J. Randy Forbes Blog Entries

Unemployment at 26-year high

Fri, 06 Nov 2009 05:00:00 GMT

Most of us know someone who has been impacted or touched by unemployment over the past year, whether it is a family member who was laid off, a son or daughter looking for employment after college, or a community of families impacted by a plant or mill closure. Today, the Administration announced that the unemployment rate hit 10.2% in October, the highest rate of unemployment since April of 1983. 190,000 jobs were lost in October alone.

And despite this news, the House majority leadership is still trying to push through a nearly 2,000 page healthcare bill that will kill an additional 5.5 million jobs, according to a methodology developed by senior economists at the White House. Burdensome regulations on small businesses created through the healthcare bill will result in employers’ inability to pay salaries or hire new workers, and result in layoffs.

Here are some of the job-killing provisions included in the bill:

Imposes an 8% payroll tax on employers who can't afford to offer coverage to employees, or on employers who offer coverage that is deemed "insufficient" by the government.
Establishes a new tax on every health insurance policy to fund government research used to ration care.
Allows small businesses to receive subsidies for healthcare costs, provided employee income is lower than $20,000, creating a perverse incentive to keep wages low and not hire new workers.

You can read additional information about how this bill will destroy jobs here.

In addition, the government-takeover of healthcare will grow our deficit and increase the number of federal bureaucracies, while increasing taxes, stifling small-business growth, and ultimately preventing job creation.

Rising healthcare costs is a significant issue that must be addressed. But, there are better solutions to healthcare reform than the job-killing bill currently before Congress. You can read about some of my healthcare solutions here.

It's Still Bad Medicine

Thu, 05 Nov 2009 05:00:00 GMT

My colleague and fellow Virginian Rep. Eric Cantor emailed me Friday with a list of 10 things every person should know about the new healthcare bill that was unveiled last week. At 1,990 pages, the bill was written behind closed doors by a handful of people and the proposals in the bill never debated – the result is these concerning provisions:

1. It Still Raises Taxes on Small Businesses
Surtax
Individuals, including small business owners (who pay their business taxes at the individual level) making $500,000 ($1 million joint) will be hit with a 5.4% surtax.

Employer mandate still applies to small businesses
Small employers with a payroll as low as $500,000 will be hit with a tax.
(0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000)).

2. New Medical Device Tax
The bill includes a new 2.5% excise tax on the sale of a medical device in the United States. Some have taken to calling this the wheelchair tax as it will cover everything from bandages to prosthetics.

3. New Taxes on Health Savings Accounts
The bill eliminates the nontaxable reimbursements of over-the-counter medication from HSAs, HRAs, and FSAs.

4. New Payroll Tax
The bill creates a new “voluntary” payroll tax to fund new long-term care program—requiring mandatory spending—aka a new entitlement.

5. Abortions Are Authorized
In a break from the Hyde Amendment and other long-standing pro-life policies, the bill includes the Capps Amendment to authorize government funding of abortions through the public option. It also establishes an accounting gimmick to justify subsidizing private plans that cover abortion.

6. Members of Congress are Exempt from “Public Option”
The bill doesn’t require Members of Congress to enroll in the new government-run plan. Instead the language says the Members “may” enroll in the public option. In contrast the bill uses the word “shall” 3,425 times.

7. Doctors’ Reimbursement Levels Are Up in the Air / Budget Gimmicks
The new government-run plan will reimburse providers based on rates set by the government. “Negotiated rates” could start at Medicare and future rates could be set at levels below Medicare reimbursements. The Secretary of Health and Human Services could coerce doctors to participate in the program by tying participation to other government run health programs, like Medicare.

Removes the Medicare Doc Fix. The Pelosi bill does not include doc fix--instead it has been introduced as a standalone bill, unpaid for – meaning that Democrats’ proposals really aren’t deficit neutral.

8. Reduces Affordability Credits and Instead Expands Medicaid
The bill reduces the size of the affordability credits for patients to purchase the insurance in the exchange and instead expands eligibility for Medicaid to 150% of the federal poverty level—placing more Americans on entitlement programs at a cost to both the federal and state governments.

9. Significantly Changes the Medicare Part D Prescription Drug Program
The bill requires the Secretary of HHS to negotiate drug prices for the prescription drug program. There are also several provisions in the bill that will likely increase seniors premiums, as identified by CBO, including that the bill would force seniors to pay at least an additional 20 percent more for their Medicare prescription drug coverage (Part D).

10. Real Medical Liability Reform, Instead Rewards Trial Lawyers
The bill includes a new grant program to encourage states to implement alternative medical liability reforms like early offer or certificate of merit programs. However, a state is not eligible for the incentive payments if its law limits attorneys’ fees or imposes caps on damages—a key reform recognized by CBO as necessary to reduce defensive medicine.

111 New Bureaucracies

Wed, 04 Nov 2009 05:00:00 GMT

111 – that’s the number of new federal bureaucracies that will be created as a result of H.R. 3962’s government takeover of healthcare.

Here’s a list of each of them:

1. Retiree Reserve Trust Fund (Section 111(d), p. 61)

2. Grant program for wellness programs to small employers (Section 112, p. 62)

3. Grant program for State health access programs (Section 114, p. 72)

4. Program of administrative simplification (Section 115, p. 76)

5. Health Benefits Advisory Committee (Section 223, p. 111)

6. Health Choices Administration (Section 241, p. 131)

7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)

8. Health Insurance Exchange (Section 201, p. 155)

9. Program for technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)

10. Mechanism for insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)

11. Health Insurance Exchange Trust Fund (Section 307, p. 195)

12. State-based Health Insurance Exchanges (Section 308, p. 197)

13. Grant program for health insurance cooperatives (Section 310, p. 206)

14. “Public Health Insurance Option” (Section 321, p. 211)

15. Ombudsman for “Public Health Insurance Option” (Section 321(d), p. 213)

16. Account for receipts and disbursements for “Public Health Insurance Option” (Section 322(b), p. 215)

17. Telehealth Advisory Committee (Section 1191 (b), p. 589)

18. Demonstration program providing reimbursement for “culturally and linguistically appropriate services” (Section 1222, p. 617)

19. Demonstration program for shared decision making using patient decision aids (Section 1236, p. 648)

20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)

21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)

22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)

23. Independence at home demonstration program (Section 1312, p. 718)

24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)

25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)

26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)

27. Quality assurance and performance improvement program for skilled nursing facilities (Section 1412(b)(1), p. 784)

28. Quality assurance and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)

29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)

30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)

31. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)

32. Demonstration program for approved teaching health centers with respect to Medicare GME (Section 1502(d), p. 933)

33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)

34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)

35. Medical home pilot program under Medicaid (Section 1722, p. 1058)

36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)

37. Nursing facility supplemental payment program (Section 1745, p. 1106)

38. Demonstration program for Medicaid coverage to stabilize emergency medical conditions in institutions for mental diseases (Section 1787, p. 1149)

39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)

40. “Identifiable office or program” within CMS to “provide for improved coordination between Medicare and Medicaid in the case of dual eligibles” (Section 1905, p. 1191)

41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)

42. Public Health Investment Fund (Section 2002, p. 1214)

43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)

44. Program for training medical residents in community-based settings (Section 2214, p. 1236)

45. Grant program for training in dentistry programs (Section 2215, p. 1240)

46. Public Health Workforce Corps (Section 2231, p. 1253)

47. Public health workforce scholarship program (Section 2231, p. 1254)

48. Public health workforce loan forgiveness program (Section 2231, p. 1258)

49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)

50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)

51. Prevention and Wellness Trust (Section 2301, p. 1286)

52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)

53. Community Prevention Stakeholders Board (Section 2301, p. 1301)

54. Grant program for community prevention and wellness research (Section 2301, p. 1305)

55. Grant program for research and demonstration projects related to wellness incentives (Section 2301, p. 1305)

56. Grant program for community prevention and wellness services (Section 2301, p. 1308)

57. Grant program for public health infrastructure (Section 2301, p. 1313)

58. Center for Quality Improvement (Section 2401, p. 1322)

59. Assistant Secretary for Health Information (Section 2402, p. 1330)

60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)

61. Grant program for nurse-managed health centers (Section 2512, p. 1361)

62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)

63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)

64. “No Child Left Unimmunized Against Influenza” demonstration grant program (Section 2524, p. 1391)

65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)

66. Grant program for interdisciplinary training, education, and services for individuals with autism (Section 2527(a), p. 1402)

67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)

68. Grant program to implement medication therapy management services (Section 2528, p. 1412)

69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)

70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)

71. Grant program to develop infant mortality programs (Section 2532, p. 1433)

72. Grant program to prepare secondary school students for careers in health professions (Section 2533, p. 1437)

73. Grant program for community-based collaborative care (Section 2534, p. 1440)

74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)

75. Grant program for reducing the student-to-school nurse ratio in primary and secondary schools (Section 2536, p. 1462)

76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)

77. Center for Emergency Care under the Assistant Secretary for Preparedness and Response (Section 2552, p. 1478)

78. Council for Emergency Care (Section 2552, p 1479)

79. Grant program to support demonstration programs that design and implement regionalized emergency care systems (Section 2553, p. 1480)

80. Grant program to assist veterans who wish to become emergency medical technicians upon discharge (Section 2554, p. 1487)

81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)

82. National Medical Device Registry (Section 2571, p. 1501)

83. CLASS Independence Fund (Section 2581, p. 1597)

84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)

85. CLASS Independence Advisory Council (Section 2581, p. 1602)

86. Health and Human Services Coordinating Committee on Women’s Health (Section 2588, p. 1610)

87. National Women’s Health Information Center (Section 2588, p. 1611)

88. Centers for Disease Control Office of Women’s Health (Section 2588, p. 1614)

89. Agency for Healthcare Research and Quality Office of Women’s Health and Gender-Based Research (Section 2588, p. 1617)

90. Health Resources and Services Administration Office of Women’s Health (Section 2588, p. 1618)

91. Food and Drug Administration Office of Women’s Health (Section 2588, p. 1621)

92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)

93. Grant program for national health workforce online training (Section 2591, p. 1629)

94. Grant program to disseminate best practices on implementing health workforce investment programs (Section 2591, p. 1632)

95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)

96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)

97. Program of Indian community education on mental illness (Section 3101, p. 1722)

98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)

99. Office of Indian Men’s Health (Section 3101, p. 1765)

100. Indian Health facilities appropriation advisory board (Section 3101, p. 1774)

101. Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)

102. Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)

103. Urban youth treatment center demonstration project (Section 3101, p. 1873)

104. Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)

105. Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877)

106. Mental health technician training program (Section 3101, p. 1898)

107. Indian youth telemental health demonstration project (Section 3101, p. 1909)

108. Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)

109. Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)

110. Native American Health and Wellness Foundation (Section 3103, p. 1966)

111. Committee for the Establishment of the Native American Health and Wellness Foundation (Section 3103, p. 1968)

Healthcare Bill Available at Local Libraries

Wed, 04 Nov 2009 05:00:00 GMT

The healthcare bill, HR. 3962, is expected to come up for a vote as early as this Saturday, November 7^th. Although the input of the American people was left out of this bill when it was drafted behind closed doors, the American people still deserve to know what is in this bill before Congress votes on it. In an effort to make sure residents of the Fourth Congressional District have access to the recently proposed healthcare reform bill, I have had my staff deliver copies of the 1,990 page bill to several local libraries.

The health care bill can be viewed at the circulation desk or reference desk at the following libraries:

Appomattox Regional Library

245 East Cawson Street, Hopewell

Phone: 804-458-6329

Amelia Public Library

16501 Dunn Street, Amelia

Phone: 804-561-4559

Colonial Heights Public Library

1000 Yacht Basin Drive, Colonial Heights

Phone: 804-520-9384

Chesterfield Public Library

9501 Lori Road, Chesterfield

Phone: 804-751-4986

Petersburg Public Library

137 South Sycamore Street, Petersburg

Phone: 804-733-2387

Powhatan Public Library

2270 Mann Road, Powhatan

Phone: 805-598-5670

Sussex Public Library

100 Wilson Avenue, Wakefield

Phone: 757-899-6500

Chesapeake Central Library

298 Cedar Rd. Chesapeake

Phone: (757) 382-6591

North Suffolk Library

2000 Bennett’s Creek Park Road, Suffolk

Phone: (757) 514-7150‎

To view the bill online, click here. To read my statements on the healthcare bill, visit my website.

The Men it Honors

Mon, 02 Nov 2009 05:00:00 GMT

Today, I had the privilege to present several military medals to Mr. James Hornshaw of Chesapeake for his service in the United States Navy during World War II and Korea.

One of my favorite opportunities as a Member of Congress is getting to participate in ceremonies such as these. Were it not for the sacrifice of Mr. Hornshaw and others who have bravely answered the call of duty to serve our nation, we would not be able to celebrate the freedoms we enjoy today.

President John F. Kennedy once said that “a nation reveals itself not only by the men it produces, but also by the men it honors, the men it remembers.” As we approach Veterans Day next week, it is our privilege as a nation to continually honor our nation’s finest men and women in uniform.

New Healthcare Bill Released

Fri, 30 Oct 2009 04:00:00 GMT

This week, House Speaker Nancy Pelosi unveiled the new version of the healthcare bill. It will take some time to read the 1,990 page bill and even then it will be difficult to sort out and understand all the ramifications of so many different pieces of legislation included in such a large bill. Since the bill was written behind closed doors by a handful of people and the proposals in the bill never debated, this bill and its parts clearly are constructed to bring a certain outcome – the government control of our healthcare.

While there are some worthwhile ideas in the new bill, it still cuts billions from Medicare, is paid for by over $700 billion in tax increases, gives bureaucrats the authority to restrict healthcare services, provides free healthcare to illegal aliens, mandates the purchase of health insurance with tax fines for failure to buy, and creates a government-takeover of healthcare that will drive private insurance out of business. And it comes at a cost of about $1,055 billion, according to the Congressional Budget Office report.

Essentially, this is just a longer version of the same bill that was introduced earlier this year - the same bill that millions of Americans made clear in town halls across the county was not acceptable to them.

Americans deserve our best ideas and solutions – not an expansion of a bad bill they've already rejected. An undertaking of something as massive as healthcare reform should be done in small pieces, so we can take our time to make sure we get it right. You can read some of my solutions:

The text of the new healthcare bill, H.R. 3962 is available here.

Confucius Syndrome

Thu, 29 Oct 2009 04:00:00 GMT

Great article in the Washington Times that points out the lack of meaningful legislative activity taking place in Congress while citizens worry about health care, the economy, and jobs….

Work flow slows as House awaits health bill

The House on Tuesday took up a resolution to honor the 2,560th birthday of Confucius -- and that's pretty much all the floor business Democratic leaders scheduled for the day, as noncontroversial bills fill up the empty hours for lawmakers awaiting health care legislation.

It seemed as if the chamber has taken to heart Confucius' words: "It does not matter how slowly you go so long as you do not stop."

Still, the light workload has become routine in recent weeks and is starting to fray nerves.

House Minority Leader John A. Boehner bemoaned the lack of floor activity, saying Democrats would rather "celebrate the birth of an ancient Chinese philosopher" than debate plans for jobs and health care with Republicans.

"It is unacceptable for Congress to take it easy at a time when the nation's unemployment rate is nearing 10 percent and millions of out-of-work families struggling to make ends meet are asking, 'Where are the jobs?' " the Ohio Republican said in a statement.

Democratic leaders said it was worthwhile to spend floor time on easy votes because the heavy lifting was being done on committees and behind closed doors.

"When there are not votes on the floor, there is still a whole lot of other business that has been going on," said Rep. Chris Van Hollen, Maryland Democrat and the special assistant to House Speaker Nancy Pelosi. "It is important to have members here doing their work."

Tuesday's floor schedule also included a nonbinding procedural vote on an already passed annual appropriations bill for the Interior Department and resolutions that would welcome the Archbishop of Constantinople on his visit to the United States, support the goals of National Adoption Month and call on Iran to release three detained American hikers.

Keep reading….

2,000 Pages

Thu, 29 Oct 2009 04:00:00 GMT

I just got this email from the Republican Study Committee and wanted to share it with you – the latest news on the healthcare bill:

H.R. 3962, the version of Obamacare unveiled by Speaker Pelosi and House Democrat leaders today, is a stunning 1,990 pages long. Compared to the original version of the bill (H.R. 3200), which came in at 1,017 pages, it’s essentially the same bill. The one obvious and major difference? The version introduced today is almost twice as long.

H.R. 3962 is nearly 2,000 pages of higher taxes, job-killing employer mandates, choice-restricting individual mandates, government-run insurance, budget-busting entitlement expansions, and countless provisions that set Washington bureaucrats firmly between you and your doctor. And with a thousand extra pages, obviously it’s even more prescriptive this time around.

So how much takeover can you cram into 2,000 pages? By comparison, the legislation that created Medicare and Medicaid in 1965, which now cost nearly $800 billion annually, was less than 300 pages long. So at 2,000 pages today, that’s a whole lot of government input for a plan the Speaker says won’t result in Washington taking over health care.

Behind Closed Doors

Wed, 28 Oct 2009 04:00:00 GMT

When I was home in Chesapeake over the weekend, I had several individuals ask me what I know about the status of the healthcare bill. If truth be told, I really don’t know much more than what my constituents know – I know what I read in the newspaper. Why? A small, select group of Democrat lawmakers and White House officials continue to make decisions on the healthcare bill behind closed doors, without regard to openness or transparency. The Washington Times points out the lack of transparency in the legislative process in an article it released yesterday:

By day, Democrats tout how open they have been while crafting a bill to reform the nation's health care system. By early evening, they're behind closed doors.

Three times last week, White House officials went to Capitol Hill to meet in closed sessions with top Senate Democrats to put together a health bill. They left with not much more than a thumbs up or a "we're making progress"-type comment to the reporters waiting outside.

It's not exactly the level of transparency that President Obama promised during the campaign, when he said health care talks would be aired live on C-SPAN.

What we do know is that this week, Senate Majority Leader Harry Reid announced that he would include a government-run plan in the Senate healthcare bill. The bill includes a provision that would let states “opt out” and includes stiffer penalties on business owners who fail to provide health coverage. Senate leaders are working hard to rush the bill to the Senate floor within the next few weeks. Senator Reid plans to send the bill to the Congressional Budget Office for cost analysis this week (see my blog entry on the latest cost analysis here) and then bring the bill to the floor for a vote.

This type of rush-it-through process is not the proper way to craft any kind of bill. There is still an opportunity to get health care reform right, but it can't be done if the healthcare bill continues to be written in secret with artificial deadlines.

I’ve proposed a number of constructive healthcare solutions where both Democrats and Republicans agree would give us significant gains in healthcare reform. You can read about those here.

When will government listen?

Wed, 28 Oct 2009 04:00:00 GMT

I spoke yesterday on the House floor about jobs and our economy. In case you missed it, you can watch the video footage here. I’ve also included the text of my speech below.

Mr. Speaker, last week I received a call every Member of Congress fears: a plant with 1,100 jobs in a town of 9,000 residents closed its doors. I want to be, and I will be there for them as the symptoms of a bad economy entangle their lives. But Americans are asking you a larger question today: when will this government listen to the voice of wisdom shouting for us to address the causes of a bad economy and not just the symptoms?

As 1 of 17 Members of Congress who voted against every one of your bailout and stimulus bills, I watched you ignore that voice of wisdom as you saddled our grandchildren with a debt they will wear for decades as a badge of dishonor for your deafness. I watched as you ignored it as you tried to impose your energy agenda knowing it would stifle America’s competitiveness and kill jobs. I have watched as you ignore it while you try to tax our existing jobs into oblivion.

When will you listen?

Gas Prices

Fri, 05 Jan 2007 05:00:00 GMT

Gas Prices