[Congressional Record Volume 150, Number 134 (Friday, November 19, 2004)]
[House]
[Pages H10053-H10054]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EXTENSION OF MEDICARE COST-SHARING FOR THE MEDICARE PART B PREMIUM FOR
QUALIFYING INDIVIDUALS THROUGH SEPTEMBER 2005
Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and
pass the Senate bill (S. 2618) to amend title XIX of the Social
Security Act to extend medicare cost-sharing for the medicare part B
premium for qualifying individuals through September 2005.
The Clerk read as follows:
S. 2618
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. EXTENSION OF MEDICARE COST-SHARING FOR THE
MEDICARE PART B PREMIUM FOR QUALIFYING
INDIVIDUALS.
(a) In General.--Section 1902(a)(10)(E)(iv) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by
striking ``2004'' and inserting ``2005''.
(b) Total Amount Available for Allocation.--Section 1933(g)
of the Social Security Act (42 U.S.C. 1396u-3(g)) is amended
to read as follows:
``(g) Special Rules.--
``(1) In general.--With respect to each period described in
paragraph (2), a State shall select qualifying individuals,
subject to paragraph (3), and provide such individuals with
assistance, in accordance with the provisions of this section
as in effect with respect to calendar year 2003, except that
for such purpose--
``(A) references in the preceding subsections of this
section to a year, whether fiscal or calendar, shall be
deemed to be references to such period; and
``(B) the total allocation amount under subsection (c) for
such period shall be the amount described in paragraph (2)
for that period.
``(2) Periods and total allocation amounts described.--For
purposes of this subsection--
``(A) for the period that begins on January 1, 2004, and
ends on September 30, 2004, the total allocation amount is
$300,000,000;
``(B) for the period that begins on October 1, 2004, and
ends on December 31, 2004, the total allocation amount is
$100,000,000; and
``(C) for the period that begins on January 1, 2005, and
ends on September 30, 2005, the total allocation amount is
$300,000,000.
``(3) Rules for periods that begin after january 1.--For
any specific period described in subparagraph (B) of
paragraph (2), the following applies:
``(A) The specific period shall be treated as a
continuation of the immediately preceding period in that
calendar year for purposes of applying subsection (b)(2) and
qualifying individuals who received assistance in the last
month of such immediately preceding period shall be deemed to
be selected for the specific period (without the need to
complete an application for assistance for such period).
``(B) The limit to be applied under subsection (b)(3) for
the specific period shall be the same as the limit applied
under such subsection for the immediately preceding period.
``(C) The ratio to be applied under subsection (c)(2) for
the specific period shall be the same as the ratio applied
under such subsection for the immediately preceding
period.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Barton) and the gentleman from Massachusetts (Mr. Olver)
each will control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Barton).
General Leave
Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material on this legislation.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I want to, first of all, commend the gentleman from
Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. Brown) for
helping to expedite this piece of legislation. They could not be on the
floor, so we have the distinguished gentleman from Massachusetts who is
going to control their floor time, and I want to thank him for his
help.
I am reluctantly doing this this evening, not because of the merits
of the bill. I support the merits of the bill, but I do not support the
procedure under which we are doing this and the reluctance of the other
body to find a way to help pay for what we are about to do.
{time} 1930
This Congress should be taking serious steps to address our budget
problems and our growing Federal debt. The President who just won
reelection, 52 percent of the vote, has told America that deficit
reduction will be one of his highest priorities, and I would like to
have the other body begin to join this body and the President of the
United States in making that a reality.
Senate 2618 is a good bill. It will extend for one year additional
funding for the Medicare Qualified Individual Program, better known as
the QI program. This program will allow approximately 160,000 low-
income beneficiaries enrolled in the program to continue to receive
assistance to pay for their Medicare part B premium which is optional.
That is fair and appropriate.
We began to help subsidize those premium payments back in 1997, so we
have been doing it now for the last 7 years. I support that. I think it
is appropriate to help our low-income seniors help pay for their
Medicare option part B coverage, but I also think we ought to have a
way to help pay for that subsidy. This bill does not do that.
I think we need to begin to address the problem of mandatory
automatic
[[Page H10054]]
entitlement growth, and to extend a program like this where we could
have an offset to pay for it, in my opinion, is inexcusable.
It has been said that nobody notices a deficit until its weight
finally collapses the government. I do not intend to ever let that
happen, and we could be taking a small step to lessen that load today.
Regrettably we are not.
Let me state what we have done in the last 2 weeks. Again, the
underlying bill that we are passing is a good piece of legislation, and
I support that. The Speaker of the House supports it. The majority
leader supports it. The ranking member on the Committee on Energy and
Commerce, the ranking member on the subcommittee, the subcommittee
chairman, the full committee chairman, we all support it; but we found
a way to pay for this bill. We found out that under existing law people
that receive prescription drug benefits that are paid for by Medicare,
the person that actually provides a prescription can file paperwork to
get an automatic rebate from the drug manufacturer. It is in the law.
We do not force the person who is providing the prescription to
actually apply for the rebate. So we have some providers of
prescriptions who for whatever reason do not fill out the necessary
paperwork to get the automatic rebate that has already been negotiated.
The offset that we came out with in the House was to simply say that
if there was a drug rebate that had already been negotiated, you had to
file for it and receive it so you could give that rebate to the State
and the Federal Government. That would save approximately $140 million
over the life of the extension. The White House supported it. CNS
supported it. The House supported it, but the other body did not
support it. They wanted to extend the program but not provide an offset
to help pay for the extension.
Now, I offered this afternoon to pull this bill back and try to work
out something that when we first got back in the next Congress we could
do the offset. The Speaker and the majority leader felt like we needed
to go ahead and pass this bill this evening, and I am going to go ahead
and do that. It is a good bill. It needs to be passed. We need to
provide this additional supplemental assistance for low-income seniors
to pay for their part B prescription drug benefit. But this is the last
time as chairman of the Committee on Energy and Commerce that I am
going to extend an entitlement program without some sort of an offset.
So for tonight we can say that this is the beginning of the Barton
doctrine. I hope in the next year or so it becomes the Bush-Hastert-
Frist, even the Pelosi, redoctrine, that we can work on a bipartisan
basis, bicameral with the administration, that as we extend the
existing entitlement programs and create new ones, we come up with a
way to pay for them. But for this evening I rise to support the passage
of this bill.
It will provide much needed assistance for 160,000 low-income seniors
for the next year. In the next year, I am going to work with interested
parties in the administration, the other body and this body to come up
with reforms that continue these necessary benefits but also come up
with a way to pay for them.
Mr. Speaker, I reserve the balance of my time.
Mr. OLVER. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I wish to confirm what the gentleman from Texas (Mr.
Barton) has already indicated, that the ranking member of the Committee
on Commerce is in full support of this bill.
The chairman has also indicated that the ranking member of the
subcommittee, the gentleman from Ohio (Mr. Brown), is in full support
of the legislation, and I think that indicates that the Committee on
Commerce members on our side of the aisle are in support of the
legislation, and I think our whole caucus would be very supportive of
that legislation.
Mr. DINGELL. Mr. Speaker, I rise in support of this legislation to
reauthorize the Qualified Individual program, or QI. This program helps
low-income Medicare beneficiaries, who earn just a little too much to
qualify for Medicaid assistance, but are still struggling with living
and health care costs. The QI program pays the cost of the Medicare
Part B premium for seniors with incomes of approximately $11,000 to
$12,500 a year. This is a good program that helps thousands of low-
income seniors each year.
The initial program was a block grant enacted in 1997. Because it
expired in 2002, Congress has had to reauthorize this program a number
of times since then. However, the uncertainty surrounding funding for
this program has had a dampening effect on enrollment. States are
hesitant to reach out to eligible individuals, resulting in
artificially low enrollment figures. I hope that my colleagues across
the aisle will join me in fixing this problem in the future--but, I am
pleased that we are at least extending this program an additional year,
through September 2005.
I thank Senators Grassley, Baucus, Bingaman, Lautenberg, and Smith
for their work in the Senate, and thank Chairman Barton, Chairman
Bilirakis, and Ranking Member Brown for their work in the House.
Mr. ISRAEL. Mr. Speaker, this past September I was contacted by
officials in the two counties that I represent urging me to do
everything I could to extend the Qualifying Individual-1, QI-1,
program. This important program gives Federal money to State Medicaid
programs to pay for the Part B premium for low-income seniors. They
stressed extending the program is particularly important this year as
the Medicare Part B premiums are increasing over 17 percent from $66.60
to $78.20.
Medicare Part B is theoretically voluntary, but in reality is
necessary for any senior who does not have some form supplemental
insurance. Medicare Part B covers outpatient services, doctor visits,
and other health care services not covered by the Hospital Insurance
component of Medicare Part A.
Unfortunately, seniors must pay a premium for Medicare Part B. Low-
income seniors live on very tight budgets. If Congress allowed this
program to expire, there would be a number of low-income seniors who
would have to decide if the monthly $78.20 would be better spent on
food rather than on their health care premium.
I responded to local officials by introducing legislation that would
extend this program for another year. My legislation is identical to
the Senate bill that we are voting on today. It extends this vital
program for another year, and I am proud to have sponsored it in the
House.
I was not the only Member to respond to this call. Representative Jim
Saxton and I both introduced this bill. Two Members of Congress in
different parties introducing the same bill shows the universal support
for this bill.
The QI-1 program has been to the brink of expiring before. It was
enacted as part of the Balanced Budget Agreement of 1997 and was
originally scheduled to expire in December of 2002. Since the program
has proved to be vital for low-income seniors, it has been extended a
number of times through continuing resolutions, TANF reauthorization,
and it was last extended in the Medicare Modernization Act. The last
extension expired on September 30, 2004; however, it was extended
through a continuing resolution through November 20, 2004.
I am very happy and relieved that QI-1 program will be extended for
another year. It is my hope that next year, Congress will enact
legislation that permanently extends this program. Our low-income
seniors and their advocates should not be made to deal with the
emotional roller coaster each year, while this program comes so close
to ending.
I urge my colleagues to pass this legislation and I look forward to
working with them to enact legislation that makes this program
permanent.
Mr. OLVER. Mr. Speaker, I yield back the balance of my time.
Mr. BARTON of Texas. Mr. Speaker, I have no further requests for
time, and I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Simpson). The question is on the motion
offered by the gentleman from Texas (Mr. Barton) that the House suspend
the rules and pass the Senate bill, S. 2618.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the Senate bill was passed.
A motion to reconsider was laid on the table.
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