[Congressional Record (Bound Edition), Volume 149 (2003), Part 11]
[House]
[Pages 15075-15076]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        DESTRUCTION OF MEDICARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from Texas (Ms. Jackson-Lee) is recognized for 5 minutes.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, the good news is that seniors 
are living longer. President Lyndon Baines Johnson, a Texan, signed the 
1965 legislation entitled Medicare, which opened the doors of life to 
seniors of America, the same senior citizens who prior to World War II 
were dying at very early ages; the same young men and women of the 
Greatest Generation who went into World War II and came home with no 
real hope that they would live their lives past 50. This 1965 
legislation gave hope to that generation and many generations 
thereafter.
  So I rise today, Mr. Speaker, somewhat troubled and certainly 
frightened by the proposition that this House and the Republican 
leadership would move to privatize a system that has worked. As we 
debated this today on the floor of the House, it is well known that the 
Committee on Ways and Means received 400 pages at 1 o'clock and began 
to mark up a proposed Medicare prescription drug benefit legislative 
initiative.
  For the years that I have been in Congress, year after year and term 
after term, I have met with my senior citizens in the 18th 
Congressional District, throughout that district, and promised them and 
agreed with them that they deserved a guaranteed Medicare prescription 
drug benefit from the United States Congress. I am sad to say that we 
have come now to a time where there may be a vigorous debate on this 
issue and our seniors will still be left out in the cold.
  The doughnut, Mr. Speaker, is growing larger and larger. This 
emerging gap in the proposal that is now being marked up by the 
Committee on Ways and Means and the Committee on Energy and Commerce 
does not answer the question of saving the lives of seniors or giving 
to them that long-held hope to have a guaranteed Medicare prescription 
drug benefit. In fact, it is a handout, not a hand up.
  If we look at this proposal of the majority of this House, it is a 
glaring and outstanding and shameful proposal where there is an 
enormous gap between the monies that these seniors will receive. If 
they spend up to $2,000, that is fine, Mr. Speaker. But after $2,000, 
they are left holding the bag, spending upwards of $5,000 on their 
prescription drug benefits, with no hope and no help. The promises we 
have made about a guaranteed Medicare prescription drug benefit, I 
think, have gone up in fumes and fire.
  Let me share with you, Mr. Speaker, what our good friends are 
proposing. Prescription drugs are the stalking hawk for the 
Republicans' boldest attempt to privatize Medicare yet. The Republican 
plan converts the Medicare program to a premium support or voucher 
system where the government only pays a percentage of the cost of the 
premium. Can you imagine, Mr. Speaker, we have survived 38 years, 2 
more years until the 40th anniversary of Medicare. It is not expected 
to go insolvent for another 3 or 4 decades, and yet we are beginning to 
privatize this system where seniors will not have the helping hand that 
they need.
  Hard-working seniors have invested into this economy, paid taxes, Mr. 
Speaker, and provided the underpinnings of our economy. Many seniors 
will have to pay more if they want to stay in the same Medicare they 
have today. Rising fee-for-service premiums will drive all but the 
sickest to the private plans, resulting in programs becoming 
unaffordable for all but the wealthy. It ends our Medicare entitlement, 
the plan begun under President Johnson in 1965. Under this program, 
beneficiaries no longer will be entitled to the benefits as they are 
today.
  I emphasize that this privatizing of Medicare does not provide a 
guaranteed Medicare prescription drug benefit, which we all know is 
needed in this Nation; with no guarantee of what seniors will get; and 
the private insurance plans, not seniors' doctors, determining what 
drugs they can get.
  I am very pleased to have heard my bipartisan colleagues on the floor 
of the House today mention how expensive and devastating it is to pay 
for prescription drugs. I want to work with my pharmaceuticals. I 
believe they could work with us on a guaranteed Medicare prescription 
drug benefit. But in the instance of this private insurance plan, it 
will be those pharmaceutical benefit officers that will be able to tell 
you what you can afford and what you cannot, no guarantee of how much 
seniors will have to pay.
  Private insurance plans set their own premiums. The $35 premium is 
not a guarantee, just a suggestion. And you know what, it will go up 
and up and up. In this instance, as the song says, the stairway to 
heaven, it certainly will not be. It will certainly be a downward trend 
to devastation and higher costs for our seniors, with a wide variance 
in costs to seniors across the country. Private insurance plans also 
determine seniors' deductibles and cost-sharing.
  Mr. Speaker, just a few years ago I sat in rooms filled with seniors 
who were crying because they had closed the six HMOs treating seniors 
in Harris County. No room at the inn. No HMOs to provide for my 
seniors. Why did they leave? They left, Mr. Speaker, because it was not 
profitable.
  Mr. Speaker, as I close, let me simply say the Medicare gap in the 
Republican Medicare prescription drug proposal is outrageous. You are 
going to burden our senior citizens with this gaping hole of $3,000 and 
upwards with that plan.
  Medicare is alive and well, 38 years, just 2 more years before its 
40th birthday. Let us pass a real Medicare guarantee drug benefit for 
our seniors and give to them the tribute that they deserve.
  Mr. Speaker, we Democrats have been fighting for years for a Medicare 
prescription drug program that is (1) affordable; (2) available to all 
seniors and Medicare beneficiaries with disabilities; (3) offers 
meaningful benefits; and (4) is available in the Medicare program--the 
tried and true program that seniors trust.
  And now it seems that we have the political momentum to make a good 
prescription drug benefit a reality. The President says he wants it. 
Both parties, both sides of Capitol--everyone has declared their 
commitment to getting affordable prescription drugs to our nation. So 
why is it that the only Medicare prescription drug ``plan'' the 
Republicans have to offer is a terrible bill full of holes, and gifts 
to the HMOs, and protections for pharmaceuticals companies. Every time 
we get a chance to take a closer look at the Republican drug scheme, it 
becomes more obvious that it is just another piece of the Republican 
machine that is trying to dismantle Medicare and turn our federal 
commitment to our nation's seniors, over to HMOs and the private 
insurance industry.
  The Republican plan would be run by HMOs, not Medicare. HMOs would 
design the new prescription drug plans, decide what to charge, and even 
decide which drugs seniors would get. Plus, HMOs would only have to 
promise to stay in the program for one year. That means that seniors 
might have to change plans, change doctors, change pharmacies, and even 
change the drugs they take every twelve months. Medicare expert Marilyn 
Moon told the Senate Finance Committee on Friday that ``There will be a 
lot of confused and angry consumers in line at their local pharmacies 
in the fall,'' if the Republican approach is not changed. She's right.
  The Republican plan provides poor benefits, and has a giant GAP in 
coverage. Under the House Republican plan, many seniors would be 
required to pay high premiums even when they don't receive benefits. 
Reportedly, under the House GOP plan, Medicare beneficiaries have a 
high $250 deductible. After they reach that deductible, they would then 
be required to pay a portion of their first $2,000 in drugs

[[Page 15076]]

costs--that is a fairly normal system. But, after a senior's costs hit 
$2,000 for a year--that is when it becomes obvious just how bad this 
plan is. Once a senior's drug costs hit $2,000, the Republican plan 
cuts them off. Even though they must continue to pay premiums, they get 
no assistance in paying their drug costs at all until their costs reach 
$5,100. Let me say that again. It seems so crazy, it is almost 
unbelievable. The sickest of our seniors, the ones on the most 
medications--once their costs reach the $2,000 mark--they fall into the 
Republican gap. They are left to pay the next $3,000 out of their own 
pockets, while continuing to pay premiums. Almost half of seniors would 
be affected by this gap in coverage. They will be outraged, and our 
offices will be hearing about it.
  I have attended hundreds of health care briefings, and have read 
everything I can get my hands on, on the subject of improving Medicare 
and getting good health insurance to the American people. And I have 
never heard anyone say that a hallmark of a smart health insurance 
program is to have a giant gap in coverage for those who need help the 
most. Why would our Republican colleagues put in this ditch in the road 
to health for seniors? Because they wasted all of our nation's hard 
earned money, on massive tax breaks for the rich, and an unnecessary 
war.
  So now they have placed an arbitrary budget cap on vital programs, 
pushed by President Bush, in order to compensate for the irresponsible 
Republican tax cut they jammed through this Congress and last Congress. 
The way they are dealing with the mess that they have made is by 
throwing bad policy after bad policy. To remain within their own 
arbitrary budget cap, they are pitching a bill that will provide a 
confusing, insubstantial benefit to the majority of seniors.
  If the Republicans wanted to save money, they could have put in a 
provision that I and many Democrats have pushed for--and that is to 
allow the Secretary of the HHS to negotiate with the pharmaceutical 
industry to get fairer prices for the American people. I believe that 
the American pharmaceuticals industry is the best in the world. They 
make good products that benefit the world. But Americans are now paying 
double the cost for drugs than their counterparts in other rich nations 
such as Germany, Canada, Great Britain, or Japan. I am glad our 
companies are making money. But as we enact a prescription drug benefit 
under Medicare, access to drugs will rise--and drug company profits 
will rise as well. It is only fair that the Secretary should have the 
power to negotiate a good price for American consumers, to make sure we 
get the best returns possible on our federal investment.
  Not only did the Republicans not put in a provision to allow such 
negotiations, they went out of their way to forbid the Secretary from 
trying to get better prices for Americans. Why, because they value the 
profits of their corporate sponsors at Pharma, more than they do the 
well-being of our nation's seniors.
  Similarly, the Republican plan's design wastes billions in kickbacks 
for HMOs--instead of using that money to bring down the premiums and 
out-of-pockets costs that seniors and the disabled are forced to pay.
  The Republican plan is not available to everyone on Medicare. First, 
the House Republican plan reportedly will introduce ``means-testing'' 
for Medicare benefits--by which seniors with higher incomes would have 
to pay considerably more out-of-pocket before they reached the 
catastrophic limit. Medicare is supposed to be for all seniors, it is 
not welfare, just for the poor. It should be protected as such. What's 
more, under the Senate Republican approach, low-income seniors and 
Americans with disabilities would receive nothing at all--the 17 
percent of Medicare beneficiaries who are also eligible for Medicaid 
are simply left out. This misguided policy endangers coverage for 
millions of seniors whose fluctuating incomes change their Medicaid 
eligibility from year to year.
  The Republican plan rolls the dice, gambling seniors' health. By 
relying on insurance companies to offer coverage instead of 
guaranteeing benefits in Medicare, the Republican approach runs the 
risk that no company will offer benefits to seniors in rural 
communities, where millions of Americans have already been abandoned by 
HMOs in search of bigger profits elsewhere. There are 9.2 million 
Medicare beneficiaries in rural areas nationwide. Eighty percent of 
these seniors have no access to any Medicare HMO. Only 13 percent of 
them have access to a Medicare HMO that offers a drug benefit. The bill 
we are getting glimpses of takes failed policy and expands it to 
critical areas.
  The Republican plan is a risky scheme only an HMO could love. The 
Bush Administration's Medicare Administrator has called traditional 
Medicare ``dumb'' and ``a disaster,'' highlighting Republicans' disdain 
for a program that Democrats have been fighting for since 1965. While 
Democrats have worked to modernize Medicare with prescription drugs, 
preventive care and other new benefits, Republicans are insisting on a 
riskier course even the Wall Street Journal calls a business and social 
``experiment.''
  The Republican plan destroys Employer Retiree coverage. The 
Congressional Budget Office has concluded that about one third of 
private employers will drop their retiree drug coverage under a 
proposal like the one being contemplated. In order to lower its costs, 
the House Republican plan stipulates that any dollar an employer pays 
for an employee's drug costs would not count towards the employee's 
$3,700 out-of-pocket catastrophic cap. This would therefore 
disadvantage seniors with employer retiree coverage because it would be 
almost impossible for them to ever reach the $3,700 catastrophic cap, 
over which Medicare would pay 100 percent of their drug costs. The 
practical effect of this is that employers will stop offering retiree 
coverage. That is a step in the wrong direction.
  We can do better. The House Democrats' legislation, that I am a proud 
cosponsor of, is designed to help seniors and people with disabilities, 
not HMOs and the pharmaceuticals industry. Under the Democratic 
proposal, the new Medicare prescription drug program would be 
affordable for seniors and Americans with disabilities and available to 
all no matter where they lived. It offers a meaningful benefit with a 
guaranteed low premium and would be available as a new ``Medicare Part 
D'' within the traditional Medicare program that seniors know and 
trust.
  I am committed to getting seniors the prescription medications that 
their doctors deem they need. I want to work with our Colleagues on the 
other side of the aisle, and the Administration to make that happen. 
But unless I see a plan without a gap--with a consistent benefit--with 
some smart cost-controls--and some protections for Medicare, an 
excellent program for Americans, I cannot support this Republican drug 
scheme.
  Let's do better.

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