[Congressional Record Volume 149, Number 54 (Thursday, April 3, 2003)]
[Extensions of Remarks]
[Page E670]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          MEDICARE OUTPATIENT CO-PAYMENT REDUCTION ACT OF 2003

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Thursday, April 3, 2003

  Mr. STARK. Mr. Speaker, I rise today with my colleagues, 
Representatives McDermott, Kleczka, DeLauro, Frank, Frost, Jackson-Lee, 
McNulty and Abercrombie to introduce legislation to expedite the 
timeframe for reducing to 20 percent the coinsurance amounts that 
Medicare beneficiaries are required to pay for hospital outpatient 
services. I'm honored that this bill has the support of the National 
Committee to Preserve Social Security and Medicare and Families USA.
  For most Medicare services, beneficiaries are required to pay 20 
percent of the allowed payment amount, and Medicare pays 80 percent. 
However, for hospital outpatient services, Medicare beneficiaries are 
required to pay much higher co-payments--up to 55 percent for some 
services.
  This is an anomaly due to an error in legislative drafting many years 
ago. Based on earlier legislation I helped enact into law, Congress has 
already taken some partial steps to correct this wrong. Under current 
law, hospital outpatient co-payments will reduce to 40 percent by 2006, 
but they will not reduce to the typical 20 percent level until 2029. We 
didn't solve the full problem because Congress didn't want to spend the 
money.
  The Medicare Outpatient Co-payment Reduction Act of 2003 will speed 
up this reduction process by decreasing beneficiary coinsurance rates 
in increments of 5 percent each year beginning in 2007 until the 
coinsurance rate for all hospital outpatient services is 20 percent by 
2010. This expedited reduction is consistent with a recent 
recommendation made by the Medicare Payment Advisory Commission or 
MedPAC--the expert body that advises Congress on Medicare.
  While high coinsurance rates affect all Medicare beneficiaries, they 
are particularly devastating for the approximate 3.6 million 
beneficiaries who have no supplemental insurance. Most of these 
individuals are the ``near poor''--with incomes too high to qualify for 
Medicaid or the Qualified Medicare Beneficiary or QMB program, but with 
incomes too low to be able to afford supplemental insurance. This group 
is made up of a disproportionate number of minorities and women.
  Furthermore, coinsurance amounts are much higher for certain services 
than others. Those with the highest coinsurance are the ``high-tech'' 
services, such as radiology services and cancer chemotherapy services. 
Thus, high coinsurance greatly limits affordable access to these life 
saving services for many Medicare beneficiaries.
  Mr. Speaker, the Medicare Outpatient Co-payment Reduction Act of 2003 
is a simple bill. We've charged seniors outrageous amounts for too long 
already for hospital outpatient services. Seniors shouldn't have to 
wait another 26 years before they are fairly charged for outpatient 
services. This is an incremental approach that lowers the co-payment 
level to 20 percent by 2010. It's a small, but important step to 
improve health care access for seniors. I look forward to working with 
my colleagues to enact it as soon as possible.

                          ____________________