[Congressional Record Volume 141, Number 163 (Friday, October 20, 1995)]
[Extensions of Remarks]
[Pages E1987-E1988]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      COALITION MEDICARE PROPOSAL

                                 ______


                            HON. BILL ORTON

                                of utah

                    in the house of representatives

                       Thursday, October 19, 1995

  Mr. ORTON. Mr. Speaker, I rise today in support of the coalition 
Medicare reform alternative. In doing so, I will be voting against both 
the Democratic and Republican Medicare reform proposals considered 
today. I would like to explain why.
  Today, we are considering only the Medicare portion of the Republican 
budget reconciliation package. This separation of Medicare from the 
rest of the Republican budget proposal is an effort to convince the 
American people that reduced spending in Medicare is not related to the 
rest of the budget. It is an effort to convince the American people 
that a $270 billion reduction in Medicare spending is necessary to 
address the impending insolvency of the Medicare HI trust fund in the 
year 2002. It is nonsense.
  The bipartisan Concord Coalition perhaps said it best: It all began 
with the irreconcilable goals announced in the GOP's Contract With 
America: Balance the budget while at the same time enacting large tax 
cuts and pushing many large programs, most notably Social Security, off 
the table. Inevitably, a disproportionate share of the budget-cutting 
burden fell on Medicare.
  The coalition Medicare reform proposal, of which I am a cosponsor, 
proves that the solvency of the Medicare HI trust fund can be restored, 
within the context of a 7-year balanced budget, while cutting $100 
billion less in Medicare spending than the Republican proposal. I am 
disappointed that the Rules Committee did not make in order 
consideration of the coalition proposal on the House floor, because I 
believe it is closer to the priorities of the vast majority of 
Americans than either of the two proposals that we will be debating 
today.
  The American people deserve a complete debate of the choices we face 
as a nation as we begin to balance the budget. Today, we will debate 
two options regarding Medicare: reducing Medicare spending by $270 
billion in the context of a budget than contains a $245 billion tax 
cut, and reducing Medicare spending by $90 billion in order to restore 
solvency to the Medicare trust fund without balancing the budget.
  There is a responsible alternative that sadly will not receive 
consideration: restoring the solvency of the Medicare program within 
the context of a balance budget without providing an immediate tax cut. 
I believe that this option represents the preferences of the majority 
of Americans.
  The coalition alternative includes many of the same proposals 
contained in the Republican proposal: it allows the formation of 
provider sponsored networks, it means-tests part B premiums, and it 
expands the choice of seniors within the Medicare system.
  However, there are many distinctions. The Republican plan raises 
premiums on all senior citizens. The coalition only raises premiums for 
wealthier seniors who are better able to afford an increase. The 
coalition plan also protects reimbursement rates in rural areas where 
hospitals are more likely to close, continues minimal standards for 
nursing homes, and maintains eligibility for health care at military 
facilities.
  Finally, unlike the Republican plan, we do not include $35 billion in 
unspecified cuts, which the Republican Senate Finance Committee 
chairman labeled ``blue smoke and mirrors.''
  We need to keep in mind two things when considering these proposals 
today: First, we cannot continue to borrow from future generations in 
order to have things we are not willing to pay for now, and second, we 
cannot overlook the needs of current generations as we set national 
fiscal priorities. I believe that the coalition alternative does the 
best job of balancing these two concerns.

[[Page E1988]]

  Further, let it be clear that while the impending trust fund 
insolvency is an extremely serious and real concern, it is not a new 
finding. For many years, the trustees' report has indicated the 
insolvency problem in the Medicare HI trust fund. In fact, recent 
estimates had actually extended the insolvency date, and the trustees 
report itself stated that the long-range status of the HI Program had 
improved.
  What is new is that Congress has decided to balance the budget and 
must address this insolvency in doing so. In addition, it is new to 
enact a $245 billion tax cut at the same time that the budget is being 
balanced--this means Congress must cut more spending in order to 
compensate for reduced tax revenue.
  The coalition Medicare proposal represents the most sensible approach 
to achieving Medicare solvency because it does not lose sight of the 
larger health care picture in a rush to balance the budget. It extends 
solvency over a 10-year period, creates a bipartisan Commission to 
address long-term solvency, protects beneficiaries, and eases the 
burden on rural hospitals which provide critical services to rural 
communities but often rely on Medicare and Medicaid for a majority of 
their funds.
  Therefore, the coalition Medicare proposal achieves and exceeds the 
goals of the Republican proposal while containing spending reductions 
to a level that can be absorbed by the health care market without 
reducing seniors' access to health care--particularly those seniors 
with low incomes--or quality of health care.
  I know that the Utah Association of Healthcare Providers and others 
share my concern about the magnitude of spending reductions contained 
in the House Republican proposal. They estimate that some hospitals in 
Utah will close as a result of these cuts, particularly hospitals in 
rural areas where over 60 percent of funding can be received from 
Medicare and Medicaid.
  The $170 billion reduction contained in the coalition budget is 
almost identical to the amount that organizations like the American 
Hospital Association have said they can achieve without severely 
reducing the quality of, or access to, health care received by 
beneficiaries.
  Let me make clear that I consider the need to balance the Federal 
budget the highest priority we face in Congress, and have worked hard 
for policies and specific spending cuts to reverse the spiraling 
deficit. But having agreed to balance the budget in a 7-year period, it 
is now crucial to have a thorough debate regarding the Nation's fiscal 
priorities. Tough spending cuts are necessary to achieve such a balance 
and seniors will have to share in these cuts. However, since the 
spending cuts contained in any balanced budget will be difficult, it is 
even more imperative that we cut spending first before cutting taxes.
  Recent polls show that insistence on tax cuts in light of the tough 
decisions necessary to achieve a balanced budget does not reflect the 
priorities of the American people. Over 80 percent of Americans oppose 
cutting future costs of Medicare to pay for a tax cut. Higher income 
Americans are even less supportive of making Medicare cuts in order to 
finance tax cuts than other Americans.
  In conclusion, containing health care costs is an essential part of 
the balanced budget equation. Health care is the fastest growing 
portion of the Federal budget, and if we do nothing, by the year 2030, 
all that our Federal tax dollar will pay for is health and retirement 
programs.
  However, there is also more than one way to achieve a balanced budget 
and contain health care spending. There are important questions to 
discuss regarding how we can contain health care costs without 
decreasing quality or denying beneficiaries access to health care.
  The Medicare reforms we are considering raise issues beyond simply 
balancing the budget and restoring solvency to the Medicare trust 
fund--reforms must include the impact of the costs of health care being 
shifted as the Federal Government pays proportionately less of health 
care spending.
  I believe that it is critical for Congress to work with, and listen 
to, the American people as we attempt to determine which proposals are 
most appropriate and cost-effective.
  The fact that the coalition Medicare proposal will not be considered 
in the debate today denies a voice to the moderate mainstream majority 
of Americans. I regret that the full details of this proposal will not 
receive a fair hearing.

                          ____________________