[Congressional Record Volume 164, Number 124 (Tuesday, July 24, 2018)]
[House]
[Pages H7115-H7116]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            IMPROVING SENIORS ACCESS TO QUALITY BENEFITS ACT

  Mr. KELLY of Pennsylvania. Mr. Speaker, I move to suspend the rules 
and pass the bill (H.R. 4952) to direct the Secretary of Health and 
Human Services to conduct a study and submit a report on the effects of 
the inclusion of quality increases in the determination of blended 
benchmark amounts under part C of the Medicare program, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4952

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Improving Seniors Access to 
     Quality Benefits Act''.

     SEC. 2. DETERMINATION OF BLENDED BENCHMARK AMOUNT STUDY.

       (a) Sense of Congress.--It is the sense of Congress that 
     the inclusion of quality increases in the determination of 
     blended benchmark amounts under section 1853(n)(4) of the 
     Social Security Act (42 U.S.C. 1395w-23(n)(4)) undermines the 
     goal of delivering high-quality care under the Medicare 
     program under title XVIII of such Act.
       (b) Study and Report.--Not later than one year after the 
     date of enactment of this section, the Secretary of Health 
     and Human Services, in consultation with relevant 
     stakeholders, shall conduct a study and submit to Congress a 
     report on the effects of the inclusion of quality percentage 
     increases under section 1853(n)(5) of such Act in the 
     determination of blended benchmark amounts under section 
     1853(n)(4) of such Act. Such study and report shall include 
     an analysis of the following:
       (1) The authority of the Secretary to remove such increases 
     from the determination of such amounts.
       (2) The effects of including such increases in the 
     determination of such amounts on Medicare Advantage 
     organizations (including the effects on any contracts entered 
     into by such organizations).
       (3) The financial impact of including such increases in the 
     determination of such amounts by county.
       (4) The effects of including such increases in the 
     determination of such amounts on individuals enrolled in a 
     plan under part C of title XVIII of such Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Pennsylvania (Mr. Kelly) and the gentleman from Massachusetts (Mr. 
Neal) each will control 20 minutes.
  The Chair recognizes the gentleman from Pennsylvania.


                             General Leave

  Mr. KELLY of Pennsylvania. Mr. Speaker, I ask unanimous consent that 
all Members may have 5 legislative days within which to revise and 
extend their remarks and include extraneous material on H.R. 4952, 
currently under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Pennsylvania?
  There was no objection.
  Mr. KELLY of Pennsylvania. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, this bill, H.R. 4952, the Improving Seniors Access to 
Quality Benefits Act, will allow us to take a deeper look at how the 
Medicare Advantage benchmark cap is affecting people across the Nation. 
I have been working with Mr. Kind and other Members to address this 
inequity that affects seniors in high-quality plans across the country.
  The Medicare Advantage program was designed to give seniors a choice 
in their healthcare and utilize the private

[[Page H7116]]

sector to provide better care and benefits. Medicare Advantage plans 
receive a capitated payment rate to cover the patient's total cost of 
care. In order to encourage quality, seniors enrolled in high-quality 
plans receive a quality bonus payment that goes directly to seniors in 
the form of reduced cost sharing or extra benefits.
  The Medicare Advantage program is very popular and has been working 
well for many years. In my district in western Pennsylvania, more than 
half of Medicare beneficiaries choose Medicare Advantage. Nationwide, 
Medicare Advantage enrollment has grown to 30 percent of Medicare 
beneficiaries. That number is even higher with 48 percent of the 
Hispanic and 38 percent of African American Medicare beneficiaries 
choosing Medicare Advantage.
  Unfortunately, the Affordable Care Act implemented a cap on payments 
to Medicare Advantage plans. This misguided benchmark cap policy has 
penalized approximately 5.8 million American seniors being denied 
important benefits like care coordination, vision, dental, and wellness 
programs.
  This issue has cost seniors in my district and across the country 
millions of dollars in benefits that they are entitled to. We talk 
often about paying for value in the Medicare program, and this policy 
undermines that goal.
  The benchmark cap is clearly a problem, and we need more information 
on it. The Improving Seniors Access to Quality Benefits Act requires 
the Secretary of HHS to analyze and report to Congress on the impact of 
including quality bonus payments in the Medicare Advantage benchmark 
cap. It also establishes a sense of Congress that this issue undermines 
the goal of delivering high-quality care in the Medicare program.
  It is my understanding that the Department of Health and Human 
Services has limited secretarial authority to make this change on its 
own. I hope to work together with the Secretary on policies such as 
this to encourage high-quality plans for seniors.
  Mr. Speaker, this legislation has broad support from many 
stakeholders, including America's Health Insurance Plans, the Better 
Medicare Alliance, the Healthcare Leadership Council, Meals on Wheels 
America, the National Minority Quality Forum, the Alliance of Community 
Health Plans, and many others.
  Mr. Speaker, I urge the adoption of this legislation, and I reserve 
the balance of my time.

                                      Committee on Ways and Means,


                                     House of Representatives,

                                    Washington, DC, July 13, 2018.
     Hon. Greg Walden,
     Chairman, Committee on Energy and Commerce,
     Washington, DC.
       Dear Chairman Walden: I write to you regarding H.R. 4952, 
     the ``Improving Seniors Access to Quality Benefits Act'' the 
     Committee on Ways and Means ordered favorably reported that 
     was also referred to the Committee on Energy and Commerce.
       I ask that the Committee on Energy and Commerce waive 
     formal consideration of the bill so that it may proceed 
     expeditiously to the House Floor.
       I acknowledge that by waiving formal consideration of the 
     bill, the Committee on Energy and Commerce is in no way 
     waiving its jurisdiction over the subject matter contained in 
     those provisions of the bills that fall within your Rule X 
     jurisdiction. I would support your effort to seek appointment 
     of an appropriate number of conferees on any House-Senate 
     conference involving this legislation.
       I will include a copy of our letters in the Congressional 
     Record during consideration of this legislation on the House 
     floor.
           Sincerely,
                                                      Kevin Brady,
     Chairman.
                                  ____

         House of Representatives, Committee on Energy and 
           Commerce,
                                    Washington, DC, July 16, 2018.
     Hon. Kevin Brady,
     Chairman, Committee on Ways and Means,
     Washington, DC.
       Dear Chairman Brady: Thank you for your letters regarding 
     H.R. 4952, the ``Improving Seniors Access to Quality Benefits 
     Act,'' H.R. 6138, the ``Ambulatory Surgical Center (ACS) 
     Payment Transparency Act of 2018,'' and H.R. 6311, the ``To 
     amend the Internal Revenue Code of 1986 and the Patient 
     Protection and Affordable Care Act to modify the definition 
     of qualified health plan for purposes of the health insurance 
     premium tax credit and to allow individuals purchasing health 
     insurance in the individual market to purchase a lower 
     premium copper plan.''
       The Committee on Energy and Commerce will forgo 
     consideration of both bills so that they may proceed 
     expeditiously to the House Floor.
       I appreciate your assurance that by forgoing action on 
     these bills, the Committee is in no way waiving its 
     jurisdiction over the subject matter contained in the bills. 
     I also appreciate your offer of support for the appointment 
     of conferees from the Committee to any House-Senate 
     conference involving this legislation.
           Sincerely,
                                                      Greg Walden,
                                                         Chairman.

  Mr. NEAL. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to urge my colleagues to support H.R. 4952, 
the Improving Seniors Access to Quality Benefits Act.
  More than 19 million Medicare beneficiaries were enrolled in Medicare 
Advantage plans in 2017--that is almost one-third of all Medicare 
beneficiaries--and that number is growing every year. This bill would 
require the Department of Health and Human Services to conduct a study 
and submit a report to Congress on the effect of including quality 
bonus payments in the benchmark cap.
  The Centers for Medicare and Medicaid Services, or CMS, believes the 
benchmark payments made to Medicare Advantage plans include the bonuses 
Medicare Advantage plans may earn from delivering care that meets 
certain basic quality standards. On the other hand, plans argue that 
these quality bonuses should not be included in the benchmark cap. The 
Medicare Payment Advisory Commission has recommended, among other 
things, that this interaction be investigated.
  This bill, by requiring a study of the issue, will help Congress come 
to a conclusion on possible solutions.
  In closing, I thank the sponsors for their hard work. I urge my 
colleagues on both sides of the aisle to support H.R. 4952, and I yield 
back the balance of my time.
  Mr. KELLY of Pennsylvania. Mr. Speaker, I yield myself the balance of 
my time.
  Mr. Speaker, it is estimated that the ACA's benchmark cap negatively 
impacts more than 40 percent of counties across our country. The 
Improving Seniors Access to Quality Benefits Act will require the 
Secretary to fully evaluate the impact of including quality bonus 
payments under the benchmark cap on our seniors residing in these 
counties.
  This bill was brought through the committee process in a bipartisan 
fashion. Now on the floor, I strongly recommend my colleagues on both 
sides of the aisle to vote in favor of H.R. 4952 to ensure seniors are 
not missing out on additional healthcare benefits or reduced cost 
sharing as a result of the ACA's benchmark cap.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Pennsylvania (Mr. Kelly) that the House suspend the 
rules and pass the bill, H.R. 4952, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________