Vote Notes: H.R. 1215, the Protecting Access to Care Act
Yesterday, the House passed H.R. 1215, the Protecting Access to Care Act, by a vote of 218 to 210. This bill provided legal reforms that were scored by the Congressional Budget Office to save $50 billion in federal healthcare cost over the next ten years.
The big question in this bill was whether or not there was preemption of state law. Initially, I thought there might be, and for this reason, I had planned to vote against it. I have always believed in the importance of medical malpractice reform, and it was with this in mind that I pushed for it as hard as I did during my years as governor.
But I also believe in the notion of federalism - that states are not wards of the federal government. Historically, issues like statute of limitation, contingency fees, or even joint-and-several liability have largely been the domain of state rather than federal government.
In many ways, these two bills represented a tug of war between these competing interests, and I have always believed that the greater of these interests lies in limiting the federal government and federal power. For that reason as mentioned, I would have opposed this bill, if it had been simply a contest of these two ideas.
What stood out though was language that was added to make certain that there was a nexus between federal spending and the spending control measures that were represented in the legal reforms this bill contained. This makes sense. One cannot say that they will disburse large amounts of money and then cede to states and localities all control for the way in which there might be accounting and judicious measure in how that money is spent. Think about that for a moment. The federal government should not tell states and individuals how to spend their money or how awards and settlements should be made within the state court system...but if the federal government puts great amounts of money into the healthcare system, wouldn’t it seem logical that the programs that use federal dollars have some degree of control on costs. So in this bill, the caps that it establishes on non-economic damages do not apply, if there wasn’t federal money involved in the healthcare that led to the malpractice suit and court action.
There are a whole host of other technicalities that you could discover on this bill that could be found here on this House Judiciary Committee document, but for the time being I just wanted to get back to you on my reasoning on yesterday’s vote.