[Congressional Record Volume 160, Number 31 (Tuesday, February 25, 2014)]
[Senate]
[Pages S1014-S1016]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. JOHANNS. Mr. President, last Friday we heard that the health care 
law is scheduled to deliver yet another blow to Americans. The 
administration released a proposal that would significantly cut 
Medicare Advantage.
  Medicare Advantage is a very well-received program. It offers private 
plan options for seniors on Medicare. Nearly 30 percent of Medicare 
beneficiaries voluntarily choose to enroll in Medicare Advantage 
because it offers extra benefits, it offers lower costs, more 
flexibility, and better care coordination than the traditional Medicare 
program.
  This program, Medicare Advantage, has been very well received in the 
State of Nebraska. About 35,000 Nebraskans are enrolled in Medicare 
Advantage.
  An analysis notes that further cuts to Medicare Advantage would 
``disproportionately affect beneficiaries with low incomes, including 
the 41 percent of enrollees with incomes below $20,000.''
  This announcement is absolutely no surprise; the health care law has 
siphoned over $700 billion from Medicare--not to strengthen the program 
but to pay for ObamaCare; $308 billion of those cuts come from Medicare 
Advantage, again disproportionately affecting beneficiaries with low 
incomes, including 41 percent who are trying to live on incomes below 
$20,000.
  The reality is these cuts will likely mean fewer benefits and higher 
out-of-pocket costs for seniors who can't afford that. Plans could drop 
out of the market all together or seniors could find out that their 
trusted doctor will no longer be covered by their plan. We have already 
started to see the consequences.
  Since the passage of ObamaCare, the number of Medicare Advantage 
plans available to seniors has not been strengthened. In fact, they 
have been reduced from 48 in 2009 to now 20.
  In rural areas, seniors have fewer choices. The plans available have 
dropped from 36 to 13, according to a Kaiser analysis.
  Another study estimates about 526,000 of current 2013 Medicare 
Advantage enrollees will have to make some changes because their plan 
is not available in 2014.
  How do these consequences match up with the President's promises? 
Well, they don't. The President spoke about Medicare, and he said: 
``Don't worry; I am not going to touch it''--or his promise: If you 
like your plan, you can keep it, which an independent fact checker has 
called the lie of the year.
  The Medicare Advantage issues unraveling today are symbolic of the 
broader problems with the law. The math doesn't add up, and the 
promises aren't kept. Nearly every week it seems the authors and 
supporters of this law are trying to bury their past. They are trying 
to create hollow promises. They are trying to get around misleading 
statements and hide behind a new position, at least until the November 
elections are over.
  It is remarkable that they are perfectly willing to evade the key 
pillars of this law. The law's employer mandate has been ignored and 
delayed. Mandated plan benefits aren't required for another year, and 
deadlines are conveniently rescheduled--to when? Until after the 
election.
  This time around 19 Democratic Senators have joined a number of 
Republicans in writing the Medicare administrator saying the 
administration's Medicare Advantage cuts ``create disruption and 
confusion'' and ``inhibit plans from driving the innovation that has 
resulted in better care and improved outcomes for Medicare 
beneficiaries.''
  What is so contradictory is that these same individuals voted against 
amendments offered by Senator Hatch, twice, during the health care law 
debate that would have struck ObamaCare's Medicare Advantage cuts. They 
twice voted against that.
  Understanding the consequences of these Medicare Advantage cuts 
before the law was passed would seem like the responsible course of 
action. But rejecting these amendments, voting for a bill that cuts 
over $300 billion for Medicare Advantage, then backpedaling when the 
politics get tough, and when the cuts become real to everyday 
folks, apparently, they were for the cuts before they were against the 
cuts.

  It is even more frustrating when you consider that recent efforts to 
dodge these cuts are only part of the story. For the past few years, 
the Obama administration has been pumping money back into Medicare 
Advantage under the guise of a so-called demonstration program that the 
Government Accountability Office says they probably don't even have the 
authority to run. GAO asserted that HHS should terminate the 
demonstration program, but the administration flat-out ignored that.
  The real purpose of the $8 billion program was to effectively mask 
the health care law's significant cuts to Medicare Advantage until 
when? After the November election. It is just another example of the 
administration's hiding their poor decisions and then rewriting the law 
as they see fit. But as this new Medicare notice clearly shows, this 
phony demonstration project is about to run out and our senior citizens 
are truly caught.
  Our taxpayers deserve a government that is held accountable for its 
actions. Americans are tired of temporary fixes and lip service. They 
are rightfully demanding the truth. It is time for my friends across 
the aisle to own up to the devastating consequences of this law and 
acknowledge it is time to repeal it.
  During the debate, Republicans also supported an amendment to ensure 
Medicare savings were invested back into Medicare, not used to back 
ObamaCare. Remarkably, nearly everyone on the Democratic side of the 
aisle rejected that idea. Republicans are still committed to that 
principle, and we stand ready to work on ensuring the Medicare Program 
is accessible, that it is flexible, and that it is cost-efficient for 
seniors today and for our grandchildren in the decades to come.
  Taking money out of Medicare to finance ObamaCare was wrong and it 
needs to stop. That is a promise worth delivering on.
  I yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Schatz). Without objection, it is so 
ordered.
  Mr. THUNE. Mr. President, I come to the floor today to discuss the 
pain ObamaCare continues to inflict on Americans. It seems like every 
week brings more ObamaCare bad news for somebody--families, businesses, 
middle-income Americans, lower income Americans. This past week the bad 
news was for seniors.
  On Friday the Obama administration announced its planned 2015 cuts to 
Medicare Advantage--cuts that were dictated by ObamaCare and will 
result in higher prices and fewer choices for millions of American 
seniors. More than 15 million seniors--close to 30 percent of all 
Medicare recipients--are enrolled in Medicare Advantage plans. The Wall 
Street Journal reports that approximately one out of every two new 
Medicare enrollees chooses Medicare Advantage.
  Medicare Advantage offers seniors a chance to pick a plan that is 
right for them instead of a one-size-fits-all approach. Advantage plans 
also frequently offer important health supplements, such as dental, 
vision, hearing, and wellness benefits, as well as smaller copays or 
deductibles. Studies also show that Medicare Advantage Program 
enrollees receive better care and experience better health outcomes 
than seniors enrolled in traditional fee-for-service Medicare.
  Despite the benefits these plans offer to seniors, Democrats and the 
President supported Medicare Advantage cuts in the President's health 
care law. In 2010, the President and Democrats paid--or I should say 
tried to pay--for ObamaCare by, among other things, cutting more than 
$700 billion from Medicare--already, I might add, on its way to 
bankruptcy--to pay for yet a new entitlement for nonseniors. More than 
$300 billion of those cuts were targeted specifically at the Medicare 
Advantage Program.

[[Page S1015]]

  Those cuts are kicking in this year, hitting Medicare Advantage 
beneficiaries with cost increases and benefit cuts of up to $70 per 
month--no small amount for a senior on a fixed income. Friday's 
announcement of further steep cuts for 2015 could mean up to an 
additional $75 per month in increased cost next year.
  But that is not all. Cost hikes are bad enough, but this year's cuts 
and the 2015 cuts announced Friday will result in a host of other 
problems for seniors who participate in Medicare Advantage. First and 
foremost, some seniors will lose their plans entirely as a result of 
ObamaCare's cuts, breaking the President's promise that if you like 
your plan you can keep it.
  The Kaiser Family Foundation estimates that more than one-half 
million seniors will lose their current plans in 2014. If the 2015 cuts 
go into effect, even more seniors will lose their plans next year. 
Seniors will also have fewer plan choices as a result of ObamaCare's 
raiding Medicare Advantage to pay for a new health care entitlement 
program. If next year's cuts go into effect, we can expect to see even 
more reductions.
  These higher costs and reductions in available Medicare Advantage 
plans will disproportionately impact low-income seniors in rural areas, 
areas such as those I represent in South Dakota. Forty-one percent of 
those seniors in Medicare Advantage plans have annual incomes of less 
than $20,000 and are least able to bear the higher costs forced on them 
by ObamaCare. Yet it is precisely those seniors who are bearing the 
greatest burden when it comes to paying for ObamaCare.
  On top of that, reports indicate that plans are responding to the 
cuts by reducing their footprint in rural markets, giving these seniors 
fewer options when it comes to choosing a health care plan.
  Finally, similar to so many other Americans suffering under 
ObamaCare, seniors on a Medicare Advantage plan may no longer be able 
to keep the doctors they have and like thanks to these cuts. Between 
Medicare cuts and the new ObamaCare tax insurance companies are facing 
this year, companies are scrambling for ways to be able to afford to 
continue their plans. Frequently their only option is to narrow their 
networks of doctors and hospitals or raise their copayments and 
deductibles, thus reducing seniors' choices and increasing their health 
care costs.
  Republicans have long touted the quality care and patient choice 
offered by Medicare Advantage plans. When the health care bill was 
being considered in 2010, we warned at the time that Medicare cuts 
being proposed in the bill would hurt seniors, damage Medicare 
Advantage, and weaken a program already hastening toward bankruptcy. 
Despite this, Democrats not only supported the health care bill, they 
also voted twice against measures to repeal the law's cuts to Medicare 
Advantage.
  Now it seems many Democrats have changed their minds. Earlier this 
month, 19 Democratic Senators, most of whom voted for ObamaCare in 
2010, joined a number of Republicans in sending a letter to Marilyn 
Tavenner, Administrator of the Centers for Medicare & Medicaid 
Services, urging her not to cut Medicare Advantage. Let's hope it is 
not too little too late.
  Democrats' support for the Medicare Advantage letter to the CMS 
Administrator reflects their increasing unease with their support for 
ObamaCare. Once they planned to tout ObamaCare to voters as a 
legislative triumph, but Democrats up for reelection now can't run away 
from the law fast enough.
  In fact, the President has repeatedly delayed parts of the health 
care law to give Democrats political cover. Each delay is a tacit 
admission that, yes, this law will hurt jobs and the economy because, 
after all, if this law is not going to hurt jobs and the economy, why 
do we have to continually delay it? The latest number is somewhere in 
the twenties. I have heard 24, 27, and 28 different delays of the 
harmful effects and impacts of ObamaCare.
  If the health care law is the panacea the American people were 
promised, Democrats and the President would be working to implement the 
law faster, not slow it down.
  The only possible reason to delay the law is because its 
implementation is going to hurt. It is a little awkward when your 
signature legislation has to be repeatedly delayed to give the folks 
who voted for it a better chance of keeping their jobs.
  Unfortunately, the President doesn't seem to have learned his lesson. 
Not content with the damage his health care law is doing to an already 
struggling economy--a recent CBO report warned that the health care law 
may result in up to 2.5 million fewer full-time workers--he continues 
to push policies that will further weaken an already sluggish economy, 
such as a minimum wage bill that CBO reports would result in up to 1 
million fewer jobs.
  At a time when our labor force participation rate is at Jimmy Carter-
era lows, a law that would further reduce the number of full-time 
workers is one of the worst possible things we could do for our 
economy. People working produces economic growth. The fewer people 
working, the less likely we are to produce the kind of growth we need 
to pull our economy out of the slump it has been in throughout the 
President's administration. What we need right now are policies that 
will create jobs and encourage businesses to expand and invest in our 
economy and in our workers.
  If the President were really serious about reversing the economic 
stagnation of the past 5 years, he wouldn't be pushing his health care 
bill or a minimum wage hike. Instead, he would be calling the Senate 
majority leader and urging him to take up and pass trade promotion 
authority, which will create thousands of jobs for American workers. He 
would sign off on the Keystone Pipeline and the 42,000-plus jobs it 
would support. He would join bipartisan majorities in both Houses of 
Congress to support a repeal of the job-destroying medical device tax 
in his health care law, a tax that has already cost more than 33,000 
jobs.
  American families and workers are hurting. They have been hit hard by 
ObamaCare and the Obama economy. It is time for the President to give 
them some help.
  I would argue there are bipartisan issues out there. The trade 
promotion authority, repealing the medical device tax, and the Keystone 
Pipeline have broad bipartisan majorities here in the Senate. We had a 
vote a year ago on the budget on repealing the medical device tax, and 
79 Senators, including 30 Democrats, voted for that. The last time we 
had a vote here on the Keystone Pipeline, 62 voted in support of it, 
again representing broad bipartisan support for that initiative. We 
know the trade promotion authority is something that enjoys support 
from both Republicans and Democrats. All of these initiatives enjoy 
broad bipartisan support and are known job creators. Those are the 
types of things we ought to be focused on, not things that, according 
to the Congressional Budget Office, are going to cost more jobs.
  Implementation of ObamaCare, according to the CBO report a couple 
weeks ago, will reduce the number of workers in this country by 2.5 
million over the next decade. It also said it would reduce overall 
wages by about 1 percent. So that is fewer jobs and lower take-home 
pay.
  Last week we had the report come out from the Congressional Budget 
Office that raising the minimum wage could cost up to 1 million jobs at 
the same time it is raising prices. So the very people we are trying to 
help are going to have fewer jobs and higher costs. How does that solve 
the problems our economy faces? How does that get people in this 
country back to work? How does that grow and expand our economy in a 
way that creates greater opportunity for middle-class families?
  There are things we can do on which there is broad bipartisan support 
that are known job creators, that are known to expand and grow our 
economy. I would add to that list as well reforming our Tax Code. We 
have lost so much in terms of economic growth in the past few years 
since the recession and coming out of that recession because we have 
had subpar growth. We haven't seen the type of growth rates we normally 
see and experience coming out of a recession during a recovery. As a 
consequence, we have much larger deficits because when the economy is 
growing at a sluggish, anemic, slow rate, it means there are fewer 
people working, fewer people investing, fewer

[[Page S1016]]

people making money, and therefore fewer people paying taxes. We need 
the opposite. We need a growing, expanding, vibrant, dynamic economy 
fueled by policies in Washington, DC, that make it less expensive and 
less difficult to create jobs rather than more expensive and more 
difficult, which is what we see coming out of the Obama administration 
and the Democratic majority here in the Senate.
  We can do better. We must do better for the American people, for 
middle-class families who have been hit hard by the effects and the 
impacts of this economy with fewer jobs, lower take-home pay, higher 
premiums, higher deductibles, and fewer choices of doctors and 
hospitals under ObamaCare. These policies are hurting the American 
people. We need to put policies in place that will help the American 
people by growing our economy and creating more jobs for middle-class 
Americans.
  I yield the floor.

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