[Congressional Record Volume 145, Number 52 (Thursday, April 15, 1999)]
[Extensions of Remarks]
[Page E681]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  GAO FINDS 43% OF ELIGIBLE MEDICARE BENEFICIARIES NOT RECEIVING LOW-
                           INCOME PROTECTION

                                 ______
                                 

                           HON. JIM McDERMOTT

                             of washington

                    in the house of representatives

                        Thursday, April 15, 1999

  Mr. McDERMOTT. Mr. Speaker, complicated administrative procedures, 
difficult and lengthy application forms and even the reluctance to 
visit a welfare office are keeping millions of low-income seniors from 
receiving Medicare benefits designed just for people like them, 
according to a new report from the General Accounting Office.
  The GAP report I requested with Representative Pete Stark found that 
43 percent of the elderly poor are not enrolled in Medicare's programs 
to assist them with their health-care costs. The federal agency said of 
the 5.1 million elderly who qualify for the assistance, about 2.2 
million were not enrolled.
  My view is that GAO's findings that the high percentage of Medicare 
beneficiaries who are eligible, but not actually enrolled in the 
programs is alarming, and warrants Congressional action.
  These are people in our society who need help the most. Often they 
are women, single, living alone, and over 80 years old. We need to 
adequately take care of our mothers, grandmothers and aunts, rather 
than force them to endure a gauntlet of administrative forms and long 
lines at the welfare agency.
  The GAO report cited a lack of outreach to get people into the 
program, complex administrative rules, and the reluctance of some 
seniors to visit a welfare office as part of the reason for lack of 
enrollment.
  To correct these problems, Representatives Stark and Berry and I 
today introduced legislation to automatically enroll eligible 
beneficiaries into the programs.
  It's clear that Congress has failed to ensure that we reach out to 
Medicare beneficiaries eligible for these programs. Section 154 of the 
Social Security Amendments of 1994 (P.L. 103-432) directed the 
Secretary of HHS to obtain all information necessary from newly-
eligible Medicare beneficiaries to determine their eligibility for 
these programs and to transmit this information to individual states.
  Medicare provides health insurance coverage to nearly 39 million 
Americans. Costs are shared by the government and the individuals. 
Medicare Part A--hospitalization--is paid through the federal payroll 
tax. But premiums for Medicare Part B--for doctor's bills--are paid by 
beneficiaries through a deduction from their Social Security payments. 
Many seniors also buy so-called Medigap policies to take care of costs 
not paid by Medicare.
  The cost of Medicare Part B premiums, which are $45.50 per month this 
year, can be a burden for low-income elderly.
  The poorest of the elderly can get help paying their premiums through 
Medicaid. But many seniors who are not quite at the poverty level still 
have trouble paying this cost. So Congress established two programs, 
the Qualified Medicare Beneficiary program, or QMB, and the Specified 
Low Income Medicare Beneficiary program, (SLMB).
  QMB began in 1986 and is aimed at Medicare beneficiaries below the 
federal poverty level. It pays Medicare premiums, deductibles and 
coinsurance.
  SLMB, started in 1993, requires state Medicaid programs to pay Part B 
premiums, but not deductibles or coinsurance. It is aimed at those with 
incomes below 120 percent of the federal poverty level.
  We introduced our bill to ensure that qualified and needy seniors can 
take advantage of these programs. Essentially, what their bill would do 
is automatically enroll qualifying seniors in the programs.
  The GAO report also stated that many potential recipients don't even 
know the programs exist.
  The report noted, ``The persistence of relatively low enrollment in 
the QMB and SLMB programs suggests that enhanced outreach or simplified 
enrollment processes would be helpful in reaching a larger share of 
eligible low-income Medicare beneficiaries.''
  Our legislation would go a step further and ensure that Medicare 
beneficiaries actually receive the benefits to which they are entitled.

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