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Chairman Yarmuth Opening Statement at Hearing on Considerations for Establishing a Single-Payer Health Care System

May 22, 2019

Washington, D.C.— Kentucky Congressman John Yarmuth, Chairman of the House Budget Committee, gave the following opening statement at today’s hearing on single-payer policy considerations and expanding access to affordable health care. Remarks as prepared are below:

This hearing will come to order. I’d like to welcome our witnesses from the Congressional Budget Office – thank you for joining us. I appreciate the opportunity to dive in to your recent report on single-payer health care systems.

Ensuring access to quality, affordable health care remains one of the greatest policy challenges of our time.

The Affordable Care Act has given us a great foundation on which to build.  Since it was enacted, 20 million more Americans have been able to gain meaningful health coverage. Now, 89 percent of Americans under 65 are insured—a historic high.

But even with these dramatic gains, 30 million Americans still live without health insurance. And even for those Americans with health insurance, many are underinsured and still struggle with high deductibles and copays. Too many American families still must make the impossible choice between going to the doctor or putting food on their table; filling their gas tank or refilling a prescription.

We cannot accept this tragic reality as the status quo. Progress must produce more progress, and we must begin to pursue the next wave of health care reforms.

That’s why last summer I promised that if I became Chairman of the House Budget Committee, we would hold a hearing on single-payer health care. In January, I requested a CBO report on key policy considerations to lay the groundwork for advancing legislation to expand quality and affordable health coverage. Earlier this month, CBO released this report, and today we will examine its findings. 

My goal for this hearing is to work through some of the policy issues laid out in this report, including: what eligibility would look like, and what benefits could be covered? How the system could be financed? How a single-payer system might affect the price of prescription drugs? What kind of transition period would be needed to allow health care providers and other stakeholders time to prepare?

Major reforms like the ones outlined in this report would mean major consequences for the health of our citizens, as well as the health of our economy. They must be done carefully and methodically – but not without urgency. Access to affordable health care isn’t just a policy proposal or a political slogan—it’s life or death for millions of Americans. 

I also hope to review what we, as a country, spend on health care now and what we get in return – as well as our long-term fiscal outlook with or without major reforms. Last year, health spending accounted for 18 percent of our economy. We spend upwards of $3.5 trillion annually as a nation on health care – more, per person, than any other country -- and yet our outcomes are some of the worst among developed nations. Our wasteful and inefficient system has led to skyrocketing prescription drug prices and out-of-pocket costs for consumers, all while insurance companies and CEOs continue to post massive profits.

A single-payer system could expand access to care, decrease our nation’s total health care spending and help grow our economy. The trick is closing the information gap on what single-payer health care truly is, so that we can close the health coverage gap for millions of American families.

I know that the advocates here today and across the country have been at the front lines of this fight for years, and I want to thank you for that hard work and dedication. I have also talked to small business owners and numerous CEO’s of Fortune 500 companies; they privately tell me they are all for a single-payer system. They know we are the only country that does it this way. Last year, the average U.S. employer spent more than $5,700 for a single employee plan and more than $14,000 for a family health insurance plan. These CEO’s know that a system of employer-based coverage puts them at a disadvantage with their global competitors. There is a consensus among economists that our system of employer-based coverage displaces wages. Relieving employers from the burden of providing coverage will empower American companies to raise employee wages, expand their businesses, and help to grow our nation’s economy.

Given all these reasons, it is incumbent upon us to begin to work through the opportunities and tradeoffs involved in a single-payer system, as well as other ways to achieve universal coverage, many of which have been proposed by members of this committee. I strongly believe it’s not a matter of if we will have universal coverage, but when. The CBO report and this hearing are designed to advance that timeline.

I thank our witnesses for helping us with this important discussion and look forward to your testimony.

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