Pennsylvania Senate Candidate Agenda Analysis: Incumbent Senator Pat Toomey

Net Spending per Year: -$89.401 billion

Government Reform

Tax Reform: “Pat believes our 60,000-plus-page tax code is unfair and broken, and it needs to be overhauled. He supports lowering rates for all Americans and closing special-interest loopholes that favor high-powered individuals and companies at the expense of hardworking Americans.” (source)

Cost per Year: Indeterminate

Notes: Simplifying the Tax Code could reduce enforcement and administrative costs.


Health Care

Affordable Care Act: Repeal: “Pat believes that ObamaCare is fundamentally flawed and should be repealed.” (source)

Cost per Year: -$94.04 billion (-$470.2 billion over five years)

Notes: The Congressional Budget Office has yet to complete  analysis of all of the spending related to President Obama’s signature health care law. A January 2016 CBO estimate of repealing the Affordable Care Act showed that direct spending would be reduced by $470.2 billion over five years. There are potentially additional unreported discretionary savings.

Association Health Plans: “Facilitate the creation of association health plans that would allow small businesses and trade groups to pool their memberships for the purchase of insurance, spreading risk and increasing leverage to negotiate lower prices.” (source)

Cost per Year: $7 million ($37 million over five years)

Notes: Related legislation has been introduced in Congress as H.R. 2868, the Small Business Health Fairness Act. The legislation’s text  was included in S. 2519, the Empowering Patients First Act of 2015. The Congressional Budget Office has not provided a cost estimate of an association health plan proposal since it analyzed H.R. 525, the Small Business Health Fairness Act of 2005. CBO determined that the Department of Labor would hire 150 workers over three years to administer the program and the legislation’s certification requirements, costing $68 million (in current dollars) over the first five years. CBO also determined that the provision would reduce Medicaid enrollment for a five year savings of $31 million (in current dollars). With the expansion of Medicaid through the Affordable Care Act, savings could be higher through this reform, but a current cost estimate is unavailable.

High Risk Pools: “Improve access for those with preexisting conditions through state-run, high-risk pools and the expansion of continuous coverage protections.” (source)

Cost per Year: $7.964 billion ($39.819 billion over five years)

Notes: It is unclear what specific level of funding Toomey would support; however, a related proposal has been drafted. In 2014, the Center for Health and Economy published a detailed plan to repeal and replace the Affordable Care Act. The reforms included a proposal to re-establish federal funding for high-risk patients to help provide health insurance coverage to those with pre-existing conditions. Funding would start at $7.5 billion in the first year and increase by three percent annually.

Medical Liability Reform: “Enact tort reform that would provide physicians with relief from the high costs of liability insurance … .” (source)

Cost: -$3.38 billion (-$16.9 billion over five years).

Notes: A related proposal was included in CBO’s report, Options for Reducing the Deficit: 2014 to 2023. A more recent cost estimate is unavailable.

Medical Research: “Pat also believes we can make great strides in improving the nation’s health through medical research and the development of new treatments.” (source)

Cost per Year: $10 million ($50 million over five years)

Notes: Toomey is a cosponsor of S. 2067, the Ensuring Useful Research Expenditures is Key for Alzheimer’s (EUREKA) Act. The bill authorizes $10 million a year to “establish EUREKA prize competitions to achieve high-priority breakthroughs in Alzheimer's disease and dementia prevention, diagnosis, treatment, and care.”

Purchase Health Insurance Across State Lines: “ … [E]ncourage competition between health insurers by allowing purchase of insurance across state lines.” (source)

Cost per Year: $38 million ($191 million over five years)

Notes: Related legislation was introduced in Congress that would allow for the purchase of health insurance across state lines. Currently, a 1945 law permits states to regulate health insurance plans within their borders; however there is an exemption for certain large employers who self-insure.

The Congressional Budget Office conducted a cost estimate for H.R. 2355 (109th Congress), the Health Care Choice Act of 2005. The bill would provide for cooperative governing of individual insurance coverage offered in interstate commerce. At the time, CBO estimated that the bill would increase spending by $160 million over five years ($191 million, adjusted for inflation). It is unclear whether this cost estimate would be higher or lower today given, that it was originally calculated prior to the implementation of the Patient Protection and Affordable Care Act. The proposal was reintroduced in the 114th Congress in the form of S. 647 and is included in S. 2519. Toomey is not a cosponsor of either bill.

Transparency & Care: “Pat believes there are … commonsense solutions to lowering health care costs and expanding access to quality care: … Empower patients through increased transparency and promotion of consumer-driven care … .” (source)

Cost per Year: Indeterminate

Notes: It is unclear what policies Toomey would promote pursuant to this objective.