[Congressional Record Volume 144, Number 5 (Tuesday, February 3, 1998)]
[Extensions of Remarks]
[Pages E74-E75]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              1972: SENATE PASSES EARLY BUY-INTO MEDICARE

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, February 3, 1998

  Mr. STARK. Mr. Speaker, Members of Congress will soon be introducing 
a bill to provide affordable health insurance for people in the age 62-
65 bracket and for displaced workers over age 55. The bill will let 
Americans buy-into Medicare at full cost--that is, without any cost to 
the existing Medicare system.
  Five Senators have already voted for this proposal: Senators Roth, 
Stevens, Thurmond, Byrd, and Inouye all voted for it in 1972, when the 
Senate version of H.R. 1 included a proposal from the Senate Finance 
Committee to let spouses of Medicare eligible individuals and early 
Social Security retirees buy into Medicare.
  Senator Dole also voted for the proposal.
  The Senate floor statements by Republican Senator Gurney of Florida 
and Democratic Senator Cranston of California are still an eloquent 
testimony to why this year's proposal makes great sense. I would like 
to include this legislative history in the Record at this point. The 
numbers cited in speeches have to be updated, of course, but the 
reasons why we should give people the option of spending their own 
money to buy into Medicare are still accurate:

Social Security and Welfare Reform--Summary of the Principal Provisions 
   of H.R. 1 as Determined by the Committee on Finance, Committee on 
Finance, United States Senate, Russell B. Long, Chairman, June 13, 1972


 Medicare Coverage for Spouses and Social Security Beneficiaries Under 
                                 Age 65

     Present Law
       Under present law, persons aged 65 and over who are insured 
     or are deemed to be insured for cash benefits under the 
     social security or railroad retirement programs are entitled 
     to hospital insurance (part A). Essentially all persons aged 
     65 and over are eligible to enroll for medicare insurance 
     (part B) without regard to insured status. The House bill 
     includes a provision that would permit persons aged 65 and 
     over who are not insured or deemed insured for cash benefits 
     to enroll in part A, at a premium rate equal to the full cost 
     of their hospital insurance protection ($31 a month through 
     June 1973).
     Problem
       Many additional social security cash beneficiaries find it 
     difficult to obtain adequate private health insurance at a 
     rate which they can afford. This is particularly true if they 
     are of an advanced age, say, age 60-64. Frequently, these 
     older beneficiaries--retired workers, widows, mothers, 
     dependents, parents for example--have been dependent upon 
     their own group coverage or that of a related worker who is 
     now deceased for health insurance protection. It is a 
     difficult task for such older persons to find comparable 
     protection when they no longer are connected to the labor 
     force.
     Finance Committee Amendment
       The provision makes Medicare protection available at cost 
     to spouses aged 60-64 of Medicare beneficiaries and to other 
     persons age 60-64 (such as a beneficiary who elects early 
     retirement at age 62) entitled to benefits under the Social 
     Security Act.

[[Page E75]]

             Social Security Amendments of 1972--Amendment


                           amendment no. 989

       (Ordered to be printed and referred to the Committee on 
     Finance.)
       Mr. GURNEY. Mr. President, I am today introducing an 
     amendment to H.R. 1 that would apply to that part of the bill 
     dealing with medicare.
       My amendment is directed toward the 3 million or so people 
     between 60 and 65 whose husbands or wives receive medicare 
     benefits but who are not eligible for it themselves. By and 
     large these people live on limited retirement incomes and, as 
     retirees, are more vulnerable to economic hardship resulting 
     from serious illness. The most reasonable solution would be 
     to bring them under the umbrella of medicare, while adding as 
     little as possible to the cost of that program.
       This amendment would do just that. It provides that one 
     spouse must be over 65 and already enrolled in the medicare 
     program for the other spouse, who must be at least 60, to 
     enroll in the program and receive equivalent benefits at 
     cost.
       The cost of these benefits to the newly eligible spouse 
     should be reasonable enough to attract enrollees yet 
     comprehensive enough to provide the necessary medical 
     coverage. For an estimated $30 to $35 a month, spouses will 
     get the same hospital insurance and insurance to cover 
     physician's charges that anyone else enrolled in medicare 
     gets.
       To discourage people from waiting until they are sick to 
     enroll, this amendment provides for a 10-percent increase in 
     premiums for each year they delay. Thus, the potential 
     enrollee has an incentive to sign up when he or she is 60. 
     Such a proviso will put the program on a sounder financial 
     basis.
       In summary, this proposal will provide the spouse of a 
     retiree on medicare with adequate medical insurance at 
     reasonable rates during a 5-year period when getting a policy 
     from a private company would be either impossible or 
     prohibitively expensive. Once the person reached age 65, 
     regular medicare would take over, dropping the $30 to $35 a 
     month charge to an estimated $5.80 per month.
       Since the financial burden of this proposal would be 
     underwritten by the subscribers and since its implementation 
     would utilize the administrative services of a program 
     already in existence--medicare--this seems to be the most 
     efficient and most economical way to reduce some of the 
     trails and tribulations faced by our senior citizens. They 
     have worked hard for their retirement and they deserve a 
     chance to live it in peace and contentment. This amendment 
     would help give them that chance without depriving them of 
     their dignity or overburdening the already hard-pressed 
     American taxpayer.
                                  ____


 Extension of Medicare Coverage to Early Retirees and Their Dependents

       Mr. CRANSTON. Mr. President, I submit for printing today 
     for myself and the Senator from Florida (Mr. Gurney) an 
     amendment to H.R. 1, which would enable certain individuals 
     who have not yet reached age 65--those who are entitled to 
     old-age, wife's, husband's, widow's, widower's, or parent's 
     Social Security benefits--to ``buy-into'' Parts A and B of 
     Medicare by the payment of equal-to-cost-premiums.
       The need for this legislation stems from the fact that 
     medicare eligibility does not begin until age 65, yet many 
     older persons lose their group health coverage when they 
     retire before the age of 65. They are then forced to enroll 
     in high-cost individual health policies--usually not even 
     available to them--or to forego any coverage whatsoever, 
     gambling that they will stay healthy at least until they 
     reach age 65 when they become eligible for medicare. This is 
     an intolerable situation, Mr. President, and I believe that 
     we can effectively counteract it through the enactment of the 
     measure we propose today.
       Senator Gurney submitted on March 3 an amendment (No. 989) 
     to H.R. 1. The amendment provides that if one spouse is over 
     65 and enrolled in medicare, the other spouse, if at least 60 
     years old, may enroll in the program and receive equivalent 
     benefits at cost. As Senator Gurney stated when he introduced 
     this measure:
       ``Since the financial burden of this proposal would be 
     underwritten by the subscribers, and since its implementation 
     would utilize the administrative services of a program 
     already in existence--Medicare--this seems to be the most 
     efficient and most economical way to reduce some of the 
     trials and tribulations faced by our senior citizens.''
       I believe that Senator Gurney has submitted an excellent 
     amendment, and I have requested to be added as a cosponsor.
       In discussing the benefits afforded by amendment No. 989, 
     which the Finance Committee has already tentatively adopted 
     in its markup of H.R. 1 in executive session, Senator Gurney 
     and I agreed that, at still no cost to the American taxpayer, 
     these benefits could be made available to an even broader 
     range of older Americans--those already on the social 
     security rolls. It is these individuals that the amendment we 
     are submitting today would cover. They include in addition to 
     the social security spouse covered by the Gurney amendment: 
     First, social security old age beneficiaries 62 years old and 
     over; second, a wife or widow, regardless of her age, if she 
     is caring for a child under 18 or disabled and the child 
     received payments based on the worker's record; third, a wife 
     62 or older or widow 60 or older; fourth, a dependent husband 
     62 or over, or a dependent widower 60 or over; or a disabled 
     widower who has attained age 60; or fifth, dependent parents 
     of a deceased worker.
       The ``buy-in'' procedure we propose today is similar to 
     that allowing States to buy into medicare on behalf of their 
     retired public employees 65 years old or older--a provision 
     contained in section 202 of H.R. 1 as passed by the House. 
     And H.R. 1 as passed by the House also extends medicare 
     coverage to recipients of social security disability 
     benefits. The Senate Finance Committee has tentatively 
     agreed to this extension of coverage which I have long 
     advocated. In light of this expansion of the medicare 
     program, I believe it is only fitting that we concern 
     ourselves, too, with the health care needs of the 
     individuals who would be covered by this amendment.
       Our amendment would allow these individuals, at an 
     estimated cost of approximately $30 per month in the first 
     year of operation--and perhaps as law as $22 per month 
     thereafter--to enroll in part A of medicare--Hospital 
     Insurance Benefits--anytime they are or become eligible 
     during a 90-day period following receipt of notice of 
     eligiblity from the Social Security Commissioner.
       Because the enrollment period is limited to a specific 
     number of days--a reasonable period of 90 days after the 
     recipient receives notice of eligibility--the opportunity for 
     adverse selection of coverage is very much reduced, thereby 
     promising to keep premium charges to the absolute minimum.
       Our amendment would allow these same elegible individuals 
     to enroll in part B of medicare--Medical Insurance Benefits--
     within the same 90 day period. The premium for part B 
     coverage would be 200 percent of the regular part B premium--
     one-half of which the Government presently underwrites for 
     medicare beneficiaries. If a provision is enacted in H.R. 1 
     to eliminate completely or place a limitation upon, as the 
     Finance Committee proposes, the part B premium cost to 
     beneficiaries--it is presently $5.60 per month--I expect that 
     the cost to those covered by this amendment would be 
     appropriately adjusted.
       Individuals may opt out of either part A or part B at 
     anytime, but automatically cease to be eligible for part B if 
     they drop or lose eligibility for part A. All of these 
     beneficiaries of course, would be eligible for the regular 
     medicare program when they reached the age of 65.
       Mr. President, on March 3 and 4, as ranking majority member 
     of Senator Eagleton's Subcommittee on Aging of the Labor and 
     Public Welfare Committee, I was privileged to preside at 
     hearings in California on legislation affecting our Nation's 
     more than 20 million older Americans. I discussed with many 
     of the witnesses present the legislation that Senator Gurney 
     and I propose today, and all testified to the importance of 
     and vital need for such a measure.
       Adequate health care coverage is a matter of the greatest 
     concern to Americans reaching retirement age. This amendment 
     addresses that concern and provides a mechanism for a 
     substantial number of particularly hard-pressed older 
     Americans to take full advantage of the benefits under the 
     medicare program.

     

                          ____________________