House Health Insurance Bill Will Include Public Option

Moments ago, House Speaker Nancy Pelosi unveiled health insurance reform legislation which includes a ­­­­­­­­public option that will allow negotiated rates to providers. The legislation presented by Speaker Pelosi represents a collaboration of the three versions passed by the House Energy and Commerce Committee, House Ways and Means Committee, and the Education and Labor Committee. This legislation could be up for a vote on the floor of the House as early as next week.

I would like to thank House Speaker Pelosi and Chairmen Waxman, Rangel and Miller for their commitment to reforming our nation's health insurance system. After months of hard work and collaboration, Speaker Pelosi presented a bill we can be proud of. This legislation, which includes a public option, will provide security and stability to those who already have insurance and will also adequately insure millions of Texans and Americans.

As you remember, on Monday, Senate Majority Leader Harry Reid released the Senate's version of this legislation which also includes a public option.

Once again, I commend our nation's leaders for moving forward on reform and for working on behalf of the American people.

Below is an article from the Washington Post on today's developments.

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House health-care reform bill includes public option

By Shailagh Murray
Washington Post Staff Writer
Thursday, October 29, 2009; 10:48 AM

House Speaker Nancy Pelosi (D-Calif.) unveiled a health-care reform bill Thursday that includes a government insurance option and a historic expansion of Medicaid, although sticking points in the legislation involving abortion and immigration remain unresolved.

The bill includes a version of the "public option" preferred by moderates and raises Medicaid eligibility levels to 150 percent of the federal poverty level for all adults, a steeper increase than in earlier drafts.

"Today we are about to deliver on the promise of making affordable, quality health care available for all Americans," Pelosi said, describing a bill that she said would insure 36 million more Americans. ". . . We are putting forth a bill that reflects our best values and addresses our greatest challenges."

The House legislation aims to provide health insurance of one form or another to 96 percent of all Americans at an expected cost just below $900 billion over 10 years, without increasing the federal budget deficit for at least 20 years, House Democrats said. "It opens the doors to quality medical care for those who were shut out of the system for far too long," Pelosi said.

House leaders abandoned an earlier effort to include a public option that would have established reimbursement rates to providers based on Medicare. Although the provision was backed by liberals, it lacked enough votes to pass. Rural Democrats strongly opposed that approach because of the potentially ruinous effect on doctors and hospitals in their districts, where Medicare rates are generally well below the national average.

Instead, Pelosi is offering a more moderate alternative in which rates would be negotiated between providers and federal health officials, similar to the way in which private insurance operates. Majority Leader Harry M. Reid (D-Nev.) said he would include a similar provision in the Senate bill, though with an "opt out" clause for states that don't want to participate.

A previous version of the House bill carried an estimated cost of $1.04 trillion over 10 years, but House negotiators were able to lower the price tag -- in part by expanding Medicaid coverage to a broader slice of the population, the equivalent of all individuals who earn about $16,200 per year. The original House legislation had sought an increase to 133 percent of the federal poverty level, or about $14,400 per year, the same level proposed in the Senate bill.

The adjustment reflects findings by congressional budget analysts that covering the poor through Medicaid -- which pays providers far less than Medicare -- is much more cost-effective than offering subsidies for private insurance policies, something the bill would provide to middle class individuals who lack access to affordable coverage through their employers.

The main revenue sources in the House bill include a surcharge on wealthy taxpayers and changes to Medicaid and Medicare worth about $500 billion in cost savings over 10 years, according to the nonpartisan Congressional Budget Office.

Democratic House aides said party leaders had yet to resolve long-standing disputes over provisions to prevent federal funds from being used to subsidize abortions and to block illegal immigrants from receiving benefits.

Health Insurance Bill Before Senate Will Include Public Option

As you know, both the Senate Health, Education, Labor and Pensions (HELP) Committee and the Senate Finance Committee passed bills dealing with health insurance reform. Senators Reid, Baucus and Dodd had been hard at work over the last week, merging the two bills to be presented to the full Senate for a vote. Senate Majority Leader Reid today announced that the merged bill will include a version of the public option.

I'd like to congratulate Senator Majority Leader Reid and chairmen Baucus and Dodd for their diligent work on health insurance reform. Today, Senator Reid presented a bill that includes a public option, something the American people overwhelmingly support. I commend the Senators for their tireless efforts, and for pushing legislation that will significantly help people in America, Texas in particular.

The Senate bill includes a provision for states to opt out of the public option. A public option will increase competition and provide more quality, affordable options for middle-income Texans and Americans. Below is an article from the Los Angeles Times on today's developments.

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Senate healthcare bill to include public option, Reid says

The majority leader says states would be allowed to opt out of the government-sponsored insurance plan.

Reporting from Washington - Fueling the push for a new government insurance plan, Senate Majority Leader Harry Reid (D-Nev.) said today that his chamber's healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out.

"The public option is not a silver bullet, [but] I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said. "Under this concept, states will be able to decide what works for them."

Reid sent the proposal to the nonpartisan Congressional Budget Office to be analyzed today, a key step before he can bring a bill to the floor for debate.

His decision does not settle the debate roiling Democratic ranks over how to create a government plan that would give consumers who don't get coverage through their employers an alternative to plans offered by commercial insurers.

The "opt-out" compromise is still two votes shy of the 60 Reid needs to overcome a Republican filibuster, according to a senior Democratic aide on Capitol Hill who requested anonymity when discussing the plan.

And while Reid expresses a preference for the opt-out proposal, others continue to push for an alternative, known as a "trigger," that would establish local public options around the country only if commercial insurers did not provide affordable plans to consumers.

That scenario is being championed by Sen. Olympia J. Snowe of Maine, the only Republican to vote for the healthcare reform measure approved by the Senate Finance Committee.

With a 60-40 voting majority, which includes two independents who caucus with Democrats, Reid has to hold all his members or pick up Republicans to head off a filibuster.

Reid and House Speaker Nancy Pelosi (D-San Francisco) are advancing separate healthcare bills in the Senate and House, which would have to be reconciled later this year before they are sent to the White House for President Obama's signature.

But Pelosi indicated Friday that the opt-out alternative could be included in a reconciled bill.

For now, House Democrats are poised to pass a bill that would create a nationwide government plan, although there is still disagreement about how much such a plan should pay doctors, hospitals and other medical providers.

Liberals, including Pelosi, favor a proposal that would link those payments to the existing Medicare program, which often pays providers less than commercial insurers. Proponents believe such an arrangement would save money and help drive down costs.

But many conservative Democrats, particularly from rural areas where Medicare typically pays less, want the government plan to negotiate its rates with providers, as commercial insurers do.

Pelosi hopes to settle those differences in time to unveil a bill later this week, according to her office.

Constitutional Amendments on the November Ballot

Below is a brief summary of the constitutional amendments on the November ballot prepared by the Legislative Study Group, the caucus that I chair. Early voting has begun, and election day is Tuesday, November 3. During session, I voted for all of these proposals, and I'm voting yes on all of them in this election. For a sample ballot with the exact ballot language, click here. Please feel free to contact my office if we can provide you with any additional information on these issues.

The following are LSG's analyses and evaluations of Constitutional Amendments that will be on the November 3, 2009 ballot.

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Proposition 1

"The constitutional amendment authorizing the financing, including through tax increment financing, of the acquisition by municipalities and counties of buffer areas or open spaces adjacent to a military installation for the prevention of encroachment or for the construction of roadways, utilities, or other infrastructure to protect or promote the mission of the military installation."

After the recent round of Base Realignment and Closures (BRAC), the necessity of strengthening the ability of military installations in Texas to compete with others around the country has been made clear. A serious problem that may lead to a Texas military installation being closed under future BRACs is encroaching development that restricts training and operational missions. The proposed amendment will allow a municipality or county to acquire buffer zones adjacent to military installations to prevent such encroachment. Texas military installations have a positive economic impact on the state. The results of this amendment could help keep Texas military installations vital to national security (thus keeping them active) and provide economic stability and security to the many communities located near such installations.

Favorable

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Proposition 2

"The constitutional amendment authorizing the legislature to provide for the ad valorem taxation of a residence homestead solely on the basis of the property's value as a residence homestead."

Prop 2 requires that a homestead be taxed as a residence rather than "highest and best" use of the property, which may result in it being appraised based on what the land would be sold for if it was converted to commercial property. The amendment and legislation would apply only to residence homesteads and not to second homes or investment properties.

Favorable

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Proposition 3

"The constitutional amendment providing for uniform standards and procedures for the appraisal of property for ad valorem tax purposes."

Prop 3 gives the state the direct authority to enforce uniform appraisal standards and procedures, rather than requiring administrative and judicial enforcement to originate in the county where the tax is imposed. This will ensure that appraisal methods and practices are the same throughout the state.

Favorable

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Proposition 4

"The constitutional amendment establishing the national research university fund to enable emerging research universities in this state to achieve national prominence as major research universities and transferring the balance of the higher education fund to the national research university fund."

Texas lags behind other major states in the number of nationally recognized research universities, with only two public research universities of national prominence -- The University of Texas at Austin and Texas A&M University. Texas must continue strengthening these existing universities, and it also must focus resources on establishing additional nationally prominent research universities. The proposed amendment and its accompanying enabling legislation, House Bill 51, Acts of the 81st Legislature, Regular Session, 2009, would in effect repurpose the permanent HEF and spur emerging state research universities in Texas in their efforts to achieve nationally recognized research status.

With far more qualified applicants than it can admit to its two public, nationally recognized, tier-one universities, Texas is losing thousands of its high school graduates to doctorate-granting universities in other states each year. Creating additional national research universities in Texas would better position the state to achieve its vision of a globally competitive workforce by providing greater educational opportunities within the state for its best and brightest students.

Favorable

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Proposition 5

"The constitutional amendment authorizing the legislature to authorize a single board of equalization for two or more adjoining appraisal entities that elect to provide for consolidated equalizations."

Prop 5 allows the board of directors in two or more adjoining appraisal districts to consolidate appraisal reviews boards through inter-local contract. This will reduce costs and provide a greater pool of talent. The ability to consolidate appraisal review boards would be especially beneficial to rural counties that have a relatively small pool of qualified persons from which to draw and have difficulty finding qualified appraisal review board members.

Favorable

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Proposition 6

"The constitutional amendment authorizing the Veterans' Land Board to issue general obligation bonds in amounts equal to or less than amounts previously authorized."

The proposed amendment would provide the secure and sufficient bonding authority needed by the VLB to continue the Veterans' Housing Assistance Program and Veterans' Land Program. This amendment would do away with the need for the VLB to repeatedly request more bonding authority or funds from voters. Instead, the amendment would allow the board to issue new bonds in place of those already issued and then retired or redeemed.

Favorable

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Proposition 7

"The constitutional amendment to allow an officer or enlisted member of the Texas State Guard or other state militia or military force to hold other civil offices."

Prop 7 would allow officers and enlisted members of the Texas State Guard or other militia or military force to be recognized under state law to hold a paying position with the state ("civil office of emolument"). Currently, a civil official may also hold office in most branches of the military, including the National Guard. But those in the Texas State Guard and other Texas military forces are prohibited from holding another civil office. This amendment is needed to allow a civil official to become active in the Texas State Guard or other state militia or military force and to allow state military personnel to hold another civil office.

Favorable

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Proposition 8

"The constitutional amendment authorizing the state to contribute money, property, and other resources for the establishment, maintenance, and operation of veterans hospitals in this state."

According to the Texas Legislative Council, with 1.7 million veterans living in the state, Texas ranks third in the nation in the number of veterans among its residents. In federal fiscal year 2007, veterans health care facilities in the state recorded more than 47,000 inpatient visits and more than 4.3 million outpatient visits. Texas currently has nine inpatient veterans hospitals located in Houston, Temple, Waco, Bonham, Dallas, Kerrville, San Antonio, Amarillo, and Big Spring, but the rising cost of traveling to these facilities can impede or delay necessary health care for some veterans. The state currently lacks authority to contribute to a veterans hospital. The amendment would encourage the United States Department of Veterans Affairs to partner with the state and with local communities to establish additional such facilities.

Favorable

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Proposition 9

"The constitutional amendment to protect the right of the public, individually and collectively, to access and use the public beaches bordering the seaward shore of the Gulf of Mexico."

The Texas Open Beaches Act is one of the strongest coastal access laws in the nation. The proposed amendment clarifies the state's intent to protect the public's right to free and unrestricted access to public beaches and by placing the law in the Texas Constitution, thus protecting it from future tampering. Property owners who build or purchase homes on Texas beaches do so with knowledge that storms and rising sea levels may cause their property to be located on a public beach in the future.

Favorable

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Proposition 10

"The constitutional amendment to provide that elected members of the governing boards of emergency services districts may serve terms not to exceed four years."

Emergency services districts are governed by a board of commissioners that provides emergency medical services, emergency ambulance services, rural fire prevention and control services, or other emergency services. Such services are necessary to local communities and, thus, justify longer terms -- currently only two years -- for district commissioners. The proposed amendment would provide emergency services district commissioners time to gain such expertise, greater continuity and experience in district leadership.

Favorable

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Proposition 11

"The constitutional amendment to prohibit the taking, damaging, or destroying of private property for public use unless the action is for the ownership, use, and enjoyment of the property by the State, a political subdivision of the State, the public at large, or entities granted the power of eminent domain under law or for the elimination of urban blight on a particular parcel of property, but not for certain economic development or enhancement of tax revenue purposes, and to limit the legislature's authority to grant the power of eminent domain to an entity."

Prop 11 reinforces owners' rights, clarifying that private property should only be seized by eminent domain for necessary public use (rather than corporate use or to increase local tax revenues) and that the property owner should agree and be fairly compensated.

Favorable

Higher Education Necessary To Ensure Success of Texas and Texans

From the desk of Representative Garnet Coleman, Chair of the Texas Legislative Study Group (LSG), House Caucus:

Please find below a report from the LSG, the caucus that I chair, regarding a press conference on higher education held today.

Today, some Legislative Study Group members from the Houston area met at the Houston Community College Coleman College for Health Sciences for a press conference on higher education.

As you know, in May 2008 the LSG put out a report calling for an expansion of slots of excellence at Texas colleges and universities -- specifically calling for the creation of additional tier one universities. This session the Legislature passed HB 51 and HJR 14, which would set in place a mechanism through which emerging research universities can compete for funds to eventually become tier one universities.

Texas currently has only two public universities classified as tier one institutions even though it has the second highest population in the nation. States like California and New York have many more tier-one public universities.

At today's press conference, Rep. Scott Hochberg, LSG board member and chair of the Appropriations Subcommittee on Education, spoke of a pool of $500 million worth of higher education dollars that is currently locked away. Voter approval of Proposition 4 on the November ballot is the key to releasing those funds and allowing universities to draw down matching funds, allowing them to work on becoming top tier research universities.

LSG board member Rep. Hubert Vo is an alumnus of the University of Houston - one of the universities that will be able to more quickly attain tier one status with this legislation. At today's press conference, Rep. Vo spoke of the great economic impact that voter approval of Proposition 4 will have. He mentioned that the state's additional investment in institutions of higher education would not only greatly expand the possibilities for students, resulting in a better educated populace, but would help the state maintain a competitive economic edge in technology and human capital in the 21st century.

LSG Chair Rep. Coleman spoke on the value of higher education, and the bridge that often links high school students and four year universities: community colleges. Ensuring a seamless transition for students from community colleges is vital, as well as properly funding these institutions and providing them with the resources they need to succeed. New and innovative programs like the Early College High School program are doing wonders and helping high school students begin their college careers on firm ground. This is the subject of LSG's latest report.

To view the LSG's report on Higher Education, click here. To view LSG's analysis and recommendation on Proposition 4, click here.

If we can provide your office with any additionally information on this or any other public policy topic, please do not hesitate to contact LSG Director Joe Madden at Joe@TexasLSG.org or 512-463-0524.

Public Option Would Lower Federal Deficit

The Congressional Budget Office estimates that the House health care bill, which includes a robust public option, would cost roughly the same as health care legislation passed by the Senate Finance Committee which lacks a public option. Within ten years, legislation that includes a robust public option would lower the federal deficit. Additionally, a robust public plan would help provide insurance coverage to nearly 96 percent of uninsured Americans.

Approximately one in three Americans are anxious about the possibility of losing their current health coverage. This sentiment is reflected in a new Washington Post-ABC News poll which found that 57 percent of Americans now favor the choice of a public health insurance option.

The status quo is eroding private coverage, translating to a lack of insurance for millions of working families. As premiums continue to rise, the number of employers offering health coverage has decreased from 63.3 percent in 2001 to 55.6 percent in 2008. Coverage outside the employer-sponsored market is unaffordable or fails to provide adequate coverage for most Americans.

A public option would promote lower premiums, give Texans more choices, and help hold insurance companies accountable. If reform is not enacted, the number of employers offering health coverage will continue to drop, patients' out-of-pocket costs will skyrocket, and spending by states on public programs will increase. Our families, businesses, and government cannot afford the status quo.

In Washington, the Senate is merging the health care legislation passed by the Finance Committee and the Health, Education, Labor, and Pensions Committee. I will keep you updated as any changes occur.

Senator Cornyn's "No" Vote on Health Care Reform

I'm very disappointed that Senator Cornyn chose to side with Governor Perry and the far right wing of his party to oppose health care reform in the Senate Finance Committee. It would behoove him, coming from a state with the highest number of uninsured and underinsured, to follow the responsible lead of fellow Republican Senator Olympia Snowe and take a seat at the table to work for reform.

It is reprehensible that Senator Cornyn turned down legislation that could yield as much as $402 billion for Texas[1] and provide quality health coverage to the 25 million uninsured and millions more underinsured Texans. Then again, assuming that Senator Cornyn would work for affordable health care is laughable. One needs only to look back to Cornyn's time as Attorney General when he fought plaintiffs in the Frew Medicaid case. His goal was to keep the state from doing more for children's dental, vision and preventive care.

Instead of focusing on Texas families, he reiterated Governor Perry's call to take reform to the state level. Gov Perry, in conjunction with Senator Cornyn, has a dismal track record on health care in Texas. Punting the ball back to a failed Governor is not a health care plan.

[1] Center for Public Policy Priorities, "Cost-Benefit Analysis of Medicaid Changes in National Health Care Reform: Huge Positive Gains for Texas," October 9, 2009, http://www.cppp.org/files/3/421_HHSC_EstimatesR.pdf

Dispatch from Washington: Senate Moves on Health Care Reform

I am in Washington, D.C., sitting in on the Senate Finance Committee. Moments ago, the committee voted out health care reform legislation, becoming the fifth Congressional committee to support health care reform.

I want to thank Chairman Max Baucus (D-Montana) and the members of the committee for their hard work on behalf of American families. (Click here to contact the members of the Senate Finance Committee to thank them for their work.) I am proud of the collaborative efforts by our nation's leaders to shape a policy that will improve access to quality, affordable health coverage for all Texans and Americans.

Senator Olympia Snowe, (R-Maine), in voting for the bill in committee today, spoke of the "consequences of inadequacy." This demonstrates that doing nothing is not a viable option. Action is needed now to address our country's health care problems. I'm disappointed that our home state Senator, Senator John Cornyn, voted against the bill, particularly when Texas stands to gain the most from reform given our state's dismal health standings.

Last week, I had the opportunity to attend a dinner in honor of Senator Ron Wyden (D-OR), who sits on the Senate Finance Committee, and speak at length with him regarding the urgent need to act on health care reform. Senator Wyden stressed affordability and choice of plans. Senator Charles Schumer (D-New York), while speaking in committee reiterated that a strong public option is a necessary component of any health reform package. These are all important facets of the legislation that must be addressed in any final version of health care reform. I appreciate all the work the committee members have done to move reform forward.

Today, our country made progress towards closing the gap that has left millions of Americans without health care, and millions more without adequate coverage.

Federal health insurance reform will increase stability and security for Americans with insurance and will lower the cost of health care for our families, our businesses, and our government. Health insurance reform will prevent any insurance company from denying coverage based on pre-existing conditions, will limit out-of-pocket costs, and would ban annual and lifetime limits on benefits. Additionally, the Congressional Budget Office has predicted that this legislation will reduce the federal deficit by $81 billion over 10 years.

This sound public policy will benefit working families, state economies, and small businesses across the country.

Tomorrow, I, along with my colleagues from the Progressive States Network (PSN), a national group representing state legislator across the country, will meet with the offices of Chairman Tom Harkin (D-Iowa), who is the Chairman of the Senate Committee on Health Education, Labor, and Pensions, Speaker Nancy Pelosi's office, and the White House.

I will continue to keep you updated on health care legislation, particularly as the Senate finance bill merges with the legislation passed by the Senate Committee on Health Education, Labor, and Pension.

Montrose Neighborhood News

I wanted to let you know that Montrose is being honored today by the American Planning Association as one of the country's ten great neighborhoods. Montrose is a vibrant neighborhood with an active community, including groups like the East Montrose Civic Association, the Andover Association and others, who understand that it is possible to promote economic development in a community while preserving the character of a neighborhood that makes it unique. In the Texas House, I passed legislation to authorize the East Montrose Management District to improve economic development while also keeping the character of the neighborhood intact.

As a University of St. Thomas graduate and a regular at Diedrich's (now Dirk's), my motto has always been to "keep Montrose funky," and the eclectic character of the neighborhood makes it a great place to live, work and play. Below is an article in today's Houston Chronicle regarding the American Planning Association's designation of Montrose as one of the country's ten great neighborhoods. I am proud to represent Montrose in the Texas House and glad to share with you this article on a great honor for a great neighborhood.

Eclectic, walkable and one of top 10

By MIKE SNYDER Copyright 2009 Houston Chronicle

Oct. 6, 2009, 9:50PM

Montrose, the central Houston community known for its diverse lifestyles, vibrant street life and stately historic homes, is being honored by the American Planning Association today as one of the country's 10 great neighborhoods.

Houston's sprawl, absence of zoning and reputation for haphazard development might make its recognition by the national planning establishment something of a surprise. Yet the qualities cited in the award for Montrose — its walkable street grid, carefully preserved historic districts and eclectic mix of homes and businesses — reflect Houston's preference for private rather than government-imposed planning, experts said.

In the early 20th century, long before it became the focus of slum-clearing urban renewal projects or the heart of Houston's gay and lesbian community, Montrose was an elite master-planned suburb, said Stephen Fox, a Rice University architectural historian.

“Its planning has really come from the developers of the individual subdivisions rather than representing any public policy,” Fox said.

Paul Farmer, the planning association's chief executive officer, will announce the awards to Montrose and nine other U.S. neighborhoods today at the Menil Collection museum in Houston.

Some history unsavory

Important chapters in Houston's story have played out in Montrose over the past century.

Lyndon B. Johnson and Howard Hughes once lived there. Banker Paul Broussard was stabbed to death in Montrose by a gang of gay-bashing teenagers in 1991. Men and women have packed its streets for countless parades and festivals. Five of the city's 15 designated historic districts are in Montrose.

David Robinson, the president of the Neartown Association, a coalition of Montrose area civic clubs, acknowledged that parts of the community haven't shed an unsavory reputation for prostitution, drug dealing and other crimes. But civic leaders are working on these issues, he said .

A walkable area

Robinson, an architect who serves on Houston's City Planning Commission, said the award shows that effective planning need not be imposed through heavy-handed government policy.

“It doesn't have to always be a prescribed method of growth,” Robinson said. “It's organic. The street grid, the sidewalks have meant that without zoning and for the most part without restrictive covenants, the area has been able to grow and adapt.”

The street grid — a web of straight streets with short blocks and none of the cul-de-sacs favored in suburban neighborhoods — has helped keep Montrose walkable since the days when people stepped off streetcars and walked to homes or shops, Robinson said.

David Morley, a research associate at the American Planning Association, said Montrose's pedestrian-friendly nature was an important factor in the award.

“It's one of the few places in Houston where people get out of their cars and walk around,” Morley said.

Marlene Gafrick, Houston's director of planning and development, said the award should help to dispel Houston's undeserved reputation as an unplanned city.

“I believe planning occurs at many levels, and one of the differences between Houston and a lot of cities is that a lot of our planning comes from the ground up rather than the top down,” she said.

mike.snyder@chron.com

Health Care Support Across Party Lines

This week, Gallup released a poll showing an increase in support for health care legislation before Congress, with 51 percent of Americans in favor of reform. This, coupled with news last week that 65 percent of Americans support the public option, shows that the public agrees with the importance of passing meaningful health care reform.

As I've reiterated over the course of these email updates, health care for Americans is not a Democratic or Republican issue - it is a moral issue. Catastrophic illnesses do not discriminate between one political party or another. The need for reform is recognized by a broad cross section of our country, and national Republican leaders are emerging to voice support for health care reform.

Former Republican Senate Majority Leader Bill Frist from Tennesee, a doctor, voiced support for the direction of health care reform, stating “I think we have a moment where we could do something that expands access, improves quality of care and, in time, controls costs.”

Tommy Thompson, President Bush's health and human services secretary and four-term governor of Wisconsin also offered strong praise for health care legislation. A few years ago, Secretary Thompson's innovative work reduced the number of uninsured in Wisconsin through a federal waiver program, a program he replicated in various states as secretary.

Former Republican and current New York City Mayor Michael Bloomberg, along with California Republican Governor Arnold Schwarzenegger, have also come forward in support of health care legislation.

These Republican leaders represent viewpoints from local, state and national government, from the East to the West Coast, and the Midwest to the South. They have seen the devastating impact on the uninsured and the underinsured, and they are united in recognizing that regardless of political affiliation or geographic location, the time to reform the status quo is now.

I welcome their entry to the debate, and hope that they are joined by more of their colleagues from their side of the political aisle.