[Congressional Record (Bound Edition), Volume 150 (2004), Part 18]
[House]
[Pages 24339-24341]
[From the U.S. Government Publishing Office, www.gpo.gov]




EXTENSION OF MEDICARE COST-SHARING FOR THE MEDICARE PART B PREMIUM FOR 
             QUALIFYING INDIVIDUALS THROUGH SEPTEMBER 2005

  Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and 
pass the Senate bill (S. 2618) to amend title XIX of the Social 
Security Act to extend medicare cost-sharing for the medicare part B 
premium for qualifying individuals through September 2005.
  The Clerk read as follows:

                                S. 2618

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. EXTENSION OF MEDICARE COST-SHARING FOR THE 
                   MEDICARE PART B PREMIUM FOR QUALIFYING 
                   INDIVIDUALS.

       (a) In General.--Section 1902(a)(10)(E)(iv) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by 
     striking ``2004'' and inserting ``2005''.
       (b) Total Amount Available for Allocation.--Section 1933(g) 
     of the Social Security Act (42 U.S.C. 1396u-3(g)) is amended 
     to read as follows:
       ``(g) Special Rules.--
       ``(1) In general.--With respect to each period described in 
     paragraph (2), a State shall select qualifying individuals, 
     subject to paragraph (3), and provide such individuals with 
     assistance, in accordance with the provisions of this section 
     as in effect with respect to calendar year 2003, except that 
     for such purpose--
       ``(A) references in the preceding subsections of this 
     section to a year, whether fiscal or calendar, shall be 
     deemed to be references to such period; and
       ``(B) the total allocation amount under subsection (c) for 
     such period shall be the amount described in paragraph (2) 
     for that period.
       ``(2) Periods and total allocation amounts described.--For 
     purposes of this subsection--
       ``(A) for the period that begins on January 1, 2004, and 
     ends on September 30, 2004, the total allocation amount is 
     $300,000,000;
       ``(B) for the period that begins on October 1, 2004, and 
     ends on December 31, 2004, the total allocation amount is 
     $100,000,000; and
       ``(C) for the period that begins on January 1, 2005, and 
     ends on September 30, 2005, the total allocation amount is 
     $300,000,000.
       ``(3) Rules for periods that begin after january 1.--For 
     any specific period described

[[Page 24340]]

     in subparagraph (B) of paragraph (2), the following applies:
       ``(A) The specific period shall be treated as a 
     continuation of the immediately preceding period in that 
     calendar year for purposes of applying subsection (b)(2) and 
     qualifying individuals who received assistance in the last 
     month of such immediately preceding period shall be deemed to 
     be selected for the specific period (without the need to 
     complete an application for assistance for such period).
       ``(B) The limit to be applied under subsection (b)(3) for 
     the specific period shall be the same as the limit applied 
     under such subsection for the immediately preceding period.
       ``(C) The ratio to be applied under subsection (c)(2) for 
     the specific period shall be the same as the ratio applied 
     under such subsection for the immediately preceding 
     period.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Barton) and the gentleman from Massachusetts (Mr. Olver) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Barton).


                             General Leave

  Mr. BARTON of Texas. 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 this legislation.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I want to, first of all, commend the gentleman from 
Michigan (Mr. Dingell) and the gentleman from Ohio (Mr. Brown) for 
helping to expedite this piece of legislation. They could not be on the 
floor, so we have the distinguished gentleman from Massachusetts who is 
going to control their floor time, and I want to thank him for his 
help.
  I am reluctantly doing this this evening, not because of the merits 
of the bill. I support the merits of the bill, but I do not support the 
procedure under which we are doing this and the reluctance of the other 
body to find a way to help pay for what we are about to do.

                              {time}  1930

  This Congress should be taking serious steps to address our budget 
problems and our growing Federal debt. The President who just won 
reelection, 52 percent of the vote, has told America that deficit 
reduction will be one of his highest priorities, and I would like to 
have the other body begin to join this body and the President of the 
United States in making that a reality.
  Senate 2618 is a good bill. It will extend for one year additional 
funding for the Medicare Qualified Individual Program, better known as 
the QI program. This program will allow approximately 160,000 low-
income beneficiaries enrolled in the program to continue to receive 
assistance to pay for their Medicare part B premium which is optional. 
That is fair and appropriate.
  We began to help subsidize those premium payments back in 1997, so we 
have been doing it now for the last 7 years. I support that. I think it 
is appropriate to help our low-income seniors help pay for their 
Medicare option part B coverage, but I also think we ought to have a 
way to help pay for that subsidy. This bill does not do that.
  I think we need to begin to address the problem of mandatory 
automatic entitlement growth, and to extend a program like this where 
we could have an offset to pay for it, in my opinion, is inexcusable.
  It has been said that nobody notices a deficit until its weight 
finally collapses the government. I do not intend to ever let that 
happen, and we could be taking a small step to lessen that load today. 
Regrettably we are not.
  Let me state what we have done in the last 2 weeks. Again, the 
underlying bill that we are passing is a good piece of legislation, and 
I support that. The Speaker of the House supports it. The majority 
leader supports it. The ranking member on the Committee on Energy and 
Commerce, the ranking member on the subcommittee, the subcommittee 
chairman, the full committee chairman, we all support it; but we found 
a way to pay for this bill. We found out that under existing law people 
that receive prescription drug benefits that are paid for by Medicare, 
the person that actually provides a prescription can file paperwork to 
get an automatic rebate from the drug manufacturer. It is in the law. 
We do not force the person who is providing the prescription to 
actually apply for the rebate. So we have some providers of 
prescriptions who for whatever reason do not fill out the necessary 
paperwork to get the automatic rebate that has already been negotiated.
  The offset that we came out with in the House was to simply say that 
if there was a drug rebate that had already been negotiated, you had to 
file for it and receive it so you could give that rebate to the State 
and the Federal Government. That would save approximately $140 million 
over the life of the extension. The White House supported it. CNS 
supported it. The House supported it, but the other body did not 
support it. They wanted to extend the program but not provide an offset 
to help pay for the extension.
  Now, I offered this afternoon to pull this bill back and try to work 
out something that when we first got back in the next Congress we could 
do the offset. The Speaker and the majority leader felt like we needed 
to go ahead and pass this bill this evening, and I am going to go ahead 
and do that. It is a good bill. It needs to be passed. We need to 
provide this additional supplemental assistance for low-income seniors 
to pay for their part B prescription drug benefit. But this is the last 
time as chairman of the Committee on Energy and Commerce that I am 
going to extend an entitlement program without some sort of an offset.
  So for tonight we can say that this is the beginning of the Barton 
doctrine. I hope in the next year or so it becomes the Bush-Hastert-
Frist, even the Pelosi, redoctrine, that we can work on a bipartisan 
basis, bicameral with the administration, that as we extend the 
existing entitlement programs and create new ones, we come up with a 
way to pay for them. But for this evening I rise to support the passage 
of this bill.
  It will provide much needed assistance for 160,000 low-income seniors 
for the next year. In the next year, I am going to work with interested 
parties in the administration, the other body and this body to come up 
with reforms that continue these necessary benefits but also come up 
with a way to pay for them.
  Mr. Speaker, I reserve the balance of my time.
  Mr. OLVER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I wish to confirm what the gentleman from Texas (Mr. 
Barton) has already indicated, that the ranking member of the Committee 
on Commerce is in full support of this bill.
  The chairman has also indicated that the ranking member of the 
subcommittee, the gentleman from Ohio (Mr. Brown), is in full support 
of the legislation, and I think that indicates that the Committee on 
Commerce members on our side of the aisle are in support of the 
legislation, and I think our whole caucus would be very supportive of 
that legislation.
  Mr. DINGELL. Mr. Speaker, I rise in support of this legislation to 
reauthorize the Qualified Individual program, or QI. This program helps 
low-income Medicare beneficiaries, who earn just a little too much to 
qualify for Medicaid assistance, but are still struggling with living 
and health care costs. The QI program pays the cost of the Medicare 
Part B premium for seniors with incomes of approximately $11,000 to 
$12,500 a year. This is a good program that helps thousands of low-
income seniors each year.
  The initial program was a block grant enacted in 1997. Because it 
expired in 2002, Congress has had to reauthorize this program a number 
of times since then. However, the uncertainty surrounding funding for 
this program has had a dampening effect on enrollment. States are 
hesitant to reach out to eligible individuals, resulting in 
artificially low enrollment figures. I hope that my colleagues across 
the aisle will join me in fixing this problem in the future--but, I am 
pleased that we are at least extending this program an additional year, 
through September 2005.
  I thank Senators Grassley, Baucus, Bingaman, Lautenberg, and Smith 
for their work in the Senate, and thank Chairman Barton,

[[Page 24341]]

Chairman Bilirakis, and Ranking Member Brown for their work in the 
House.
  Mr. ISRAEL. Mr. Speaker, this past September I was contacted by 
officials in the two counties that I represent urging me to do 
everything I could to extend the Qualifying Individual-1, QI-1, 
program. This important program gives Federal money to State Medicaid 
programs to pay for the Part B premium for low-income seniors. They 
stressed extending the program is particularly important this year as 
the Medicare Part B premiums are increasing over 17 percent from $66.60 
to $78.20.
  Medicare Part B is theoretically voluntary, but in reality is 
necessary for any senior who does not have some form supplemental 
insurance. Medicare Part B covers outpatient services, doctor visits, 
and other health care services not covered by the Hospital Insurance 
component of Medicare Part A.
  Unfortunately, seniors must pay a premium for Medicare Part B. Low-
income seniors live on very tight budgets. If Congress allowed this 
program to expire, there would be a number of low-income seniors who 
would have to decide if the monthly $78.20 would be better spent on 
food rather than on their health care premium.
  I responded to local officials by introducing legislation that would 
extend this program for another year. My legislation is identical to 
the Senate bill that we are voting on today. It extends this vital 
program for another year, and I am proud to have sponsored it in the 
House.
  I was not the only Member to respond to this call. Representative Jim 
Saxton and I both introduced this bill. Two Members of Congress in 
different parties introducing the same bill shows the universal support 
for this bill.
  The QI-1 program has been to the brink of expiring before. It was 
enacted as part of the Balanced Budget Agreement of 1997 and was 
originally scheduled to expire in December of 2002. Since the program 
has proved to be vital for low-income seniors, it has been extended a 
number of times through continuing resolutions, TANF reauthorization, 
and it was last extended in the Medicare Modernization Act. The last 
extension expired on September 30, 2004; however, it was extended 
through a continuing resolution through November 20, 2004.
  I am very happy and relieved that QI-1 program will be extended for 
another year. It is my hope that next year, Congress will enact 
legislation that permanently extends this program. Our low-income 
seniors and their advocates should not be made to deal with the 
emotional roller coaster each year, while this program comes so close 
to ending.
  I urge my colleagues to pass this legislation and I look forward to 
working with them to enact legislation that makes this program 
permanent.
  Mr. OLVER. Mr. Speaker, I yield back the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I have no further requests for 
time, and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Simpson). The question is on the motion 
offered by the gentleman from Texas (Mr. Barton) that the House suspend 
the rules and pass the Senate bill, S. 2618.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the Senate bill was passed.
  A motion to reconsider was laid on the table.

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