[Congressional Record Volume 157, Number 56 (Friday, April 15, 2011)]
[Extensions of Remarks]
[Page E731]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        CONCURRENT RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2012

                                 ______
                                 

                               speech of

                          HON. HENRY A. WAXMAN

                             of california

                    in the house of representatives

                        Thursday, April 14, 2011

       The House in Committee of the Whole House on the State of 
     the Union had under consideration the bill (H. Con. Res. 34) 
     establishing the budget for the United States Government for 
     fiscal year 2012 and setting forth appropriate budgetary 
     levels for fiscal years 2013 through 2021:

  Mr. WAXMAN. Mr. Chair, I would like to draw your attention to a 
letter from Secretary Sebelius on the impact of H. Con. Res. 34.

                                           The Secretary of Health


                                           and Human Services,

                                   Washington, DC, April 14, 2011.
     Hon. Henry A. Waxman,
     Ranking Member, House Energy and Commerce Committee, 
         Washington, DC.
       Dear Ranking Member Waxman: We received your letter today 
     requesting our assessment of the impact of the enactment of 
     House Concurrent Resolution 35 (H. Con. Res. 35) on Medicare, 
     Medicaid, and the other affected health programs at the 
     Department of Health and Human Services. We have not yet had 
     an opportunity to fully evaluate the extensive impact that 
     the language of the resolution would have, but offer a few 
     initial observations.
       As you know, the Affordable Care Act modifies and improves 
     almost every Medicare payment system--including the inpatient 
     hospital prospective payment system, the outpatient hospital 
     prospective payment system, the physician fee schedule, 
     Medicare Advantage plan payments, and prescription drug plan 
     payments. If this resolution were enacted, the Centers for 
     Medicare and Medicaid Services (CMS) would not be able to use 
     any funds to carry out these payment provisions based on any 
     rate calculated on the basis of provisions of the Affordable 
     Care Act--which is to say virtually all rates.
       In a system in which millions of claims are paid each week, 
     millions of claims would accumulate, which CMS and its 
     contractors would be prohibited from paying. As a result, 
     providers and suppliers of services to Medicare 
     beneficiaries--many of which are small businesses--would 
     experience significant disruption.
       H. Con. Res. 35 would adversely affect health care in rural 
     areas as well. As an example, as a means to encourage 
     physicians to provide services in rural areas, the Affordable 
     Care Act established a new 10 percent bonus payment for 
     primary care services furnished by primary care practitioners 
     and for major surgical procedures furnished by general 
     surgeons in shortage areas. Without available funding, CMS 
     would no longer be able to provide the bonus to primary care 
     and general surgery physicians for eligible services.
       The Affordable Care Act also gives CMS new tools to fight 
     fraud and helps us move from a pay-and-chase system to a 
     comprehensive prevention-focused strategy. By precluding the 
     use of funds for such efforts, H. Con. Res. 35 would 
     substantially impede CMS's proven and successful efforts to 
     reduce fraud and waste in the health care system resulting in 
     increased erroneous payments. H. Con. Res. 35 would 
     effectively require CMS to cease enforcing new screening and 
     enrollment standards, diminish CMS's ability to suspend 
     payments when credible allegations of fraud are uncovered, 
     and reduce resources that have been made available for 
     investments in anti-fraud work.
       The Affordable Care Act also includes numerous other 
     policies to make health care more affordable, accessible, and 
     accountable for seniors, individuals with disabilities, 
     children, and all other Americans, as well as businesses 
     large and small. Its improvements are already woven into the 
     fabric of our health care system. A broad prohibition on the 
     use of funds would halt, among other things, the operation of 
     the Early Retiree Reinsurance Program, the Pre-existing 
     Condition Insurance Plan, and the health insurance rate 
     review, consumer assistance, and health insurance Exchange 
     grant programs.
       I hope this information is helpful. We would be pleased to 
     answer any additional questions you may have. I have sent an 
     identical letter to Ranking Member Levin.
           Sincerely,
     Kathleen Sebelius.

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