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March 19, 2010

END GAME: Altmire undecided on his health-care vote

U.S. Rep. Jason Altmire says he knows which way his district is leaning on proposed health care reform legislation.

“There’s no question the district tilts in opposition to the bill,” he said yesterday.

However, he added, “In the end, I have to vote on the finished product.”

Yesterday he and other House members received that finished product: Both a budget reconciliation bill and the Congressional Budget Office’s cost analysis.

According to the budget office, the legislation would cost $940 billion over 10 years, but reduce deficits by $138 billion over the first 10 years.

Altmire, in his second term representing the 4th District, is one of several Democrats who have yet to say how they will vote. He voted against the House bill in November.

The House has two pieces of legislation to consider. One is the reconciliation bill that contains fixes to the Senate measure negotiated by the two chambers. If the reconciliation bill passes, it will go to the Senate for its consideration.

The other piece is the Senate bill itself. If approved by the House, it can be signed into law by the president.

The CBO report includes a letter to House Speaker Nancy Pelosi of about four and one-quarter pages and 20 pages of tables.

Altmire said “tens of thousands” of his constituents have made their positions known on health care reform either through telephone calls, e-mails, letters and by stopping at his district office.

“Most importantly, it’s me going out into the district and just talking to people.”

He said there are several reasons people are opposed to the bill: Senior citizens who are concerned the Medicare trust fund will be cut, small business owners who believe their insurance rates will be increased, people who are worried the legislation will change their insurance plans and they will end up paying for somebody else, “government asserting itself” and the cost of the bill.

For those constituents who may be mistaken or have a misconception about some portion of the bill, Altmire said, “When they’re inaccurate, we correct them.”

“I think by now I have a feel where the district is,” he said, adding, “Especially in Lawrence County.”

Asked how he balances his district views with the bill’s impact on Americans in general, Altmire said, “It’s the impact on my district. What the district would want me to do. And how the bill would impact the district.

“What’s the relative value of passing this bill or not passing anything.”

From the hospital perspective, Douglas Danko said Jameson Health System “could probably provide some support” for the reform legislation if some changes are made.

Danko, chief executive officer of the health system, said the bill cuts funding for the disproportionate share program that provides services to people under Medicaid and the uninsured.

Having this in the bill would be a direct cut, he said.

“It would prevent us from doing other things.”

Danko noted that Jameson provided $168 million in charity care last year.

Another provision would deny payments for patients who are readmitted to a hospital for the same condition within 60 days.

“The hospital shouldn’t be held accountable,” Danko said.

He said the Centers for Medicare and Medicaid Services currently makes payment now — even though the payments often come late to the hospital. Under the bill, this would stop.

Another provision in the bill would allow certain hospitals to qualify for drug discounts. Jameson, Danko said, purchases $7 million worth of pharmaceuticals a year.

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