[Congressional Record Volume 141, Number 79 (Friday, May 12, 1995)]
[Senate]
[Page S6581]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page S6581]]
                            CUTS IN MEDICARE

  Mr. AKAKA. Mr. President, earlier this week House and Senate 
Republicans unveiled their respective 7-year budget resolutions. The 
promise of the House resolution--a balanced budget by the year 2002 and 
tax cuts for wealthy Americans--is being championed by several 
prominent Senate Republicans. Although the Senate budget resolution 
contains a Boxer amendment that expresses the sense of Congress that 90 
percent of the benefits of potential tax cuts go to the middle class, I 
have every expectation that the Republican bill will be a windfall for 
the wealthy. Moreover, the details on how the savings would be achieved 
are sketchy and are left for authorizing and appropriating committees.
  The Senate Budget Committee resolution assumes a $256 billion cut in 
Medicare spending over 7 years, but provides no guidelines to the 
Senate Finance Committee on how these savings will be achieved. This 
proposed cut is by far the largest Medicare cut in history, and the 
adverse impact on beneficiaries and providers is clear.
  If Medicare cuts of this magnitude are approved, the Department of 
Health and Human Services estimates that senior citizens' out-of-pocket 
expenses will increase by $900 a year or a total of $3,500 over the 7 
years. As 83 percent of Medicare benefits go to beneficiaries with 
incomes of $25,000 or less, it is obvious who will be hurt by these 
cuts, yet the budget remains silent on how it will be done.
  In addition, cuts to providers would have serious ramifications on 
overall health care costs as cuts in provider reimbursement are often 
passed along to other payers. Provider cuts could also have a 
potentially devastating impact on urban safety-net hospitals which 
already bear a disproportionate share of the Nation's growing burden of 
uncompensated care. These reductions in Medicare payments could also 
endanger access to care in rural areas. Nearly 10 million Medicare 
beneficiaries--25 percent of the total--live in rural areas. There is 
often only a single hospital in their county. Significant cuts in 
Medicare have the potential of causing rural hospitals to close or 
increase the number of providers that refuse to treat Medicare 
beneficiaries.
  I was appalled to hear that during markup of the resolution, the 
Senate Budget Committee, on a party-line vote, rejected two proposals 
to restore funding to Medicare in lieu of providing tax cuts. 
Obviously, this massive cut in Medicare funding would be unnecessary if 
Republicans did not have to pay for a tax cut for wealthy citizens.
  We must work to ensure that any effort to extend the solvency of the 
Medicare trust fund does not put Medicare beneficiaries at risk. And we 
must protect the program for future enrollees. I support President 
Clinton's view that the Medicare trust fund must be resolved in the 
context of health care reform.
  Mr. President, without comprehensive health care reform, significant 
cuts in Medicare and Medicaid will seriously harm beneficiaries and the 
total health care system as costs will be shifted onto families and 
businesses. Only by focusing on the entire health care delivery system 
will be able to address issues within Medicare and preserve access for 
Medicare beneficiaries and underserved populations.
  Let me close on this point. While we have heard Members on the other 
side of the aisle promise to protect Social Security, the GOP budget 
reaches balance by the year 2002, only by including the Social Security 
trust funds in the budget calculations.
  While I fully recognize the critical need to ensure long-term 
stability in the Medicare Program and support efforts to balance our 
budget, I am opposed to using arbitrary cuts in the Medicare Program to 
finance a tax break for wealthy Americans. I look forward to working 
with my colleagues on addressing these important issues.
  Mr. President, I yield the floor. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. HATFIELD. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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