[Congressional Record Volume 142, Number 58 (Wednesday, May 1, 1996)]
[Extensions of Remarks]
[Pages E693-E694]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     MEDIGAP PROTECTION ACT OF 1996

                                 ______


                            HON. KEN BENTSEN

                                of texas

                    in the house of representatives

                         Wednesday, May 1, 1996

  Mr. BENTSEN. Mr. Speaker, I rise today to introduce vital consumer 
protection legislation, H.R. 3374, for Medicare beneficiaries. H.R. 
3374, the Medigap Protection Act of 1996, will provide real freedom to 
senior citizens to

[[Page E694]]

choose between traditional fee-for-service Medicare and managed care 
Medicare programs without risk of penalty. It does so by guaranteeing 
access to Medigap supplemental insurance for seniors who choose to 
enroll in fee-for-service Medicare after participating in a Medicare 
managed care plan.
  Congress is currently debating fundamental changes to the Medicare 
system. The Republican plan to reform Medicare would strongly encourage 
Medicare beneficiaries to enroll in managed care plans. Nationwide, 
approximately 13 percent of the Medicare population have enrolled in 
managed care options. I support providing freedom of choice for senior 
citizens, but the choice must be real and not coerced. As more senior 
citizens enroll in managed care plans, we need to ensure that they can 
reenroll in Medicare without losing benefits or paying a financial 
penalty.
  Under current law, Medicare beneficiaries can enroll in either a 
managed care product or traditional Medicare Program. Many enrollees in 
traditional Medicare choose to purchase supplemental insurance 
policies, called medigap to cover the cost of copayments, deductibles, 
and other uncovered benefits such as prescription drugs. When Medicare 
beneficiaries make this initial choice, current law protects them by 
requiring all insurers to sell medigap insurance. Regrettably, this 
consumer protection is not provided after this initial enrollment 
period.
  H.R. 3374 would require guaranteed issue of medigap policies for 
those senior citizens who choose to enroll in traditional Medicare 
after leaving a managed care Medicare Program. This bill would require 
any issuer of medigap insurance to provide an annual enrollment period 
of 30 days for those Medicare beneficiaries that reenroll in the 
traditional Medicare Program. The Secretary of Health and Human 
Services would issue regulations to enforce this act. The bill would 
become effective 90 days after enactment.
  Without this protection, senior citizens do not have real choice. In 
addition, many senior citizens are not aware of this lack of protection 
and may enroll in managed care plans without knowledge of this problem. 
A constituent of mine, Ms. Nona Phillips of Pasadena, contacted me when 
she had difficulty obtaining medigap insurance after switching back to 
fee-for-service Medicare from an HMO. Consumers should be able to 
choose plans without financial coercion or penalties, such as lack of 
medigap insurance. For many senior citizens, medigap benefits are 
extremely important because traditional Medicare does not provide 
prescription drug coverage. I want to ensure that Medicare 
beneficiaries make a choice between equal options. It also provides 
greater freedom and choice for seniors without forcing them to cover 
the costs of higher copayments, deductibles, and prescription drugs.
  This is another incremental health care reform we can pass 
immediately that should be supported on a bipartisan basis. President 
Clinton has endorsed this provision as part of his 1997 budget. We need 
to pass common sense, reasonable legislation, H.R. 3374, that will 
improve the Medicare Program so senior citizens are protected and have 
real choice. I urge my colleagues to join me in this effort to 
strengthen consumer protections for Medicare beneficiaries.

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