[Congressional Record Volume 158, Number 161 (Thursday, December 13, 2012)]
[Senate]
[Pages S8031-S8032]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                MEDICARE

  Mr. FRANKEN. Mr. President, I have come to the floor to talk about 
Medicare. My esteemed colleague from Alabama just talked about Medicare 
reform. The Presiding Officer and I--all of us--pay into Medicare every 
month, so we are entitled to Medicare benefits when we reach age 65. 
The fact that we are entitled to these benefits is not bad. In fact, it 
is very good for so many millions of American seniors. The fact that 
many call it an entitlement only means we have a right to expect to get 
the benefits we paid in for. Entitlements, in this case, should not be 
a pejorative.
  We have heard a lot about entitlement programs recently and about the 
place of Medicare in the conversation about our Federal deficit. We 
just heard the Senator from Alabama talk about that. He said there is 
no discussion of reform of Medicare. But in these discussions sometimes 
I think a critical component is missing, which is we already reformed 
Medicare, and these reforms extended the life of Medicare by 8 years 
while expanding benefits for seniors.
  During the recent campaign, as the Presiding Officer has pointed out, 
we saw a lot of ads about the so-called $716 billion in cuts to 
Medicare and how terrible that was, is, and will be. I would like to 
take just a few minutes to explain what these savings were, what they 
are, and what they will be.
  The two biggest sources of the $716 billion are, one, insurance 
companies overcharging the government for Medicare Advantage and 
savings in payments to hospitals.
  First, Medicare Advantage. As the Presiding Officer knows, as people 
watching no doubt know, seniors can choose to get their Medicare 
benefits directly from the Medicare Program or get them through a 
private insurance program that gets paid by Medicare, which is called 
Medicare Advantage.
  Before we passed the Affordable Care Act, we were overpaying those 
private insurers by 14 percent. These insurers were getting much more 
than they should have based on the benefits they were providing to 
seniors. So we cut what Medicare gives to these private insurance 
companies. Over the next 10 years, we are going to cut these insurance 
payments by 14 percent, which CBO scored in 2010 as saving Medicare 
$136 billion over 10 years.
  We were told by some of our colleagues that insurance companies were 
going to leave the market, that we were not going to have Medicare 
Advantage anymore. So far, enrollment in Medicare Advantage has gone up 
by 11 percent. That is many billions of dollars we were able to take--
instead of overpaying insurance companies--to extend the life of 
Medicare.
  Second is the lower reimbursements to hospitals. Why does this work 
out for hospitals? When we insure 31 million more people, and those 31 
million people go to the emergency room, go to the hospital, the 
hospital is no longer on the line to pay for that.
  They are not left holding the bag. Those 31 million people now have 
insurance that pays for it. So the hospitals are now able to take lower 
reimbursements for Medicare patients. That is why it works out. So when 
people talk about the $716 billion, this is a huge part of what they 
are talking about. It is not cuts to benefits. It is not shifting costs 
to seniors. It is streamlining the program and making it more 
efficient.
  We took these savings and we reinvested the savings in the program. 
We overall extended the life of Medicare by 8 years. That is 
entitlement reform, extending the life of the program. That is what we 
are talking about when we talk about reforming Medicare. That is what 
we did. But not only that, we actually expanded benefits for seniors.
  I go to a lot of senior centers around Minnesota, nursing homes. I 
have to tell you seniors are very happy we expanded their benefits. 
They are happy about the new free preventive care they get, wellness 
checkups, colonoscopies, mammograms. They know an ounce of prevention 
is worth a pound of cure. This saves us all money and keeps people 
healthier.
  What else are we doing with this money in addition to expanding the 
solvency by 8 years? We are closing the doughnut hole, the prescription 
drug doughnut hole. I have to tell you, seniors are very happy about 
that too. For more than one-third of seniors, for them, Social Security 
provides more than 90 percent of their income. For one-quarter of 
elderly beneficiaries, Social Security is the sole source of retirement 
income. So when they hit their doughnut hole, that is serious.
  Sometimes they have to make choices between food and heat and 
medicine. Because we are closing the doughnut hole, in many cases, 
people do not have to make that choice anymore. This is important 
stuff. When I was running for the Senate, a nurse who worked in 
Cambridge, MN, a town north of the Twin Cities, came to me and told me 
that in the hospital she worked in very often they would admit a senior 
who was very sick and the doctors would treat this senior and get them 
back on their feet and send them home with their prescriptions.
  As this started happening, they would call the drug store, the 
pharmacy a few days later, 1 week later, and say: Has Mrs. Johnson 
filled these prescriptions? The pharmacist would say: No; because she 
was in her doughnut hole. A couple weeks later, Mrs. Johnson would be 
back in the hospital. How wasteful is that? How wise? That costs a 
tremendous amount of money to our system. This is saving money. This is 
health care reform. This is Medicare reform. It is improving people's 
health and saving money at the same time. So we have increased 
benefits. We have extended the life of Medicare. That was done as part 
of health care reform. That is Medicare reform.
  In the election we had a discussion about this. There were a lot of 
ads about it. We know what Governor Romney would have done to Medicare. 
He said very explicitly that--and again the Presiding Officer has 
quoted this. He said very explicitly he would restore those billions 
and billions of dollars in overpayments to private insurance companies 
for no reason, for no good effect, just so, I guess, these insurance 
companies could have more profit. Instead, we reinvested this money 
into Medicare. But he would have given it to the insurance companies. 
He would have replaced this health care law. He would have made the 8 
years we extended Medicare vanish. Governor Romney supported raising 
the Medicare eligibility age. If we raise the age from 65 to 67 as he 
suggested, that means hundreds of thousands, if not millions, of 
seniors would no longer have access to Medicare.
  They would end up receiving Federal subsidies in the exchanges and 
some of them would go to Medicaid. They would be--these 65- to 67-year-
olds--by definition, older and as a population sicker than the other 
people in the exchanges and in Medicaid. So they would make both these 
programs more expensive.
  They would also make Medicare more expensive because they would be 
the youngest and least sick and be taken out. Although this sounds like 
a reasonable compromise, trust me, it is a bad idea. It would cost the 
health care system twice as much as it would save Medicare. This is 
exactly the kind of bad idea which explains why we pay twice as much as 
other developed countries around the world for our health care and in 
many, if not most, cases with worse outcomes.
  Medicare reform was an issue in the campaign because we already did 
it. We extended the program by 8 years. It is not like it was a secret. 
It was part of the conversation during the election. In the election, 
the American people

[[Page S8032]]

voted to keep those reforms. As we continue this conversation about our 
fiscal future, I would love to hear from my colleagues across the aisle 
about how they would reform Medicare, how they would expand its life by 
8 years while expanding or at least, at the very least, not cutting 
benefits. How would they do it? Because we extended its life for 8 
years and increased benefits--very meaningful benefits.
  I would ask my colleagues why, before the election--and this is the 
very point the Presiding Officer made a few days ago on this floor--why 
they were attacking us--incorrectly I might add, inaccurately--for 
making cuts in Medicare, but since the election they have been 
insisting we make cuts to Medicare.
  Going forward, I think we need to move from talking points to taking 
a thoughtful look at policies and working together to tackle our 
Nation's fiscal challenges and do it based on a little bit deeper look 
at what we have done and what the health care reform was that we passed 
in the Senate and the House, now the law of the land, what that does.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.

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