[Congressional Record Volume 151, Number 57 (Wednesday, May 4, 2005)]
[Extensions of Remarks]
[Page E862]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               INTRODUCING THE MEDICARE EARLY ACCESS ACT

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Wednesday, May 4, 2005

  Mr. STARK. Mr. Speaker, today, during Cover the Uninsured Week, I am 
pleased to introduce a bill to help nearly four million people age 55-
65 obtain access to affordable health insurance. I am joined by my 
colleague Rep. Sherrod Brown and more than 90 additional Democratic 
cosponsors in introducing the ``Medicare Early Access Act,'' one of 
three signature bills that offer attainable, common sense solutions for 
the uninsured.
  We have 45 million Americans without health insurance--8 million of 
whom are children. Millions more are underinsured with paltry policies 
that exclude necessary benefits or charge a king's ransom for co-pays 
and deductibles. Increasingly, access to coverage and quality care in 
this country is determined by an ability to pay rather than medical 
need.
  There are many approaches to addressing the needs of the growing 
population without health coverage in this country. As most of my 
colleagues know, I am an advocate of a universal health care system in 
which each and every American would have health coverage. That is the 
most fair, affordable, and sustainable solution to our national health 
care needs.
  However, that won't be accomplished overnight. In the meantime, there 
are steps that Congress can and should be taking to develop immediate, 
if smaller, steps to providing people affordable health insurance 
coverage options. That's why we've joined together to introduce three 
separate bills that each target a specific population that is seeing 
its uninsured rate climb.
  The Medicare Early Access Act targets early retirees; the Family Care 
Act, being introduced by Rep. Dingell, targets children and families; 
and the Small Business Health Insurance Promotion Act, being introduced 
by Rep. Barrow, targets small businesses and self-employed individuals.
  The Medicare Early Access act would provide people age 55 to 65 with 
the option of buying into Medicare--a program with a proven track 
record that works.
  Unfortunately, retiree health benefits have vanished or are quickly 
disappearing, leaving people with few or no affordable coverage 
options. Still, among the 55-65 population, it is more likely that 
someone who is retired will have health insurance than someone still in 
the workforce. Access to health insurance diminishes for individuals in 
low-wage jobs. Thirty-five percent of workers age 55-65 who earn less 
than 200 percent of poverty are uninsured compared with 17 percent 
uninsured nationwide.

  Age rating and other underwriting techniques resulting in excessive 
premiums make coverage unaffordable. Those who are offered coverage are 
often required to pay astronomical deductibles and co-pays, or are 
severely limited by pre-existing condition exclusions, leaving them 
grossly underinsured.
  In 1965, Medicare was specifically designed to provide coverage for 
those the market would not insure. Today we have the opportunity to 
expand on the original purpose of Medicare by providing access to 
people the market does not adequately cover. The Medicare Early Access 
Act would reduce the number of uninsured, provide better coverage for 
the underinsured, and improve the health status of this vulnerable 
population without harming Medicare or other insurance markets.
  That's why the Medicare Early Access Act makes so much sense. It 
would allow people in this cohort to buy-into Medicare and enjoy the 
exact same benefits available to all other Medicare beneficiaries. 
Premiums for these new participants would be based on actuarial 
calculations of the cost of providing services to the population. There 
would be no effect on the Medicare trust fund because premiums will 
cover the entire cost of services provided.
  To ensure premiums are affordable, the bill provides a 75 percent 
advanceable, refundable tax credit. Thus, participants would pay a 
monthly premium equal to 25 percent of the cost of the program--an 
amount similar to what employed individuals pay for their health 
benefits.
  I am pleased to report that advocacy organizations representing 
consumers and seniors agree with us. The Medicare Early Access Act has 
been endorsed by the AFL-CIO, the Alliance for Retired Americans, the 
Center for Medicare Advocacy, Consumers Union, Families USA, the 
National Academy of Elder Law Attorneys, SEIU, and the UAW.
  This bill would provide affordable, comprehensive coverage to the 
most vulnerable uninsured who have few, if any, health insurance 
options in the current marketplace. The system necessary to implement 
this bill is already in place; all we have to do is agree the uninsured 
deserve viable coverage options. I look forward to working with my 
colleagues on both sides of the aisle to enact the Medicare Early 
Access Act this year.
  Following is a summary of the bill.

                     The Medicare Early Access Act

       The Medicare Early Access Act gives early retirees and 
     others between ages 55 and 65 the option of purchasing 
     Medicare coverage. Millions of near elderly who are uninsured 
     can benefit from a Medicare buy-in. This bill provides 
     affordable health insurance to a vulnerable population, while 
     protecting the solvency of the Medicare Trust Fund.


                              ELIGIBILITY

       Starting January 2006, individuals age 55-65 who do not 
     have access to coverage under another public or group health 
     plan are eligible to purchase Medicare. Enrollees will 
     receive the full range of Medicare benefits. Participants are 
     not required to exhaust employer-based COBRA coverage before 
     choosing the Medicare buy-in option. At age 65, buy-in 
     participants move into regular Medicare.
       In addition, because employers are dropping retiree health 
     benefits at an alarming rate, early retirees who have access 
     to retiree health coverage may also participate, and their 
     employers can wrap around the Medicare benefit.


                                PREMIUMS

       Enrollees must pay a premium to receive Medicare coverage. 
     The premium will be set by the Centers for Medicare and 
     Medicaid Services at the actuarial level necessary to cover 
     the full cost of services provided to the buy-in population. 
     The premium will be adjusted annually to ensure its accuracy. 
     Premiums will also differ slightly by region to reflect 
     geographic differences in healthcare costs.


                               TAX CREDIT

       Program enrollees receive a 75 percent refundable, 
     advanceable tax credit to offset premium costs. Thus, 
     participants in the Medicare buy-in are only personally 
     responsible for 25 percent of their monthly premiums. The tax 
     credit is modeled on the payment mechanism created by the 
     Trade Adjustment Assistance (TAA) health care tax credit for 
     displaced workers, which was enacted in 2002.


                               FINANCING

       Premiums are deposited in a new Medicare Early Access Trust 
     Fund. Participant premiums and tax credits are transferred to 
     the Early Access Trust Fund to pay for Medicare services, 
     ensuring this new program does not financially affect 
     Medicare.

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