[Congressional Record Volume 148, Number 87 (Wednesday, June 26, 2002)]
[House]
[Pages H4030-H4031]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   PRESCRIPTION DRUGS UNDER MEDICARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Green) is recognized for 5 minutes.
  Mr. GREEN of Texas. Mr. Speaker, last week the Committee on Energy 
and Commerce spent 3 long days and one very long night marking up a 
piece of legislation that is supposed to provide seniors with a 
Medicare prescription drug benefit. I say ``supposed to'' because most 
Americans support putting prescription drugs under Medicare. I have a 
graph here that shows those who support or oppose rolling back the tax 
cut that Congress passed last year and using that money to provide a 
prescription drug benefit under Medicare for seniors. Supporting is 64 
percent, opposing is 25 percent, and 6 percent do not think Medicare 
ought to have prescription drugs. This poll was done between March 28 
and May 1 of this year.
  So instead of having the huge tax cut that we passed last year before 
September 11 and extending them even after 9 years from now, the 
American people really want a prescription drug benefit for seniors 
before they want a tax cut.
  What is frustrating is that if we had been able to pass even one 
single Democratic amendment during that markup, I think all those days 
and that night would have been well spent. Unfortunately, every effort 
we made to improve the bill, and there was so much to improve, was shot 
down on basically party line votes.

[[Page H4031]]

  When I look at all the problems of the bill, I have to wonder why my 
friends on the other side of the aisle fought so hard to preserve it, 
because their bill creates such a complicated scheme of varying copays, 
high deductibles, and insufficient coverage. When seniors sit down 
around their kitchen table to figure out how the Republican plan 
affects them, they will find this bill simply does not add up.
  Under the Republican proposal, the beneficiary pays a $250 
deductible. For the first $1,000 of drugs, they have to pay a 20 
percent copay, or an additional $150. Does not sound too bad. But for 
the second $1,000 worth of pharmaceuticals they have to buy, the copay 
jumps to 50 percent, or $500. So far we are up to $900 in out-of-pocket 
expenses for a $2,000 benefit.
  The legislation that came out of our committee had a gaping hole in 
coverage from $2,000 to $3,700 where seniors have to pay every single 
dime for that $1,700 worth of coverage. At the same time, they are 
still paying their $35-plus a month for coverage they are not 
receiving. So to get to the catastrophic coverage, there has to be 
$3,700; but seniors will have to have $4,800 worth of drug costs before 
they will receive the catastrophic benefit under the Republican plan.
  Most seniors never will actually reach that level. If a senior's drug 
cost, for example, is $300 a month, they will hit that $2,000 by 
midyear. For the next 6 months, they will be paying these premiums but 
getting nothing in return. And while we are talking about the monthly 
premium, let us point out that the legislation does not specify exactly 
what it should be. It says that the private drug plans can charge 
whatever they want.
  Now, in the committee we talked about $35 a month, and that is great. 
But when we tried to put an amendment on that said it could be $35 or 
cost of living after that, that was defeated. But the $35 a month adds 
up to $420 a year in premium before they even get to the copay. Mr. 
Speaker, under this plan, the seniors' out-of-pocket expenses are 
adding up, but their benefits are not.
  There are even more holes in the bill that should cause great 
concern. Under the legislation, private health care plans can create a 
benefit that an actuary can call an ``equivalent'' plan to the 
Republican scheme. That means that the insurance companies can create 
any plan they want, any premiums, any deductibles, any copays as long 
as an actuary deems it an ``equivalent'' plan.

  Under this plan, the health insurance companies could go to an 
actuary, such as Arthur Andersen, with a plan and have them sign off on 
it and sell it as a Medicare product. There is no guarantee that a 
private plan would look anything like the Republican proposal.
  Finally, I want to focus a moment on a point that seniors will be 
thinking about. The Republican plan relies on private insurance 
companies to run this new benefit. It will be separate from Medicare 
part A and Medicare part B and will be run by something called a 
Medicare Benefits Administration. Why is this relevant? Because this is 
the first step to long-term efforts to privitization in Medicare.
  The Republicans have tried to do it for 5 or 6 years. It has not 
worked. Those HMOs just do not make enough money to serve seniors. My 
Republican colleagues have been long-time crusaders for the free 
market. I agree with the free market, but you cannot have the free 
market and private insurance trying to cover seniors. It does not work. 
We learned that in 1965.

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