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This is turning into a series.  I am supposedly represented by Jim Gerlach (repulsican PA6) who seems to be a bit of a chicken when it comes to the whole shut down/CR thing.  He's been writing his little fingers off.  I think he's a afraid of being primaried by the right and losing to the Democrat.    

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Gerlach, because he is the spineless wonder kind of republican, has put himself between  a rock and hard place.  He would like to not shut down the government, he'd like to vote for a clean CR, he'd like to defund Obamacare and he'd like everyone to leave him alone.

So this fourth email in a week and half, is full of lies and half lies.  

Thank you for contacting me regarding your thoughts about the Patient Protection and Affordable Care Act (P.L. 111-148) – commonly known as ObamaCare.  I appreciate the opportunity to respond and share my position on this legislation.

First, let me make clear that I appreciate you taking the time to share with me your thoughts on this law and how it may positively impact you.  Since this legislation was signed into law in March 2010, I have had the opportunity to hear from many of my constituents regarding their thoughts and beliefs about this law and the role of the federal government in health care.  The perspectives of constituents, like you, are valuable in learning the real world implications, impact, and effects of this law.  

That being said, the experience of many Americans will differ greatly as a result of implementation of this law.  While some individuals, including those with pre-existing conditions, may be able to find more affordable health care options through federal health care exchanges, others will see their health care premiums increase or find that their employers, who previously provided health care coverage, will no longer do so.

For example, according to the Wall Street Journal, 27-year old non-smoker males in the Philadelphia metro region will see premiums more than double – just to obtain the least-expensive or "bronze" policy available – from $73/month to $195/month.  Further, according to findings issued by the Manhattan Institute for Policy Research, this law will increase rates on similar policies for 40-year old men nationwide by an average of 99 percent and 40-year old women nationwide by an average of 62 percent.  

While I have long advocated for health care reform, I opposed this law when it passed the House in 2010 and remain opposed to it today because I disagree with the law's imposition of universal, one-size-fits-all mandates and penalties for both individuals and employers.  These mandates and penalties fail to take into consideration regional effects, the fragile nature of our current economy, and the evolving state of the health care industry.  With unemployment at unacceptably high rates and more individuals giving up looking for work and dropping out of the labor force altogether, now is not the time to force some Americans to pay upwards of $100 more in after-tax dollars each month to maintain their health care coverage.

Nor is it the time for the federal government to impose additional mandates on our country's businesses.  By requiring employers with 50 or more workers who work 30 or more hours a week – a definition of "full-time" employment previously not set forth in federal law – employers are incentivized to focus their staffing needs on part-time or temporary jobs, as compared to full-time careers.  As a result, businesses such as SeaWorld have limited weekly part-time hours for employees from 32 to 29 while companies like Trader Joe's and Home Depot have indicated that they will stop providing medical coverage for part-time employees.  In addition, small businesses with workforces close to or near the law's 50 person threshold will be uniquely affected as this law will directly impact long-term staffing decisions.  According to the National Federation of Independent Business, a mid-sized restaurant that goes from 49 to 50 employees could face up to a $40,000 per year penalty as a result of these very requirements.

Another example of this law's negative impact on job creation and economic development is its imposition of a new 2.3 percent tax on the sale of medical equipment and devices, which took effect on January 1, 2013.  In the 6th Congressional District of Pennsylvania, innovation, investment, and jobs in the life sciences and biotechnology sector are at risk because of this new $30 billion tax hike on medical innovation.  There are almost 600 medical device companies that employ over 20,000 Pennsylvanians in high paying jobs.  The non-partisan Congressional Budget Office (CBO) has confirmed that this tax would cause job losses or be passed onto consumers in the form of higher prices—and ultimately higher premiums.  To date, nationwide over 7,000 employees have been laid off by medical device companies and recent studies project that over 40,000 additional jobs will be adversely impacted as a result of this tax.

During the 112th Congress, I introduced legislation (H.R. 488) to repeal this job-crushing tax, and in the current 113th Congress, I am pleased to work with my colleague on the House Committee on Ways & Means, Rep. Erik Paulsen of Minnesota, to support legislation (H.R. 523) to repeal this tax.  Currently, this legislation has over 260 bipartisan cosponsors.  You may be interested to know that on October 2nd, I joined with a bipartisan group of House Members, including Rep. Ron Kind of Wisconsin, to offer a legislative proposal to repeal the medical device tax in an effort to end the ongoing federal government shutdown.

Further, I remain opposed to this law because I continue to have concerns about the law's unintended and unforeseen negative consequences.  During the 111th Congress, the underlying legislation was rushed through the legislative process without the necessary deliberation, review, and consideration that comprehensive health care reform deserves.  As a direct result, since enactment in March 2010, President Obama himself has signed into law seven pieces of legislation to defund or repeal harmful parts of this law.  These laws repealed ObamaCare's burdensome Form 1099 reporting requirements and the Community Living Assistance Services and Supports (CLASS) program – which was deemed by individuals in both political parties to be unsustainable; removed $14 billion in unintended taxpayer costs by clarifying the eligibility calculation for certain programs; and eliminated $2.5 billion in excess funding for the "Louisiana Purchase" – a political promise made by the President to certain elected officials from Louisiana in exchange for their votes in support of the law.

In addition, this law has been besieged by delays, glitches, and lawsuits – with more than 70 legal actions still pending before federal courts – many resulting from numerous flaws in drafting and an unprecedented and unconstitutional reliance on federal agencies to legislate in the place of Congress.  Simply stated, efforts to reach across the aisle and work together to get this law right the first time were sacrificed for political expediency.

Despite these significant concerns, this law does contain some common-sense policies that I support.  For example, I support policies to forbid insurance companies from denying coverage based on a pre-existing condition or disability, allow unmarried children to remain on their parents' insurance through age 26, encourage incentives for Americans to seek preventive care, and increase funding for community health centers that provide routine care for thousands of patients in Pennsylvania.  In addition, I support Congress providing tools to attempt to reduce Medicare waste, fraud, and abuse, which add costs to the current health care system, and creating an FDA licensure pathway for the development of lifesaving drugs and therapies that protect patient safety and innovation.  

While I support the aforementioned policy goals, I disagree with the legislative methods set forth in the law to achieve them, and as a result I have supported legislation to enact alternatives and reforms to this law, which would enact common-sense solutions to lower health care costs and increase access to quality care.  The critical reforms proposed and included as part of these efforts would:

    Enact medical liability reform to combat skyrocketing medical liability insurance rates, frivolous lawsuits, and end the practice of defensive medicine;

    Allow Americans to purchase health insurance across state lines, which would open up the market for low-cost insurance to individuals residing in states with expensive health insurance rates and plans;

    Expand Health Savings Accounts (HSAs), which have proven to be popular savings tools that allow families to obtain cost-effective health care, and improve HSAs to make it easier for patients in high-deductible health plans to use them to obtain access to quality care;

    Ensure that health care is accessible for all – regardless of pre-existing conditions or past illnesses – by expanding state high-risk pools and reinsurance programs and preventing insurers from denying coverage to someone with prior coverage on the basis of a pre-existing condition or dropping existing coverage due to illness; and

    Incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans.

You may be interested to know that each of the above-mentioned reforms was included in the Republican alternative legislation that I cosponsored during the 112th Congress – H.R. 397, the proposed Reform Americans Can Afford Act – which was introduced by Representative Wally Herger of California.  Unfortunately, this legislation was not considered by the U.S. House of Representatives prior to the adjournment of the last Congress.

Currently in the 113th Congress, with the implementation date of this law fast approaching, I have worked with my colleagues in the House to advance legislative reforms to address some of the most onerous provisions in this law.  In addition to my efforts to repeal the medical device tax imposed by this law, I have cosponsored and/or voted to support legislation offering the following reform proposals:

    Delay for One Year the Tax Penalties for Failure to Comply with the Law's Insurance Mandates.  Since enactment, the Administration has acted to delay selected provisions of this law on 12 separate occasions.  Most notably, on July 2nd, the U.S. Treasury – not Congress – acted to amend the law and delay enactment of the "employer mandate" until 2015.  According to the U.S. Treasury, the delay in the employer mandate was necessary to assess ways to simplify the reporting process and to allow businesses additional time to adjust health coverage.  While providing businesses with more time to adjust and study their options, the Administration failed to offer that same consideration to American families who will be struggling to grasp the new options provided through these exchanges and register for the law prior to its January 1, 2014 effective date.

As a result, I cosponsored three bills (H.R.2667, H.R. 2668, and H.R.2809) that would delay until 2015 the requirements that (1) individuals maintain minimal essential health care coverage, and (2) employers offer full-time employees the opportunity to enroll in minimum essential coverage offered through federal health care exchanges or face tax penalties.  All that these bills would do is enact into law the U.S. Department of Treasury's July 2nd regulation delaying the law's employer mandate and then extend that relief to the average American family.

Without enactment of this legislation, families and individuals will still be required to buy some kind of insurance – warts and all – or face taxes levied by the IRS.  No matter what side of the aisle you're on, it simply is not fair to relieve businesses of the burdens imposed by this law and not provide the same relief to individuals and families.  As you may know, H.R. 2667 and 2668 passed the House on July 17th and the language of H.R. 2809 was included as an amendment to H.J. Res. 59, which passed the House on September 28th.  The Senate did not consider H.R. 2667 or H.R. 2668 and rejected the language of H.R. 2809 included in H.J. Res. 59.

    Increase and Improve Consumer Choice through Expanded Health Savings Account Access.  As stated above, this law unreasonably restricts families' ability to place tax-free dollars in HSAs and flexible spending accounts (FSAs), which are effective savings tools that allow families to have flexibility in determining how to best dedicate their health care dollars based on their unique needs.  Currently, this law imposes a $2,500 FSA contribution cap and prohibits HSA and FSA participants from using their own account dollars to purchase over the counter medicines without a prescription.

I have cosponsored legislation (H.R. 1248 and H.R. 2835), which would amend those provisions of the law that prohibit the use of tax-free HSA and FSA funds to purchase over-the-counter medicines and impose a cap of $2,500 on FSA contributions.  Instead of limiting the ability for Americans to use money in these tax-free accounts for health care purposes, I support efforts to improve opportunities for my constituents to save tax-free dollars and exercise greater choice and flexibility in how they spend their health care dollars.

    Redefine the Law's Definition of Full-Time Employee to Save American Jobs.  As stated above, this law provides incentives for businesses to shift the number of hours employees work in order to avoid penalties imposed under the law.  I have cosponsored H.R. 2575, the proposed Save American Workers Act of 2013, which would amend the Tax Code to redefine "full-time employee," for purposes of the law's employer mandate, as an employee who is employed on average at least 40 hours of service a week, as compared to at least 30 hours a week.

By increasing the number of hours that a "full-time" employee is allowed to work each week – this law would encourage, not discourage – employers to continue to provide full-time employment options without fear of federal taxes or penalties.

    Prevent Unelected Bureaucrats from Cutting Medicare.  I am opposed to this law's creation of the Independent Payment Advisory Board (IPAB), which is a 15-member, nonelected board empowered to recommend changes to Medicare if projected per beneficiary spending growth exceeds specific levels.  In an effort to ensure that Congress works in a bipartisan manner to establish new payment and delivery models that provide health care providers with the ability to improve patient care and reduce long-term costs, I am a cosponsor of legislation (H.R. 351, the proposed Protecting Seniors' Access to Medicare Act of 2013), which would repeal the IPAB and strengthen Medicare by giving beneficiaries more control over their health care and allowing patients and their doctors, not the federal government, to make decisions about their needs.

    Ensure that Protections are Operational to Prevent Fraud and Program Abuse.  Given the alarms sounded by the Obama Administration and government watchdogs about concerns that this law is not ready to be implemented on time, I have cosponsored and voted to support legislation to ensure that that no premium tax credits or government dollars are spent for the purchase of qualified health benefit plans under this law until the Secretary of Health and Human Services can certify that there is a program in place, consistent with ACA requirements, to verify the household income and coverage requirements of individuals applying for such credits and cost-sharing reduction through government run exchanges.  This legislation, H.R.2775, the proposed No Subsidies Without Verification Act, passed the House with my support by a vote of 235-191 on September 12th.  To date, the U.S. Senate has not considered this legislation.

    Support Efforts to Combat Rare Diseases.  This law also links certain fee exemptions for the development of "orphan drugs" – or drugs designated to treat certain rare diseases – to the ability of the drug manufacturer to receive the "Orphan Drug Tax Credit."  As you may know, a rare disease is one for which 200,000 or fewer patients in the US have been diagnosed.  There are roughly 6,800 rare diseases according to The National Organization for Rare Disorders and only approximately 300 of those have U.S. Food and Drug Administration approved treatments.

By imposing this policy on all orphan drug manufacturers, regardless of size or ability to obtain this tax credit, this law has had the unintended consequence of stifling innovation and limiting the development of "orphan drugs" to only those corporations that either qualify for the Tax Credit or are able to pay the fees imposed by this law – which is counter to 25 years of congressional history to encourage development of such therapies.  In an effort to fix this problem, I have introduced legislation (H.R. 2315) that would provide a narrow revenue-neutral remedy to allow all businesses to continue research and development efforts for Orphan Drugs without penalty.  It is my hope that this legislation will be brought to the House floor for consideration in near future.

At the end of the day, while we may disagree on the merits of this law, I believe we share a common goal in improving the affordability, availability, and quality of health care for all Americans.  Please know that I remain committed to this goal, and as Americans continue to face problems in the health care system, I will continue to work in Congress to correct and address them and will keep you updated on this progress.

Again, thank you for contacting me regarding this important issue.  Please let me know if I can be of any assistance to you or your family in the future.  

With kind regards, I am

Sincerely,

Jim Gerlach
Member of Congress                   

This letter is in response to an email I sent to his office regarding is obstructionism of the CR and the ACA.  Notice he trots out the typical rightie talking points about medical malpractice suits, across state lines insurance companies,  health savings accounts would lower rates with absolutely no proof at all.  We know that states that have severely limited a patient's ability to sue for malpractice have not reduced health care costs.  How health care saving accounts would cut costs is beyond me.  

Of course he wants to delay the ACA because freedom.  He throws out the talking point that the ACA is cutting jobs and will hurt job creation, again when the facts do not support this.  He wants to repeal the tax on medical devices because somehow this small tax will stop people from creating or using these devices(?).  I'll delay a knee replacement because of small tax on the manufacturer?  Drug manufacturers should pay a tax but not device makers?  I long for logic.

And let's not forget that this program is full of fraud and abuse (even though it's private insurance) and so must be monitored by some board except he doesn't like boards like IPAB. So while he has no plan to cover the uninsured except to implement things that the working poor can't afford anyway, I'm sure he'd like us to think he really wants to do something.  I think maybe he should support universal health care for all because he doesn't want to touch Medicare benefits.  Did I mention that Pennsylvania has the second highest number of elderly after Florida?

I'm sure I'll be hearing from Jimmeh again.

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