[Congressional Record Volume 141, Number 154 (Friday, September 29, 1995)]
[House]
[Pages H9722-H9727]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
TOP 10 GOP OUTRAGES REGARDING MEDICARE REFORM
The SPEAKER pro tempore. Under the Speaker's announced policy of May
12, 1995, the gentleman from West Virginia [Mr. Wise] is recognized for
60 minutes as the designee of the minority leader.
Mr. WISE. Mr. Speaker, before I begin my next text, I yield to the
gentlewoman from New York [Ms. Slaughter].
forgery of national alliance for justice document
Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from West Virginia
[Mr. Wise] for that, because I want to tell everyone what Washington's
dirty little secret is, since they have been talking about it all
afternoon.
The committee staff of this group over here forged a document
yesterday. They took a letterhead from an organization that they had
asked to come in to testify, took it, as though it was from this
organization, copied down the board of directors and listed their
members and put next to some of them millions of dollars that they
claimed they got in Federal grants.
Mr. Speaker, when we heard from the the National Alliance for
Justice, the woman who heads it up, she told these people over here
that she does not get a dime's worth of Federal money. She said that
she not only resented the fact that they forged that document with
false testimony, but she also said, I will not tell you what these
people get in Federal money. I do not know. But there is one person
here, she said, this afternoon, that has given me permission to tell
you how much Federal money she gets. It is the Arts Alliance. Zero.
Zip.
Mr. Speaker, do the people care on this committee? Not a bit. I sat
as a member at the Waco hearings.
Mr. McINTOSH. Mr. Speaker, would the gentlewoman yield?
Mr. WISE. Mr. Speaker, I control the time, and the gentleman will
have time later.
The SPEAKER pro tempore. The gentleman from West Virginia controls
the time.
Mr. McINTOSH. Mr. Speaker, the gentlewoman has made a very serious--
--
Mr. WISE. Regular order, Mr. Speaker.
The SPEAKER pro tempore (Mr. Everett). The gentleman from West
Virginia controls the time and has yielded to the gentlewoman from New
York.
The gentlewoman from New York may proceed.
Ms. SLAUGHTER. Mr. Speaker, on the Waco hearings we found that the
committee had turned over lots of its responsibilities to the NRA, and
now we find this same committee staff is forging documents to be given
out to the press purporting to be a true statement. Mr. Speaker, in the
name of all the men and women who served us before in this House, who
stood on this floor and with truth and with eloquence did the best they
could for the American people, I am more than outraged at the dirty
little secret that this subcommittee would stoop to crime in order to
make their point.
I am sure they are going to have an hour more of it this afternoon,
but if people want to know the truth of the testimony, they should let
us send them the record of that hearing.
Mr. WISE. Mr. Speaker, I am going to address an issue because, as
this Congress heads off for recess, I think it is time to talk about
the Republican excesses.
What has been going on here for the last few weeks, Mr. Speaker, it
suddenly occurred to me, I hear a lot about Medicare when I am home,
and I hear a lot about Medicaid, and they are very, very important
topics. But I think it is also important to look at some of the other
things taking place that affect middle-income and low-income men and
women in this country and to talk about exactly what is taking place.
It occurred to me it is a lot like watching a freight train go by.
The train builds up speed, and when it starts rolling, a person cannot
pay attention to what is in each car, they just know there is an
enormity. There is a big train going by. I want to talk about what is
in each car. So I have compiled a list here, and with apologies to
David Letterman, we have titled it the top 10 GOP outrages, because I
think the people in the country, Mr. Speaker, ought to know exactly
what has taken place.
This is not a complete list. This is only a quick culling of the
various committees to see what we consider to be the top 10 outrages.
Top 10 outrage No. 1, this is the most incredible one, in some ways, to
me, because it is the idea that came about in the Senate finance
committee called child support surcharges.
People are not going to believe this one. This is if an individual
has to get the State to get child support for them and to track their
deadbeat spouse down someplace to get that child support, they will now
pay a 10 percent surcharge under this one. They will pay a 10 percent
commission. Child support surcharges. I like it. It turns every human
resource worker into a bounty hunter. Put a star on them, send them
out, 10 percent right off the top. They are already down, let us put
them down a little more.
No. 9 sort of follows up on this. This does get into the Medicaid
area. No. 9 is liens on Medicaid families. This one may boggle people's
minds a little bit. Medicaid families, by definition, for the most
part, are already low income. In many cases they may be middle-income
families that have their mother or father or grandparent in a nursing
home. This takes all the Federal protections that are built in against
putting them into poverty.
What it would do, Mr. Speaker, is to permit Medicaid to put liens on
the elderly and their families in this way. There would be no more
guarantee under the Medicaid block grant of coverage for nursing home
care after an individual or family has spent its savings. Right now if
a family spends their assets down to a certain level, they do not get
kicked out of the nursing home. This would remove that protection. It
eliminates current protections that stop the States from imposing liens
on personal residences. That is homes and farms.
States would be required to require adult children of nursing home
residents to contribute toward the cost of their parents' care,
regardless of the financial obligations. Regardless of the financial
circumstance or family obligations of the adult children. The States
could be allowed to do this.
There would, finally, be no more guarantee, it is gone, that spouses
of nursing home residents would be able to retain enough monthly income
to remain in the community. Presently, there is some protections for
families from Medicaid. Those protections under the Medicaid
legislation would be removed. That is No. 9.
Now, Mr. Speaker, continuing in the same vein let us go to No. 8. No.
8 is no more Federal nursing home standards. That one, I know, is hard
to believe, that anyone, in their right mind, would say that after all
the years that it took to finally get some nursing home standards, some
minimal standards so that people are no longer lying in their feces, so
that they are guaranteed adequate care, so that they cannot be strapped
down without adequate due process, so that a whole lot of other things
cannot happen to the loved ones we put in nursing homes, I know it is
hard to believe, but, yes, it is true there would be no more Federal
nursing home standards. It would strictly be up to the States.
I happen to think States are quite capable of the job, but the
reality is, in many cases, it took the Federal Government to make sure
there were adequate nursing home standards. So that is No. 8, no more
nursing home standards.
To continue this juggernaut, No. 7, if an individual cannot get in
the nursing home to get warm, they should not go home, because there is
no more energy assistance. The LIHEAP program, the Low Income Heating
and Energy Assistance has been stricken by the Republican leadership.
It has eliminated all funding for LIHEAP, the Low Income Heating Energy
Assistance Program that provides heating assistance for low-income
senior citizens.
Mr. Speaker, in my State of West Virginia alone last year, LIHEAP
served 190,000 people in the coldest
[[Page H 9723]]
parts of the winter, and it was $12.2 million of energy assistance.
We can see a pattern developing here. We are going to charge people
for getting them their child support, we are going to put increased
liens on Medicaid families, we are going to remove the Federal nursing
home standards and so that when they get home there is no energy
assistance to assist them there either.
I want to turn for a second now, Mr. Speaker, to those men and women
who are working and who have been trying to put away enough for their
retirement. I call this one ``There may not be any light at the end of
the tunnel after all.'' We have worked for 40 years for our pension;
right? Well, problem. Because No. 6 is the pension grab.
Here is what happened, just happened last week in the Committee on
Ways and Means under the Republican leadership, they have now permitted
employees to raid the employee pension plans.
Here is how it works. Presently, companies that want to go into
pension assets, the ones that have been built up for the benefit of the
retirees, if they want to go in without penalty they can only do so to
use the funds for the health insurance for retirees. But to use the
money for other reasons they have to pay a penalty tax of 50 percent
withdrawal.
What that does, Mr. Speaker, is it tells them to keep their fingers
off the pension fund. I think we remember the 1980's and the trouble a
lot of people got into, both pensioners and companies. This is designed
to stop that and it has been pretty effective.
Now, the Republican leadership would permit firms with pension plans
that hold at least 125 percent of the assets needed to meet anticipated
pension liabilities to withdraw the funds for any purpose, any purpose,
without the worker's permission. We may say what is the problem? One
hundred twenty-five percent of assets needed, surely that is enough to
cover any future liabilities. Mr. Speaker, it is enough to cover it
today when the stock market is high, but what about those pension plans
that are heavily involved in stock purchases? What happens when those
stock values drop? Does anyone think the stock market is not going to
dip?
What happens is, after they have gone in and taken the money out and
the stock market drops, then that pension fund is undervalued. The
great all American pension grab.
We are not content just to stop with seniors or potential retirees or
working people, let us move to No. 5. This one is kind of old but it
has such resonance that I thought it should be brought up there because
this one will create the ultimate food fight and it is cuts in child
nutrition.
As I say, Mr. Speaker, what this will do is to put the school lunch,
the school breakfast, the summer lunch program into block grants with
lower funding levels, and also the women, infant and children program
will go into a separate block grant and send it to the States. And,
yes, I have heard the arguments ad infinitem, ad nauseam. It is like
eating the third helping of broccoli to hear this again, about how it
is not a cut, it is an increase because we are giving it a 4.5-percent
increase.
Mr. Speaker, what they are not saying is that is not enough to keep
up with the demand. They are also not telling us that while it is a
4.5-percent increase in their calculations for school lunches, they
took from something else that is all in the block grant. It is like it
is all on one tray now, and now we have to decide how many beans we
want and how many carrots and so on.
Mr. Speaker, West Virginia alone received $50 million in cash
assistance and $5 million in commodity assistance last year, served
180,000 school lunches, and 77,000 school breakfasts. 57 percent of
school lunches in my State go to those who qualify for a free or
reduced lunch. And just so we understand, Mr. Speaker, West Virginia is
not simply relying on the Federal Government, we put an equal amount of
money in ourselves. But making this into a block grant and cutting
school nutrition and child nutrition is going to be a real body blow to
our children. As the button once said, pick on somebody your own size.
Let us jump back for a second to senior citizens. This one kind of
fascinates me. There have been a lot of hearings around here. Mr.
Speaker, we all know we can walk up and down these halls everyday and
there is no shortage of hearings. My goodness, we had 28 days of
hearings on Whitewater alone. The only person who has not been called
as a witness is Socks, but he may be coming up shortly.
On this one, what is the program that probably is the most important,
the largest part of our budget in health care, most important to 37
million Americans and senior citizens? Medicare. This program has just
celebrated its 30th anniversary. Its 30th birthday. If we are going to
change it, one would think we would have, I presume, a lot of
exhaustive fact-finding hearings. But this leads to number four on our
list of Republican outrages. One day of hearings on Medicare.
That is true, the program that is scheduled to be cut $270 billion,
the program that 37 million senior citizens depend upon, the program
that is vital to many of the health care providers in this country, the
program that helps fund the medical education and research that we all
take for granted in this country, that program, 30 years of experience,
gets one day of hearings. And, incidentally, some of the witnesses not
permitted to testify were the trustees of the Medicare program.
{time} 1645
Is not it interesting, every Republican I know has been waving the
Medicare trustees' report saying this is why we have to make these cuts
because of the Medicare trustees' report and then they never invited
the people who wrote the report that they are talking about.
Interesting. Anyway, that earned outrage No. 4.
But turning quickly in the same vein to outrage No. 3, No. 3 is $270
billion in Medicare cuts. Why is that an outrage? If that is what is
necessary to save the program, by golly do it. That is what senior
citizens are saying. They want to see the program made solvent. The
outrage is that what everyone estimates to save the program is not $270
billion over 7 years; it is somewhere between $90 billion and $120
billion on 7 years. That leaves a gap of $150 to $170 billion too much
that they are taking out of Medicare.
And where does that go? Well, it goes, of course, to the tax cut. We
will talk about that in a minute; that is $245 billion. But it has
other implications as well. The 40 percent of the money that will come
out of Medicare will not go to save Medicare because it cannot.
Medicare is in two parts, Part A, the trust fund, and Part B,
outpatient care. The trust fund is what is considered in trouble. The
trust fund is the only part that you can put money in to ``save.'' That
is estimated to be $90 billion, and yet 40 percent of the money comes
out of Part B and therefore does not even go toward the trust fund. It
will result in higher premiums for our senior citizens. It is going to
result in a lot of troubles for our hospitals.
In West Virginia, Calhoun General closed just this week. I cannot say
it is because of this, but this will make it inevitable that other
hospitals close. What happens when a hospital closes in that area? When
you are injured in Calhoun County, you have a 90-minute drive to the
closest emergency room. That is what it means.
That is No. 3, $270 billion in Medicare cuts, and would not it be
nice if we could let the Medicare trustees tell the Committee on Ways
and Means what they think of the committee's proposals?
No. 2, 100 percent of senior citizens are going to take a whack, a
real hit because of No. 3. Hold that figure in mind. It is not too hard
to remember. 100 percent. Every senior citizen. Now, outrage No. 2 is
tax breaks for the wealthy, because as those senior citizens are being
cut about three times what is necessary to make Medicare solvent where
is the difference going? The difference is going to the $245 billion
tax cut basically to the upper income.
Now, I have heard the talk about how there is a $500 child care tax
credit and that will go to middle income and low-income people. The
problem is it will not, Mr. Speaker. This tax cut, 51 percent of the
benefits go to people making over $100,000 a year, they get around
$2,400 back. Now, for the person
[[Page H 9724]]
making $20,000 a year or less, they get something like $90 back.
What does that translate into? For about two-thirds of the people in
my State, it is 20 cents a day, is what they get back in a tax cut; $7
a day is what the person over $100,000 a year gets back. The person
getting 20 cents back loses their student loan ability and their
Medicaid, they lose their earned income tax credit assistance, and they
will pay more for Medicare. Their senior citizen mother or father or
grandparent, they may be paying a lot more for them out of pocket, so
they are going to lose a whole lot because of this.
So, tax cuts, I thought we were about balancing the budget. If you
are balancing the budget, which is tough enough to do in 7 years
without a tax cut, you really want to add $245 billion. Incidentally,
if you are making $350,000 a year, you hit the lotto because you get
$20,000 a year back. The folks at the other end get 20 cents a day
back. That is No. 2, tax cuts for the wealthy.
No. 1, I know, Mr. Speaker, this is just a crescendo of excitement.
Drum rolls. Really, Bob, that is the No. 1 outrage. It is enough, Bob,
you really ought to stop. Stop me, Mr. Speaker, before I peel again.
Here we go. No. 1 is after a lot of consultation, remember I just
told you about the tax cut for the wealthy? Now I know you are not
going to believe this, Mr. Speaker, but it is true. A middle income tax
increase. That is right. Middle income tax increase. While the
Republican leadership is putting through a bill that will cut taxes for
the wealthiest, it is increasing taxes for low and middle income
persons.
Bob, you must be all wet. They would not do that, would they? Look at
what happens. Presently there is something in the law right now called
the earned income tax credit. A working family in this country that
earns under, I believe, $28,000 a year is eligible for a tax credit.
And it not only goes to their income taxes; it means they can get money
back from their Social Security tax, their FICA tax and sales tax. It
is money directly in their hands.
What it means it is good for business and it is good for the
employee, because it is like subsidizing the low-income worker. And
when Congress voted to increase that earned income tax credit just 2
years ago that I proudly voted for, and I might add not one Republican
voted for, when Congress voted to increase that, it voted to make the
person making minimum wage, about $4.25, in effect it made their wage
about $6. Not one penny came out of the employer, but it was done
through the Tax Code.
So now it is being proposed in the Committee on Ways and Means to
take back some of that tax credit. What that is is a middle income tax
increase. These people will be paying more in taxes after all this
passes than they did before.
Let me tell my colleagues in West Virginia, that means that 98,800
middle income families will face a tax increase, about 90 percent of
the families in this program. Remember, the Republican tax plan for a
child care credit, it does not pay you the money if you did not pay
that much in taxes, so you do not get as much benefit from it if you
are in the lower income brackets. But this program, the one they are
cutting into, that does pay you. So the Republican plan means very
little for low income and middle income people. This plan puts money in
your pockets, and that is the one they are cutting. So, the $500 per
child tax credit does not help many of our middle income families. In
fact, one in three American children will receive no aid from their
credit. They do get aid from this. And so after everything is done,
there is a middle income tax increase coming, thank to the Republican
leadership.
So let me just quickly run over this list again because I know
everybody has got pencils and they are jotting it down. I think Mr.
Speaker, that it would be worthwhile for every Member to be talking
about this when they are home. The excesses are during the recess, and
I hope that every constituent across the country will ask with these 10
things, the 10 top outrages that Congress has been working on in the
last few weeks.
First of all, No. 10, child support surcharge. That is right,
charging single parent families 10 percent to go get the child support
that they are not able to get themselves.
No. 9, relaxing and doing away with the regulations that stop people
from having liens put on them on Medicaid families.
No. 8, removing Federal nursing home standards.
No. 7, no more energy assistance for low income senior citizens.
No. 6, going after the pensions and permitting corporations to take
money out of pension funds without adequate protection and with no
penalty.
No. 5, cutting child nutrition programs making it harder for kids to
be able to get that one hot meal a day.
No. 4, only 1 day of Medicare hearings when they were able to have 28
days of hearings on Whitewater, 10 on Waco, and however many have been
going on on Ruby Ridge.
No. 3, $270 billion in Medicare cuts when $90 billion will do the
job.
No. 2, tax breaks for the wealthy.
And of course, No. 1 at the same time they are giving tax breaks for
the wealthy No. 1 is actually asking middle income and low-income
people to pay a tax increase.
Mr. Speaker, those are my selections for the top 10 GOP outrages of
the last 2 weeks, and my hope is that we will all be hearing about
these a lot during our October recess.
Mr. Speaker, at this point, I yield the balance of my time to the
gentleman from New Jersey [Mr. Pallone].
The SPEAKER pro tempore (Mr. Everett). The gentleman from New Jersey
is recognized for up to 36 minutes.
Mr. PALLONE. Mr. Chairman, I would also like to point out that one of
the items that the gentleman from West Virginia mentioned as one of his
top Republican outrages was the fact that there was only 1 day of
hearings on Medicare last week in the House of Representatives before
the Committee on Ways and Means.
However, I would like to point out that in my committee, the
Committee on Commerce which also has jurisdiction over Medicare, as
well as jurisdiction over Medicaid, which is the Federal Health Care
Program for poor people, we have not had any hearings on either one of
the issues.
In fact, last Friday, we reported out a Medicaid reform bill that
cuts Medicaid by $180 billion and essentially eliminates the
entitlement status of Medicaid, so that poor people have no guarantee
of health insurance anymore. We did not have a single day of hearings
on the Medicaid changes.
In addition, I understand now that the Republican leadership has
finally introduced a Medicare reform bill in order to implement the
$270 billion in cuts to Medicare, and my committee, the Committee on
Commerce, will be meeting on Monday, this coming Monday, to mark up the
Medicare bill without even 1 hour or 1 minute of hearings on the
Medicare bill.
So here we have a situation where probably the most important change
that will take place in this House and in this Congress, the effects
and the changes on Medicare and Medicaid which affect millions and
millions of Americans, and we will not have had a single day of
hearings on either one of these bills before the time when they came to
the committee to be marked up.
It is indeed an outrage. It is an outrage that is out of proportion,
when we think about the level of cuts; $270 billion in cuts in Medicare
and $180 billion in cuts in Medicaid. Cuts that these two health
insurance programs, primarily for seniors, cannot take without major
changes that are going to be negative and affect the quality of
Americans' health care, and particularly seniors' health care, in a
very, very negative way.
Fortunately, the Democrats, realizing the fact that there were not
going to be any hearings on either one of these programs, decided,
starting last week, to have their own hearings, alternative hearings on
the Medicare Program on the lawn of the Capitol. We finished 4 days,
today, of those hearings, and I want to tell my colleagues that they
were very productive hearings.
Mr. Speaker, I wanted to give some information about what some of my
constituents said who attended the hearings, both health care
providers, representatives of hospitals in my district in New Jersey,
as well as senior citizens and senior citizen advocates from my home
State of New Jersey.
Before I get to that, I wanted to point out the fact that
increasingly
[[Page H 9725]]
this opposition to Speaker Gingrich and the Republican leadership's
Medicare cuts and Medicare changes for both Medicare and Medicaid are
being opposed in a bipartisan fashion.
One of the things that has bothered me the last few weeks in
listening to some of the statements on the floor of this House is that
increasingly my colleagues on the other side, on the Republican side,
suggest that somehow this is all very partisan, that the Democrats are
attacking the Republican leadership for the changes that are being
proposed in Medicare and Medicaid, and that all of this is coming from
the Democratic side and that we are just being very partisan about it.
The reality is that increasingly, over the last weeks, it has not
been a partisan battle. There has been bipartisan opposition to the
Medicare and Medicaid proposals that Speaker Gingrich and the
Republican leadership have come forward with.
In a sampling of opposition, this Wednesday there were a number of
Republican Senators who expressed concern about the Medicare proposal
put forward by the Republican leadership. On Wednesday, there were
three Republican Senators who voiced doubts about mixing a big tax cut
with planned surgery on Medicare and Medicaid. They said in essence,
look, why is it that we are cutting Medicare and Medicaid this amount
in order to finance a very large tax cut primarily for wealthy people?
Senator Orrin Hatch of Utah and Senator Alan Simpson of Wyoming and
Senator Alfonse D'Amato of New York expressed skepticism about cutting
taxes while Congress is struggling to balance the budget. They
indicated strongly their concern about how they are going to make these
cuts in Medicare at the same time that tax cuts were being proposed for
wealthy Americans.
In addition to that, I was very pleased to see that in my own home
State, the gentlewoman from New Jersey [Mrs. Roukema] has expressed
concern about both the Medicare changes as well as the Medicaid
changes. The gentlewoman is quoted in an article that is in today's New
York Times where she says she is concerned about the effects of the
Medicare proposals.
Mr. Speaker, the gentlewoman noted recent estimates from the
Congressional Budget Office showing that most of the $270 billion in
Medicare savings would be achieved by limiting payments to hospitals,
nursing homes, and home care agencies.
These are sobering numbers. They open up a number of
concerns about whether the savings will come through a
reduction of care or through the new choices that people are
given.
{time} 1700
I would like to repeat again. In my home State of New Jersey, along
the Jersey shore which I represent in Congress, I represent a large
part of the New Jersey shore, we had three Republican State
legislators. they are Senator Leonard Connors, Assemblyman Jeffrey
Moran and Assemblyman Christopher Moran, all Republicans from Ocean
County in New Jersey. They sent a letter to Senator Dole and also to
Speaker Gingrich this week asking them to back off on the proposed cuts
in Medicare because of the impacts that they could have on senior
citizens.
They pointed out that financing tax breaks for the rich on the backs
of our elderly is morally bankrupt. The Senator and the two
assemblymen, again all Republican, also were critical of the increases
proposed by Speaker Gingrich in his plan in the Medicare part B
coverage, from $552 annually to $1,116. they said the plan is signing a
death warrant for millions of senior citizens across the country.
So for my colleagues on the other side of the aisle who would suggest
that somehow this is strictly the Democrats that are complaining about
these cuts in Medicare and what they are going to mean for senior
citizens, I tell you we have U.S. Senators, U.S. Congressmen, we have
State legislators from the State of New Jersey, all Republicans who are
concerned about what is happening here. They have reason to be
concerned, for a number of reasons.
Let me give some of the concerns expressed at the alternative
hearings that were held by the Democratic Caucus on the lawn on the
East Front of the Capitol this week. I attended each of those hearings.
We had some representatives from my district in New Jersey who spoke
out each of the days, Wednesday through today, and expressed their
concerns.
One of the speakers who gave testimony who I was most impressed with
was Dr. Anita Curran, who is associate dean for Environmental and
Community Medicine at the University of Medicine and Dentistry in New
Jersey and the Robert Wood Johnson Medical School in New Brunswick,
which is in my district. Dr. Curran pointed out how every aspect of
health care in New Jersey as well as in this country as a whole is very
interconnected and that programs like Medicaid for the poor, Medicare
for senior citizens, nutrition programs, even some of the welfare
reform that we have talked about on the House floor, the very cuts that
impact health care in each of these programs have a cumulative effect.
She represents the Robert Wood Johnson Medical School, a teaching
hospital. Many of the significant cuts in Medicare affect teaching
hospitals, making it more difficult for those hospitals to train
residents and train doctors who are going to go into the community in
the future. A lot of those doctors at the Robert Wood Johnson Medical
School also work at the Eric B. Chandler Health Center, which is a
community-based health center in New Brunswick that handles a lot of
Medicaid recipients, poor people who are on Medicaid.
What Dr. Curran pointed out is that when you cut back on the amount
of money going to teaching hospitals, like Robert Wood Johnson, you are
also having an impact on the community health center because there will
not be the teachers there to work at the community health center and
help the poor and needy people in New Brunswick and in the area served
by the Eric B. Chandler Health Center.
Also, the Medicaid dollars that are being cut for the health center
through Medicaid are going to have an effect on the teaching hospital
because now all of a sudden there is less money coming in through
Medicaid as well. So the cutbacks in Medicare and the cutbacks in
Medicaid do not just affect seniors, they do not just affect poor
people, they also affect everyone. Essentially, if the hospital in the
community does not have the money to operate and either has to close or
cut back on services either for inpatients or for outpatients, everyone
suffers, and that is the dramatic impact of these cuts both in Medicare
and Medicaid.
We had other people that spoke at the hearings that were held out on
the lawn. I wanted to mention Margaret Chester, who is executive
director of the Middlesex County Office on Aging in my district. She
spoke very eloquently about the programs and how these cutbacks are
going to affect the senior population that are helped by the Middlesex
County Office on Aging.
One of the things I asked about, which was particularly disturbing,
again points out how the interrelationship between cuts in Medicare and
Medicaid, are a group of seniors or elderly who are called qualified
Medicaid beneficiaries. These are seniors who are low income. I think
they cannot be making more than about $625 a month through Social
Security or pensions or whatever they get. And right now under current
law, their Medicare part B premiums the premium that they have to pay
in order to have their doctor bills covered through Medicare, that
money is paid by Medicaid. So even though they are on Medicare, the
program for seniors, and they have to pay this premium to get their
doctor's bills paid, Medicaid says for that Medicare part B premium.
Under the Medicaid bill that was passed out of the Committee on
Commerce, my Committee on Commerce last Friday, there no longer is any
guarantee that Medicaid will pay that part B premium for those elderly
and poor Medicare senior recipients. Where are they going to get the
money? Where are they going to get the money to pay for that part B
insurance to cover their doctor bills? They are already so poor that
they barely can make ends meet.
Their Medicare part B premiums under Speaker Gingrich and the
Republican leadership proposal are going to double over the next 7
years. So, if they were paying $40 now, they are going to be paying
probably $100 within
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the next 7 years. Yet they do not have Medicaid paying for any part of
it anymore. There is no way that they can afford to pay that. The end
result is that, if some of the States decide not to take on that extra
burden, they are simply going to be out on the street. They will not
have any health care.
Last, today at our alternative Medicare hearings, we had two senior
citizen advocates from my district, one is Dave Sheehan, who is the
director of the Edison Township Senior Center in Edison, NJ, and also
Dave Keiserman, who is State chairman of the New Jersey Council on
Senior Citizens. And what they pointed out and what I wanted to
reiterate today is how unable, how difficult it is going to be, if not
impossible, for seniors who now receive Medicare to pay these
additional payments out of pocket that have been proposed in both the
bill put forward by the Republican leadership in the House and the bill
put forward by the Republican leadership in the Senate.
I already mentioned some of the proposals in the House bill with
regard to Medicare part B that pays for doctors' expenses for seniors,
doubling of the part B premiums over the next 7 years. How can these
seniors, most of whom make less than $25,000 a year, something like 75
percent of the seniors in the country make less than $25,000 per year,
how are they going to be able to pay double their part B premiums? But
if you look at the Senate bill, the one that is being considered on the
other side of the Capitol, they go beyond the increase in the part B
premiums. They talk about doubling the part B deductible from $100
today to $210 in 7 years. They talk about also delaying eligibility for
Medicare from age 65 to age 67. We really do not know how far these
additional out-of-pocket payments are going to go. We have heard now
about increased deductibles, increased part B premiums, raising the age
of eligibility for seniors for Medicare. Where do we go from here?
Well, the bottom line is that increasingly what we are finding, when
these Republican leadership proposals go to the Congressional Budget
Office, is that there are huge gaps in how much money they can actually
save. There is a real question about whether or not any of these
proposals on the Senate side or the House side are going to be able to
save $270 billion to achieve that level of cuts in Medicare. And so
what I think is going to happen is that we are going to see more and
more of an effort to try to find more and more of that money to pay for
those cuts out of increased out-of-pocket costs to the beneficiaries,
to the senior citizens.
Do not be surprised to see larger deductibles. Do not be surprised to
see copayments. Do not be surprised to see eligibility going from 65 to
67 or maybe even to 70. Do not be surprised to see even larger Medicare
part B premiums than what has already been discussed.
I just wanted to spend a little time, Mr. Speaker, if I could, on
Medicaid, the program for poor people, which I would point out again,
70 percent of that money in New Jersey for Medicaid goes to pay for
senior citizens and those who are primarily in nursing homes. The
figure for the rest of the country is pretty much the same. A majority
of the money that we now spend on Medicaid, even though it is a program
for poor people, is for senior citizens, most of which pays for nursing
home care.
The bill that our Committee on Commerce reported out on Medicaid last
Friday was a travesty. We had no hearings, again. Whatever they do on
Ways and Means, we do not have any hearings in the Committee on
Commerce. We get the bill and then the next day we have the markup, and
we do not even have an opportunity to have a hearing at all.
In the Committee on Commerce, the Medicaid bill that was reported out
was indeed a travesty. The New York Times, in an editorial on September
26 called it a cruel revision of Medicaid. Just let me give you a
sentence for two. They said, ``Congress shows no signs of slowing its
assault on the social safety net stitched together over six decades.
The House Commerce Committee tore another hole in the net on Friday by
eliminating the Federal guarantee of Medicaid insurance.''
Essentially, what the Republicans did in this Medicaid bill was to
eliminate the entitlement statute for Medicaid. So in effect, there is
no guarantee that anyone gets Medicaid coverage anymore. They send the
money in a block grant to the States, and they leave it up to the
States to decide what they want to do with the money, with very few
strings attached.
I have to tell you, Mr. Speaker, I had a forum last Monday, actually
it was Tuesday, in my district, after this Medicaid bill had passed out
of the Committee on Commerce. And I told the senior citizens at a
senior center in Long Branch, the town that I live in, about some of
these cuts and what they will mean, and they were really outraged. And
they had reason to be outraged.
One of the things that we pointed out to the seniors and really to my
constituents in general is the fact that all the protections that
existed under the Medicaid Program in the past, when someone had to be
placed in a nursing home, all the protections with regard to the
nursing home, all the protections with regard to the family of the
person who went to the nursing home, the family, the spouse that had to
stay back in the home or the kids that were still in the community, all
those were just eliminated completely by the Republican majority on the
Committee on Commerce.
There are no longer any nursing home standards. The money goes to the
States in a block grant. The nursing homes can do what they want unless
the States come in and start regulating them. So all the concerns about
proper sanitation in nursing homes, code enforcement in nursing homes,
proper care, that there are nurses that are visiting the patients in
nursing homes, none of that has any Federal protection anymore. Just as
bad was the fact that the protections for the spouse who has to stay at
home were eliminated.
Right now, under current law, if your husband goes to a nursing home
and you are the woman who stays at home, you get to keep your home, you
get to keep your car. And you get to keep about $14,000 in a savings
account that they cannot go against you to pay for that nursing home
care for your husband who is in the nursing home. That is all out the
window now. If a State wants to, they can simply go after those assets
or include those assets in calculating whether or not someone is
eligible for Medicaid placement in nursing home.
They also eliminated all the protections under current law for
children. So there is nothing to prevent a State, if it wants to, to
say, your dad is now in a nursing home and so we are going to go after
your house, the children, or we are going to go after your assets to
pay for his nursing home care. Again, all those protections were simply
eliminated.
The other thing that happened, which I found extremely disturbing, is
that the Federal law right now with regard to Medicaid, links the
actual reimbursement rate that is paid to nursing homes to a standard
based on the amount of money that is necessary to pay for adequate
care. In other words, the States, under current law, have to give the
nursing homes enough money to pay for adequate care of the person who
is in the nursing home. That was abolished. We had a vote on it. Again,
it was voted down by the Republican majority.
So what we are going to see increasingly is less money going to the
States, no safeguards for the States, the States paying less and less
money for nursing home care that is less than adequate, and no way to
make sure that under Federal law that those nursing homes are adequate
and provide proper care.
The last thing that I wanted to mention, going back again to the fact
that this is not at all a partisan issue, and I hate the fact that it
keeps being characterized as such, is that in my home State of New
Jersey, in a lot of the other States around the country, many of the
Republican elected officials have been very critical of this Republican
leadership Medicaid proposal because of the formula that is being used
to decide how much the individual States are going to receive.
I would point out that it really does not matter what the formula is
because since there is going to be so much less money going to the
States to pay for Medicaid, however you figure out the formula, the
States are not going to have enough money to provide adequate care. But
I want to commend my
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Governor, Governor Christine Whitman, and also the members of my State
delegation, the Republicans in my State delegation, New Jersey, all of
whom have protested to Speaker Gingrich and to the Republican
leadership that the formula for Medicaid is inadequate and certainly
unfair to the State of New Jersey.
{time} 1715
Now what the Governor of New Jersey pointed out is that in the next
year, in 1996, there will be a 7.2-percent Medicaid grant increase to
the States under the formula that Speaker Gingrich has put forward, but
after that, for the fiscal years from 1997 to 2000, there is only a 2-
percent annual increase in the amount of money the States get to
provide for Medicaid expenses, and essentially what the Governors said,
and I quote, is that ``we cannot achieve that level of savings, we
cannot operate that program with the level of money that we are going
to be getting from Medicaid.''
So, if I could just conclude by pointing out again, as much as most
of the people opposing this Gingrich plan are Democrats, there are a
lot of Republicans in my State and in other parts of the country at
every level, whether it is the Senate, whether it is the Governors,
whether it is the other members of our congressional delegation, or
State legislators who are pointing out that there is absolutely no way
that we can continue to provide adequate care under the Medicaid
Program for our poor people and particularly for our elderly who are
the main beneficiaries of the Medicaid Program, and the same concerns
are now being expressed as well on the Medicare Program, that this
level of cuts that are being proposed by Speaker Gingrich and the
Republican leadership are simply inadequate to provide quality care for
our seniors and for the people who are part of the Medicare and
Medicaid Programs.
Mr. Speaker, I am pleased to see that the cracks are starting to
show, that we are seeing a slowdown in effect in the effort to try to
move both of these bills through Congress. We have a week now, next
week, and there will be no votes on the floor of the House of
Representatives on any bills, and I am hopeful that the momentum will
continue to build during this next week so that, when we come back
around Columbus Day, there will be even more and more opposition on a
bipartisan basis to these terrible changes that are being proposed in
the Medicare and Medicaid Programs.
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