed a comprehensive health insurance reform bill, marking a historic point in the effort to lower health-care costs for families and businesses, improve American’s health and wellness, and provide all Americans with access to quality, affordable health care. The legislation passed by a vote of 220-215.

Rep. Lois Capps

Rep. Lois Capps

“This is a historic moment for our country, as we take a huge step forward in our effort to fix our broken health insurance system,” said Capps, a nurse and vice chairwoman of the Health Subcommittee of the House Energy and Commerce Committee.

“I’ve spent the better part of my life working to improve the health and well-being of my patients and I am thrilled that with this vote we are closer than ever to delivering affordable, quality health care for all of us on the Central and South Coasts. I am proud that I was able to share my experience as a nurse and public-health educator to strengthen several provisions of the legislation dealing with prevention, access to affordable health insurance, securing a public-health insurance option and increasing the number of health professionals.”

The bill would enact critical health insurance reforms to stop insurance companies from refusing coverage based on consumers’ pre-existing medical conditions — such as pregnancy or high blood pressure — or refusing to cover a consumer’s medical expenses after a serious and often costly injury or diagnosis like cancer. It would also better serve consumers by closing the Medicare Part D “doughnut hole,” and ending insurance companies’ “gender rating” in which women are charged higher premiums just because they are women. The legislation would also establish a public-health insurance program to ensure that all Americans have access to health insurance and provide financial assistance for lower- and middle-income families to help them secure health insurance coverage. The public option would provide much needed competition to health insurance companies, which currently monopolize the vast majority of markets and leave consumers little leverage. The bill would ramp up programs to train more doctors, nurses and other health professionals to improve quality of care for all patients and refocus efforts on improving prevention and wellness efforts.

“The pride and joy that I feel today as we move one step closer on this important journey is tempered by my disappointment that this victory for all Americans’ access to affordable, quality health insurance came at a cost,” Capps said. “As is too often the case, women’s access to reproductive health care, specifically abortion services, were sacrificed by the adoption of the Stupak Amendment. I have said it time and again but it bears repeating, comprehensive health-insurance reform legislation is not the place to be re-debating federal abortion policy, nor is it the place to dramatically expand or contract access to abortion services. This victory for comprehensive health-care reform is a bittersweet one. I will continue to work to see this illogical, discriminatory and unnecessary language removed from the final legislation to ensure that comprehensive health-care reform works for all Americans.”

The Stupak Amendment will prohibit the use of federal funds from covering any part of the costs of any health-care plan that includes coverage of abortion. It also forces women seeking insurance coverage for abortion care to purchase such coverage through a “rider,” a supplemental policy that a woman would have to purchase separately that covers only abortion. This amendment is, in effect, a ban on abortion coverage that will take coverage away from millions of women who currently have it.

Capps Initiatives Included in the Affordable Health Care for America Act (H.R. 3932):

» Improve Maternity Care: This Engel-Capps Amendment would ensure that the quality of maternity care is being measured in Medicaid and CHIP programs.

» Prohibit Co-Pays for Medicaid Preventive Services: This amendment prohibits cost-sharing requirements for Medicaid clinical preventive services (like screening for cancer and heart disease, as well as preventing serious infectious diseases, substance abuse, and vision and hearing disorders) that are rated A & B (highly recommended) by the U.S. Preventive Services Task Force.

» Improve Children’s Access to Comprehensive and Easily Accessible Preventive and Primary Health Care (School-Based Health Clinic Establishment Act of 2009, H.R. 3003): This initiative would improve children’s access to comprehensive and easily accessible preventive and primary health care service to medically underserved communities at school-based health clinics. The legislation would provide a consistent, dedicated stream of federal funding to support the school-based health clinics.

» Support Nurse-Managed Health Clinics (derived from the Nurse-Managed Health Clinic Investment Act of 2009 H.R.2754): The initiative supports Nurse-Managed Health Clinics in providing comprehensive and accessible primary health care and wellness services to vulnerable populations in medically under-served communities. The services provided by these clinics would help reduce the level of health disparities experienced by these vulnerable populations while training the next generation of nurse professionals.

» Improve Nurse Education Grant Programs under Title VIII: During the drafting process Capps served as a liaison between the nursing community and the Energy and Commerce Committee to make sure their priorities are included. The improvements to the nurse education grant programs under Title VIII include:
» Expanding education, practice and retention programs for nurses.
» Enhancing existing student loan, scholarship and loan repayment programs.
» Enhancing development of advanced practice nurses, including those who deliver primary-care services.
» Expanding existing loan repayment programs to increase number of nursing faculty.

» Ensure Nurse Practitioners Can be Lead Coordinators for the Medical Home Pilot Program.

» Increase Reimbursement for Certified Nurse-Midwives.

» Improve Pain Care and Treatment (derived from The National Pain Care Policy Act H.R. 756): This Capps initiative would improve coordination of pain care and facilitate better sharing of information about pain across health disciplines. The legislation would combat pain in three ways: by authorizing an Institute of Medicine Conference on Pain Care; authorizing a Pain Consortium at the National Institutes of Health; and by instituting a public awareness campaign on pain management. More than 90 leading organizations representing the pain care community have joined Capps and Rep. Mike Rogers, D-Mich., in support of this legislation, including the American Cancer Society Cancer Action Network, the American Pain Foundation and a coalition of leading professional organizations in the pain field.

» Expand the Centers for Disease Control and Prevention’s WISEWOMAN Screening Program for Low-Income & Uninsured Women: This Capps amendment expands the CDC’s WISEWOMAN screening program for low-income and uninsured women. Currently the program is available in only 20 states. The expansion of the successful WISEWOMAN program is a key provision of legislation authored by Capps and Rep. Mary Bono Mack, R-Calif., the Heart Disease Education, Research and Analysis, and Treatment (HEART) for Women Act (H.R. 1032). The HEART for Women Act is endorsed by a number of leading health and women’s organizations, including the American Heart Association/American Stroke Association, WomenHeart, the Society for Women’s Health Research and the Association of Black Cardiologists.

» Support Evidence-Based Programs that Reduce Teen Pregnancy and Sexually Transmitted Diseases (the “Healthy Teen Initiative” Teen Pregnancy Prevention Program): This Capps amendment establishes grants to states to conduct or support evidence-based programs that reduce teen pregnancy and sexually transmitted diseases. Programs must be scientifically shown to reduce teen pregnancy or STD rates or the risk behaviors that lead to them. States can work with schools, faith-based organizations, community organizations and other partners. Requires independent evaluation, medical and scientific accuracy, and age-appropriateness. There is no litmus test on “philosophy” of the program — i.e., no preference given to comprehensive or abstinence-only programs, rather programs are funded based on scientific evidence of effectiveness and accuracy. It in no way preempts or limits state laws on parental involvement and decision making in their children’s education.

» Geographic Payment Fix (GPCI) for the state of California: Fixes flawed Medicare reimbursement system by updating methodology used to calculate geographic areas in California that are lumped together for calculating regional payment rates for physicians and other health providers.

— Emily Kryder is communications director for Rep. Lois Capps, D-Santa Barbara.