[Congressional Record (Bound Edition), Volume 148 (2002), Part 10]
[Senate]
[Pages 13600-13601]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   21ST CENTURY MEDICARE ACT OF 2002

  Mr. ENZI. Mr. President, since I still have time remaining under 
morning business, I will comment on another issue that I am sure will 
be commented on throughout the day and later next week. Later this 
morning I will be at a conference meeting on the accounting reform 
bill. I have had a considerable role in that process and will be doing 
that when we get to the actual debate on this bill. I see that as a top 
priority as well.
  Today I rise in support of the tripartisan 21st Century Medicare Act, 
which was introduced on July 15 by Senators Grassley, Snowe, Jeffords, 
Breaux, and Hatch. This bill is a giant step forward for seniors in 
this country and it demonstrates a sincere commitment to future 
beneficiaries, by taking steps to preserve, improve, and modernize the 
Medicare Program. No other proposal before the Senate can deliver on 
such a promise.
  Some of them have not been introduced yet. In fact, we have been a 
little disappointed that bills have not been introduced so that a more 
direct discussion can be done on that.
  I should say, not only no other proposal is before the Senate, no 
other proposal that is being talked about out there can deliver on the 
promise that this bill does.
  This bill very likely has the support of the majority of the Senate. 
Of course, we would need a supermajority, or support of 60 Members, to 
adopt the bill. It raises a very important and interesting question. It 
is a budget question, because the score of the tripartisan bill exceeds 
by $70 billion the $300 billion Congress reserved last year for 
Medicare; there is a budget point of order that can be raised against 
the bill.
  Essentially, if a Senator votes against removing or bypassing the 
budget point of order, they will be saying this bill costs taxpayers 
too much, so I will not support it. But what is really interesting is 
that many of those who oppose this bill are actually supporting a 
proposal that is significantly more costly to the taxpayers. So I 
suggest people take a look to see who votes against this bill on the 
basis it exceeds the amount of money we have set aside by $70 billion 
and then perhaps votes for a bill that is $700 billion, $800 billion, 
$900 billion--or a trillion dollars--perhaps twice or three times the 
cost of this bill.
  My point is a number of my colleagues could find themselves in the 
position of voting against one bill because it costs too much only to 
turn around and support a competing bill that is two or three times 
more costly.
  Beyond cost to taxpayers, there are other important policy 
differences between the two Medicare drug benefit proposals. I believe 
the most important is that the tripartisan bill stretches Federal 
dollars further than any other proposal and provides a permanent, 
comprehensive drug benefit that's affordable for seniors and taxpayers. 
This is a critical achievement.
  And, the bill does even more. It provides seniors with the option of 
an expanded fee-for-service plan, including drug coverage, that will 
serve as the first modernization of the scope of benefits under 
Medicare since the program was created almost 40 years ago.
  Lastly, while Medicare managed care plans--known as Medicare Plus 
Choice plans--are not serving Wyoming, millions of seniors across the 
country made the ``choice'' to enroll in those plans, and this bill 
makes long overdue improvements to how those plans compete for seniors' 
business. My colleagues from more populous and urban states undoubtedly 
know that seniors who have Medicare Plus Choice plans as an option now 
want to keep that option and want to see it expanded and improved.
  All of this sounds like a lot. And it is. But I won't stand here and 
tell my

[[Page 13601]]

constituents in Wyoming that this is everything they might dream of in 
a prescription drug benefit. It is a giant step forward and it will 
absolutely reduce the drug costs seniors bear today. It won't make 
those costs disappear, but it will dramatically reduce them. And, it's 
a benefit we can afford to enact for seniors today and keep our promise 
to implement it in 2005. The proponents of the Daschle bill are also 
making seniors promises about a great new drug benefit. Except we can't 
afford it, so it's a hollow promise.
  The opponents of the tripartisan bill will say that our bill doesn't 
provide a real benefit to seniors. Well, here's the skinny on our bill 
and what it will save seniors in out-of-pocket costs. The Congressional 
Budget Office (CBO) determined that Medicare beneficiaries will spend 
an average of $3,059 per year on drugs in 2005. If enacted, this bill 
would cut those costs by 53%--a savings of over $1600. That is real 
money. CBO also determined that the bill would cut costs for lower-
income beneficiaries at or below 135% of poverty by 98%, a savings of 
$2,988! The estimated out-of-pocket cost per prescription among the 50 
most-prescribed medications would be $21. And, every beneficiary would 
have at least 2 drug plans to choose from when selecting the plan that 
best fits their health care needs.
  The Democrat bill, on the other hand, has a statutorily prescribed 
cost sharing for all drugs that the government decides to include in 
the plan, and every senior must participate in that one-size-fits-all 
plan. That's a concerning and very significant difference from the 
tripartisan bill. All of us in this body have numerous choices of 
health plans both at and above the standard benefit package under the 
Federal Employees Health Benefit Program. I do not believe seniors 
should be--by law--without a choice in their own health coverage. 
Unlike the tripartisan bill, the Daschle bill completely misses the 
opportunity to improve Medicare through expanded choices for seniors 
when selecting the right drug coverage.
  To restate another distinction I raised earlier, the tripartisan bill 
has been officially scored by the CBO to cost $370 billion over 10 
years. The sponsors of the Daschle bill have not provided us with an 
official score, but the unofficial scores are as high as $1 trillion 
over 10 years. More importantly, the drug benefit is not permanent 
under the Daschle bill. It would sunset in the year 2010. That is to 
hold costs down as much as possible. There are rumors of a 4th 
iteration of the bill that would not sunset the benefit, but that bill 
has not been introduced and will be much more costly.
  Since I'm talking about the cost of the Daschle bill to taxpayers, I 
would be remiss if I did not talk about the cost of the bill to seniors 
themselves. Because the bill would cement in Federal law fixed co-
payment amounts for all drugs, seniors will actually pay more for 
certain drugs than they would if the bill allowed drug plans to offer 
lower co-payments. The CBO analysis and score of the tripartisan bill 
proves that it employs this logic and essentially proved that drugs 
will be provided in a more cost-effective way under the tripartisan 
model.
  I have mentioned it before, but I just want to say again that, in 
addition to the very high profile issue of needing to provide a drug 
benefit, Medicare has many other shortcomings. It is crying out for 
updating and improvements. No one in this chamber can possibly be 
satisfied with the program's status quo. Every day--literally--I either 
meet with or hear from my constituents who interact with the Medicare 
program or beneficiaries. They are all complaining, and rightly so. The 
program was created with the best of intentions. But since that day 
some 40 years ago, the rest of the health care world has evolved and 
improved, from standards of care to technology to disease management. 
Not to mention how providers are reimbursed and empowered in the 
delivery of health care services. I question whether any of this 
progress has penetrated the morass of the Medicare program. In fact, 
all I seem to hear from my constituents is that things are pretty bad 
with Medicare right now. That is before the new program is started.
  I am astonished that only one of the two major bills--the tripartisan 
bill--tries to address the other problems with Medicare. The foundation 
of the program desperately needs reinforcement; simply building on its 
weak foundation the way the Daschle bill does is dangerous and falls 
short of our obligation to do our best for seniors where all of their 
health care is concerned. Where the tripartisan bill has an enhanced 
fee-for-service option and improvements to the existing Medicare Plus 
Choice option, the Daschle bill is eerily silent. Such an absence of 
reform will only cost seniors more money in patch jobs down the road.
  I guess I have come full circle. This debate is all about giving 
seniors additional coverage options and saving them money. Many seniors 
currently lack drug coverage. All of the bills will give them coverage 
and cost them less out-of-pocket than what they pay right now. But only 
the tripartisan bill will give them flexibility in their coverage 
choices and buy them and taxpayers the most that a dollar will buy. 
That takes competition and modernization. The tripartisan bill has 
both. The Daschle bill prohibits competition in its statutory language 
and does not entertain even modest improvements to the rest of the 
Medicare program.
  The choice is clear to me and, I imagine, will be crystal clear to 
the American people. For that reason, Mr. President, I would ask 
unanimous consent that I be added as a cosponsor of the 21st Century 
Medicare Act.
  The PRESIDING OFFICER (Mr. Corzine). Without objection, it is so 
ordered.
  Mr. ENZI. Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant bill clerk proceeded to call the roll.
  Mr. ALLARD. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Colorado is recognized.
  Mr. ALLARD. Mr. President, I ask unanimous consent that I be allowed 
to speak for 20 minutes in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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