Health Care

Health care is the fastest growing area of federal spending, with the country spending over $2.5 trillion annually. Coupled with the fact that over 40 million Americans lack insurance, meaningful health care reform was long overdue.

People across western and central Wisconsin have shared with me for years their concerns with our current health care system. Our economy continues to suffer as Wisconsin families fall further into debt due to rising health care costs. Comprehensive health care reform could not wait and I was glad to help shape and support the Affordable Care Act of 2010. As a member of the Ways and Means Subcommittee on Health, I was intimately involved in the health care reform debate. Now, as the law continues to be implemented, I will fight efforts to repeal the law. We cannot afford to put insurance companies back in charge of health care decisions.

I am also committed to protecting and preserving Medicare for our seniors and will fight Republican efforts to end Medicare as we know it.

Health Care Reform: Affordable Care Act of 2010

The House of Representatives voted to pass the Patient Protection and Affordable Care Act as well as The Reconciliation Act of 2010, on Sunday, March 21, 2010. For more details, click here. makes it easy for consumers and small businesses to compare insurance plans and find other important information.

Passage of health care reform:

  • Puts American families and small business owners—not the insurance companies— in control of their own health care.
  • Creates a Health Insurance Exchange, a marketplace for individuals and small employers to buy affordable insurance.
  • Ensures that insurance companies cannot deny applicants based on health status or pre-existing conditions or drop people when they get sick or injured.
  • Assists small employers with tax credits and individuals with affordability credits.
  • Improves Medicare benefits with lower prescription drug costs for those in the ‘donut hole,’ provide better chronic care, free preventive care, and help secure the future of Medicare.
  • Cuts the deficit by $143 billion in the first 10 years and by $1.2 trillion by 2030.

Passage of health care reform increases access to affordable, stable coverage for the 29,500 uninsured residents in the Third Congressional District and allows the 9,000 individuals in western Wisconsin with pre-existing conditions to get the coverage they are currently denied. Reform improves Medicare for 111,000 beneficiaries in the district. Health care reform also transforms our health care system into one that delivers higher quality care at a lower cost, eliminating waste in the system and increasing the quality of care for all Americans.

For more information about the health care reform bill, please click here.

For more information about how the Affordable Care Act is impacting Wisconsin, two years after it was signed, click here

Value Over Volume

Part of the health care reform bill included provisions from legislation I authored, the Medicare Payment Improvement Act of 2009. The provisions move the Medicare system from one that pays for the quantity of services provided to one that is quality-based and addresses the long-term sustainability of the program. Currently, Medicare reimbursements are based on the number of procedures performed. This often results in unnecessary or repeated medical services and billions of dollars in waste. The long term sustainability of our health care system depends on us changing this flawed structure. Including these provisions in the larger health care reform bill creates incentives for physicians and hospitals to work together to improve patient care and to use resources efficiently.

Affordable Coverage for Small Businesses and Family Farmers

The health care reform bill also included state based exchanges, which were modeled after legislation I authored, call the Small Business Health Options Program (SHOP) Act. The exchange makes health insurance more affordable and accessible for small businesses by allowing businesses to enter into a larger pool to find coverage and offering tax to make that coverage more affordable. To read more about how small businesses would benefit from reform, please click here.


At a time when we should be focusing on creating jobs and growing the economy, efforts to repeal health care reform are a waste of time and irresponsibly increase the deficit by $230 billion. With the possibility of increased out-of-pocket costs, higher prescription drug prices, and lost coverage, western Wisconsin can’t afford repeal either.

If the repeal passes the Senate and is signed into law, critical consumer protections enacted under the Affordable Care Act would be lost. Big insurance companies will again be able to deny coverage to children with pre-existing conditions, cancel coverage when people get sick, raise prescription drug costs, and limit the care people can receive. In western Wisconsin alone,

  • 2,100 young adults would lose insurance coverage through their parent’s health plans
  • 110,000 seniors covered under Medicare would be denied preventive care benefits
  • 8,800 seniors on Medicare would see significantly higher prescription drug costs, fall back into the Medicare Part D Donut Hole, and be denied a 50% discount on prescription drugs this year
  • 15,700 small businesses and 182,000 families would lose health care tax credits
  • Health care providers would not be rewarded for high quality, low cost care; there would be increased waste in the system and the cost of care would continue to rise

We cannot afford to repeal health care reform. Watch the speech I made on January 19, 2011 on the floor House of Representatives defending patient's rights and the Affordable Care Act.  For more videos, click here.


Republican Plan to End Medicare As We Know It

In March 2012 - House Republicans revealed their budget, which ends Medicare as we know it and replaces it with a voucher system that increases seniors’ costs and reduces benefits.  The GOP plan ends the guaranteed coverage seniors paid for.  I strongly oppose this.

The nonpartisan Congressional Budget Office (CBO) states that, under the GOP plan, seniors “would bear a much larger share of their health care costs than they would under the traditional program.” CBO also estimates that under the proposed budget, out-of-pocket costs for the average senior will be more than $1,200 higher by 2030 and $5,900 higher by 2050. Seniors’ health care costs would continue to skyrocket over time because the voucher would grow much slower than health care costs, leaving seniors to pay more. 

In response to the budget, AARP wrote a letter to Members of Congress that states that “By creating a ‘premium support’ system for future Medicare beneficiaries, the proposal is likely to simply increase costs for beneficiaries while removing Medicare's promise of secure health coverage -- a guarantee that future seniors have contributed to through a lifetime of hard work.”

The Republican plan would also:

  • Give enormous flexibility to the private insurance companies – meaning the GOP plan no longer guarantees seniors the same level of benefits and choice of doctor that they have today under Medicare.  
  • Raise prescription drug costs for millions of seniors – getting rid of health reform’s provisions providing a 50% discount for brand-name drugs for seniors in in the ‘donut hole’ coverage gap and completely closing the ‘donut hole’ by 2020.
  • Raise costs for seniors by getting rid of the new free preventive care benefit under Medicare, which went into effect on January 1st.
  • Phase in an increase in the age at which seniors are eligible for the new voucher program that replaces Medicare from 65 to 67.

The non-partisan Center on Budget and Policy Priorities also reports that the Ryan plan would shift substantial costs to Medicare beneficiaries.

**Read my editorial on why the Ryan plan doesn't work for Wisconsin, here

Republican Plan Cuts Medicaid

Under the 2012 budget proposed by House Republicans, Medicaid’s guarantee of coverage would be eliminated, Medicaid would be turned into a block grant program, and the federal contribution to Medicaid would be reduced by nearly $800 billion over the next decade. Other changes proposed by House Republicans would allow states to eliminate coverage for seniors, individuals with disabilities, children, pregnant women, and others currently enrolled in Medicaid. These changes would have a profound impact on Medicaid’s ability to provide health coverage to millions of Americans.

The non-partisan Center on Budget and Policy Priorities discusses the cuts to Medicaid propopsed under the GOP budget and the fast that the budget would add millions to the uninsured and underinsured.