[Congressional Record Volume 141, Number 161 (Wednesday, October 18, 1995)]
[Senate]
[Pages S15271-S15272]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MEDICARE AND MEDICAID

  Mr. BINGAMAN. I thank the Chair. I appreciate that time to speak 
about some of what is going on in Congress. There is a lot going on, 
but I wish to speak particularly about the Medicare and Medicaid 
proposals that we are going to have to vote on in the near future.
  Mr. President, 30 years ago, when President Johnson signed into law 
the Medicare legislation, which really did establish a contract with 
the people of this country, New Mexico was very proud at that time 
because one of our great statesmen, Senator Clinton Anderson, was 
standing with President Johnson there in Missouri at the time that 
legislation was signed.
  As many who have studied American history may recall, the legislation 
that enacted Medicare was called the King-Anderson bill, and Anderson, 
of course, was the Senate sponsor of that legislation, and very proudly 
so.
  Since that historic day in the summer of 1965, the Medicare Program 
has made health care a reality for thousands of people throughout this 
country and, of course, thousands in New Mexico. It has been the 
lifeblood of many of my State's rural hospitals and rural health care 
providers. Today, the program is at a serious risk, and I am not at all 
confident that the contract that President Johnson and Senator Anderson 
then had worked out and fought for will survive in the same form that 
they enacted it.
  The Republican majority here in Congress is proposing to reduce 
Federal resources for health care in this year's budget by $450 billion 
from Medicare and Medicaid. That will occur, of course, over the next 7 
years. In New Mexico, the result clearly will be less health care for 
poor children and a greater financial burden on seniors and families 
who attempt to care for seniors.
  Today, there are some 300,000 New Mexicans who depend upon Medicaid 
for health care, and 60 percent of those 300,000--180,000, roughly--are 
poor children. I think that is a fact on which many have not focused in 
this debate, particularly on Medicaid. A significant majority of the 
people who are beneficiaries of Medicaid are poor children. That is 
certainly true in my State.
  Under legislation that has been proposed by the Republican majority 
in the House and the Senate, many of these children are bound to go 
with less health care available to them. Both the House and Senate 
bills call for major reductions in Medicaid funds to my State, New 
Mexico. In the House bill, the reductions in funding for New Mexico 
will exceed $900 million over the next 7 years, almost $1 billion. In 
the Senate bill, the reductions will exceed $600 million. The Federal 
Department of Health and Human Services predicts that the loss in 
funding will cause our State, New Mexico, to reduce the number of 
people being served by Medicaid by 19 percent.
  Now, if 19 percent of the 180,000 children presently served are 
dropped from the program, then more than 34,000 poor New Mexico 
children who today are covered by Medicaid will not be covered by 
Medicaid in the future.
  Some may argue that this will never happen; that the State will make 
up the difference; that any shortfall in funds will be made up by our 
State legislature and/or Governor. If that is true, I guess my question 
is, why is my State joining with 23 other States in sending a letter 
protesting the overly prescriptive and onerous provisions that are 
contained in the Senate bill, specifically the requirements that States 
provide health care for below-poverty-line pregnant women and children 
up to age 12.
  Mr. President, under the current Medicaid Program, our State is 
required to provide service to these vulnerable individuals, and my 
question is, why do we not just continue with that requirement? 
According to the Governors' letter, which I referred to earlier, 
continuing with that requirement could potentially lead to a huge cost 
shift to the States and the States want the flexibility to avoid that 
cost shift and thereby reduce the benefits to that vulnerable group.
  In New Mexico, more than 212,000 seniors and children and adults with 
disabilities currently depend upon Medicare in addition to those who 
depend upon Medicaid, and by the year 2002 more than 257,000 New 
Mexicans are anticipated to be eligible for the program. More than 
210,000 of those will be seniors.
  What do these program cuts that are contained in the legislation we 
are going to vote on this next week mean to seniors? According to the 
American Association of Retired Persons study of this issue, the 
average Medicare beneficiary in my State will pay a minimum of $2,000 
more in higher deductibles, higher copays, and there are many services 
that will not be covered. It also means a raising of the eligibility 
age from 65 to 67 beginning in the year 2003.

  Mr. President, a cost shift of this type and this size is especially 
tough on New Mexico seniors and their families because so many of those 
in my State who are seniors live at or near poverty. One in every five 
New Mexicans, including about 26,000 seniors, lives in poverty in my 
State. Many of the State's seniors are barely making ends meet today. 

[[Page S 15272]]

  The question is, how can poor, elderly New Mexicans possibly come up 
with the additional resources, this additional $2,000 that it is 
anticipated they will have to come up with? Medicaid currently pays for 
$188 million of nursing home care in New Mexico annually. I heard the 
Senator from North Dakota speak about the woman who had a husband in a 
nursing home.
  We have many people in nursing homes in my State, and they benefit 
substantially from the payments that Medicaid makes. Through the 
Medicaid Program the State typically picks up the extra cost where 
Medicaid falls off. But to do so, under the cuts that are proposed, the 
State must raise additional revenue. And it would be substantial 
additional revenue, this $188 million that I referred to earlier. That 
would be in addition to the $600 to $900 million shortfall which also 
would have to be made up if services were to continue as they presently 
are.
  If New Mexico will not or cannot raise the revenue needed to keep the 
safety net in place without Federal assistance for these 300,000 
current beneficiaries, the results are very clear, Mr. President. 
Thousands of seniors and children in my State will be denied adequate 
health care in the future.
  The arguments for these cuts are well known by all of us. Proponents 
say the cuts are necessary to get us to a balanced budget. But if a 
balanced budget is the goal, then my question is, why here today at 
this very moment do we have a committee marking up a bill to cut taxes 
in this country by $245 billion over this same period? If a balanced 
budget is the goal, and poor children and seniors have to do without 
health care in order to meet that goal, then why cannot the Congress 
also limit spending for the Pentagon to the amount that the Pentagon 
requested?
  All of New Mexico's shortfall, every single dollar of New Mexico's 
shortfall in Federal funds for health care could be offset by foregoing 
one of the additional B-2 bombers that the Republican Congress insists 
on ordering.
  So this debate, in my view, is not about whether we should reduce 
expenditures on health care. Clearly, we need to make some reductions. 
And we will do that. The debate is how deep those cuts will be, where 
the greatest burden of this deficit reduction will fall, what the 
priorities of this Nation are. These priorities should include 
maintaining decent health care for the most vulnerable in our society. 
The proposal that is being presented to us this next week does not 
provide for that.
  Mr. President, I appreciate the opportunity to speak. And I yield the 
floor.
  The PRESIDING OFFICER. The Chair recognizes the Senator from West 
Virginia.
  Mr. DORGAN. I yield 7 minutes to the Senator from West Virginia.

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