[Congressional Record Volume 141, Number 188 (Tuesday, November 28, 1995)]
[House]
[Pages H13724-H13725]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




NEW YORK TO BE DISPROPORTIONATELY HURT BY CUTS IN MEDICARE AND MEDICAID

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from New York [Mrs. Maloney] is recognized for 5 minutes.
  Mrs. MALONEY. Mr. Speaker, I believe we have the greatest health care 
system in the world and New York City has many of the Nation's best 
hospitals to support that great system, hospitals that have the 
enormous responsibility of caring for the citizens of America's largest 
city, that train a disproportionate number of our next generation of 
health professionals, that conduct the cutting edge research to save 
and improve our lives. Yet many of these hospitals will be decimated by 
Republican Medicare and Medicaid cuts that will cost these great New 
York City hospitals billions in reduced payments.
  Where will these institutions be forced to make up these cuts? 
Conservative estimates put the New York City job loss at 107,000 health 
care positions, more than 2.3 percent of the city's total employment.
  Doctors will be cut, nurses will be cut, janitors who keep our 
hospitals clean and sanitary will be cut. New York medical technology 
will not be purchased. Yes, this will hurt seniors; yes, this will hurt 
the poor; yes, this will hurt the health care of every New Yorker and 
every American.

  The House of Representatives voted to cut Medicare spending by $270 
billion over 7 years and to cut $170 billion to the Medicaid Program. 
There are several unique features of the New York City health care 
system which make it especially vulnerable to the type of targeted cuts 
in the spending contained in the Republican legislation.
  The New York City metropolitan area trains 15 percent of the medical 
residents for the entire Nation. The New York biomedical system is a 
recognized world center of advanced science, medicine and education. 
New York hospitals reach these heights while simultaneously serving a 
high percentage of patients with special needs far exceeding the 
national average. These patients include the elderly, the disabled, the 
chronically ill, and the poor, and it is not only the health care we 
all receive that will be affected by the proposed cuts. New York's 
economy will also be hard hit due to the State and city's dependence on 
its large and complex health care system.
  Cuts in the formulas for Medicare, graduate medical education, and 
disproportionate share payments, would create unacceptably severe 
reductions in payments for New York's hospitals. This is because 
indirect medical education and disproportionate share payments are 
based on percentages of overall medical payment rates. As the overall 
Medicare payment rates are reduced as a result of smaller inflation 
adjustments, payments for graduate medical education and 
disproportionate share are automatically reduced and their rates of 
growth are slowed. Thus, further reductions in graduate medical 
education and disproportionate share would amount to double cuts, which 
our hospitals, most of which are operating below the break-even point, 
simply cannot withstand.
  Changes in Medicaid will also have a drastic impact on New York's 
health care providers, especially those providing long-term care. New 
York has received one of the lowest rates of Medicaid payment increases 
among the States. New York's nursing homes could lose 25 percent of the 
money necessary for their survival by 2002.
  According to the Health Care Association of New York, New York State, 
with 7 percent of the Nation's population, would take 11 percent of the 
cuts in Medicare and Medicaid. New York City, with 2.9 percent of the 
Nation's population, would absorb 6.5 percent of these cuts, more than 
double its fair share. Over 7 years, cuts in Medicare and Medicaid 
payments to hospitals would cost New York State $20 billion and New 
York City $12 billion. Funding for long-term care and personal health 
services would decline by $11 billion in New York State and $7 billion 
in New York City.
  The proposed cuts will dangerously damage health care services, but 
that is not all. The cuts would wreak havoc with New York's many health 
care workers, their employment and their income. New York City will 
lose 107,000 jobs, and New York State may stand to lose well over 
200,000 jobs. Any budget plan must include everyone having to do their 
part to balance the budget, but I argue that any budget plan must treat 
all States equally.
  I think the cuts to Medicare and Medicaid and the impact on hospitals 
and health care systems across the country is deeply disturbing. The 
disproportionate impact of these cuts on New York State and New York 
City is 

[[Page H 13725]]
unacceptable. Protecting New York State's and New York City's 
hospitals, health care providers and medical educators helps to 
safeguard the health of our Nation while preserving the health and 
economic well-being of one of our country's most densely populated 
cities and States.

                              {time}  2245

  As the budget negotiations continue, I ask my colleagues to join me 
in fighting to reduce these cuts. I am proud to have voted against the 
reconciliation bill and I will oppose any future budget that cuts with 
the injustice and scope of the Republican proposal.
  Mr. Speaker, I yield back the balance of my time.

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