[Congressional Record (Bound Edition), Volume 146 (2000), Part 14]
[Senate]
[Pages 19586-19587]
[From the U.S. Government Publishing Office, www.gpo.gov]



                THE MEDICARE PRESCRIPTION DRUG PROPOSAL

  Mr. HARKIN. Mr. President, it is time to shed some light on the 
Medicare prescription drug proposal advanced by some of my colleagues 
on the other side of the aisle and by their nominee for President, Gov. 
George Bush.
  Unfortunately, there is a big TV ad campaign being waged across the 
country to deceive and frighten seniors about the Medicare prescription 
drug benefit proposed by Vice President Al Gore and the Democrats in 
the Senate. So I want to set the facts straight.
  First, let's examine Bush's ``immediate helping hand.'' That is what 
Governor Bush calls his Medicare proposal. Quite simply, it is not 
immediate and it doesn't give much help. Will it be immediate? The 
answer is no. His plan for Medicare would require all 50 States to pass 
enabling or modifying legislation. Right now, only 16 States have any 
kind of drug benefit for seniors. Each State will have a different 
approach. Many State legislatures only meet once every 2 years. So for 
Bush's plan to go into effect, the State has to pass some kind of 
enabling legislation.
  Well, our most recent experience with something like this was the 
CHIP program, the State Children's Health Insurance Program, which 
Congress passed in 1997. It took Governor Bush's home State of Texas 
over 2 years to implement the CHIP program.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. HARKIN. I ask unanimous consent to continue for 10 additional 
minutes.
  The PRESIDING OFFICER. Is there objection?
  Mr. THOMAS. I object. We have a time agreement and I think we ought 
to stick with it.
  The PRESIDING OFFICER. Objection is heard.
  Mr. HARKIN. Parliamentary inquiry. What is the time allotment for the 
remainder of morning business?
  The PRESIDING OFFICER. Senator Robb is to be recognized for 5 
minutes, Senator Leahy has 15 minutes, and Senator Thomas has 10 
minutes.
  Mr. HARKIN. Repeat that, please.
  The PRESIDING OFFICER. Senator Thomas has 10 minutes, Senator Robb 
has 5, and Senator Leahy has 15.
  Mr. HARKIN. Mr. President, who is next in order to be recognized?
  The PRESIDING OFFICER. There is nobody.
  Mr. THOMAS. If the time has been divided on both sides and if the 
Senator wants to use some of his associate's time, I have no objection.
  Mr. HARKIN. I will check on that.
  I ask unanimous consent that I may take Senator Robb's 5 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. HARKIN. Mr. President, as I said, most State legislatures meet 
every 2 years. Governor Bush's own State didn't even implement the CHIP 
program for over 2 years. In addition, the States don't even want this 
block grant. In February of this year, the Governors rejected Bush's 
proposal. They said:

       If Congress decides to expand prescription drug coverage 
     for seniors, it should not shift that responsibility or its 
     costs to the States.

  That was the National Governors' Association. Republicans and 
Democrats

[[Page 19587]]

said Bush's proposal won't work. So that won't be immediate. Bush's 
proposal takes years to get any effect for people.
  Will it give a helping hand? Well, Bush's plan only covers low-income 
seniors. Middle-class seniors are told they don't need to apply. That 
is what Bush's plan is. It only helps low-income. For example, if you 
are a senior and your income is over $14,600 a year, you get zero, zip, 
no help at all, from Bush's Medicare proposal.
  A recent analysis shows that the Bush plan would only cover 625,000 
seniors, or less than 5 percent of those who need help. So his plan is 
not adequate and it is not Medicare. Seniors want Medicare, not 
welfare.
  The other thing is that under the Bush proposal for Federal care, for 
his prescription drug program, seniors would probably have to go to the 
State welfare office to apply for it. Why is that? Because there is an 
income cutoff. The agencies in the States that are set up to determine 
whether or not you meet income guidelines for programs are welfare 
agencies. So that means that under the Bush program, every senior, to 
get prescription drugs, has to go down to the welfare agency and show 
that they don't make over $14,600 a year. That is the first 4 years. 
Bush's program is for 4 years. States have not acted. As I pointed out, 
some State legislatures don't even meet except once every 2 years.
  They have to go down to the welfare office. It only helps those below 
$14,000 a year.
  Then what happens after 4 years? After 4 years, Governor Bush's plan 
becomes even worse because his long-term plan, after 4 years, involves 
privatizing Medicare. It would raise premiums and force seniors to join 
HMOs.
  The Bush plan is the fulfillment of what Newt Gingrich once said when 
he wanted Medicare to ``wither on the vine.'' Bush's plan after 4 years 
will begin withering Medicare on the vine because after 4 years, 
Governor Bush's program leaves seniors who need drug coverage at the 
mercy of HMOs.
  Under his plan, they don't get a guaranteed benefit package. The 
premium would be chosen by the HMOs, and the copayment would be chosen 
by the HMO. The deductible would be chosen by the HMO. The drug you 
get, again, is chosen by the HMO--not by your doctor, and not by your 
pharmacist, but by the HMO.
  Even worse, the Bush plan would leave rural Americans in the cold. 
About 30 percent of seniors live in areas with no HMOs. In Iowa, we 
have no Medicare HMOs. There are only eight seniors in the entire State 
of Iowa who happen to live near Sioux Falls, SD, who belong to a plan 
with a prescription drug benefit--eight out of the entire State of 
Iowa.
  HMOs are dropping like flies out of rural areas. Almost 1 million 
Medicare beneficiaries lost their HMO coverage just this year.
  Under the Bush plan, first of all, it is not immediate. States would 
have to enact these plans. The Governors say they don't even want to do 
it.
  Under the Bush plan, Medicare would ``wither on the vine.'' Premiums 
for regular Medicare would increase 25 percent to 47 percent in the 
first year alone, and seniors would be forced to join HMOs to receive 
affordable benefits.
  Mrs. BOXER. Mr. President, will my friend yield for a question?
  Mr. HARKIN. Certainly, I will yield for a question.
  Mrs. BOXER. It is just a very brief question. I thank my friend. I 
think that is the clearest explanation I have ever heard of the Bush 
plan. It is very clear.
  Something that I read yesterday reminded me of the days when Newt 
Gingrich was in control, and as the Senator well remembers, in 1995 it 
led to a Government shutdown. They wanted to cut $207 billion out of 
Medicare over 10 years. And we said that is the end of Medicare. It 
turns out that Governor Bush in those years said that Gingrich and the 
Republicans were courageous to do this, and he lauded it. I think if 
you take that statement and mesh it with what the Senator from Iowa 
just taught us about his plan, it all adds up now. It is the end of 
Medicare.
  Mr. HARKIN. Here is basically the thing.
  Mrs. BOXER. Mr. President, I ask that my friend get an additional 2 
minutes.
  Mr. THOMAS. I object.
  The PRESIDING OFFICER. Objection is heard. The Senator's time has 
expired.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. THOMAS. Mr. President, I want to again say that we have divided 
this time, and I expect to live within the divisions that we have 
agreed to and, therefore, we will try to do that.
  Mr. HARKIN. It works both ways.
  Mr. THOMAS. Certainly, it works both ways. We have divided the time, 
and that is the way it is.

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