[Congressional Record Volume 155, Number 148 (Wednesday, October 14, 2009)]
[House]
[Pages H11370-H11373]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  THE CONGRESSIONAL BLACK CAUCUS HOUR

  The SPEAKER pro tempore (Mr. Kissell). Under the Speaker's announced 
policy of January 6, 2009, the gentlewoman from Ohio (Ms. Fudge) is 
recognized for 60 minutes as the designee of the majority leader.


                             General Leave

  Ms. FUDGE. Mr. Speaker, I ask for unanimous consent that all Members 
be given 5 days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Ohio?
  There was no objection.
  Ms. FUDGE. Mr. Speaker, the Congressional Black Caucus, the CBC, is 
proud to present this hour on issues that concern America's senior 
citizens. The CBC is chaired by the Honorable Barbara Lee from the 
Ninth Congressional District of California. I am Representative Marcia 
L. Fudge from the 11th Congressional District of Ohio, and I am the 
anchor of the CBC hour.
  The vision of the founding members of the Congressional Black Caucus, 
to promote the public welfare through legislation designed to meet the 
needs of millions of neglected citizens, continues to be a focal point 
for the legislative work and political activities of the Congressional 
Black Caucus today.
  Tonight, the CBC will focus its attention on the issues currently 
confronting our seniors. In his last speech, Hubert Humphrey said, The 
moral test of government is how that government treats those who are in 
the dawn of life, the children; those who are in the twilight of life, 
the elderly; and those who are in the shadows of life, the sick, the 
needy, and the handicapped.
  The fact that some Americans work their entire life, regularly paying 
into Social Security and are confronted by poverty in their golden 
years is indeed a problem, Mr. Speaker.

                              {time}  1800

  The social insecurity facing our Nation's seniors is not a Democratic 
problem or a Republican problem; it is an American problem, Mr. 
Speaker. This year's news headlines tell the story: ``Seniors Struggle 
With High Cost of Housing and Food, Barely Getting By''; ``Seniors 
Struggle to Survive''; ``Single Seniors Can't Make Ends Meet''; 
``Subsidized Lunches in Greater Demand Among Senior Citizens''; ``Forty 
Percent of Senior Citizens Not Taking Prescribed Medicines Due to 
Budget''; ``Senior Citizens See Largest Gain in Credit Card Debt As 
Recession, Medical Costs Take a Toll.''
  Mr. Speaker, our country will recover from this recession, but we 
cannot forget the seniors who struggled before the recession began. 
Many live on fixed incomes and find it difficult to live under the 
pressure of high medical bills and the rising cost of essentials like 
medication, food, and housing.
  One of the most disheartening news headlines of 2009 had the title, 
``U.S. Is Losing Ground on Preventable Deaths.'' In this story, AARP 
reported that Americans are dying too soon, although the United States 
spends $2.4 trillion a year on medical care, vastly more per capita 
than comparable countries. Our Nation ranks last when compared to 19 
other industrialized nations on premature deaths caused by illnesses 
such as diabetes, epilepsy, stroke, influenza, ulcers and pneumonia, 
all medical issues that disproportionately attack and weaken American 
seniors.
  In my district, senior citizens call my office daily. Some call 
looking for reassurance that Medicare will be strengthened through the 
health care reform, and others asking questions about the future of 
Social Security.
  One senior called just this past week. He is an 85-year-old man 
living in public housing. He has an artificial leg which he has had 
since the age of 11. He is worried that his Social Security check will 
not cover the cost of the medications he uses for complications caused 
by his artificial limb if the cost of his medications continues to 
climb.
  I am confident, Mr. Speaker, this Congress will answer the calls and 
the concerns of these seniors, and I will not rest until all seniors 
have their answers.
  Reports have been looming for years about the long-term financial 
problems of Social Security. The retirement program is projected to 
start paying out more than it receives in the year 2016. According to 
the Social Security trustee, without changes, the retirement fund will 
be depleted by 2037.
  Demographic factors are accelerating Social Security problems. Life 
expectancy is increasing faster than anticipated. In 1940, a 65-year-
old man could expect to live maybe another 12 years. Today it's 15 
years, and by 2040, it will be 17 years. The fertility rate is falling 
faster than expected, from 3.6 children for a typical woman of 
childbearing age in 1960 to just two today, and a projected 1.9 by 
2020.
  The elderly portion of the population will likely rise from 12 
percent today to 20 percent by 2050, increasing the number of retirees 
from 34 million to 80 million. The smaller working age population and 
larger elderly population

[[Page H11371]]

means that where there were more than five workers for each retiree in 
1960 and 3.3 workers per retiree today, by 2030 there will be just two 
workers to pay the taxes for the benefits of each retiree.
  Social Security is a pay-as-you-go system, as you know, with each 
generation of workers paying the benefits of current retirees. This 
works fine as long as the working population grows faster than the 
retired population; but now that the trend has reversed, the system is 
simply unsustainable.
  Congress and the Social Security Administration are seeking solutions 
to this long-term problem; but at the same time, we have to work on the 
existing problems confronting our seniors on Social Security. Recently, 
the Congressional Budget Office reported that for the first time in 35 
years older Americans will not receive a cost-of-living adjustment, or 
COLA, increase in their Social Security checks in 2010. This is bad 
news for many retirees living on a fixed income because although the 
cost of necessary goods like food will continue to rise, seniors who 
rely on Social Security checks will not see their budgets increase.
  To compound this problem, millions of the same seniors whose budgets 
may be tighter than ever will also face much higher Medicare part B and 
Medicare part D premiums next year. Medicare part B insurance covers 
doctors visits, lab work, physical therapy, and other types of 
outpatient services. Medicare part D is the Medicare prescription drug 
program.
  A Federal law, known as the ``hold harmless'' rule, prevents the 
annual cost of part B premiums from rising higher than that year's 
Social Security COLA. For example, if your annual Social Security 
income increases by 5 percent, the yearly part of part B premiums 
cannot increase by more than 5 percent. The problem is that, while this 
hold harmless rule covers some Medicare part D patients, it does not 
cover any of the 28 million seniors insured by Medicare part D 
prescription drug coverage, and it does not cover about 11 million 
Medicare part B seniors.
  Mr. Speaker, I have been joined today by my colleague and friend, the 
Congressman from Minnesota. I would like to yield as much time as he 
may consume.
  Mr. ELLISON. I want to thank the gentlelady from the great State of 
Ohio for doing such a wonderful job talking about health care, our 
seniors, talking about all these critically important issues facing our 
Nation right now.
  As the gentlelady is very well aware, we are at the very edge, at the 
very moment where we can have real health care reform for all, or maybe 
not. The reality is that we are optimistic. We are closer than we have 
been in 60 years, closer than we were in 1994, closer than we were when 
Roosevelt first said all Americans should have health care and have 
health and wellness, closer than we were when Truman said we need 
universal health care coverage.
  We are close. We have five bills reported out, three bills through 
the House, two bills through the Senate. And right now, Americans all 
around the country are saying, will the Congress finally do it?
  Do you know that upwards of 77 percent of Americans want real health 
care reform? They want health care reform with a public option. They 
want real change, and it's time that they get it.
  But I wanted to mention to my friend from Ohio, the great 
Congresswoman Fudge, we all need health care reform. The fact is that 
when health care reform arrives, it will benefit communities of color 
more than it will other communities. It will benefit everybody. 
Everybody who will never be turned down for a preexisting condition 
will benefit. Everybody who has seen their premiums double over the 
last 10 years and will probably see them double in the next 10 years 
will benefit. But when you look at the startling disparities people of 
color are facing every day, I think that they will benefit more.
  Just to let everybody know, the fact is that, yes, it's true, life 
expectancy for the average American has gone up. But for average 
African Americans, it still lags behind about 5 to 6 years. For African 
American men, it's not even 70 years old yet. African American men, on 
average, can expect to live to be about 69. Their counterparts can 
expect to live to be about 75. Now, imagine a child being born at the 
age when their grandpa is 69 years old. That means that if that child 
is African American and their grandfather is, they may never know 
grandpa.

  But if we really address health care disparities, maybe we can get 
African American men up to 75 years old. That means that they will get 
a chance to bounce on his knee, get to know him, get to talk to him, 
get to learn something from him, maybe learn how to go fishing. It's a 
quality of life issue, more years. Addressing that cervical cancer 
earlier means grandma will be around longer.
  Most of us, if you grew up like I did, know that mom and dad had to 
be tough on you because they had to raise you right. But there is one 
person who you knew thought you were absolutely terrific no matter what 
you did, and that's grandma, right?
  Ms. FUDGE. That's absolutely right. Will the gentleman yield?
  Mr. ELLISON. I will yield to the gentlelady.
  Ms. FUDGE. I just wanted to say that, as you talk, it just really 
gives me some encouragement that we have put in place legislation that 
is going to allow us to deal with preventive care and wellness. 
Certainly that is an issue in our neighborhoods and all neighborhoods, 
especially neighborhoods of poor people and middle class people. It has 
become a major issue just finding the resources and the time and 
ability to go to the doctor and say, I have a small problem, let's take 
care of it before it becomes a big problem.
  And I think that just what you're talking about is preserving the 
longevity of grandma and your uncles and your aunts based upon the fact 
that they are going to be healthier longer is very, very important. And 
I yield back.
  Mr. ELLISON. Well, I accept the gentlelady's yielding because it's 
important that when we talk about health care--you know, Mr. Speaker, 
we talk about statistics. And we drop stats, and we're talking about 
statistics and numbers and all of this stuff that we talk about. But we 
can never forget we are talking about human beings' lives. We're 
talking about human beings having more time with each other. We're 
talking about, as we said, your grandmother being there; and yet 
because of health disparities, inequality in the area of health, she is 
not being there. And how enriched a human being is by having that 
generational exchange.
  These are just little examples of what we're talking about. And 
that's why Democrats are pushing forward on health care. That's why the 
Black Caucus is pushing forward on health care. That's why we need all 
Americans who care about a better quality of life to be pushing forward 
on health care. We can't survive with the status quo. Literally, we 
cannot survive with the status quo.
  I yield to the gentlelady.
  Ms. FUDGE. Thank you. You are absolutely right; we cannot survive 
with the status quo.
  And the other thing that this bill does is it allows us to say to 
those who have for so long not been able to really live a healthy 
lifestyle--not because they don't want to, but because they don't have 
the ability to--to now say, look, we are going to put resources in your 
neighborhood community clinic so that you can go and make sure that 
your children have the proper exams and the proper things before they 
go to school.
  We are going to be in a position where we say to them, we are going 
to make this health care accessible to you, not just on Monday through 
Friday from 8 to 4, when working parents have to work; but because of 
the resources we're providing, we are now opening these clinics on 
Saturday. We are now saying to them we are going to make this more 
convenient for you because we want you to be healthy. We want to set 
the example, set the standard; and it's time we do those kinds of 
things for the people we serve because that is our job is to take care 
of the people we serve.
  I yield back.
  Mr. ELLISON. I thank the gentlelady for yielding.
  Mr. Speaker, I mean, the point is that part of this bill says, if 
it's enacted into law, that, you know what? You will not have to pay a 
copayment for preventative services. We want you to engage in 
preventative medicine.

[[Page H11372]]

Get your sugar checked. Get your blood pressure checked. Come on in 
here and let's make sure that you get a prostate or a mammogram. The 
fact is these are the things that are going to keep you around here 
longer and will save the system money in the long run. These things are 
so important.
  And I just want to give folks an example. In the year 2004, just a 
few years ago, African Americans had the highest age-adjusted causes of 
death rates for all races and ethnicities. In addition, African 
Americans have the highest age-adjusted death rate for heart disease, 
cancer, diabetes, HIV and AIDS. All of these things would be addressed 
if we can pass this bill and keep those things in the bill that address 
health disparities. That's why we need people to step forward and do 
the right thing and support this bill.
  You know, the American people have called for change, but I just want 
to let folks know that the change that we're calling for will help all 
Americans. And while it might not help some executive insurance 
companies, it will everybody else. And when everybody else gets helped, 
this rising tide will lift people at the bottom higher, and it will 
help extend their lives and improve the quality of their life.
  At this point, I am going to have to turn it back over to the 
gentlelady. She has been doing such an excellent job, but I just want 
to say thank you for doing what you can do to raise the consciousness 
of the American people because the American people want change, they 
want optimism, they want people who will fight for change. They don't 
want folks who are going to give us the same old thing, because we 
can't survive with the status quo; but with change, we can.
  Ms. FUDGE. Thank you very, very much. I am so pleased to have you 
join me this evening, Mr. Ellison. I thank you for your work. You do 
outstanding work on behalf of people in the most need, and I am happy 
you could join me.
  It seems as though now we have been joined by our Chair, the 
Honorable Barbara Lee, the gentlelady from California. I will now yield 
to our chairwoman. Thank you so much for being here.

                              {time}  1815

  Ms. LEE of California. Thank you very much. Let me thank the 
gentlelady for yielding.
  Let me also, once again, thank you for your leadership in making sure 
that all of the issues that are so important to our country and to the 
Congressional Black Caucus, to all of us, are really brought forward on 
this floor.
  I rise tonight on behalf of--and I just have to say--our nearly 
70,000 senior citizens whom I have the privilege to represent in the 
Ninth Congressional District of California, but also the seniors across 
this country. As our Nation's economic uncertainty continues, it is 
these individuals who are struggling at a disproportionate rate to 
overcome the grip of poverty and to maintain their quality of life, so 
it is important that tonight we talk about what is going on with our 
senior citizens and how important this moment is for them.
  During the present turmoil, these hardships are especially acute 
amongst people of color, minorities, with more than 22 percent of 
African American and 19 percent of Latino seniors living below the 
poverty line. These poverty levels are more than double the national 
average for all individuals over 65 years of age.
  Now, I firmly believe, like Congresswoman Fudge and like all of us 
here believe in the Congressional Black Caucus, that we have a moral 
responsibility, a duty and an obligation to reverse this disturbing 
trend by utilizing the full constitutional power, statutory authority 
and resources of our government to provide opportunities for all and to 
develop these pathways out of poverty for our seniors. Some of these 
pathways include critical programs such as Social Security, continued 
support of Medicare and reforming our Nation's health care system, 
which you heard about earlier and which we are in the midst of 
reforming as we speak.
  Social Security benefits constitute 90 percent of the income of one-
third of Americans over 65. Many of the 75,000 residents in my district 
who receive Social Security are dependent on their guaranteed benefits. 
Without these vital benefits, nearly 50 percent--mind you, 50 percent--
of seniors nationwide would be forced to live in poverty, which is a 
five-fold increase over the present rate. This makes it very critical 
for all of us to fight against any efforts that would threaten the 
benefits on which so many senior citizens rely.
  I hear this from my mother, Mildred Massey, each and every day. So, 
on her behalf, I want to reiterate that once again.
  We must also understand that, as the costs of medical care continue 
to rise, ensuring individuals' economic stability is inextricably 
linked to reforming our broken health care system. Today, as a Nation, 
we spend approximately $2.2 trillion per year on health care, or $7,400 
per person, which is nearly twice the average of other developed 
nations and more than what we currently spend on either housing or 
food.
  Members of Congress, especially members of the Congressional Black 
Caucus here, really do disproportionately represent the men, women, 
children, and especially seniors who are underinsured and uninsured and 
whose health and wellness have suffered because of the numerous gaps.
  Some of us are calling these, really, moral gaps in our Nation's 
health care system. We support efforts to reform and to modernize 
America's health care system through comprehensive health care reform, 
and members of the Congressional Black Caucus support health care 
reform that includes a strong, robust public option like Medicare, 
which is a component of health care reform for which we are unwavering 
in our support. We want to continue to strengthen and to protect 
Medicare for our seniors, and we are determined to do that in this 
health care reform effort--that is, strengthen and protect Medicare for 
our seniors. We agree that Medicare services should not be reduced as a 
means of paying for this health care reform bill.
  While the proposed provisions for our robust public option will not 
be implemented until 2013, we also recognize that, as early as 2010, 
many positive reforms will be enacted, such as prohibiting the abusive 
health insurance practice of rescinding existing coverage in order to 
avoid future costs, improving preventative care and coverage, making 
prescription drugs more affordable by eliminating the gaps in coverage, 
and increasing funding for community health centers. So this is 
essential in our health care reform package, but as I said earlier, we 
want to strengthen and we want to protect Medicare for our seniors.
  Finally, let me just say, as a member of the Subcommittee on Labor, 
Health and Human Services and Education of the Appropriations 
Committee, I would like to highlight the initiatives in the 2009 
omnibus appropriations bill which strive to close the huge gaps in 
coverage and access for America's seniors by providing $22 million for 
a new initiative to reduce hospital and clinic infections that cause 
nearly 100,000 deaths each year. That's staggering. Hospital and clinic 
infections cause nearly 100,000 deaths each year. What we did is we put 
in $22 million so we can begin to combat these avoidable infections and 
reduce hospital readmission rates.
  In addition, $45 million has been set aside for health insurance 
counseling for seniors so that millions of Medicare beneficiaries can 
get the help that they need to understand and to utilize their complex 
benefits. I understand how complex some of this can be, and this 
counseling is so important. For those of us who have mothers and 
fathers and grandparents and aunts and uncles who are senior citizens, 
we know very clearly how difficult it is to weed through some of these 
forms and through some of these benefit regulations and rules, and we 
need to make it less complicated. So, hopefully, this $45 million will 
help our senior citizens.
  From the members of the Greatest Generation to the aging baby 
boomers, our seniors have given much over the years, so it must be our 
charge to support them and to remain focused on tackling the many 
challenges facing our Nation. We look forward to working with our 
leadership on both sides--Democrats and Republicans--in the following 
weeks to do everything that we can to continue to guarantee continuing 
care--Medicare and health

[[Page H11373]]

services--for this great group of Americans.

  Thank you, Congresswoman Fudge.
  Ms. FUDGE. Thank you so much, Madam Chair. It's always a pleasure to 
have you join me. Even though we generally do this on Monday nights, 
this is a special Wednesday night for us, so I appreciate your taking 
the time to stop by. Thank you very much.
  Mr. Speaker, as I mentioned, I believe this Congress is willing to 
take a stand for seniors. I am proud to be a cosponsor of several 
pieces of legislation and to be a signatory on a number of letters to 
congressional leadership and Federal agencies which were authored to 
help seniors who are facing mounting financial and medical concerns.
  One important bill, the Social Security COLA Fix for 2010 Act, 
ensures that seniors receive their COLAs for 2010. This legislation 
will help offset rising costs by providing seniors with a one-time $150 
payment in lieu of the Social Security COLA. The offset is fully paid 
for, and the legislation would not affect other Federal programs. For 
example, the one-time $150 payment would not count as income, and as a 
result, it would not push seniors who are too young to qualify for 
Medicare out of the eligibility for Medicaid.
  I want to talk just a bit about end-stage renal disease, Mr. Speaker, 
which is a disease that affects many seniors in my district and around 
the country. They are those who experience kidney failure. Last year, 
Congress passed legislation to provide up to six sessions of pre-end-
stage renal disease education to Medicare beneficiaries experiencing 
kidney failure.
  I joined a number of other Members of Congress and sent a letter to 
the directors of the Centers for Medicare and Medicaid Services, urging 
them to reconsider the proposed physician fee schedule, which would 
reimburse a 60-minute kidney education service, provided by a licensed 
physician, at the same rate as a 15-minute session provided by a 
nutritionist. The letter also requests that CMS reconsider the 
restriction on who can administer pre-end-stage renal disease 
education. Currently, only physicians can provide this service, 
although, licensed practitioners, such as nurses and nutritionists, are 
available and are trained to provide this education as well.
  Adjusting the reimbursement rate and allowing multiple types of 
licensed practitioners to educate seniors with kidney failure will 
ensure that seniors facing end-stage renal disease will get the care 
and education they need.
  For many seniors, their major concern about aging is the fear of 
losing their mental capabilities. That is why I am a cosponsor of the 
Alzheimer's Breakthrough Act of 2009, which is a bipartisan piece of 
legislation that includes an authorization of $2 billion for 
Alzheimer's funding at the National Institutes of Health, for support 
for caregiver programs and for a national summit on Alzheimer's.
  Another piece of legislation which is essential to the welfare of 
America's seniors is the America's Affordable Health Choices Act of 
2009. While some seniors have received misinformation and have voiced 
suspicions that health care reform would cut Medicare benefits, many 
know the truth about this bill. Medicare will be absolutely 
strengthened under the proposal.
  As we all know, the health care reform bill is not yet complete, and 
many more changes will be made before it becomes law. While I cannot 
predict how the bill will be structured once it is finalized, I can 
tell you that I am fighting to ensure health care for seniors will not 
be diminished in any way.
  Under the House proposal, seniors should notice a number of 
improvements in services. To be more specific, the House proposal will 
protect Medicare by shoring up funding for the program across the board 
so that all Americans will have this benefit as they grow older.
  The bill will lower drug costs by eliminating the Medicare part D 
doughnut hole for prescription-drug coverage. The doughnut hole refers 
to a costly gap in the Medicare part D prescription drug plan. The plan 
currently covers up to $2,700 per year in prescription-drug benefits. 
Then it stops. Coverage does not begin again until a recipient's drug 
cost exceeds $6,100 annually, thus, leaving the recipient responsible 
for paying all drug costs between $2,700 and $6,100.
  Under the proposed legislation, seniors could receive a 50 percent 
discount on brand name drugs in the doughnut hole immediately after the 
bill passes. This is a measure that would provide immediate relief for 
seniors who must choose to either purchase medication or food--a choice 
no American should be forced to make.
  The legislation provides free preventative care. Seniors would pay 
nothing on preventative screenings and services designed to keep them 
healthier longer.
  The bill improves primary care by ensuring that seniors are able to 
spend more time with their primary care doctors.
  There are provisions to enhance safety by developing national 
standards that measure medical care quality by investing in patient 
safety and by rewarding doctors and nurses who administer high-quality 
care.
  The legislation increases oversight by cracking down on waste, fraud, 
abuse and medical overpayments.
  There are provisions that encourage hospitals with high readmission 
rates to provide transitional and coordinated care services.
  Finally, Mr. Speaker, the bill has new initiatives to improve nursing 
home quality and transparency.
  Seniors should not be fearful. Change, we know, is difficult, but as 
Henry Ford said: Don't find fault; find a remedy.
  Experts who have studied the House health care reform legislation 
found that the proposed changes actually strengthen Medicare and 
improve beneficiaries' care and access to physicians. Passing 
legislation that improves the lives of seniors is the number one 
priority in this Congress. Seniors should not have to fear or wait any 
longer. I say to all of the seniors: We are fighting for you. Every 
day, we are fighting for you, and we will not let you down.

                          ____________________