[Congressional Record Volume 151, Number 120 (Thursday, September 22, 2005)]
[Extensions of Remarks]
[Pages E1940-E1941]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 THE MEDICARE INFORMED CHOICE ACT: A FIRST STEP IN PROTECTING MEDICARE 
                             BENEFICIARIES

                                 ______
                                 

                       HON. JANICE D. SCHAKOWSKY

                              of illinois

                    in the house of representatives

                      Thursday, September 22, 2005

  Ms. SCHAKOWSKY. Mr. Speaker, I am pleased to join my colleague, 
Representative Pete Stark, in introducing the Medicare Informed Choice 
Act, an immediate and essential first-step in protecting Medicare 
beneficiaries.
  I believe that fundamental changes are needed to make the new 
Medicare drug benefit more affordable and less complicated. Along with 
my colleagues Representative Marion Berry and Bob Andrews, I have 
introduced H.R. 752, the Medicare Prescription Drug Savings and Choice 
Act, which would establish a meaningful drug benefit in Medicare and 
require Medicare to negotiate for price discounts, as the VA and large 
employers do today. In the meantime, however, it is clear that 
Medicare's 42 million beneficiaries need immediate relief from the 
confusion and complexity of this fall's enrollment process. The 
Medicare Informed Choice Act would provide that relief by providing 
three simple changes in 2006: elimination of the late enrollment fee, a 
one-time opportunity for every beneficiary to switch plans, and 
protection against the loss of retiree health benefits.
  I recently received a letter from a constituent, Phyllis Arist from 
Evanston, Illinois. She wrote:

       I urge you to suspend the late-enrollment penalty for 
     Medicare Part D.
       Enrollment in Part D will be a challenge for anybody and 
     everybody, whether that person is health care savvy or not. 
     There will be dozens of complex plans that consumers will 
     have to confront. How would you choose among a slew of 
     different drug plans, each covering different drugs, using 
     their own cost-sharing scheme, working with different 
     pharmacy networks, and no guarantee that the plan will be 
     around next year?
       If Medicare Part D were a straight-forward benefit like 
     Medicare Part B, the penalty might be justified. But given 
     the circumstances, it is unfair. People with Medicare need 
     more time to understand the new Medicare drug benefit. 
     More time, combined with reliable and comprehensive 
     information, will ensure more people are making the right 
     choices and not taking a leap of faith into the unknown.

  I agree with Ms. Arist. It is abundantly clear that the enrollment 
process for the new Medicare drug benefit is complicated, confusing and 
can result in bad decisions by beneficiaries. Any of us who have tried 
to explain the basic benefit to our constituents knows how difficult it 
is to do so, let alone explain the variations in the multiple private 
plans that will be available to senior citizens and persons with 
disabilities. Private plans will vary in terms of premiums, cost-
sharing requirements, covered drugs, and pharmacy sources. 
Beneficiaries taking multiple medications will find it difficult to 
sort out their options, especially in areas like Chicago where about 50 
plans are expected to be available.
  No one who is on the ground believes that the support and outreach 
services will be available to provide the one-on-one counseling

[[Page E1941]]

that beneficiaries and their families will want and will require to 
make informed choices. As the former executive director of the Illinois 
Council of Senior Citizens, I know that it will take hours with each 
beneficiary, many of them taking multiple medications, to fully explain 
private plan options and how each choice will affect their access to 
the drugs they need. A majority of beneficiaries lack regular access to 
a computer or have the ability to navigate websites. A recent HHS 
Inspector General's report found that 44 percent of callers to the 
Medicare hotline had difficulty accessing information. Many 
beneficiaries are frail, some suffer from dementia, and others are not 
English-proficient. We have to reach beneficiaries living in Centers 
for Independent Living, nursing homes and isolated areas. And, of 
course, we have to address the needs of the evacuees from Hurricane 
Katrina.
  Tina Kitchin, director of the Oregon Department of Human Services, is 
not alone in saying ``I don't know how Oregon will successfully do this 
within this timeframe.'' The State Health Insurance Program coordinator 
for McLean County, Illinois, is asking beneficiaries to call early 
because, ``There are too many people for us to handle all of them on or 
after November 15,'' the first day that enrollment can begin. Already, 
the constituent advocates in my own district office have had difficulty 
getting answers to questions about how the new federal drug benefit 
will coordinate with our state's pharmaceutical assistance program. And 
already, we are seeing constituents who are confused, scared and angry 
about the inability to get answers to their questions while being 
pressured to make a fast decision.
  It is time to recognize that the late enrollment penalty imposed in 
the Medicare Modernization Act is unfair to the 42 million 
beneficiaries who want to make informed choices, will not have access 
to unbiased assistance in making those decisions, but who will face 
substantial and permanent late enrollment fees if they don't act by May 
15th. The Medicare Informed Choice Act will give beneficiaries the time 
they need to make the decision that is right for them.
  Senior citizens and persons with disabilities will face obstacles in 
getting access to independent information, but they will be inundated 
with materials from private plans seeking customers. Beginning next 
month, Medicare beneficiaries and their families will be subjected to 
multi-million advertising campaigns by insurers. As reported in The 
Wall Street Journal (``Insurers Bet Big on New Drug Benefit,'' 
September 7, 2005), ``The payoff could be big. The new drug benefit is 
expected to boost 2006 revenue at seven of the largest health insurers 
by at least $4.45 billion in 2006, and lift earnings by 2 percent to 4 
percent according to CIBC World Markets analyst Carl McDonald.'' Some 
companies expect increased profit levels of 4 percent to 6 percent.
  The pressure to make a quick decision will be enormous, particularly 
when coupled with a sales pitch arguing that failure to choose will 
result in a permanent, financial penalty. Without adequate, independent 
and personalized counseling, many beneficiaries will make the wrong 
decision. Getting rid of the late enrollment fee is only part of the 
solution. Our bill will give all beneficiaries the opportunity to 
switch their plan and enroll in one that better meets their needs, 
whether they enrolled by mistake or because they succumbed to sales 
pressure.
  Finally, there is massive confusion about how the new Medicare drug 
benefit will mesh with current retiree benefits. Unfortunately, a 
beneficiary's misunderstanding and enrollment in a Medicare drug plan 
could result in the loss of retiree benefits. Again the Medicare 
Informed Choice Act gives a one-year grace period to sort out confusion 
and correct any errors.
  I urge my colleagues to support the Medicare Informed Choice Act so 
that we can protect our constituents from unfair penalties or the loss 
of retiree benefits.

                          ____________________