[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.
____________________