[Congressional Record Volume 150, Number 21 (Wednesday, February 25, 2004)]
[Senate]
[Page S1592]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID:
  S. 2121. A bill to amend part C of title XVIII of the Social Security 
Act to prohibit the comparative cost adjustment (CCA) program from 
operating in the State of Nevada; to the Committee on Finance.
  Mr. REID. Mr. President, there is nothing more important we could do 
for our senior citizens than help them with the soaring cost of health 
care, especially the high cost of prescription drugs.
  Unfortunately the Medicare bill passed by this Congress and signed 
into law by President Bush doesn't do this. In fact, for many seniors 
this law will do more harm than good.
  One provision of this new and overly complicated law establishes 
``comparative cost adjustment'' demonstration programs that will take 
place in six metropolitan areas. ``Comparative cost adjustment'' is 
just a fancy term that really means: How much you pay for your Medicare 
premiums depends on where you live.
  In other words, some Medicare recipients will pay more than others 
for the exact same coverage, simply because of where they live.
  Medicare premiums for seniors living in the six regions selected to 
participate in the pilot program would be based on a set payment--like 
a voucher--from the government. This payment would be based on a 
combination of the prices charged by private plans and the cost of 
Medicare fee-for-service in their area.
  Seniors would enroll in either a private plan or in fee-for-service 
Medicare. But those who chose a plan that cost more than the defined 
contribution would have to pay the difference out of their own pockets.
  And since senior citizens in the fee-for-service program tend to be 
older and sicker than those who enroll in Medicare HMOs, costs for that 
group would probably be higher, and the defined contribution likely 
would not cover the entire cost of the fee-for-service premium.
  So over time, seniors who want to remain in the traditional Medicare 
program, because they want to keep choosing their own doctor or for any 
other reason, would have to pay more and more out of their own pockets.
  Under this experimental program, I fear that traditional Medicare 
would become too expensive for many patients simply because of where 
they happen to live. We have a large population of retirees in north 
and south Nevada, and I am told there is a good chance one or both of 
these areas will be selected for this experimental pilot program. That 
would place a disproportionate burden on seniors in my State who are 
already struggling to make ends meet and pay for their health care.
  So the legislation I am introducing today will prohibit any of the 
six demonstration programs from occurring in Nevada.
  Senior citizens in Nevada should not have to pay more than their 
neighbors for the same Medicare services. I will keep fighting to 
protect Nevadans from being used as guinea pigs in this ill-advised 
experiment.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2121

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. PROHIBITION ON OPERATION OF MEDICARE COMPARATIVE 
                   COST ADJUSTMENT (CCA) PROGRAM IN NEVADA.

       (a) In General.--Section 1860C-1(b) of the Social Security 
     Act, as added by section 241 of the Medicare Prescription 
     Drug, Improvement, and Modernization Act of 2003 (Public Law 
     108-173), is amended by adding at the end the following:
       ``(3) No cca areas within nevada.--A CCA area shall not 
     include an MSA any portion of which is within the State of 
     Nevada.''.
       (b) Effective Date.--The amendment made by this section 
     shall take effect as if included in the enactment of the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003 (Public Law 108-173).
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