[Congressional Record Volume 161, Number 121 (Wednesday, July 29, 2015)]
[Extensions of Remarks]
[Pages E1159-E1160]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        A SACRED TRUST: CELEBRATING MEDICARE'S 50TH ANNIVERSARY

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                        Wednesday, July 29, 2015

  Mr. SMITH of New Jersey. Mr. Speaker, I take this opportunity today 
to mark the 50th anniversary of Medicare and to express my strong 
support for the programs that provide health coverage for older 
Americans.
   Fifty years ago, our country made a commitment to our seniors. A 
commitment that said

[[Page E1160]]

if you worked hard and paid into the system you would have access to 
quality healthcare in retirement. To this day, Medicare continues to 
provide health insurance coverage for millions of Americans age 65 and 
older, and adults with permanent disabilities. Medicare, along with 
Social Security, is a sacred trust that I have consistently fought to 
preserve and one that we must continue to protect for the 54 million 
Americans enrolled in Medicare today--and those who will enroll 
throughout our nation's tomorrows.
   Amended and improved throughout the years, Medicare has come to play 
a key role in providing health coverage to millions of Americans. The 
Social Security Amendments of 1965, established Medicaid to ensure low-
income families have access to healthcare; Social Security Amendments 
of 1972, extended Medicare eligibility to individuals under age 65 with 
long-term disabilities; then later the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2006, established the Medicare 
Advantage program and a new landmark prescription drug benefit known as 
Medicare Part D.
   In addition to large scale changes to the program, I have supported 
and worked on policies that address specific aspects of Medicare to 
both raise the quality of life for beneficiaries while also saving the 
program money in the long run. For example, I authored legislation that 
was signed into law (PL 100-203) to provide Medicare coverage for 
therapeutic shoes for seniors with severe diabetic foot disease. At the 
time, Medicare covered costly amputations--which an estimated 25,600 
seniors received annually--but not the therapeutic shoes what would 
prevent the need for those amputations. The American Diabetes 
Association estimated that my bill would save Medicare over $100 
million in one year alone, while the affordable and available foot care 
would spare seniors the trauma of an amputation.
   And my work to sustain and protect the program continues. Earlier 
this year I was pleased to lend my support to the Medicare Access and 
CHIP Reauthorization Act of 2015 (PL: 114-10) which finally repealed 
the flawed SGR--the statutory method for determining the annual update 
to the Medicare physician fee schedule. Previous temporary patches to 
the SGR were unsustainable and unproductive, leaving seniors 
questioning if they could visit their own doctors if the so-called 
patches were not extended.
   A final repeal of the SGR modernizes the formula for determining 
Medicare reimbursements and will help the Centers for Medicare and 
Medicaid transition to a new system intended to incentivize quality of 
care and overall health improvements. This law allows seniors to retain 
access to quality healthcare, establishes predictability for the 
doctors who treat Medicare beneficiaries, and continues to give seniors 
the security and confidence they need when making healthcare decisions.
   With that work successfully accomplished, we can and must do even 
more to strengthen Medicare and ensure the healthcare needs of all 
seniors are met, now and into the future.
   Accordingly, yesterday, I introduced the Program of All-Inclusive 
Care for the Elderly (PACE) Innovation Act. My new bill, introduced 
with a group of bipartisan co-sponsors--including the lead Democratic 
cosponsor Rep. Earl Blumenauer, the Ways and Means Subcommittee on 
Health Chairman Kevin Brady and Ranking Member Jim McDermott--will 
allow CMS to test models that bring PACE's effective care plans to more 
seniors as well as individuals with disabilities.
   By way of background, PACE is an effective, integrated and 
community-based program that works to raise quality of life of senior 
citizens, while keeping them in their homes and supporting their 
independence. It delivers the entire range of medical and long-term 
services including: medical care and prescription drug services; 
physical or occupational therapy; day or respite care; and medical 
specialties, such as dentistry, optometry, and podiatry.
   Currently, participating in a PACE program is limited to those aged 
55 and older who meet state-specified criteria for needing a nursing 
home level of care (LOC). However, many populations--including younger 
individuals, people with multiple chronic conditions and disabilities, 
seniors who need comprehensive care but do not yet meet the nursing 
home LOC standard--could benefit from the all-inclusive nature of the 
PACE model.
   Having worked to bring the first PACE program to New Jersey, St. 
Francis Medical Center's Living Independently for the Elderly (LIFE) in 
Trenton, I've personally visited seniors who are enrolled in PACE and 
witnessed how this important program works to raise the quality of life 
of its enrollees. Today over 100 PACE programs are serving seniors 
throughout the country including four, soon to be five, centers in my 
home state of New Jersey. This bill is important to build on the 
success of the program and make it better, offering better 
comprehensive care and preserving the dignity of those most deserving 
of our care and attention.
   To further strengthen the Medicare system and aid those individuals 
and families who are facing the reality of Alzheimer's disease, I also 
recently introduced the HOPE for Alzheimer's Act (HR 1559). My HOPE Act 
would provide for Medicare coverage of a care-planning session for 
newly diagnosed patients and their family caregivers or legal 
representatives.
   Mr. Speaker, my Alzheimer's legislation will fill an important gap 
in current Medicare services. Take for example an experience of one of 
my constituents, Mary Gerard of Ocean New Jersey. Mary was one of the 
15 million family members and friends who act as unpaid caregivers to 
Alzheimer's and dementia patients across the country every year.
   When her mother Helen was diagnosed with Alzheimer's, Mary took 
charge and was there with her mother day in and day out--faithfully and 
lovingly--until she passed. She is a trained critical care nurse. She 
was equipped with knowledge and resources that many first time 
caregivers do not have. Yet even with a medical services background, 
she still struggled with the challenges of her new life as a caregiver.
   Alzheimer's caregivers provide an estimated 17 billion hours of 
unpaid care every year. The emotional and financial toll can be 
immense. Many are untrained and offered little guidance to function in 
their new role. Navigating the long-term care system is a daunting task 
and can appear overwhelming, particularly for those who have only 
recently received the news that a loved one has Alzheimer's disease.
   Upon receiving this diagnosis, patients and their families--like 
Mary's--are frequently at a loss for how to effectively plan for the 
next stage of their lives. Passage of my legislation will empower 
individuals with much-needed information to outline their future 
treatments and care--giving patients HOPE, and a plan for their future.
   As our population ages, it is imperative that we preserve and expand 
access to the services that enable senior citizens to live healthy and 
productive lives, and give seniors the security and confidence they 
need when planning for their future medical care.
   Strengthening and preserving Medicare is a promise that every 
preceding generation has made and kept. It is our duty to continue to 
honor the senior citizens in New Jersey and around the country who have 
worked hard to provide for their families and help build our 
communities and deliver on promises made, for--at a minimum--another 50 
years to come.

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