[Congressional Record (Bound Edition), Volume 148 (2002), Part 9]
[Extensions of Remarks]
[Pages 12021-12022]
[From the U.S. Government Publishing Office, www.gpo.gov]




             THE MEDICARE RX DRUG BENEFIT AND DISCOUNT ACT

                                 ______
                                 

                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                        Wednesday, June 26, 2002

  Mr. RANGEL. Mr. Speaker, today, I am proud to introduce the Medicare 
Rx Drug Benefit and Discount Act with John Dingell, the Dean of the 
House and Ranking Member of the Energy and Commerce Committee. Our 
Ranking Member on the Ways and Means Health Subcommittee, Pete Stark, 
has had a leadership role in the development of this legislation, as 
have so many other health care leaders in our caucus.
  This legislation makes good on our promise to add affordable, 
comprehensive prescription drug coverage to Medicare.
  The Democratic bill will look, smell, taste, and feel like any other 
Medicare benefit, because it is a Medicare benefit. Beneficiaries will 
not have to deal with an HMO or other private insurer.
  Under this legislation, every beneficiary will be guaranteed a $25 
monthly premium, $100 annual deductible, 20% co-insurance and $2000 
out-of-pocket limit, no matter where they live.
  We provide additional assistance for low-income beneficiaries. Those 
with incomes up to 150% of the poverty level ($13,290 for one person) 
will pay nothing. Those with incomes between 150-175% ($13,290-$15,505 
for a single person) of poverty will pay premiums on a sliding scale.
  The Medicare Rx Drug Benefit and Discount Act would: Lower 
prescription drug costs for all Americans, regardless of whether they 
participate in our plan; give all Medicare beneficiaries the option of 
a reasonably-priced guaranteed prescription benefit under Medicare; and 
ensure that senior citizens and people with disabilities receive 
coverage for the drug their doctor prescribes and not some substitute 
that an insurance company deems ``equivalent.''
  Unlike the competing Republican legislation, our plan would never 
force seniors into an HMO or similar private plan in order to get a 
prescription drug benefit.
  Republicans claim they are giving seniors a ``Medicare'' prescription 
drug benefit, but their legislation really provides subsidies to 
insurance plans and HMOs, not to beneficiaries. Republicans claim they 
are offering beneficiaries a certain level of coverage, but their 
legislation really leaves virtually all of the important decisions to 
the private insurance companies.
  Under the GOP plan, private insurers will decide which drugs are 
covered and which are not. If your drug is not on the list, too bad. 
Millions of seniors will not be able to afford their prescriptions 
under the GOP plan. Under the GOP plan, private insurers can pick and 
choose which pharmacies to include in their networks. If your 
neighborhood pharmacy is not on the preferred list, you are out of 
luck.
  The bottom line is that those who can buy insurance under the GOP 
plan may find their choice of pharmacies severely limited or that they 
cannot get coverage for the drugs prescribed by their doctor.
  Many HMOs have unfairly limited health care in the past. That's what 
the Patients' Bill of Rights debate has been about. They've been 
unreliable partners in Medicare to date; just look at the problems in 
the Medicare+Choice program. And now the Republicans want to put them 
in charge of this medication benefit under their ``privatization'' 
model.
  Republican leaders have never liked Medicare. Former Speaker Gingrich 
once said Medicare would ``wither on the vine because we think people 
are voluntarily going to leave it.'' In 1995, Dick Armey called 
Medicare: ``a program I would have no part of in a free world.''
  Their legislation--the so-called Medicare Modernization and 
Prescription Drug Act--lays the ground work for them to make good on 
their desire to do away with the program. The Republican prescription 
drug plan is the first step towards privatizing Medicare.
  It forces seniors to deal with private insurance companies instead of 
having the choice of getting prescriptions through Medicare. It 
includes a premium support demonstration program that could 
significantly raise the premiums of beneficiaries who wish to stay in 
traditional fee-for-service Medicare. And it creates a new agency to 
oversee the private plans that lacks authority to provide adequate 
oversight and disadvantages the agency currently responsible for 
administering Medicare.
  In contrast, we base our plan--not on a flawed privatization model--
but on the successful Medicare program. We offer a genuine Medicare 
plan, providing an affordable voluntary drug coverage to all American 
seniors through Medicare.
  Under this legislation, no senior will ever have to choose between 
putting food on the table or paying the rent and the drugs they need.
  This legislation also helps reduce the sky-rocketing costs that 
seniors and other beneficiaries currently pay for prescription drugs by 
utilizing the collective bargaining power of Medicare's 40 million 
beneficiaries to guarantee lower drug prices. By closing some loopholes 
in current law that prevent or delay generic drugs from coming to 
market, this legislation also reduces drug prices for all Americans.

[[Page 12022]]

  While our colleagues on the other side of the aisle are engaged in a 
cynical political exercise designed to bring themselves political 
cover, ours is serious legislation. It would bring senior citizens 
Medicare prescription drug coverage.
  When President Harry Truman first proposed Medicare in his second 
term, a wide array of Republican forces were against him saying he 
could not do it. Truman said: ``We may not make it [now], but someday 
we will.'' Eventually, Truman and other Medicare advocates succeeded. 
Harry and Bess Truman became the first Medicare enrollees in 1965.
  The Republican leadership may prevent us from passing a true Medicare 
prescription drug benefit now, but they cannot stop us in the long run 
because that is what seniors and all Americans have said they really 
want.
  As Pete Stark points out, prescription drug coverage is as essential 
to seniors'good health in the 21st century as coverage of doctor visits 
and hospital stays was in the 20th century.
  We have also included in this bill provider payment reforms and 
increases that match or, in some important areas, exceed those in the 
Republican-crafted Medicare Modernization and Prescription Drug Act.
  If you want to see the real difference between Democrats and 
Republicans, look at prescription drug coverage. While Republicans 
protect the pharmaceutical industries' profits, the Democrats protect 
seniors from skyrocketing prescription drug costs. I urge my colleagues 
to look at the fine print, and to vote for this legislation when the 
opportunity arises.

                          ____________________