[Congressional Record Volume 143, Number 12 (Tuesday, February 4, 1997)]
[Extensions of Remarks]
[Page E140]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     MEDIGAP PROTECTION ACT OF 1997

                                 ______
                                 

                            HON. KEN BENTSEN

                                of texas

                    in the house of representatives

                       Tuesday, February 4, 1997

  Mr. BENTSEN. Mr. Speaker, I rise today to introduce vital consumer 
protection legislation for Medicare beneficiaries. The Medigap 
Protection Act of 1997 will provide real freedom to senior citizens to 
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 Medicare 
managed care plan.
  Congress this year will again debate fundamental changes to the 
Medicare System. Previous reform proposals would strongly encourage 
Medicare beneficiaries to enroll in managed care plans. Nationwide, 
approximately 13 percent of the Medicare population already is enrolled 
in managed care options. I support providing freedom of choice for 
senior citizens, but this 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 traditional 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, often 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 the initial 
enrollment period.
  This legislation 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 who reenroll in the 
traditional Medicare Program. The Secretary of Health and Human 
Services would issue regulations to enforce this act. The bill would be 
become effective 90 days after enactment.
  Without this protection, senior citizens do not have a 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. Consumers should be able to choose plans without 
financial coercion or penalties, such as the inability to purchase 
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. This legislation 
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 common sense health care reform we can pass 
immediately that should be supported on a bipartisan basis. President 
Clinton endorsed this provision as part of his 1997 budget. We need to 
pass common-sense, reasonable legislation 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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