Budget

Committee on the Budget

Diane Black

Chairman Black Floor Statement: The American Health Care Act

2017/03/24

I rise today to speak in favor of the American Health Care Act – a bill that repeals many of the worst aspects of Obamacare and begins to repair the damage caused by the law by bringing choice, competition and patient-centered solutions back into our health care system.

Standing here in the House debating this bill is a proud moment for me. I was working as a nurse in Nashville in the 1990s when, fresh off the failure of HillaryCare, the Clinton administration pushed a single-payer pilot program in Tennessee called TennCare. Vice President Gore and the Democratic governor sketched out the program on a napkin while sitting at a local bar.

I saw first-hand the negative impact government-run health care has on patient care. I saw costs rise and the quality of care fall. I saw the burdens being placed on doctors, hospitals, and other health care providers. I saw patients faced with fewer choices and more regulations. And I saw the devastating impact TennCare was having on the state’s budget, gobbling up so much state spending that other priorities like education and infrastructure were getting squeezed.

I couldn’t sit idly by while this was happening in my state, so I decided to get involved in public service. It’s what inspired me to run for office. And when, in 2009 and 2010, I saw the same principles being debated and eventually implemented on the national level, I thought my experience in Tennessee could be valuable to the national debate.

I told the people of my district that if elected to Congress, I would fight to repeal and replace Obamacare. In 2011, I sponsored the first piece of legislation that repealed part of Obamacare. And today, we take the largest step yet in rescuing the American people from the damage done by Obamacare.

We are united in our goal: to repeal Obamacare and replace it with patient-centered health care. Right now, Obamacare is imploding. We were promised premiums would decrease by $2,500; instead, average family premiums in the employer-market soared by $4,300. We were promised health care costs would go down; instead, deductibles have skyrocketed. We were promised we could keep our doctor and our health insurance plans; instead, millions of Americans lost the insurance and the doctors that they liked.

In short, the Affordable Care Act was neither affordable, nor did it provide the quality of care that the American people deserve.

The American Health Care Act is a first step in our efforts to deliver patient-centered health care reform. This bill seeks to return to the American people freedom and choice in their health care decisions. It gets government out of the relationship between patients and their doctors and puts people back in charge of their own health care.  And it brings the free-market principle of competition to an industry that has long been dominated by government intervention.

Today we are faced with a stark choice. Do we vote to continue the damage Obamacare is doing to our country and our constituents or do we vote to go down another path – a better way of doing health care in this country.

While no legislation is perfect, this bill does accomplish some important reforms. It zeroes out the mandates. It repeals the taxes. It repeals the subsidies. It allows people to choose health insurance plans to meet the unique needs of their families, instead of purchasing one-size-fits-all plans mandated by a Washington bureaucrat. And it modernizes Medicaid, a once in a lifetime entitlement reform. Ending Medicaid’s open-ended funding structure will play an important role in addressing future budget deficits and our growing national debt.

I applaud my colleagues who have stayed in this fight and continued to make this bill better. The members of the Budget Committee, which I chair, outlined four principles they believed would improve the bill. Those principles led to significant changes to allow more state flexibility in Medicaid and ensure that the tax credits truly serve the people they’re meant to. Others fought to eliminate federal Obamacare regulations that drive up the cost of health care for all Americans and give those powers back to the states. At the same time, we also ensure that states have the resources to provide maternity and newborn care and treatment for mental health and substance abuse.

I agreed with these changes and applaud my colleagues’ work to make sure we truly reverse the damage Obamacare is doing to our health care system and our economy.

Obamacare’s legacy is clear: more government, less choice, and higher costs. Our vision for health care in America is the opposite: more freedom, more choice, lower costs.

Put simply, the American Health Care Act is a good first step, but it is only our first step. My good friend and our former colleague, Dr. Tom Price, will use his position as Secretary of Health and Human Services to address some of the regulatory burden of Obamacare through administrative action. And we have voted already and will continue to vote on individual pieces of legislation to implement even more patient-centered, free market reforms that we cannot address through reconciliation. In fact, we just passed two bills already this week. One would allow small businesses to join together to purchase insurance and the other would increase competition by tearing down antitrust regulations. That bill received 416 votes. This shows that these bills are common sense measures that includes bipartisan support.

The day is finally here where we have an opportunity to fulfill the promise we’ve made to the American people. I, for one, cannot sit idly by and let this opportunity go to waste. Campaigning is easy, compared to governing. But our constituents did not elect us to do what is easy. They elected us to do what is right.

I urge my colleagues to join me in voting yes on the American Health Care Act to rescue the American people from Obamacare.

Thank you, Mr. Speaker. And I reserve the balance of my time.

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Chairman Black Rules Committee Opening Statement: Markup of the American Health Care Act

2017/03/22

Remarks as prepared for delivery: 

Good morning. Thank you Chairman Sessions and members of the committee for the opportunity to speak here today. I come before you to discuss H.R. 1628, the American Health Care Act of 2017.

The American Health Care Act is a first step in our efforts toward patient-centered health care reform. This bill seeks to give the American people freedom and choice in their health care decisions. It gets government out of the relationship between patients and their doctors and puts people back in charge of their own health care.  And it brings the free-market principle of competition to an industry that has long been dominated by government intervention.

We are united in our goal: to repeal Obamacare and replace it with patient-centered health care. Right now, Obamacare is imploding. We were promised premiums would decrease by $2,500; instead, average family premiums in the employer-market soared by $4,300. We were promised health care costs would go down; instead, deductibles have skyrocketed. We were promised we could keep our doctor and our health insurance plans; instead, millions of Americans lost the insurance and the doctors that they liked. 

In short, the Affordable Care Act was neither affordable, nor did it provide the quality of care that the American people deserve. 

Last week, the House Budget Committee favorably reported the American Health Care Act to the full House of Representatives for consideration. Our markup was filled with lively debate and I applaud our members for working to make this bill better. There was concern from members of my committee that this bill did not reflect a strong enough conservative vision for health care reform and I joined them in that concern.

The Budget Committee approved four motions to be recommended to this committee and the full House, as laid out in our report. These motions describe potential changes that would address our concerns, including greater state flexibility in the design of their Medicaid programs, minimizing new Medicaid enrollment by able-bodied adults, promoting work-requirements in state Medicaid programs, and ensuring that tax credits are targeted to those individuals who need them most.

The Manager’s Amendment submitted this week includes changes advocated for by my committee. This is the way the legislative process is supposed to work and I applaud my colleagues for staying in the fight and making sure that we pass a bill that truly reflects our values.

It goes a long way towards resolving some of the conflict and disagreement within our conference and addressing the concerns of my committee. It is a step in the right direction and I urge the members of this committee to support it.

We have a once in a generation opportunity to reform health care with free-market principles in the driver’s seat – not government. It’s an opportunity that we cannot let pass us by.

As this bill continues to better reflect our patient-centered vision of health care, we will soon be faced with a stark choice. The choice is between repealing and replacing Obamacare and voting to keep Obamacare’s status quo.

While no legislation is perfect, this bill does accomplish some important reforms. It zeroes out the mandates. It repeals the taxes. It repeals the subsidies. It allows people to choose health insurance plans to meet the unique needs of their families, instead of purchasing  one-size-fits-all plans mandated by a Washington bureaucrat. And it modernizes Medicaid, a once in a lifetime entitlement reform. Ending Medicaid’s open-ended funding structure will play an important role in addressing future budget deficits and our growing national debt.

Put simply, this is a good first step, but it is only our first step. My good friend and our former colleague, Dr. Tom Price, will use his position as Secretary of Health and Human Services to address some of the regulatory burden of Obamacare through administrative action. And we will vote soon on individual pieces of legislation to implement even more patient-centered, free market reforms that we cannot address through reconciliation.

This is the three-pronged approach we are taking to rescue the American people from the damage Obamacare has done to our economy and our health care system.

But as we talk about our work to repeal Obamacare and replace it with patient-centered reforms, we also have to remember that the problems with Obamacare are not merely numbers on a page. I’ve been a nurse for 45 years. I saw the impact in the 1990s of a government-run, single-payer health care system had on people during the TennCare pilot program in Tennessee. I saw costs rise and the quality of care fall. It’s what inspired me to get involved in public service in the first place. 

And when I saw the same broken principles applied to health care on a national level with Obamacare, I felt compelled to bring my voice and my experience to Congress. 

I get calls every single day in my office saying please help us, rescue us. Premiums in my state of Tennessee have skyrocketed. There are parts of Tennessee that don’t have a single insurance provider in the marketplace, while in other parts of my state, people may have an insurance card but they can’t get care. 

We must work together on a conservative vision for repealing and replacing Obamacare. It’s a promise we’ve made to voters for years. And it’s a promise we finally have an opportunity to keep. I intend to keep that promise.

I urge all members to work toward this common goal. And with that, I look forward to answering your questions. 

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Statement from House Budget Committee Chairman Diane Black on President Trump’s Budget Submission

2017/03/16

WASHINGTON, D.C. - Today, House Budget Committee Chairman Diane Black released the following statement following President Trump’s budget submission: 
 
“I appreciate the White House’s submission on how we can be better stewards of taxpayer dollars and strengthen our national security. We are all committed to investing in our men and women in uniform to ensure that we are the strongest military force in the world. The complex international and military challenges we face require special attention, which the previous administration neglected. At home, I’m pleased that the administration is committed to reviewing how our agencies operate to better streamline programs and reduce overlap.
 
“We look forward to continuing our discussions with the White House, with our committee members and with the full House as we work towards introducing the Fiscal Year 2018 budget.”  Read More

Chairman Diane Black Opening Statement: Markup of the American Health Care Act

2017/03/16

Remarks as prepared for delivery: 

Good morning and welcome to this markup at the House Budget Committee. We are here today to act on the American Health Care Act. This bill seeks to address one of the most fundamental policy challenges that we face: how to reduce the cost of health care and give all Americans access to quality care.

This is something House Republicans have talked about for years, and the opportunity is finally here to fulfill our promise to the American people. Under the leadership of Speaker Ryan, this body began to formalize an approach for patient-centered health care under our “Better Way” plan. 

The “Better Way” plan outlined our philosophy for health care reform. We need to take control of health care decisions away from the government and give it back to patients and doctors. We need to reduce costs and ensure that everyone has access to quality care. And we need to reform and allow states to modernize government programs like Medicaid to strengthen them and ensure they provide for the people they were intended to help. 

That’s what this bill does. 

The American Health Care Act provides for portable, monthly tax credits not tied to a job or a Washington-mandated program. This provides more flexibility to Americans who don’t currently have insurance through their employer and would lower costs by increasing competition and choice. 

This bill also provides for more insurance options by allowing individuals and families to buy the insurance plan they need and want at a price they can afford. It is not the job of the government to tell all Americans exactly what type of insurance coverage they should purchase. Our plan allows for people to choose the plan that best meets their needs and increases the amount of money that can be placed in Health Savings Accounts to ensure that individuals and families can spend and save their health care dollars the way they want. 

The American Health Care Act is also a once-in-a-generation entitlement reform. Medicaid spending is growing out of control. This bill reforms and modernizes Medicaid for the 21st Century. Reforming the program and giving States greater flexibility to make the program fit the needs of their citizens will protect the program and make sure it is available for the populations it was intended to serve. After all, the issues they face in California are very different from the issues we face in Tennessee. Most importantly, this bill protects our most vulnerable citizens. 

In total, this bill reduces the deficit by $337 billion over ten years and lowers taxes by $883 billion over that same time period for individuals and small business owners. At the same time, premiums will decrease by 10 percent by 2026.

This legislation is a conservative vision for free-market, patient-centered health care. It dismantles Obamacare’s mandates and taxes. It puts health care decisions back in the hands of patients and doctors, where they belong. And as a nurse, I know how important that is. 

This is the conservative health care vision that we’ve been talking about for years. And it is our response to the outcry from our constituents to rescue them from Obamacare. 

To my Republican colleagues who have doubts today, I encourage you: Don’t cut off discussion. Stay in this effort and help us enhance this proposal by advancing it out of committee and pushing for further conservative reforms. Members who desire to see this bill improved have every right to make their voices heard.

We are united in our goal: to repeal Obamacare and replace it with patient-centered health care. Right now, Obamacare is imploding. We were promised premiums would decrease by $2,500; instead, average family premiums in the employer-market soared by $4,300. We were promised health care costs would go down; instead, deductibles have skyrocketed. We were promised we could keep our doctor and our health insurance plans; instead, millions of Americans lost the insurance and the doctors that they liked. 

In short, the Affordable Care Act was neither affordable nor did it provide the quality of care that the American people deserve. 

But we also have to remember that the problems with Obamacare are not merely numbers on a page. I’ve been a nurse for 45 years. I saw the impact in the 1990s of a government-run, single-payer health care system had on people during the TennCare pilot program in Tennessee. I saw costs rise and the quality of care fall. It’s what inspired me to get involved in public service in the first place. 

And when I saw the same broken principles applied to health care on a national level with Obamacare, I felt compelled to bring my voice and my experience to Congress. 

I get calls every single day in my office saying please help us, rescue us. Premiums in my state of Tennessee have increased 60 percent. There are parts of Tennessee that don’t have a single insurance provider in the marketplace while in other parts of my state, people may have an insurance card but they can’t get care. 

Jenny W., a resident of my district, reached out to say that her family’s insurance premiums rose from $340 a month to $860 a month. “Health insurance shouldn’t cost the same as a mortgage payment,” she said. 

George C. from Westmoreland, Tennessee reached out to my office to say that this will be the first year since he was very young that he would not be able to afford health insurance. Before Obamacare, he was paying $458 a month for health insurance. This year, his premium will cost $1,160 a month.  

He said “please do something, anything to work and help this situation.” During a recent teletown hall with over 8,000 residents of my district, more than 70 percent surveyed said Obamacare had a negative impact or no positive impact on their life. 

These are the real stories of real people who have been negatively impacted by Obamacare. These stories are the reason I was drawn to public service in the first place. We have a chance to truly fix the problems that are ailing our healthcare system, and I cannot sit idly by and let this opportunity pass. 

We made a promise to the American people to repeal this law and replace it with patient-centered health care reforms where Americans can have the health insurance they want and need at a price they can afford. This bill is a good first step. 

But it’s not all that we’re doing. My good friend and former Chairman of this committee, Dr. Tom Price, now Secretary of HHS, has already begun the process of rolling back the burdensome regulations and federal requirements enacted by Obamacare. That process will continue as Secretary Price works to dismantle the regulatory regime that’s putting government in between patients and their doctors and driving up the cost of coverage. 

At the same time, I look forward to future legislation, which addresses issues that cannot be included in reconciliation. These pieces of legislation will provide a more robust and competitive marketplace to bring down health care costs for all Americans. 

Already, my colleagues on the Judiciary Committee and the Education and Workforce Committee are working on separate pieces of legislation that will foster greater competition among health care insurers, that will implement significant medical malpractice reforms, and that will allow small businesses to band together through association health plans and negotiate lower costs for their employees. 

This is our three-pronged approach to delivering patient-centered health care reform. The American Health Care Act is a strong first step in this process. It secures key conservative victories to lower costs and put patients back in charge of their health care decisions, while ushering in the most significant reforms to entitlement programs in decades. 

In accordance with the 1974 Congressional Budget Act, the Budget Committee plays an important role in combining the legislation from the Energy & Commerce and Ways & Means Committees into a single bill as was outlined in the Fiscal Year 2017 Budget Resolution. I want to thank the committees who helped draft this legislation for their efforts and I look forward to today’s mark up. 

I strongly support this bill. I urge all of my colleagues, on both sides of the aisle, to work with us to pass this important piece of legislation and bring relief to the American people.

Thank you. And with that, I yield to the ranking member, Mr. Yarmuth.  Read More

Statement from Chairman Diane Black on Passage of the American Health Care Act by the House Budget Committee

2017/03/16

Washington, D.C. - Today, after the House Budget Committee reported the American Health Care Act to the House for consideration, Chairman Diane Black released the following statement: 
 
“I am proud of the work done by this committee. Our role in this process is to combine the work of the authorizing committees and report the full bill to the House and we have dutifully completed that responsibility. There is always debate and disagreement during the legislative process but I firmly believe that the result is a better piece of legislation. 
 
Obamacare is collapsing and we made a promise to the American people that we would save them from this disastrous law. We have now taken yet another step toward our goal of bringing our patient-centered, free-market reforms to the American people.” 
 
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Diane Black: “I am confident this bill is going to come out of Budget”

2017/03/15

This morning, House Budget Committee Chairman Diane Black talked to MSNBC’s Hallie Jackson about the American Health Care Act and her confidence that the committee will pass the bill tomorrow to help those suffering under Obamacare.

“We don’t want to have the American people suffer anymore,” said Chairman Black. “I come from a state where there was a 63% increase in premiums last year. We have two thirds of our counties that only have one provider. That’s not choice; that’s a monopoly. And we actually have places in East Tennessee where there are no providers left…for the exchanges.  So let me just say that my constituents are suffering and they’re saying ‘help us out.’ [Obamacare] is a failed plan and we’re going to rescue them and put something more patient-centered in place that will give them an opportunity to have what they want at a cost they can afford.”

Watch the full video here

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Diane Black Unplugged: Patient-Centered Health Care

2017/03/14

As a registered nurse, Diane Black knows what it’s like to actually provide health care. The fundamental problem with Obamacare was that it disrupted the personal relationship between patients and their doctors while rising costs put real care out of reach for many Americans.

This week, the Budget Committee will act on the American Health Care Act as it moves through the legislative process. Listen to Diane Black, in her own words, discuss how the failures of government-run health care and her commitment to helping patients inspired her to get involved in public service. 

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House Budget Committee Chairman Diane Black Statement on CBO Score

2017/03/13

WASHINGTON, D.C. - Today, House Budget Committee Chairman Diane Black released the following statement regarding CBO’s score of the American Health Care Act:

“Obamacare was a law built on government control and federal mandates. The American Health Care Act is a bill built on choice and freedom in health care decisions. Our goal has always been to provide access to health insurance for everyone who wants it and to reduce health care costs for all Americans. Our bill does exactly that. Dismantling the individual mandate gives Americans the freedom to make choices for themselves, even if that choice is to not have health care coverage. We believe and are committed to the idea that the American people are best suited to make decisions about their own lives.

"The CBO report shows that our bill lowers premiums by 10 percent by 2026, while increasing choice and creating a vibrant marketplace for consumers. The bill reduces the deficit by $337 billion and lowers taxes by $883 billion for Americans and small business owners. The American Health Care Act expands choice and freedom while reducing costs and saving taxpayer dollars. We look forward to acting on it in the House Budget Committee this week.”  Read More

"Open the marketplace back up again and allow more competition"

2017/03/13

WASHINGTON, D.C. - On Friday, House Budget Committee Chairman Diane Black appeared on the PBS Newshour to discuss the American Health Care Act and how this bill creates more competition to help drive down costs and allows states to tailor their Medicaid program to fit the unique needs of their populations.

You can watch the full interview here and check out key highlights below.

On how competition, not government, helps lower costs:

"First of all, we want to make sure everyone knows we're not going to pull the rug out from underneath of them. But what we do want to do is open the marketplace back up again and allow more competition. ... Out of the 23 co-ops, 18 are gone. Which meant here in my state when we lost that co-op, over 20,000 people who were in that health care policy lost their insurance because you just can't afford it when it's government-run and there are so many requirements on it, it drives the cost of the policy up."

On modernizing Medicaid for the 21st century:

"We are still going to have Medicaid there for them. But it's going to be changed in the way it's done so it's more patient-centered. We're also going to give the states an opportunity to make a decision about how they can best use those dollars. What's good for New York and California is not necessarily what's good for here in the state of Tennessee. And we'll allow the governor here in our state to make that decision about how best to spend those dollars that are sent down from Washington."

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McCarthy and Black Op-Ed in National Review: Conservative Repeal and Replace Is Here

2017/03/08

By Majority Leader Kevin McCarthy and Budget Committee Chairman Diane Black

Read Online 

Our health-care system is broken. It was inefficient before Obamacare, and Obamacare’s Washington-knows-best-mandates made it many times worse. The American people have suffered as a result. We can’t return to the pre-Obamacare status quo, because Americans need more access to health care. But we also can’t leave the American people tied to a sinking Obamacare ship, forced to face higher annual premiums and fewer provider choices.

We need relief based on clear principles: Government shouldn’t dictate our health-care choices, health care should be driven by market principles, and we must help those who truly need our help.

This week, House Republicans introduced legislation rooted in those principles. Our market-driven, patient-centered reforms offer relief from Obamacare, providing a stable transition to a new and reformed health-care system. Big problems require big fixes, so we’ll take this opportunity to lay out clearly what our repeal-and-replace legislation does and why. 

Our plan dismantles Obamacare just as promised and gets rid of the individual mandate. Washington has no right to tell the American people what products it must buy. Such policies are a fundamental affront to our basic freedom, and they have no place in our country. 

Our plan provides massive tax relief and stops the growth in health-care costs. As repeatedly proven by history, free markets and fair competition produce lower costs. By removing Washington impositions such as the medical-device tax and health-insurance taxes, we’ll enable the marketplace to produce higher-quality care for consumers. 

Our plan nearly doubles the amount of money people can contribute to market-friendly Health Savings Accounts (HSAs) and makes them more flexible, so people can use them to purchase things they actually need, like over-the-counter medications. 

Our plan blocks federal funds from going to abortion providers, such as Planned Parenthood, ensuring that health-care funds are used to save lives rather than to destroy them. 

Our plan stops insurance companies from kicking people off their coverage for getting sick, and ensures that people with pre-existing conditions won’t be denied insurance. As long as people continue to enroll in an insurance plan, they will never be denied coverage. 

Our plan returns power to the states with the biggest entitlement reform in a generation. It puts Medicaid on a budget, ending the program’s open-ended funding, focusing funds on those most in need, and proving that entitlements aren’t a third rail — they can be reformed and made solvent for future generations. What’s more, as we scale back Obamacare’s Medicaid expansion, we won’t punish those who got insurance through Medicaid under Obamacare. The federal government will continue to pay the same rate as before for every person still on Medicaid as long as he or she remains eligible for the program. 

Finally, our plan gives all Americans some tax relief. As of now, workers who receive health insurance from their employers benefit through a tax exclusion: The money both employer and employee use to pay for their health insurance is untaxed. Similarly, Americans who are enrolled in government health-care programs benefit from the direct spending of taxpayer dollars. But those Americans who do not get their health care from a government program or through their employers receive neither benefit. Our plan rectifies this unfairness by offering tax credits and expanded HSAs to help these Americans purchase the coverage they choose. 

Repealing and replacing Obamacare with this plan offers the American people freedom, protection, and compassion. Obamacare is on its way out, and we say good riddance. The health-care reform people truly need has been introduced. In the weeks to come Congress will give this measure a fair hearing and, ultimately, the vote that Americans deserve and have been waiting for.

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Contact Information

207 Cannon HOB
Washington, DC 20515
Phone 202-226-7270
Fax 202-226-7174
budget.house.gov


Membership

Diane Black

TENNESSEE's 6th DISTRICT

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