Joe Biden on Health Care
Vice President; previously Democratic Senator (DE)
Those near doughnut hole you get $600 more for Rx benefits
Q: Will benefits for Americans under Medicare have to change for the program to survive?
RYAN: Give younger people, when they become Medicare-eligible, guaranteed coverage options that you can't be denied, including traditional Medicare. Choose your
plan, and then Medicare subsidizes your premiums.
BIDEN: It's a voucher. Now they got a new plan: "Trust me, it's not going to cost you any more." Folks, follow your instincts on this one. What we did is we saved $716 billion and applied it to
Medicare. We cut the cost of Medicare. We stopped overpaying insurance companies. And it extends the life of Medicare to 2024. They want to wipe this all out. It also gave more benefits. Any senior out there, ask yourself: Do you have more benefits
today? You do. If you're near the doughnut hole, you have $600 more to help your prescription drug costs. You get wellness visits without copays. They wipe all of this out, and Medicare becomes insolvent in 2016.
Source: 2012 Vice Presidential debate
, Oct 11, 2012
Medicare gives seniors choice, even if Rx prices negotiated
BIDEN: If we just did one thing--allow Medicare to bargain for the cost of drugs like Medicaid can--that would save $156 billion right off the bat.
RYAN: And it would deny seniors choices.
BIDEN: All you seniors out there, have you been denied
choices? Have you lost Medicare Advantage?
RYAN: Because it's working well right now.
BIDEN: Because we changed the law!
Q: Why not very slowly raise the Medicare eligibility age by two years, as Congressman Ryan suggests?
I was there when we did that with Social Security, in 1983. We made the system solvent to 2033. We will not, though, be part of any voucher [that says] when you're 65, go out there, shop for the best insurance you can get; you're out of Medicare.
This voucher will not keep pace with health care costs, because if it did keep pace with health care costs, there would be no savings.
RYAN: A voucher is you go to your mailbox, get a check and buy something. Nobody's proposing that.
Source: 2012 Vice Presidential debate
, Oct 11, 2012
Advised delaying ObamaCare while busy avoiding Depression
Reforming health care was always going to be hard. To make matters harder, Obama's own top people--from Rahm Emanuel to Joe Biden--were unenthusiastic at first. hey felt that a big reform package would overload the circuits.
Whether to pursue major
health care reform in the first year had been a furious topic of debate going back to the transition. Rahm believed that pushing something too big on health care in 2009 was a mistake.
Joe Biden was on Rahm's side.
He said during the transition that the Americans he and Obama had met on the campaign trail would understand if health care reform had to be delayed because the government was busy avoiding a depression. "They'll give you a pass on this one," he
told the president. Anyone who knew Congress understood that getting a bipartisan bill would be difficult amid so much economic wreckage.
Source: The Promise: Obama Year One, by Jonathan Alter, p.244-245
, May 18, 2010
Modernize, simplify & expand health insurance
His plan for dealing with the healthcare crisis is vague to nonexistent, with references to containing costs by “modernizing” and “simplifying” the system; “expanding” health insurance;
and looking at “innovative alternatives” pioneered by the states to “evaluate what works best in providing affordable access to healthcare for all.”
Source: The Contenders, by Laura Flanders, p.180
, Nov 11, 2007
Help medical students find ways to finance their tuition
You got to help them pay off their education. They start off in the hole. They graduate and have these gigantic bills, 40,000 bucks a year. They graduate hundreds of thousands of dollars in debt. You got to give them ability to write that off if they
engage in public service, move into areas where they need doctors, and get the insurance company out of looking over their shoulders & everything. They know the decisions to make and what they should be doing. They should be rewarded for their decisions.
Source: 2007 Democratic debate at Drexel University
, Oct 30, 2007
Start paying for universal coverage with $100B in redundancy
Q: Do you favor universal coverage for everyone without exception?
A: Yes, I do.
Q: How would you pay for it?
A: I would pay for it by three ways. 1) I start off dealing with going into a prevention-and-treatment mode here that required us to
simplify and modernize the system. That could save $100 billion a year in redundancy that goes on right now. 2) I would immediately provide for catastrophic health insurance for all Americans, and I’d immediately move for insuring every single child in
America. That would cost less than what the top 1% tax break costs, $85 billion a year. 3) Then what I would do is I would move to insuring everyone through one of two vehicles. Either a system we work out among the stakeholders, an agreement that
everyone essentially gets Medicare from the time you’re born or a system whereby everyone can buy into the federal system. Those who don’t have the means to buy in, then you subsidize them into the system. I would pay for that by direct revenues.
Source: Huffington Post Mash-Up: 2007 Democratic on-line debate
, Sep 13, 2007
Rethink healthcare by focusing on prevention
Q: Do we need to fundamentally rethink the way we view health care?
A: Absolutely. We have to view it in three ways. Prevention. You know, an ounce of prevention worth a pound of cure is real. We virtually do not have anything that rewards those
people who are engaged in their physician’s or insurer’s companies that emphasize prevention. The second thing we have to do is we have to provide for changing the way we think of it as an employer-based system totally.
We have an overwhelming opportunity now to get universal health care, because business needs more than labor or business needs it more than the uninsured. They cannot compete internationally. We have to think about it really differently, but the delivery
of health care we have to think about differently, too. The idea we’re not going to be opening up little clinics in shopping centers all across America that is going to generate avoidance of operating of emergency rooms is just not reasonable.
Source: Huffington Post Mash-Up: 2007 Democratic on-line debate
, Sep 13, 2007
Start with catastrophic insurance and insuring all kids
Q: How would you address the millions of uninsured, and the cost for those insured?
A: We need not just 100,000 new cops, but 100,000 new nurses that we fund in order to make things better. We have to be in a position where we don’t let the perfect
become the enemy of the good. In the first year, I’d insure every single, solitary child in America and make sure catastrophic insurance exists, and for every single person in America, while we move toward a national health care system covering anybody.
Source: 2007 AFL-CIO Democratic primary forum
, Aug 8, 2007
Got tested for AIDS after blood transfusion; no shame in it
Q: African-Americans, though 17% of all American teenagers, are 69% of the population of teenagers diagnosed with HIV/AIDS. What is the plan to protect these young people from this scourge?
BIDEN: You’re asking, how do we prevent these 17-year-olds from
getting HIV? All the things that were said here [by the other candidates] are good ideas; but they don’t prevent that. There’s neglect on the part of the medical and the white community focusing on educating the minority community out there. I spent last
summer going through the black sections of my town, trying to get black men to understand it is not unmanly to wear a condom, getting women to understand they can say no, getting people in the position where testing matters. I got tested for AIDS.
I know Barack got tested for AIDS. There’s no shame in being tested for AIDS.
OBAMA: I got tested with my wife Michelle, in public, when we were in Kenya.
BIDEN: And I got tested to save my life, because I had 13 pints of blood transfusion.
Source: 2007 Democratic Primary Debate at Howard University
, Jun 28, 2007
Survived two aneurysms in the 1990s
Joe Biden of Delaware last ran for the presidency in 1988. He's been into he Senate going on thirty years. Right from the start, Joe has a fire-in-his-belly problem: People will ask, rightly, whether he has it.
Without it, as Fritz Mondale once remarked (and never lived down), you're facing a long road of Holiday Inns.
Running is a horrible strain, and those with long memories will recall that
Biden survived two aneurysms more than a decade ago. Racing to Iowa every spare second to go to farm breakfasts at 5:30 a.m., making calls every minute begging for money, flying commercial
(coach, no less) day after day, gets old awfully fast if you don't have that fire in your belly.
Source: The Case for Hillary Clinton, by Susan Estrich, p.166
, Oct 17, 2005
Joe Biden on Voting Record
McCain health plan is ultimate Bridge to Nowhere
Q: Are you interested in defending Sen. McCain’s health care plan?
PALIN: He’s proposing a $5,000 tax credit for families so they can purchase their own health care coverage. That’s budget neutral. That doesn’t cost the government anything as opposed t
Barack Obama’s plan to mandate health care coverage and have a universal government-run program.
BIDEN: McCain’s health care plan, you know, it’s with one hand you giveth, the other you taketh. You know how John McCain pays for his
$5,000 tax credit a family will get? He taxes as income every one of you who has a health care plan through your employer. That’s how he raises $3.6 trillion: taxing your health care benefit, which his website points out will go straight to the insurance
company. Then you’re going to have to replace the plan you get through your employer--on average it costs $12,000--you have to replace a $12,000 plan with a $5,000 check you just give to the insurance company. I call that the “Ultimate Bridge to Nowhere.
Source: 2008 Vice Presidential debate against Gov. Sarah Palin
, Oct 2, 2008
Voted YES on overriding veto on expansion of Medicare.
Pres. GEORGE W. BUSH's veto message (argument to vote No):
- Extends Medicare to cover additional preventive services.
- Includes body mass index and end-of-life planning among initial preventive physical examinations.
- Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.
I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it because:In addition, H.R. 6331 would delay important reforms like the Durable Medical
Equipment, Prosthetics, Orthotics, and Supplies competitive bidding program. Changing policy in mid-stream is also confusing to beneficiaries who are receiving services from quality suppliers at lower prices. In order to slow the growth in Medicare spending, competition within the program should be expanded, not diminished.
- It would harm beneficiaries by taking private health plan options away from them.
- It would undermine the Medicare prescription drug program.
- It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.
Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.
Reference: Medicare Improvements for Patients and Providers Act;
; vote number 2008-S177
on Jul 15, 2008
Voted NO on means-testing to determine Medicare Part D premium.
CONGRESSIONAL SUMMARY:To require wealthy Medicare beneficiaries to pay a greater share of their Medicare Part D premiums.
SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.
OPPONENT'S ARGUMENT FOR VOTING NO:Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.
Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.
Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56
Bill S.Amdt.4240 to S.Con.Res.70
; vote number 08-S063
on Mar 13, 2008
Voted NO on allowing tribal Indians to opt out of federal healthcare.
TRIBAL MEMBER CHOICE PROGRAM: Members of federally-recognized Indian Tribes shall be provided the opportunity to voluntarily enroll, with a risk-adjusted subsidy for the purchase of qualified health insurance in order to--
- improve Indian access to high quality health care services;
- provide incentives to Indian patients to seek preventive health care services;
- create opportunities for Indians to participate in the health care decision process;
- encourage effective use of health care services by Indians; and
- allow Indians to make health care coverage & delivery decisions & choices.
SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix
any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.
Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.
OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?
LEGISLATIVE OUTCOME:Amendment rejected, 28-67
Reference: Tribal Member Choice Program;
Bill SA.4034 to SA.3899 to S.1200
; vote number 08-S025
on Feb 14, 2008
Voted YES on adding 2 to 4 million children to SCHIP eligibility.
Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.
Proponents support voting YES because:
Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:
- It terminates the coverage of childless adults.
- It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
- It contains adequate enforcement to ensure that only US citizens are covered.
Opponents recommend voting NO because:
Rep. DEAL: This bill
[fails to] fix the previous legislation that has been vetoed:
- On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
- On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
- On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.
Veto message from President Bush:
Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.
Reference: Children's Health Insurance Program Reauthorization Act;
Bill H.R. 3963
; vote number 2007-403
on Nov 1, 2007
Voted YES on requiring negotiated Rx prices for Medicare part D.
Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.
Proponents support voting YES because:
This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.
It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses.
HR4 does not require using the Department of Veterans Affairs' price schedule.
Opponents support voting NO because:
Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.
Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Reference: Medicare Prescription Drug Price Negotiation Act;
Bill S.3 & H.R.4
; vote number 2007-132
on Apr 18, 2007
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)
Voted YES on expanding enrollment period for Medicare Part D.
To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Reference: Medicare Part D Amendment;
Bill S Amdt 2730 to HR 4297
; vote number 2006-005
on Feb 2, 2006
Voted YES on increasing Medicaid rebate for producing generics.
Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs;
Bill S Amdt 2348 to S 1932
; vote number 2005-299
on Nov 3, 2005
Voted YES on negotiating bulk purchases for Medicare prescription drug.
Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Reference: Prescription Drug Amendment;
Bill S.Amdt. 214 to S.Con.Res. 18
; vote number 2005-60
on Mar 17, 2005
Voted YES on $40 billion per year for limited Medicare prescription drug benefit.
S. 1 As Amended; Prescription Drug and Medicare Improvement Act of 2003. Vote to pass a bill that would authorize $400 billion over 10 years to create a prescription drug benefit for Medicare recipients beginning in 2006. Seniors would be allowed to remain within the traditional fee-for-service program or seniors would have the option to switch to a Medicare Advantage program that includes prescription drug coverage. Private insurers would provide prescription drug coverage. Private Insurers would engage in competitive bidding to be awarded two-year regional contracts by the Center for Medicare Choices under the Department of Health and Human Services.Enrolled seniors would pay a $275 deductible and an average monthly premium of $35. Annual drug costs beyond the deductible and up to $4,500 would be divided equally between the beneficiary and the insurer. Beneficiaries with incomes below 160 percent of the poverty level would be eligible for added assistance.
Reference: Medicare Prescription Drug Benefit bill;
; vote number 2003-262
on Jun 26, 2003
Voted YES on allowing reimportation of Rx drugs from Canada.
S. 812, as amended; Greater Access to Affordable Pharmaceuticals Act of 2002. Vote to pass a bill that would permit a single 30-month stay against Food and Drug Administration approval of a generic drug patent when a brand-name company's patent is challenged. The secretary of Health and Human Services would be authorized to announce regulations allowing pharmacists and wholesalers to import prescription drugs from Canada into the United States. Canadian pharmacies and wholesalers that provide drugs for importation would be required to register with Health and Human Services. Individuals would be allowed to import prescription drugs from Canada. The medication would have to be for an individual use and a supply of less than 90-days.
; vote number 2002-201
on Jul 31, 2002
Voted YES on allowing patients to sue HMOs & collect punitive damages.
Vote to provide federal protections, such as access to specialty and emergency room care, and allow patients to sue health insurers in state and federal courts. Economic damages would not be capped, and punitive damages would be capped at $5 million.
; vote number 2001-220
on Jun 29, 2001
Voted NO on funding GOP version of Medicare prescription drug benefit.
Vote to pass an amendment that would make up to $300 billion available for a Medicare prescription drug benefit for 2002 through 2011. The money would come from the budget's contingency fund. The amendment would also require a Medicare overhaul.
Bill H Con Res 83
; vote number 2001-65
on Apr 3, 2001
Voted YES on including prescription drugs under Medicare.
Vote to establish a prescription drug benefit program through the Medicare health insurance program. Among other provisions, Medicare would contribute at least 50% of the cost of prescription drugs and beneficiaries would pay a $250 deductible
; vote number 2000-144
on Jun 22, 2000
Voted NO on limiting self-employment health deduction.
The Santorum (R-PA) amdt would effectively kill the Kennedy Amdt (D-MA) which would have allowed self-employed individuals to fully deduct the cost of their health insurance on their federal taxes.
Status: Amdt Agreed to Y)53; N)47
Reference: Santorum Amdt #1234;
Bill S. 1344
; vote number 1999-202
on Jul 13, 1999
Voted YES on increasing tobacco restrictions.
This cloture motion was on a bill which would have increased tobacco restrictions. [YES is an anti-smoking vote].
Status: Cloture Motion Rejected Y)57; N)42; NV)1
Reference: Motion to invoke cloture on a modified committee substitute to S. 1415;
Bill S. 1415
; vote number 1998-161
on Jun 17, 1998
Voted NO on Medicare means-testing.
Approval of means-based testing for Medicare insurance premiums.
Status: Motion to Table Agreed to Y)70; N)20
Reference: Motion to table the Kennedy Amdt #440;
Bill S. 947
; vote number 1997-113
on Jun 24, 1997
Voted YES on blocking medical savings acounts.
Vote to block a plan which would allow tax-deductible medical savings accounts.
Status: Amdt Agreed to Y)52; N)46; NV)2
Reference: Kassebaum Amdt #3677;
Bill S. 1028
; vote number 1996-72
on Apr 18, 1996
Rated 100% by APHA, indicating a pro-public health record.
Biden scores 100% by APHA on health issues
The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.
The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.
Source: APHA website 03n-APHA on Dec 31, 2003
Establish a national childhood cancer database.
Biden co-sponsored establishing a national childhood cancer database
Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.
Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of: Legislative Outcome: House version H.R.1553; became Public Law 110-285 on 7/29/2008.
Source: Conquer Childhood Cancer Act (S911/HR1553) 07-S911 on Mar 19, 2007
- activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
- activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
- direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.
Page last updated: Oct 22, 2012