[Congressional Record Volume 160, Number 54 (Thursday, April 3, 2014)]
[House]
[Pages H2894-H2897]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROTECTING MEDICARE ADVANTAGE
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 3, 2013, the gentleman from Florida (Mr. Murphy) is recognized
for 60 minutes as the designee of the minority leader.
General Leave
Mr. MURPHY of Florida. Madam Speaker, I ask unanimous consent that
all Members have 5 legislative days to revise and extend their remarks
and include extraneous material on the subject of my Special Order.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. MURPHY of Florida. Madam Speaker, there are currently many
concerns regarding health insurance in our country, especially among
our Nation's seniors. At this time of major transition in our Nation's
health care industry, it is critical that seniors enrolled in
traditional Medicare and Medicare Advantage can keep the coverage on
which they depend.
Unfortunately, proposed cuts to Medicare Advantage are putting these
important benefits at risk. This is a very serious situation across the
country, and it is of great concern to me, with Florida being home to
over 4 million seniors. My district alone has over 160,000 seniors,
with more than one-third of them choosing a Medicare Advantage plan
whose coverage would be severely impacted by the proposed cuts released
in the draft rule that CMS put out in February.
We are already seeing what last year's cuts to Medicare Advantage
have meant: smaller networks of doctors, cuts to add-on benefits, and
higher out-of-pocket limits. The additional proposed cuts to the
program released in February have raised great concerns from my
constituents about their coverage and about the potential of having to
pay more and having fewer benefits. That is why we are here today,
urging the administration to reverse course and keep rates flat for
2015.
At this point, I would like to yield to my good friend Ms. Sinema
from Arizona, who has been fighting tirelessly to protect the seniors
in her area as well.
Ms. SINEMA. Thank you, Congressman Murphy, for hosting this Special
Order so that we can stand up and speak out for seniors in our
districts. We are here today because CMS, the Centers for Medicare and
Medicaid Services, has proposed cuts to Medicare Advantage.
Next week, CMS will publish its final rule. I urge CMS to not cut
Medicare Advantage. These cuts will decrease choice, create
uncertainty, and undermine access to care for our seniors.
I oppose these cuts. Like Mr. Murphy and many of our colleagues
participating in this Special Order, I have repeatedly called on the
Federal Government to reconsider its proposal and make no further cuts
to Medicare Advantage.
Medicare Advantage is a popular and effective alternative to
traditional fee-for-service Medicare, especially in Arizona, where
statewide, 38 percent of Medicare-eligible beneficiaries choose a
Medicare Advantage plan. In my district, nearly 43 percent of Medicare-
eligible beneficiaries choose a Medicare Advantage plan.
Medicare Advantage plans consistently receive high customer
satisfaction ratings and are helping to control cost, drive innovation,
and improve health outcomes for beneficiaries. I keep saying
``beneficiaries.'' But what I should say is, our parents, our
grandparents, and our loved ones. These plans provide affordable, high-
quality care for our loved ones.
Bonnie Grant, a proud Arizonan in my district, is in her sixties and
lives in Phoenix. Through her Medicare Advantage plan, she has access
to a transportation system called Van Go. Bonnie uses the service to go
shopping and to go other places ``instead of being stuck at home.'' She
said that it helps because ``instead of being holed up in your home,''
she can be engaged in the community and enjoy her life. The Van Go
benefit is the type of creative service offered by Medicare Advantage
plans that improves the well-being of enrollees.
Joseph Ford, another constituent, lives in suburban Phoenix. He was
disabled in a car accident. The hands-on managed care he receives
through his Medicare Advantage plan, including in-home visits, allows
Mr. Ford to stay in his home and live a fuller life. Keeping
individuals like Mr. Ford in his home instead of in institutional care
facilities is better for the beneficiary and presents a significant
cost savings to the Medicaid and Medicare programs.
I am concerned that the proposed payment reductions for 2015 will
undermine the choices made by my fellow Arizonans, by Ms. Grant, by Mr.
Ford, and by others in my congressional district by causing our loved
ones to lose needed services and to experience increases in premiums.
These cuts could also have the unintended and costly consequence of
putting our seniors at risk of being placed in institutions, rather
than staying in their homes.
Instead of cutting funding for these popular plans, we should work
together to find reasonable solutions that drive down cost, increase
choice, address waste, fraud, and abuse, spur innovation, and
ultimately improve the quality of life provided to our seniors.
Again, I urge CMS to maintain payment levels for Medicare Advantage
so that our loved ones do not experience increased out-of-pocket costs,
negative disruptions, or confusion in 2015.
Thank you, Congressman Murphy, for working with me on this important
issue and for hosting this Special Order today.
Mr. MURPHY of Florida. I thank the gentlelady from Arizona for her
comments and for reminding us that these aren't simply numbers on a
ledger, that all of these beneficiaries are folks we know. These are
our parents. These are our grandparents. They are more than just
numbers.
And like Ms. Sinema, I am constantly hearing from residents in my
district about the negative impact these cuts would have on the well-
being of their spouses, their parents, or personally, including Cheryl
from Palm Beach Gardens, in my district.
After doing everything right to plan for her retirement, like many
seniors do, Cheryl and her husband saw their savings cut in half during
difficult economic times. Now they are seeing their health care options
limited and their out-of-pocket costs going up. These are changes they
simply cannot afford.
I agree with Cheryl that it is unfair to shift the burden onto those
on fixed incomes, those who have little resources to make up the
difference. Seniors cannot afford further cuts and the negative
consequences if these misguided proposals move forward.
At this point, I would like to take a moment to yield to the general,
Mr. Enyart from Illinois, and thank him for his leadership in fighting
for seniors on behalf of Illinois and the rest of our country.
Mr. ENYART. I thank the gentleman from Florida.
Madam Speaker, I rise today to show support for the 50 million
Americans enrolled in Medicare. Medicare is vital not only to my
district, like Mr. Murphy's district in Florida, but our entire Nation,
which is why my fellow colleagues and I should support its promise to
all our citizens who have earned it, who have paid for it through their
taxes, and who now rely on it for a stable health care system and for
their medical care.
Medicare has a long and valued history since its inception in 1965.
Social Security recipients have consistently benefited from the
opportunity to access quality, affordable health care, a right now
guaranteed to those who worked hard for that privilege.
There are 122,380 constituents from the 12th District of Illinois who
participate in the Medicare program. That is one out of every seven
citizens in my district.
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Many of these constituents are disabled, and almost all are on a
fixed or limited income. Medicare gives these citizens the opportunity
to receive essential medical care and to take part in preventive care
programs designed to maintain good health, which lowers the cost of
health care--lowers the cost of health care.
Of those 122,000 southern Illinoisans, over 28,000 also participate
in Medicare Advantage. That is one in four of those Medicare
participants taking part in a program specifically designed for those
seniors who have high rates of chronic disease. Medicare Advantage
focuses on
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prevention and on disease management, which reduces the need for
unnecessary hospitalizations--keeping our most vulnerable populations
healthier and out of the hospital waiting room.
Medicare and Medicare Advantage serve our seniors, low-income
families, and those susceptible to disease. I ask, are these the
populations we want to cast aside? Are these the citizens that we need
not care for? I say no. Yet, the proposed budget unveiled this week
virtually eliminates Medicare for future enrollees. It includes plans
to shift health care costs to seniors. It removes the guarantees
provided by our current Medicare system to make quality, affordable
health coverage available for those who need it most. It undermines the
promise our Nation made to its citizens--that if you work hard and you
pay your taxes, some day, should you need it, your health care needs
will be met.
The recently proposed budget also implements what they label a
premium support system. That is a plan to move Medicare to a voucher
program. I vehemently oppose this proposition. Our seniors don't need a
health care coupon--they need health care.
They need the ability to choose their own doctor. They need the
ability to access billions in savings for prescription drugs. They need
access to wellness visits--all of which are in jeopardy under this
Republican budget plan.
I am tired of hearing proposals to eliminate vital government
services simply because of party ideology. Let us not govern blindly
through rhetoric and sound bites, but rather, let us work for our
constituents to better serve those who have paid into the Medicare
system their entire working life and now need it most.
Medicare serves those who have earned it, who have paid for it, and
who deserve it. Should we take away that service, I fear what the
future may hold for our seniors--seniors like Carolyn Morgan from Du
Quoin, Illinois. Carolyn needed Medicare's help in March of 2013, when
she became ill and hospitalized, put on oxygen, and given a daily
regimen of prescription drugs.
I hold her letter to my office in my hand.
Carolyn states:
I cannot afford out-of-pocket health care. My supplemental insurance
is useless without Medicare, so it would have been wasted money every
month.
I know I will be spending the remainder of this congressional term
fighting for Carolyn and fighting for our seniors and disabled to make
sure that the health care promises we made so many years ago are not in
danger from partisan budget cuts.
My fellow colleagues, I urge you to join me. Let's avoid a grim
future for the elderly, for the disabled, and the fixed-income citizens
of this great Nation. Let's help Carolyn and the many more American
citizens just like her. Let's fight to keep Medicare.
Mr. MURPHY of Florida. I want to thank the gentleman from Illinois
for his generous words and reminding us of the importance of Medicare
and Medicare Advantage and what it means to so many folks across our
great country.
At this point, I would like to take a minute to let the gentleman
from Georgia talk about what is happening in his district. Mr. Barrow
has been fighting for years up here in D.C. for Medicare and seniors
across the country.
Mr. BARROW of Georgia. I thank the gentleman.
Madam Speaker, I would like to thank my colleague, Mr. Murphy, for
gathering us all here to talk about this important issue. This is an
issue that affects folks in every part of this country, and in my view,
is one of the most important issues facing seniors in our communities
today.
I applaud all of my colleagues gathered here for taking a leadership
role in our efforts to fight proposed reductions to the Medicare
Advantage program.
Nearly 15 million seniors across the country are enrolled in Medicare
Advantage, including more than 300,000 in my home State of Georgia.
This program serves our seniors well, particularly those with high
rates of chronic disease. Nearly 30 percent of all Medicare
beneficiaries turn to Medicare Advantage to cover their health care
costs.
By focusing on prevention and disease management, Medicare Advantage
plans reduce the need for hospitalization, and that, in turn, reduces
health care costs. It is a proven program that folks in my district
have come to rely on.
The Centers for Medicare and Medicaid Services recently proposed a
5.9 percent cut to this program, which could result in a reduction of
benefits and increased premiums on Medicare beneficiaries by $35 to $75
a month. That is an added cost that many seniors simply cannot afford
to pay every single month.
My colleague from the other side of the aisle, Dr. Bill Cassidy, and
I have been leading the charge to urge the Federal Government to take
any and all steps necessary to preserve this program. Just last month,
more than 200 Members of Congress from this House joined us in our
effort to urge the Centers for Medicare and Medicaid Services to
preserve the standard of care that seniors are currently getting. I,
for one, do not want to put our seniors, men and women who have worked
their entire lives, in the financial trouble these reductions would
cause.
I have urged the administration to take a long, hard look at how
these cuts would affect everyday lives of our seniors. If the goal here
is to save money, there are better, more suitable ways to do it than on
the backs of our seniors.
Again, I would like to thank my colleague for getting folks together
to talk about how we can work together to make sure Medicare Advantage
isn't jeopardized. It is an issue that isn't for Democrats or
Republicans, but one that we all need to address. I have been proud to
work on this issue in a bipartisan fashion with Dr. Cassidy, and it is
my hope that all of our colleagues will get on board and help us
preserve Medicare Advantage.
Mr. MURPHY of Florida. I thank the gentleman from Georgia for sharing
your thoughts and stories and reminding us that this isn't a partisan
issue. It shouldn't be a Republican, Democratic, or Independent issue.
These are seniors. These are folks that built this great country, many
of whom are veterans who fought for our country and laid the foundation
which we have today.
So thank you for reminding us of that and being here today and taking
a moment out of your busy schedule to share your thoughts.
I would now like the gentleman from Arizona, who has been championing
this issue back home, to talk about what he is doing with Medicare
Advantage and why he is here today. Mr. Barber, thank you.
Mr. BARBER. I want to thank the gentleman for bringing us together
tonight to talk about the importance of preserving and protecting
Medicare Advantage.
I rise today, Mr. Speaker, on behalf of the citizens that I represent
all across southern Arizona--thousands and thousands of seniors who
have come to rely on Medicare Advantage to keep them in their homes, to
keep them well, and to provide them with the support that they so
dearly need as they age in place.
They live in communities all across my district, from Tucson to
Sierra Vista, to Douglas, to Benson, to Bisbee, to Willcox, and to
``the town too tough to die,'' Tombstone. And I am determined to fight
on their behalf to make sure that Medicare Advantage continues to serve
them and does not disappoint the delivery of services by losing
funding, as is proposed by the President this month.
Medicare Advantage offers seniors and individuals with disabilities
quality and affordable health care that they can depend on. And they
depend on us--those of us who represent them--to fight for their right
to continue this program.
Medicare Advantage focuses on prevention and innovation. It is a
proven fact that this program improves health outcomes and contains
costs. Isn't that what we should be doing for our seniors and for
everyone in America? But now, as I said, the President is proposing
harmful cuts to Medicare Advantage.
So let's examine what these cuts would mean if they go into effect.
They will mean fewer benefits, fewer doctors, and less choice. This is
wrong, and we cannot let it happen. I oppose these cuts, and I have
called upon the President to reverse course and protect this critical
program.
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For the people in my Second District of Arizona and for seniors all
across this great Nation, there are over 390,000 Medicare Advantage
enrollees or recipients in the State of Arizona alone, and it is
working for them. They will attest to that, and they have to me. They
have contacted my office in person and by phone, they have met with me
in community gatherings all across the district over the last several
weeks, and they have expressed their deep concerns that they will lose
this valuable program that they have come to rely upon that keeps them
well and keeps them in their homes.
Before I came to the Congress and before I worked for Congresswoman
Giffords, I administered a regional and then a State program for people
with disabilities that focused on the same kinds of services that are
provided to seniors and individuals with disabilities under the
Medicare Advantage program--cost effective, in-home support, keeping
people well, and preventing more illness. This makes sense. It makes
sense for them, it makes sense for our country, and it makes sense for
the appropriations that we are trying to protect in this Congress.
I certainly urge the President to reverse course and stop these cuts.
We cannot stand for it. I will not stand for it, and I will not back
down until we are successful in reversing this impossible and
irresponsible decision.
Mr. MURPHY of Florida. I want to thank the gentleman from Arizona for
his leadership and for continuing to fight for seniors back home and
continuing to be a champion here in Washington, D.C., for those folks.
Thank you, also, for reminding us that this is a successful Medicare
program that has already had a solid success record at reducing
hospital readmissions and improving health outcomes, and continues to
be a popular option for seniors, reducing annual out-of-pocket expenses
from traditional Medicare and offering expanded benefit packages that
include important dental, hearing, vision, and chiropractic care.
Medicare Advantage plans also normally include the successful and
cost-saving part D prescription drug plan and come without an annual
deductible. By offering great coordinated care and innovative health
care approaches, this program is highly effective at keeping seniors
out of the hospital. But, if they do end up in the hospital, Medicare
Advantage helps them recover more quickly and with less chance of
returning. We should be building on this success, not stifling it.
At this time, I would like to take a moment to yield to the gentleman
from Florida who, similar to myself, has many seniors in the great
State of Florida and will continue to be a champion for the seniors and
is going to share with us some stories.
Mr. GARCIA. I would like to thank my colleague from Florida and my
good friend, Mr. Murphy, for his fight for seniors.
I rise today to express my strong support for Medicare and my
opposition to any cuts to Medicare. Medicare is one of our Nation's
greatest achievements. For half a century, this program has lifted
millions of seniors out of poverty and provided seniors with the health
care they need, they have earned and they deserve.
In Congress, we have a responsibility to strengthen and modernize
Medicare to ensure that it continues to provide seniors who have worked
all their lives to receive those Medicare benefits they have earned and
they depend on.
Medicare Advantage serves over 1 million seniors in Florida, and it
provides innovative treatments and care. In my district, I hear
firsthand from so many seniors how well Medicare is serving them.
This is not a political issue. This is not a partisan issue. While
outside groups have been misleading my constituents and others on my
record on Medicare, I have been working with my colleagues on both
sides of the aisle to oppose cuts to Medicare.
My colleagues and I are strongly advocating against changes to
Medicare that would disrupt the lives of seniors.
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I have spoken to the President about this. I have spoken to the
Secretary and CMS about this issue. We have written letters to the
administration, and we stand here today. I am committed to continuing
to do everything I can to protect Medicare for our Nation's seniors.
With that, I want to again thank Mr. Murphy for all of his efforts.
He has been a leader in our caucus, he has been a leader in this
Congress in fighting for seniors, and I am proud to stand by his side,
just as I am sure that Mr. Murphy will fight against cuts like the ones
proposed in the Ryan budget, which cuts over $800 billion from seniors
and Medicare, which puts the hole back in the doughnut, and I just want
to thank him again for his leadership.
Mr. MURPHY of Florida. I want to thank the gentleman from Florida for
continuing to fight for seniors and reminding us of what proposals on
the other side might entail.
The political games being played are not necessary in today's
environment. These are real people. These are seniors. They are not
just numbers on a spreadsheet. These are our grandparents and parents.
These are folks who fought for our country and fought for our freedoms.
Thank you for reminding us not to make this a political puck. This is
serious, and we must work together as a Congress and the United States
Government to ensure seniors are protected.
I want to take a second to look at another scenario, gym memberships.
A common add-on benefit for Medicare Advantage plans is free or
discounted gym memberships. Cut Medicare Advantage too deeply, too
quickly, and gym memberships are gone. Some think that is a good thing.
I disagree.
A recent study found that regular balance exercise for seniors
reduces falls that cause injuries by 37 percent and broken bones by 61
percent. Most elderly Americans survive a broken hip, but it often
undercuts confidence and diminishes quality of life.
If a fall robs an elderly woman of her independence, it is a
financial and emotional hardship. Whether it is the cost of Medicare of
a hospitalization or 2 months of therapy, the cost to Medicare and
Medicaid for a nursing facility, or most importantly, the cost to the
senior of her quality of life and independence, Silver Sneakers doesn't
seem like much of a cost at all in comparison.
That is why, even during a time of great partisanship and gridlock in
Congress, there is a growing bipartisan coalition calling on the
administration to keep the rates flat for this year, putting the well-
being of our Nation's seniors before party lines.
Together, we are making several recommendations for changes to CMS'
proposals that we believe could contribute to stabilizing the program
while preventing devastating impacts on the program and the
beneficiaries it serves.
For example, providing more care at home, CMS could narrow the
proposals on in-home health risk assessments and protect the benefit of
medication management and continuity of care. If the visits are an
important component of the disease management and provide value to
seniors and taxpayers, they should be maintained. This is exactly the
type of innovation we need.
At this point, I would like to take a moment to yield to the
gentleman from California who has been a champion for seniors in his
great State. He will share with us his leadership and what he has heard
back home.
Mr. PETERS of California. I thank you, Mr. Murphy. I appreciate you
and your work on behalf of seniors in Florida and around the country on
this important issue.
I just want to recognize you and the bipartisan group we have here
standing up for our seniors and Medicare Advantage. I was honored to be
part of a group of freshmen in our party who met with Secretary
Sebelius yesterday, and we were able to, with the help of our
leadership, express to the Secretary our concern about the proposed
cuts.
Part of what we told her was that Medicare Advantage continues to
offer seniors and individuals with disabilities additional choices for
high-quality, coordinated care in their communities.
With a focus on innovative services, prevention, and disease
management, these plans have consistently delivered improved health
outcomes while containing costs and requiring copayments or deductibles
from beneficiaries.
Further, consistent with the goals of HHS, these plans reduce
hospitalizations and readmissions, decrease the
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length of stay in nursing facilities, and manage high-risk, high-need
patients more effectively.
I thank the gentleman for letting me add my voice to folks who don't
want to see us do something that is pennywise and pound foolish. We
have a system that is incentivizing well-being and focusing on
prevention.
It can really add a lot for the benefit of our seniors, and we all
want to see it preserved as it is. Thank you very much for the time.
Mr. MURPHY of Florida. I thank the gentleman from California for
taking a minute out of his busy schedule to come and talk about how
important Medicare and Medicare Advantage plans are to you and your
constituents back home.
Finding ways to collect better and more thorough health information
allows for better coordinated care with convenience to our seniors. We
should also continue to reward programs that are performing the highest
and providing the best care to seniors.
To do that, CMS should also increase the percentage of rebates to
reward and promote higher quality while averting negative consequences
for beneficiaries.
Other recommendations include keeping beneficiary stability and
continuous plan improvement paramount when Medicare Advantage's
benchmark calculations and bidding rules.
By rewarding performance, while taking into account the challenges
faced in low-income populations, Medicare would accelerate delivery
system innovation and keep Medicare Advantage as a viable option.
These are just a few of the smart changes that we should be making to
build off the success of this program, instead of cutting these
beneficial plans to the detriment of our Nation's seniors.
I am proud to stand with my colleagues today to once again call on
the administration to preserve the Medicare Advantage choice for
beneficiaries after a lifetime of hard work.
Madam Speaker, we could be facing a serious situation throughout the
country. Both sides of the aisle are concerned about the proposed cuts
to Medicare Advantage.
Further cuts not only risk new health care efficiencies and
innovation, but the health and well-being of seniors who depend on
these plans. Simply put, these cuts are counterproductive if it means
more hospital readmissions and worse health outcomes.
Cuts already happening this year have resulted in a 10 percent
increase in overall out-of-pocket costs for seniors relying on Medicare
Advantage, with the annual maximum for these expenses increased by
$560.
For seniors on fixed incomes, that can mean the difference between
being able to fill a needed prescription, making a mortgage payment, or
putting food on the table.
If further cuts are made to this important program, it would be even
worse, costing seniors an estimated $50 more a month in out-of-pocket
expenses. It is wrong to shift this burden onto seniors.
From Cheryl and her husband from Palm Beach Gardens to Walter from
Tequesta to Robert from Palm City to Gary from Port St. Lucie to
Lorraine from Fort Pierce, this touches the lives of seniors across my
district and across this country.
They deserve better after a lifetime of hard work than having to
worry about losing their doctor or the affordable health coverage that
works for them.
This doesn't just impact my constituents across the Treasure Coast
and palm beaches, but seniors and families across this great Nation.
I thank my colleagues who stood with me today to urge the
administration to protect seniors from further cuts, keeping rates flat
for this year.
I am committed to fighting for the well-being for seniors on the
Treasure Coast and palm beaches, the great State of Florida, and across
our Nation, protecting their earned benefits.
Madam Speaker, I yield back the balance of my time.
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