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Making Healthcare Work for American Families: Ensuring Affordable Coverage

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Making Healthcare Work for American Families: Ensuring Affordable Coverage MAKING HEALTHCARE WORK FOR AMERICAN FAMILIES: ENSURING AFFORDABLE COVERAGE HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED ELEVENTH CONGRESS FIRST SESSION MARCH 17, 2009 Serial No. 111–16 ( Printed for the use of the Committee on Energy and Commerce energycommerce.house.gov U.S. GOVERNMENT PRINTING OFFICE 67–813 WASHINGTON : 2012 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Mar 15 2010 23:52 Mar 23, 2012 Jkt 067813 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 E:\HR\OC\A813.XXX A813 jbell on DSK7SPTVN1PROD with HEARING COMMITTEE ON ENERGY AND COMMERCE HENRY A. WAXMAN, California, Chairman JOHN D. DINGELL, Michigan JOE BARTON, Texas Chairman Emeritus Ranking Member EDWARD J. MARKEY, Massachusetts RALPH M. HALL, Texas RICK BOUCHER, Virginia FRED UPTON, Michigan FRANK PALLONE, JR., New Jersey CLIFF STEARNS, Florida BART GORDON, Tennessee NATHAN DEAL, Georgia BOBBY L. RUSH, Illinois ED WHITFIELD, Kentucky ANNA G. ESHOO, California JOHN SHIMKUS, Illinois BART STUPAK, Michigan JOHN B. SHADEGG, Arizona ELIOT L. ENGEL, New York ROY BLUNT, Missouri GENE GREEN, Texas STEVE BUYER, Indiana DIANA DEGETTE, Colorado GEORGE RADANOVICH, California Vice Chairman JOSEPH R. PITTS, Pennsylvania LOIS CAPPS, California MARY BONO MACK, California MICHAEL F. DOYLE, Pennsylvania GREG WALDEN, Oregon JANE HARMAN, California LEE TERRY, Nebraska TOM ALLEN, Maine MIKE ROGERS, Michigan JAN SCHAKOWSKY, Illinois SUE WILKINS MYRICK, North Carolina HILDA L. SOLIS, California JOHN SULLIVAN, Oklahoma CHARLES A. GONZALEZ, Texas TIM MURPHY, Pennsylvania JAY INSLEE, Washington MICHAEL C. BURGESS, Texas TAMMY BALDWIN, Wisconsin MARSHA BLACKBURN, Tennessee MIKE ROSS, Arkansas PHIL GINGREY, Georgia ANTHONY D. WEINER, New York STEVE SCALISE, Louisiana JIM MATHESON, Utah PARKER GRIFFITH, Alabama G.K. BUTTERFIELD, North Carolina ROBERT E. LATTA, Ohio CHARLIE MELANCON, Louisiana JOHN BARROW, Georgia BARON P. HILL, Indiana DORIS O. MATSUI, California DONNA M. CHRISTENSEN, Virgin Islands KATHY CASTOR, Florida JOHN P. SARBANES, Maryland CHRISTOPHER S. MURPHY, Connecticut ZACHARY T. SPACE, Ohio JERRY MCNERNEY, California BETTY SUTTON, Ohio BRUCE L. BRALEY, Iowa PETER WELCH, Vermont (II) VerDate Mar 15 2010 23:52 Mar 23, 2012 Jkt 067813 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 E:\HR\OC\A813.XXX A813 jbell on DSK7SPTVN1PROD with HEARING SUBCOMMITTEE ON HEALTH FRANK PALLONE, JR., New Jersey, Chairman JOHN D. DINGELL, Michigan NATHAN DEAL, Georgia, BART GORDON, Tennessee Ranking Member ANNA G. ESHOO, California RALPH M. HALL, Texas ELIOT L. ENGEL, New York BARBARA CUBIN, Wyoming GENE GREEN, Texas HEATHER WILSON, New Mexico DIANA DEGETTE, Colorado JOHN B. SHADEGG, Arizona LOIS CAPPS, California STEVE BUYER, Indiana JAN SCHAKOWSKY, Illinois JOSEPH R. PITTS, Pennsylvania TAMMY BALDWIN, Wisconsin MARY BONO MACK, California MIKE ROSS, Arkansas MIKE FERGUSON, New Jersey ANTHONY D. WEINER, New York MIKE ROGERS, Michigan JIM MATHESON, Utah SUE WILKINS MYRICK, North Carolina JANE HARMAN, California JOHN SULLIVAN, Oklahoma CHARLES A. GONZALEZ, Texas TIM MURPHY, Pennsylvania JOHN BARROW, Georgia MICHAEL C. BURGESS, Texas DONNA M. CHRISTENSEN, Virgin Islands KATHY CASTOR, Florida JOHN P. SARBANES, Maryland CHRISTOPHER S. MURPHY, Connecticut ZACHARY T. SPACE, Ohio BETTY SUTTON, Ohio BRUCE L. BRALEY, Iowa (III) VerDate Mar 15 2010 23:52 Mar 23, 2012 Jkt 067813 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 E:\HR\OC\A813.XXX A813 jbell on DSK7SPTVN1PROD with HEARING VerDate Mar 15 2010 23:52 Mar 23, 2012 Jkt 067813 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 E:\HR\OC\A813.XXX A813 jbell on DSK7SPTVN1PROD with HEARING C O N T E N T S Page Hon. Frank Pallone, Jr., a Representative in Congress from the State of New Jersey, opening statement .......................................................................... 1 Prepared statement .......................................................................................... 3 Hon. Nathan Deal, a Representative in Congress from the State of Georgia, opening statement ................................................................................................ 5 Hon. Anna G. Eshoo, a Representative in Congress from the State of Cali- fornia, opening statement .................................................................................... 5 Hon. Gene Green, a Representative in Congress from the State of Texas, opening statement ................................................................................................ 6 Hon. Lois Capps, a Representative in Congress from the State of California, opening statement ................................................................................................ 7 Hon. John D. Dingell, a Representative in Congress from the State of Michi- gan, opening statement ....................................................................................... 8 Hon. Joseph R. Pitts, a Representative in Congress from the Commonwealth of Pennsylvania, opening statement ................................................................... 9 Hon. Michael C. Burgess, a Representative in Congress from the State of Texas, opening statement .................................................................................... 10 Hon. Marsha Blackburn, a Representative in Congress from the State of Tennessee, opening statement ............................................................................ 11 Hon. Phil Gingrey, a Representative in Congress from the State of Georgia, opening statement ................................................................................................ 11 Hon. Kathy Castor, a Representative in Congress from the State of Florida, opening statement ................................................................................................ 12 Hon. Betty Sutton, a Representative in Congress from the State of Ohio, opening statement ................................................................................................ 12 Hon. Tammy Baldwin, a Representative in Congress from the State of Wis- consin, opening statement ................................................................................... 13 Hon. Tim Murphy, a Representative in Congress from the Commonwealth of Pennsylvania, opening statement ................................................................... 13 Hon. Jim Matheson, a Representative in Congress from the State of Utah, opening statement ................................................................................................ 14 Hon. Joe Barton, a Representative in Congress from the State of Texas, prepared statement .............................................................................................. 153 Hon. Roy Blunt, a Representative in Congress from the State of Missouri, prepared statement .............................................................................................. 158 Hon. Henry A. Waxman, a Representative in Congress from the State of California, prepared statement ........................................................................... 160 WITNESSES Uwe Reinhardt, Ph.D., Professor of Political Economy, Economics and Public Affairs, Princeton University .............................................................................. 15 Prepared statement .......................................................................................... 18 Sally C. Pipes, B.A., President and Chief Executive Officer, Pacific Research Institute ................................................................................................................ 31 Prepared statement .......................................................................................... 33 Judy Feder, Ph.D., Senior Fellow, Center for American Progress Action Fund 36 Prepared statement .......................................................................................... 38 Mila Kofman, J.D., Superintendent of Insurance, State of Maine Bureau of Insurance .......................................................................................................... 92 Prepared statement .......................................................................................... 95 Jon Kingsdale, Ph.D., Executive Director, Commonwealth Health Insurance Connector Authority ............................................................................................ 100 Prepared statement .......................................................................................... 103 (V) VerDate Mar 15 2010 23:52 Mar 23, 2012 Jkt 067813 PO 00000 Frm 00005 Fmt 5904 Sfmt 5904 E:\HR\OC\A813.XXX A813 jbell on DSK7SPTVN1PROD with HEARING VI Page Karen Pollitz, M.P.P., Research Professor, Georgetown University Health Pol- icy Institute .......................................................................................................... 107 Prepared statement .......................................................................................... 109 Katherine Baicker, Ph.D., Professor of Health Economics, Harvard School of Public Health .................................................................................................... 116 Prepared statement .......................................................................................... 119 Edmund F. Haislmaier, B.A., Senior Research Fellow, Center
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