For much of this year, both the House and Senate have been working on health care reform legislation with the goal of providing health care coverage for all Americans and lowering the unsustainable costs in our health care system. This is an undertaking that has been decades in the making and this week's passage of the Affordable Healthcare for America Act represents a historic moment that lends great momentum to finally achieving this most important need and our late Senator Ted Kennedy's lifelong dream.

At its core, this health care reform legislation is built on the principle of "shared responsibility". Individuals will be required to have coverage, employers will be required to provide coverage, and the government will assist in the purchase of insurance for those who cannot afford to it on their own. In this regard, it is very similar to the universal health care system in Massachusetts that we already have.

As this health care bill was crafted over the last several months, I solicited input from thousands of Fifth District residents. I also met extensively with doctors, nurses, hospitals, insurance company representatives, patient advocates, and other health care stakeholders in our district. I heard repeatedly that driving down the high cost of health care and correspondingly the cost of insurance is our greatest challenge.

The Affordable Health Care for America Act takes many steps to address skyrocketing health care costs. First, it requires insurance companies to cover, with no extra charge, routine checkups and preventive care, like mammograms, colonoscopies, and routine vaccinations. That way, fewer people will need to rely on expensive emergency room and hospital care for potentially preventable illnesses.

But more importantly, this bill makes significant steps towards changing the way we pay for healthcare. By encouraging hospitals and doctors to work together to manage and coordinate care, we can avoid duplicating tests and can pay doctors a salary rather than a fee for each service. These types of payment structures have been successful in reducing costs in places such as the Cleveland and Mayo Clinics, while maintaining outstanding levels of care. Our current fee-for-service system is part of the reason why health care premiums have doubled in 9 years.

In order to keep insurance companies honest, increase competition, provide consumers with more choices, and lower some of these unsustainable costs, the bill will provide consumers with the option of choosing a public health insurance plan. This public option will operate on a level playing field with private insurers, and will have to be self-sufficient, relying on the premiums it collects.

This health care reform measure also gives families the peace of mind that they will have access to health care when they need it, by preventing the denial of health care coverage due to pre-existing conditions and making it illegal for insurance companies to drop your coverage when you get sick.

Additionally, seniors will see their prescription drug costs go down. Seniors, 7,400 of whom live in the Fifth District, who currently fall into the Medicare "donut hole", the gap in which prescription drugs are not covered, will see that gap in coverage completely closed over time.

The Affordable Healthcare for America Act takes significant steps towards covering all Americans, while enabling anyone happy with their current plan to keep it, facts which have earned it the endorsement of the American Medical Association, American Nurses Association, the AARP, and many other leading health care provider and patient advocacy groups.

Finally, this bill is fully paid for, not adding a dime to our deficit now or in the future. The non-partisan Congressional Budget Office estimates that the bill will reduce our nation's growing deficit over ten years by $104 billion.

As with any undertaking of this magnitude, the legislation is not perfect. I am very disappointed that the final bill included language that severely restricts access to reproductive health services for women. I will be working with my colleagues in the House of Representatives to change this unreasonable and unwarranted language in conference.

But overall, I strongly believe that this bill expands access to health care for nearly all of our citizens, and begins to control the unsustainable cost of care. It is for these reasons that I was proud to support it.

Congresswoman Niki Tsongas represents Haverhill as part of the 5th District in the U.S. House of Representatives.

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