[Congressional Record Volume 161, Number 3 (Thursday, January 8, 2015)]
[Senate]
[Pages S109-S110]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




SENATE RESOLUTION 25--COMMEMORATING 50 YEARS SINCE THE CREATION OF THE 
                     MEDICARE AND MEDICAID PROGRAMS

  Mr. WYDEN (for himself, Ms. Baldwin, Mr. Blumenthal, Mr. Booker, Mrs. 
Boxer, Mr. Brown, Ms. Cantwell, Mr. Cardin, Mr. Casey, Mr. Coons, Mr. 
Donnelly, Mr. Durbin, Mrs. Feinstein, Mr. Franken, Mrs. Gillibrand, Mr. 
Heinrich, Ms. Heitkamp, Ms. Hirono, Mr. Kaine, Mr. King, Ms. Klobuchar, 
Mr. Leahy, Mr. Markey, Mrs. McCaskill, Mr. Menendez, Mr. Merkley, Ms. 
Mikulski, Mr. Murphy, Mrs. Murray, Mr. Nelson, Mr. Peters, Mr. Reed of 
Rhode Island, Mr. Reid of Nevada, Mr. Sanders, Mr. Schatz, Mr. Schumer, 
Mrs. Shaheen, Ms. Stabenow, Mr. Tester, Mr. Udall, Mr. Warner, Ms. 
Warren, Mr. Whitehouse, Mr. Bennet, and Mr. Manchin) submitted the 
following resolution; which was referred to the Committee on Finance:

                               S. Res. 25

       Whereas on January 7, 1965, President Lyndon B. Johnson 
     called on Congress to provide health insurance for the 
     elderly and most vulnerable;
       Whereas over the past 50 years, Congress has strengthened 
     Medicare and Medicaid with improvements to, and expansion of, 
     health care benefits;
       Whereas today, as a result of President Johnson's call to 
     action and Congress' bipartisan initiative that created the 
     Medicare program, 54,000,000 seniors and people with 
     disabilities have access to guaranteed health care benefits;
       Whereas today, 68,000,000 Americans, including children, 
     pregnant women, individuals with disabilities, elderly who 
     are poor and frail, and low income adults and parents have 
     access to health care through Medicaid;
       Whereas Medicare and Medicaid have been leaders in 
     improving the quality of care delivered to the Nation, 
     resulting in 1,300,000 fewer infections, accidents or other 
     adverse events and avoiding 150,000 unnecessary hospital 
     readmissions;
       Whereas Medicare has been an innovator in developing 
     alternative ways to pay for health care that emphasize care 
     coordination across all health care providers and settings;
       Whereas Medicare provides access to needed care, including 
     primary and specialty care, free preventative services, and 
     prescription drugs;
       Whereas the creation of a prescription drug benefit in 2003 
     has ensured that nearly 90 percent of Medicare beneficiaries 
     have prescription drug coverage, and since 2010, over 
     8,200,000 seniors have saved more than $11,500,000,000 on 
     their prescription drugs as a result of closing the Medicare 
     Part D coverage gap;
       Whereas in 2013, an estimated 37,200,000 people with 
     Medicare took advantage of at least one preventative service 
     with no cost sharing;
       Whereas Medicaid is a critical source of comprehensive, 
     affordable health coverage for millions of otherwise 
     uninsured low-income adults and parents, including millions 
     of nonelderly low income adults in states that expanded their 
     Medicaid programs as part of health reform;
       Whereas Medicaid ensures access to long-term services and 
     supports for vulnerable low income seniors and persons with 
     disabilities by covering 60 percent of nursing home 
     residents, picking up 40 percent of the Nation's long-term 
     care costs, and allowing loved ones to live with health and 
     dignity in their own homes and communities;
       Whereas Medicaid provides early comprehensive childhood 
     screening, diagnosis, and treatment for 32,000,000 of the 
     Nation's children, including half of all low-income children; 
     and
       Whereas Medicaid provides crucial services for pregnant 
     women and babies in that Medicaid covers 45 percent of births 
     nationwide, 53 percent of hospital stays for infants born 
     prematurely or with a low birth weight, and 45 percent of 
     hospital stays for infants with birth defects: Now, 
     therefore, be it
       Resolved, That it is the sense of the Senate that--
       (1) all efforts to improve Medicare and Medicaid must 
     support and build upon President Johnson's vision ``to assure 
     the availability of and accessibility to the best healthcare 
     to all Americans, regardless of age or geography or economic 
     status'';
       (2) Medicare's guaranteed benefit is a lifeline to millions 
     of Americans and must remain intact for this and future 
     generations;
       (3) Medicare should not be transformed into a voucher 
     program, leaving seniors and people with disabilities 
     vulnerable to higher out-of-pocket costs;
       (4) with the strong support of the Federal Government, 
     Medicaid continues to serve as a safety net for vulnerable 
     children, pregnant women, persons with disabilities, elderly 
     who are poor and frail, and other low income adults; and
       (5) Medicaid should not be dismantled through block grants, 
     per-capita caps, or by other policies that slash funding, 
     shift cost to states, reduce benefits, and erode the safety 
     net relied on by over 68,000,000 Americans.
  Mr. WYDEN. Mr. President, I rise to highlight a Presidential message 
that was delivered to Congress 50 years ago today.
  But before I reiterate the importance of Medicare and Medicaid--facts 
that I think my colleagues and I can all agree to I would like to look 
back at where we have been, to recall what life was like for so many 
people who were poor and disabled, uninsured or unlucky before these 
vital safety net programs were here.
  Those were the days of the ``poor farm'' and the ``almshouse,'' 
places the poor and uninsured would go for care. It wasn't a happy 
choice and more often than not, it was the only choice.

[[Page S110]]

These places provided care, often rudimentary, and often carried a 
stigma. Accommodations were sparse at best. In return for health care 
and housing, residents were expected to work in the adjoining farm or 
do housework or other menial labor to offset the cost of their stay.
  This was the primary option for someone whose extended family 
couldn't provide help or didn't want to--right here in the USA. Few 
Americans today remember those days.
  When President Johnson submitted his message to Congress 50 years ago 
today, fewer than half of America's elderly even had health insurance. 
In that era, and it wasn't that long ago, it wasn't uncommon for the 
sick elderly to be treated like second class citizens, and as a result, 
many aging Americans without family to care for them ended up 
destitute, without necessary health care, or on the street.
  It was a time no one wants to revisit, a time that one sociologist 
said was ``another America'' where ``40 to 50 million citizens were 
poor, who lacked adequate medical care, and who were `socially 
invisible' to the majority of the population.''
  It is worth remembering how far we have come. Today, I ask my 
colleagues to use this anniversary as a vivid reminder of the 
difference Medicare and Medicaid make in the daily lives of Americans, 
and also the health care advances that have occurred as a result.
  A couple facts to highlight for my colleagues:
  Today, with rock-solid essential health services, 54 million 
Americans--nearly every senior and person with disabilities--has access 
to Medicare's guarantee.
  Meanwhile, Medicaid has made a critical difference for 68 million of 
the Nation's most vulnerable, including more than 32 million children, 
6 million seniors, and 10 million persons with disabilities. Because 
Medicare and Medicaid made health care possible for millions of people, 
they have also been the catalyst for innovations in treatment that 
benefit people of all ages. Here's one example:
  In the first 30 years of Medicare alone, deaths from heart disease 
dropped by a third for people over age 65. By providing coverage and 
access for millions, these programs became catalysts for changes in how 
medicine is practiced and paid for, while finding the root causes of 
disease and perfecting better therapies to treat them.
  As time has marched on, these programs evolved and improved, and the 
rest of the health care system followed.
  In 1967, Early and Periodic Screening, Diagnosis, and Treatment, 
EPSD, comprehensive health services benefit for all Medicaid children 
under age 21 was created--helping improve the health of our Nation's 
kids.
  In 1981, home and community-based waivers were established so that 
states could provide services in a community setting, allowing 
individuals to remain in their home for as long as possible. Every 
state now uses this option to facilitate better care and services to 
their Medicaid population.
  In 1983, Medicare took one of many legs away from fee-for-service 
with the advent of the hospital prospective payment system, a system 
that pays hospitals based on a patient's illness, and how serious it 
was, not based solely on how much it cost to treat them. This change, 
once considered drastic, has become common place and accepted.
  In 2003, the prescription drug coverage was added to Medicare's 
benefit, providing access to necessary medications for those most 
likely to need them. As a result of greater access to prescription 
drugs, beneficiaries' health have dramatically improved.
  In 2010, as a result of health reform, preventive services became 
free to patients, prescription drugs became cheaper for those 
beneficiaries who fell in the donut hole, Medicare began to move away 
from purely volume-driven care, and onto paying for quality and value, 
and the life of the Medicare trust fund was extended.
  Finally, in 2012, the Centers for Medicare and Medicaid began 
releasing loads of claims data for the public to use. Access to this 
information has been game-changing in understanding the cost of care 
and variations in the way medicine is practiced across the country.
  Today, any of these examples are easy to forget because they are 
commonplace. But that makes them no less remarkable.
  I will close by noting something else, just as striking about 
Medicare and Medicaid: It was a bipartisan effort. The enactment of 
these programs shows that Congress can craft bipartisan solutions to 
very complex and politically difficult problems. That's what happened 
in 1965 when the Senate passed the legislation creating Medicare and 
Medicaid by a 68-32 vote after the House approved it three months 
earlier on a robust 313-115.
  As the 114th Congress gets underway, my colleagues and I could all 
take a page from President Johnson's playbook: Congress shouldn't use 
partisan tactics when the solutions can be bipartisan.
  And there's the lesson; that despite sharp differences and 
partisanship, the Congress of Johnson's day was able to rise above that 
culture and those challenges to find agreement and make America a much 
better place. As this new Congress begins, I hope we can use that 50-
year-old spirit to strengthen, protect and improve Medicare and 
Medicaid to keep the guarantee strong and ensure health care to those 
who need it most.

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