[Congressional Record (Bound Edition), Volume 155 (2009), Part 17]
[House]
[Pages 22517-22525]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     MEDICARE PREMIUM FAIRNESS ACT

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3631) to amend title XVIII to provide for the application of 
a consistent Medicare part B premium for all Medicare beneficiaries in 
a budget neutral manner for 2010.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3631

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Premium Fairness 
     Act''.

     SEC. 2. MEDICARE PART B PREMIUM FOR 2010.

       (a) Premium Computation.--Section 1839 of the Social 
     Security Act (42 U.S.C. 1395r) is amended--
       (1) in subsection (a), by adding at the end the following 
     new paragraph:
       ``(5) The monthly premium under this subsection for 2010 
     shall be the monthly premium under this subsection for 
     2009.''; and
       (2) in subsection (i)(3)(A), by adding after and below 
     clause (ii) the following:

     ``In applying clause (ii) for 2010, the monthly actuarial 
     rate described in such clause shall be such monthly actuarial 
     rate for 2009.''.
       (b) Offset From Medicare Improvement Fund.--Section 1898(b) 
     of such Act (42 U.S.C. 1395iii(b)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (A), by striking the semicolon at the 
     end and inserting the following: ``, reduced by the sum of--
       ``(i) the amount transferred under paragraph (5); and
       ``(ii) $567,000,000;'';
       (B) by redesignating subparagraph (B) as subparagraph (C); 
     and
       (C) by inserting after subparagraph (A) the following new 
     subparagraph:
       ``(B) fiscal year 2015, the amount specified in 
     subparagraph (A)(ii); and''; and
       (2) by adding at the end the following new paragraph:
       ``(5) Transfer and offset.--There are hereby transferred 
     from amounts in the general fund of the Treasury to the 
     Federal Supplementary Medical Insurance Trust Fund an amount 
     equivalent, as estimated by the Chief Actuary of the Centers 
     for Medicare & Medicaid Services, to the aggregate reduction 
     in premiums payable under part B that result from the 
     application of paragraph (5) of section 1839(a) and the last 
     sentence of section 1839(i)(3)(A).''.

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


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  I urge my colleagues on both sides of the aisle to support H.R. 3631, 
the Medicare Premium Fairness Act of 2009, of which I am an original 
cosponsor.
  Unless Congress acts quickly, millions of America's seniors will find 
themselves with a smaller Social Security check at a time when they are 
already stretching every dollar they have. If we don't act today, 27 
percent of Medicare beneficiaries will see their part B premium 
increase from $96 to $110 or $120. That's potentially a 25 percent 
increase in their Medicare part B premiums when they're getting no 
increase in their Social Security COLA.
  It won't just be Medicare beneficiaries who are harmed either. Cash-
strapped States will also feel a pinch if we don't act. Most of those 
impacted by the possible premium increases are dual-eligibles, or those 
beneficiaries who qualify for both Medicare and Medicaid because they 
may have low incomes. Their premium increases will have to be paid for 
by States as part of their Medicaid programs. As we all know, States 
across the Nation are facing large budget deficits and are being forced 
to slash critical services and increase taxes. This simply is not the 
time that the Federal Government should be shifting more costs to 
States who are simply unable to absorb it.
  Mr. Speaker, even though this is an emergency situation, we have 
found a way to make sure that the bill is completely paid for and does 
not add one dime to the deficit. It is imperative that Congress act 
today in order to make sure that every Medicare beneficiary is 
financially protected and is able to afford the Medicare services he or 
she deserves.
  I once again urge my colleagues on both sides of the aisle to support 
this bill. Please vote ``yes.'' Vote to protect America's seniors.
  I reserve the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  We are here today because the Democrat leadership apparently doesn't 
know what our senior citizens have known for the last 6 months. I held 
a town meeting in Wortham, Texas, in August. The population of Wortham, 
Texas, is approximately 1,100 people perhaps. A constituent, a senior 
citizen, stood up at my town hall meeting and asked me if it was true 
that their Medicare part B premiums were going to go up while their 
Social Security COLA did not increase. I said that I did not know, but 
I would check it out. I had my staff check it out, and sure enough, 
they were telling the truth.
  Well, yesterday, right before the Energy and Commerce Committee 
markup was scheduled to conclude, I got a note from my staff that there 
was going to be a special meeting of the Rules Committee last evening 
and that we were going to have a same-day rule and have an emergency 
bill put on the floor today to hold harmless our senior citizens who 
choose Medicare part B and who are having their premiums go up. I asked 
the distinguished subcommittee chairman, Mr. Pallone, if he knew 
anything about it, and to his credit, he said he was aware of it, but 
he had just become aware of it. I said, Well, why didn't we have a 
hearing on this? Why didn't we have a markup? Why didn't we find out 
what the policy is? Why didn't we do all kinds of things? To his 
credit, his answer was that it was just something that had to be done.
  Well, Mr. Speaker, I'm tired of the Democratic leadership waiting 
until the last moment. And to give them the benefit of the doubt, they 
don't know what's happening in these programs, so they have to 
scramble. Or they do know, and they don't give a darn about what the 
process is and what the policy is.

                              {time}  1130

  I think it's inexcusable that we are here on the House floor today on 
a bill that there's not any serious opposition that we need to do 
something but I think there is a real policy debate about how to 
prevent this from happening in the future.
  For my friends who don't really know a lot about Medicare part B, 
Medicare part B is voluntary. It is the part of Medicare that handles 
physician payments and outpatient reimbursement. Now, most Medicare 
recipients choose part B. About 98 percent choose part B.
  Within part B there are three classes of Medicare beneficiaries. 
There are Medicare beneficiaries that have a high income. There are 
Medicare beneficiaries that have average incomes, and there are 
Medicare beneficiaries that have low income.
  Under current law if you have been covered in Medicare in a prior 
year and you don't have a high income, you don't have a low income, you 
are held harmless by the current law. But if you're a new Medicare 
beneficiary, in other words, you weren't on the program last year, if 
you're a high-income Medicare beneficiary, or if you're a low-income 
Medicare beneficiary, then you're not held harmless.
  And those groups, about 25 percent of the total Medicare population, 
are the people that were going to have their Medicare premium 
increased. The current premium this year is about $96,

[[Page 22518]]

and under current law if you weren't protected, it would go up to about 
$104. So that's about an $8 increase or a little over maybe 7 or 8 
percent.
  So under years when the average inflationary and the consumer price 
index goes up, there's a Social Security COLA increase. So if Medicare 
expenses go up, which they did last year, the Medicare part B premium 
goes up but the Social Security benefit goes up, and since Medicare 
part B premiums are deducted from Social Security, then that is kind of 
offset.
  But this year we didn't have inflation. The consumer price index, 
because of the recession, didn't go up; so our seniors didn't get their 
Social Security increase. But Medicare spending went up last year 
because we haven't reformed the program. So the Medicare part B 
premium, which is optional, went up; and if you weren't protected, your 
premium went up.
  Now, Mr. Speaker, there are lots of policy questions there. Maybe we 
need to change the current law. Maybe we need to protect all Medicare 
part B beneficiaries. Maybe we need to look at these high-income 
seniors? Did we have that hearing? Did we have that policy debate? No.
  The Democrat majority is simply putting this bill on the floor saying 
let's take $2.7 billion and let's hold everybody harmless. Well, now 
that's good politics. I am not negating the politics of it. But is that 
good policy?
  My good friend Mr. Pallone from New Jersey said not one dime is going 
to be added to the deficit. Well, he didn't tell you where the money's 
coming from. Here's where the money is coming from, and I have read the 
bill. Luckily, it's only two pages; so it's not that hard to read. But 
here's where the money is coming from: It is coming from something 
called the Medicare Improvement Fund; $567 million is coming from the 
Medicare Improvement Fund. That's a fund that our majority has set up 
in a bill last year, and I think, and I could be wrong and Mr. Pallone 
could tell me, he probably knows, that there's about $20 billion in 
that fund. And the rest of it is a transfer that is coming from the 
Treasury of the Federal Supplementary Medical Insurance Trust Fund, and 
they're going to take $567 million from this what I call a temporary 
fund, and then they are going to take the rest of it from the General 
Federal Supplementary Medical Insurance Trust Fund.
  So they're taking money that has been paid in by our Medicare taxes 
and they're just saying we're going to use some of that money. That 
trust fund's going broke. It's in the red and going broke every year. 
We're just going to take some of that money and use it this year. Plus 
we're going to take some of the money from the special fund that we set 
up last year. Now, there are all sorts of policy questions there.
  So our friends on the majority are right to say for this year, for 
this $2.7 billion, there's no added borrowing; but they are wrong to 
say, in my opinion, that it's not adding to the deficit because they 
are taking money out of the general Medicare fund that we're going to 
need in future years and they're taking money from this special fund 
which I may be wrong in but I think was set up with borrowed money from 
the general fund.
  Again, the minority is not objecting to the fact that for that 25 
percent of our seniors that are not protected by ``hold harmless'' that 
we do something to help them. But we are very upset that it has been 
done so cavalierly on such short notice with absolutely no process at 
all.
  Democracy cannot work, Mr. Speaker, if we don't let the people know 
why we are making decisions, what the policy implications are, not to 
just our senior citizens but to all our citizens.
  I am not going to ask for a ``no'' vote because we do need to do 
something. But I am going to ask that my friends in the majority really 
think about holding a hearing on this, even though it will be after the 
fact, so we can get the facts on the table and that we try to set up a 
process so that we don't have to next year and the next year and the 
next year come out here with absolutely no advance warning and no real 
understanding of what the long-term implications of this are.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the distinguished 
chairman of the Energy and Commerce Committee, Mr. Waxman.
  Mr. WAXMAN. Mr. Speaker and my colleagues, this is a simple bill. It 
corrects a minor formulaic problem with the calculation of Medicare 
premiums for some beneficiaries, not all but just some. And we are 
faced with a very short time in which to act. The administration has 
told us that the Social Security agency needs to know what premium to 
program into their system by or about October 1.
  This legislation deals with the situation where, under current law, 
some seniors will face unusually steep premium increases next year. 
Beneficiaries who pay $96 today could face premiums of $110 or even 
$120 per month next year if we don't act today. The reason for that is 
that there's no increase in the cost of living under their Social 
Security. But for these few Medicare beneficiaries, there would be an 
increase in their part B premium passed on to them.
  About three-quarters of beneficiaries face this steep premium 
increase. The legislation would protect the other one-quarter, over 11 
million beneficiaries. It will help new Medicare enrollees, older civil 
service retirees, and others who don't receive Social Security benefits 
and State government benefits. It would not add to the deficit. It 
would be financed by reductions in other Medicare spending.
  It's an important bill. It's not the most important bill that we're 
going to face in the health care area. That's coming up very soon. But 
for those of us who have always supported the Medicare program and have 
been concerned about the Medicare beneficiaries, we see that we've been 
successful from most of them not having to face this problem. But we 
need to correct this problem that will be faced by a good number of 
people and to make sure that it does not happen to them. I would have 
liked to have a COLA for all Social Security beneficiaries, but at 
least don't let them see a reduction in Social Security to pay for an 
increase in Medicare premiums.
  Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the gentleman 
from Kentucky (Mr. Whitfield), a member of the committee.
  Mr. WHITFIELD. I thank the gentleman for yielding the time.
  I'm not going to get into a discussion of process today, but I would 
like to commend the chairman and the ranking member and the chairman of 
the subcommittee for bringing this bill to the floor to correct this 
inequity for our senior citizens.
  But I would like to discuss another matter relating to the national 
health care debate that is of great concern to me.
  Last week the Congressional Budget Office, in examining the bill 
proposed by Senator Baucus, said that that bill would reduce by $123 
billion the Medicare Advantage program. This is a program that provides 
private health insurance for our Medicare beneficiaries. And I might 
say there are many of them in rural areas and over 10,000 in my 
district.
  One of the companies that provides this private option is Humana 
Corporation, headquartered in Louisville, Kentucky. They sent out a 
notice to their Medicare beneficiaries explaining that the Baucus plan 
would reduce by $123 billion the amount of money available for 
Medicare.
  When Senator Baucus heard about that, he ordered Medicare regulators 
to investigate and, if necessary, punish Humana for trying to educate 
its own enrollees about how they would be damaged by the Senate bill. 
Now, I might add that the acting director of CMS, Jonathan Blum, used 
to work for Senator Baucus.
  But the thing that is really troubling about this is that while they 
are issuing an order against Humana, the Association for the 
Advancement of Retired Persons, AARP, which claims to represent senior 
citizens on Medicare, they also have an advantage program through 
United Health Care that they offer 1.7 million enrollees, and yet

[[Page 22519]]

they've been sending out information and on their Web site saying that 
Medicare funds would not be reduced, and yet CMS is not taking any 
action against them.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. PALLONE. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman 
from Maryland (Mr. Sarbanes).
  Mr. SARBANES. I thank the gentleman for yielding.
  Mr. Speaker, this is a very, very important bill, and it's one that 
we need to pass today.
  In August, as was referenced, many of us heard from our constituents 
that they were going to be in this crunch where, on the one hand, the 
cost-of-living adjustment for Social Security was not going up based on 
the formula that looks at inflation cost but, on the other hand, they 
were facing an increase in their Medicare part B premium. I pledged 
actually on the spot that I knew we would come back and we would be 
trying to take a look at this and explore various options that could 
help 10 million Medicare beneficiaries across the country, including 
thousands in Maryland.
  There are a number of ways to address this issue. I think what 
happened was the idea of looking at the Medicare part B premium and 
making an adjustment there instead of holding it down is one that came 
into focus recently. We might have been able to go do hearings based on 
that, but we realized we've got to move quickly because the Medicare 
program needs to implement this right away if it's going to be put in 
force. So that's why we're moving quickly.
  The bottom line here is people spoke to us and we listened, and that 
should be an assurance to all those seniors out there who are 
expressing some anxiety about where we are going generally with our 
health reform efforts. We are hearing those concerns. They're part of 
what we're trying to do here to keep the Medicare program strong and to 
look out for the best interests of our seniors, and that's why we ought 
to support this legislation today.
  Mr. BARTON of Texas. Mr. Speaker, I yield the balance of my time to 
the gentleman from California (Mr. Herger) and ask unanimous consent 
that he control that time.
  The SPEAKER pro tempore. Without objection, the gentleman from 
California will control the balance of the time.
  There was no objection.
  Mr. HERGER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Florida (Ms. Ginny Brown-Waite).

                              {time}  1145

  Ms. GINNY BROWN-WAITE of Florida. I thank the gentleman for yielding.
  Mr. Speaker, I rise today in reluctant support of this bill because I 
do believe it is a promise that we must keep to our seniors. It is not 
fair for our seniors to shoulder the burden of this Congress because of 
the policies passed by the Democrat majority.
  However, wouldn't it have been a whole lot better to pay for it from 
the unused stimulus money?
  This savings to seniors will be especially and critically important 
to Medicare recipients. CBO Director Elmendorf just announced yesterday 
that seniors can expect to see a reduction in their Medicare benefits 
if H.R. 3200 is passed. That will mean that some of our poorest 
citizens will be asked to pay even more for their out-of-pocket medical 
costs. This is not change that they can afford.
  The President and the majority in this House and in the Senate owe 
our seniors an honest explanation. AARP also owes an explanation to its 
members for misleading them about the Medicare cuts contained in H.R. 
3200.
  According to the CBO Director, 2.7 million seniors will lose their 
current Medicare Advantage plans under the policies of the House health 
care bill. When I said the President was flat wrong about cuts to 
Medicare benefits, this is exactly what I meant.
  I am, however, pleased that this bill does work to protect some of 
our seniors from future financial hardships, but the correct approach 
would be to scrap H.R. 3200, to fix Medicare first and to pursue a real 
bipartisan approach that delivers honest reform that the American 
people actually want.
  Mr. PALLONE. Mr. Speaker, may I inquire as to how much time we have 
remaining on our side?
  The SPEAKER pro tempore. The gentleman has 14\1/2\ minutes.
  Mr. PALLONE. I yield 1\1/2\ minutes to the gentlewoman from Illinois 
(Ms. Schakowsky).
  Ms. SCHAKOWSKY. I thank the gentleman for yielding.
  Mr. Speaker, I rise in support of H.R. 3631, the Medicare Premium 
Fairness Act, and hope that we have good bipartisan support for this 
sensible legislation.
  We know that everyone, and particularly seniors who are on fixed 
incomes, have been hard hit by the worst recession in 70 years. The 
Labor Department data shows that, for people over 65, 447,000 filed for 
unemployment in August, which is a 127 percent increase over December 
of 2007. Over the past year, the number of unemployed workers 75 and 
older has increased by 33 percent. Why are they even going to work? 
Because seniors are hurting. They need the money. Now they learn there 
will be no cost-of-living increase in their Social Security checks.
  At a time when health care costs are already claiming a big chunk of 
their Social Security checks and at a time when out-of-pocket costs are 
rising and they're forgoing much of their needed care, we can't allow 
their part B premiums to increase. They need help right now.
  I strongly support the Medicare Premium Fairness Act, and I urge my 
colleagues to support the senior citizens and persons with disabilities 
by passing H.R. 3631.
  Mr. HERGER. I would like to inquire as to how much time we have 
remaining on our side, Mr. Speaker.
  The SPEAKER pro tempore. The gentleman has 7 minutes remaining.
  Mr. HERGER. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. I yield 1\1/2\ minutes to the gentleman from Vermont 
(Mr. Welch).
  Mr. WELCH. I thank the gentleman from New Jersey.
  Mr. Speaker, this is a very important bill that is going to make a 
real difference in Vermont to about 130,000 seniors. That's the number 
of people who receive Social Security benefits in the State of Vermont, 
and 41 percent, Mr. Speaker--about 52,000 people--rely on Social 
Security for fully 90 percent of their income. They're going to get a 
zero increase in their cost of living, but on the other hand, they're 
going to get an increase in premiums which could be $110, $120 a month. 
That is a hammer to their finances for the month.
  We have a bipartisan commitment to Social Security. The situation our 
seniors face is as a result of the recession, something over which they 
have no control but are very much affected by. This modest legislation 
is going to be a lifeline of support for seniors in Vermont, and my 
hope is that we will pass it on a strong bipartisan basis.
  Mr. HERGER. Mr. Speaker, I continue to reserve the balance of my 
time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Nevada (Ms. Titus), who is the sponsor of this legislation.
  Ms. TITUS. Thank you, Chairmen Rangel, Stark, Waxman, Dingell, and 
Pallone, for your leadership on this important issue.
  Mr. Speaker, my State of Nevada has been particularly hard hit by the 
economic downturn. In addition to record unemployment and high 
foreclosure rates, Nevadans have watched as their retirement savings 
have plummeted in value. This has been especially hard on our senior 
population, which has been the fastest growing in the country for the 
last decade.
  To make matters worse for our economically strapped seniors, some of 
whom have had to choose between buying food and buying medicine, it is 
now projected that Social Security recipients will not receive a cost-
of-living increase in their benefits next year for the first time in 35 
years. Simultaneously, Medicare part B premiums will continue to rise. 
So, unless Congress acts quickly and decisively, this

[[Page 22520]]

could mean a reduction in Social Security benefits at a time when many 
Nevada seniors count on every dollar to get by.
  As the gentleman from Texas pointed out, not all seniors will see a 
decrease in their Social Security checks caused by part B premium 
increases, thanks to a hold harmless policy. About 27 percent of 
enrollees, some 11 million people, however, nationally and thousands in 
Nevada are excluded from that hold harmless policy. As a result, they 
will see their Social Security checks shrink if we don't pass this 
bill.
  The Medicare Premium Fairness Act before you today will eliminate 
this inequity, and it will protect all Medicare enrollees so that no 
senior will see his or her premium increase or will experience a Social 
Security check decrease.
  Because this bill is fully paid for by using existing funds, 
including the Medicare Improvement Fund, and because it meets the PAYGO 
requirements, it's a responsible way to stand up and provide for our 
seniors during these tough economic times. So I urge my colleagues on 
both sides of the aisle to support this crucial legislation.
  Mr. HERGER. I yield myself such time as I may consume.
  Mr. Speaker, we need to keep in mind the broader challenges facing 
Medicare. Medicare's trustees have expressed concerns about spending in 
part B, warning that legislation to avert cuts in physician payments, 
together with restrictions on premium increases, could ``jeopardize 
part B solvency and require unusual measures to avoid asset 
depletion.'' I am concerned that we are doing exactly what the trustees 
warned us against--placing the Medicare part B program at risk of 
bankruptcy.
  Furthermore, the nonpartisan Congressional Budget Office found that 
H.R. 3200, the House Democrats' health care bill, would increase 
Medicare part B premiums by $25 billion. I find it ironic that the bill 
before us reduces premiums by about one-tenth the amount that H.R. 3200 
would increase seniors' Medicare premiums.
  I am also especially concerned that the majority Democrats are 
attempting to shut down the debate on how their health care bill would 
affect seniors enrolled in the Medicare Advantage program. The CBO has 
confirmed that the $156 billion in Medicare Advantage cuts contained in 
H.R. 3200 could, indeed, force plans to limit benefits, including 
premium relief. Yet CMS has issued a gag order prohibiting Medicare 
Advantage plans from informing their customers of this fact.
  At the same time, CMS has apparently taken no action against the 
sponsor of the largest Medicare Advantage plan, AARP, whose Web site 
urges seniors to contact their Members of Congress in support of the 
Democrats' health care bill, which would slash Medicare by more than 
$500 billion.
  Mr. Speaker, why the double standard? It appears that people are free 
to express their opinions on health care as long as those opinions are 
in line with the majority party's.
  So, while the House Democrats claim to be helping seniors, the 
reality is that they're trying to cobble together 218 votes to pass a 
$25 billion part B premium increase through the House, and the Obama 
administration is abusing its regulatory powers to keep that fact from 
seniors. Mr. Speaker, that is wrong.
  I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from 
North Carolina (Mr. Butterfield).
  Mr. BUTTERFIELD. I want to thank Chairman Pallone for yielding me 
this time, and I really thank him for his leadership on our committee.
  Mr. Speaker, this is an important bill. Holding down the cost of 
Medicare premiums means so much to millions of Americans. We cannot 
ever lose sight of the plight of our senior citizens, who are 
struggling to make ends meet.
  I want to thank the various chairmen who have decided to move 
decisively on this measure this week. I would only hope that our 
Republican friends would work with us on this one. Let's not use this 
issue as a weapon in the health care reform debate. This is a separate 
issue. Not only does it affect my district, but it affects all of our 
districts. In my State of North Carolina, 1.392 million North 
Carolinians have Medicare, and they need this legislation this week.
  I ask my colleagues to join with me in voting for the Medicare 
Premium Fairness Act.
  Mr. HERGER. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield the remaining time to the gentleman 
from California (Mr. Stark), and I ask unanimous consent that he 
control that time.
  The SPEAKER pro tempore (Mr. Holden). Is there objection to the 
request of the gentleman from New Jersey?
  There was no objection.
  Mr. STARK. Mr. Speaker, I yield myself such time as I may consume.
  Today, we have a bill before us that will basically protect the 
Social Security checks from dropping in 2010 as a result of what could 
be called a ``quirk'' in the relationship between our Medicare part B 
premiums and the Social Security checks. Some seniors will still be 
feeling the effects of the recession in 2010, and this bill at least 
ensures that they will receive stable Social Security checks.
  If we fail to act, about 4 million seniors and people with 
disabilities will see an increase in their part B premiums, which would 
result in a decrease in their Social Security checks.
  I am quite sure that all of us understand that, even among the higher 
income beneficiaries under Social Security, a Social Security check 
becomes part of the financial fabric of most of our beneficiaries. They 
budget it. They know they're going to spend it on rent or on groceries 
or on presents for their grandkids. It will be difficult for all of us 
to explain why there was a $5, a $10 or even a $15 cut in their checks.
  Some people have suggested we send checks at the end of the year as, 
I guess, we did last year. I don't think they'd make that connection. I 
don't think they'd figure out why those checks came and from whom they 
came.
  This levels the playing field so that a small percentage of 
beneficiaries will not be paying to hold the other 75 percent harmless. 
There is a very small number of upper-income seniors who will basically 
receive a cut in their part B benefits. These seniors, this group, 
already has a higher premium because it's income related, and they pay 
taxes on their Social Security benefits, which some of the lower-income 
beneficiaries do not.

                              {time}  1200

  Also, we hold harmless some very low-income beneficiaries whose 
payments are made by Medicaid. Therefore, if we didn't pass this, some 
of the States who are already having severe problems with their 
Medicaid would have an extra burden for that small group.
  The bill is paid for out of a Medicare fund which we set up some 
years ago for just this kind of a program. It's a fund where we set 
aside money each year in the event we needed dollars to solve a 
problem. This is a problem that we foresaw coming up for a diverse 
group of our beneficiaries, and it seemed to be a fair way to not 
disrupt their financial planning and to provide a level playing field 
so that all the beneficiaries receive the same treatment and some were 
not subsidizing others. It's a bill that I hope will have broad 
bipartisan support, and I think it will serve our Social Security 
beneficiaries well.

                                           Judge David L. Bazelon,


                                 Center for Mental Health Law,

                               Washington, DC, September 24, 2009.
     Hon. Charles B. Rangel,
     Chairman, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
     Hon. Henry A. Waxman,
     Chairman, Committee on Energy and Commerce, House of 
         Representatives, Washington DC.
       Dear Chairman Rangel and Chairman Waxman: The Bazelon 
     Center for Mental Health Law supports H.R. 3631, the 
     ``Medicare Premium Fairness Act.'' This bill will protect the 
     Social Security benefits of persons with disabilities by 
     ensuring that their monthly payments are not reduced due to 
     an increase in Medicare Part B premiums.
       It is expected that there will be no cost of living 
     adjustment (COLA) in Social Security benefits paid in 2010, 
     which will cause a hardship for individuals with disabilities 
     and others who receive Social Security payments.

[[Page 22521]]

     However, Medicare Part B premiums are expected to increase. 
     Fortunately, under current law, most of these beneficiaries 
     will be ``held harmless'' and will not see an actual 
     reduction in their monthly Social Security benefits. However, 
     about 27% of beneficiaries are not covered by the ``hold 
     harmless'' provision, including low-income individuals who 
     are eligible for both Medicare and Medicaid, new Medicare 
     enrollees, and new enrollees whose Medicare premiums are not 
     deducted from their Social Security checks. Their monthly 
     Social Security benefits, which are the sole source of income 
     for many, could be reduced by more than $20 per month to pay 
     for the premium increase.
       A substantial number of people with mental illness are 
     dually eligible for SSDI and Medicare benefits. However, as 
     major mental illness typically has an age of onset in a 
     person's early twenties, their work history is very short and 
     their benefits are very low (benefit level depends upon 
     quarters you have paid in as well as earnings) making 
     increased Medicare costs even more difficult to bear. H.R. 
     3631 would extend the current ``hold harmless'' policy to all 
     Medicare beneficiaries. As a result, no individual with 
     disabilities who is a Social Security beneficiary will see a 
     decrease in his or her monthly Social Security benefits due 
     to Medicare Part B premiums. And former beneficiaries who 
     buy-in to Medicare will be protected.
       We support your effort to pass H.R. 3631.
           Sincerely,
     Chris Koyanagi.
                                  ____

                                                    Consortium for


                                   Citizens With Disabilities,

                               Washington, DC, September 24, 2009.
     Hon. Charles B. Rangel,
     Chairman, Committee on Ways and Means, House of 
         Representatives, Washington, DC.
     Hon. Henry A. Waxman,
     Chairman, Committee on Energy and Commerce, House of 
         Representatives, Washington DC.
       Dear Chairman Rangel and Chairman Waxman: The undersigned 
     Co-Chairs of the Consortium for Citizens with Disabilities 
     (CCD) Task Forces on Health, Long-Term Services and Supports, 
     and Social Security, we support H.R. 3631, the ``Medicare 
     Premium Fairness Act.'' This bill will protect the Social 
     Security benefits of persons with disabilities by ensuring 
     that their monthly payments are not reduced due to an 
     increase in Medicare Part B premiums.
       It is expected that there will be no cost of living 
     adjustment (COLA) in Social Security benefits paid in 2010, 
     which will cause a hardship for individuals with disabilities 
     and others who receive Social Security payments. However, 
     Medicare Part B premiums are expected to increase. 
     Fortunately, under current law, most of these beneficiaries 
     will be ``held harmless'' and will not see an actual 
     reduction in their monthly Social Security benefits. However, 
     about 27% of beneficiaries are not covered by the ``hold 
     harmless'' provision, including low-income individuals who 
     are eligible for both Medicare and Medicaid, new Medicare 
     enrollees, and new enrollees whose Medicare premiums are not 
     deducted from their Social Security checks. Their monthly 
     Social Security benefits, which are the sole source of income 
     for many, could be reduced by more than $20 per month to pay 
     for the premium increase. Another unprotected group is former 
     beneficiaries of Social Security disability benefits who are 
     now working and who ``buy-in'' to Medicare under the Ticket 
     to Work and Work Incentives Improvement Act.
       H.R. 3631 would extend the current ``hold harmless'' policy 
     to all Medicare beneficiaries. As a result, no individual 
     with disabilities who is a Social Security beneficiary will 
     see a decrease in his or her monthly Social Security benefits 
     due to Medicare Part B premiums. In addition, former 
     beneficiaries who buy-in to Medicare will be protected.
       We support your effort to pass H.R. 3631.
           Sincerely,
     Marty Ford,
       The Arc of the United States and United Cerebral Palsy.
     Andrew Morris,
       United Spinal Association and National Spinal Cord Injury 
     Association.
     Susan Prokop,
       Paralyzed Veterans of America.
     Liz Savage,
       The Arc of the United States and United Cerebral Palsy.
     Paul Seifert,
       Council of State Administrators of Vocational 
     Rehabilitation.
     Ethel Zelenske,
       National Organization of Social Security Claimants' 
     Representatives.
                                  ____


   AARP Applauds New Bill To Help Seniors Struggling in Tough Economy

       Washington--AARP Executive Vice President Nancy LeaMond 
     issued this statement applauding the introduction of the 
     ``Medicare Premium Fairness Act'' (H.R. 3631):
       ``As health care costs continue to soar despite lower 
     inflation throughout the economy, older Americans are hit 
     particularly hard. Retirees have seen their savings wiped 
     away by market losses while their health care bills continue 
     to climb. People in Medicare today spend nearly a third of 
     their income on health care. The lack of a cost-of-living 
     update in Social Security means that millions more in 
     Medicare could see their health care costs rise further out 
     of reach.
       ``AARP applauds Chairman Rangel, Chairman Stark, Rep. 
     Titus, Chairman Henry Waxman, Chairman Emeritus Dingell and 
     Chairman Pallone for introducing this important legislation. 
     By holding Medicare premiums steady for all beneficiaries for 
     the next year--premiums that have doubled since 2000--their 
     bill would help ensure that health care is more affordable 
     for people in Medicare--without burdening taxpayers or future 
     generations with new spending.
       ``We urge every House member who worries about the health 
     and economic security of their constituents in Medicare to 
     support this legislation when it reaches the floor 
     tomorrow.''
                                  ____



                               Alliance for Retired Americans,

                               Washington, DC, September 23, 2009.
     Representative Charles Rangel,
     Chair, Committee on Ways and Means, House of Representatives, 
         Washington, DC.
     Representative Henry Waxman,
     Chair, Committee on Energy and Commerce, House of 
         Representatives, Washington, DC.
       Dear Chairmen Rangel and Waxman: The Alliance for Retired 
     Americans, on behalf of its more than three million members 
     throughout the nation, supports your legislation, the 
     Medicare Premium Fairness Act, H.R. 3631, and we urge its 
     prompt passage by the House of Representatives.
       Your legislation will protect members of the Alliance and 
     all older Americans from unfair increases in their 2010 
     Medicare Part B premiums. Without enactment of this 
     legislation, more than 10 million Medicare Part B 
     beneficiaries will see their premiums increase even though 
     they will not receive a Social Security cost of living 
     increase in 2010. Many of those affected by this change are 
     low income beneficiaries who would be particularly hard hit 
     without this legislation. In addition, Alliance members who 
     are new enrollees to Medicare would also be adversely 
     affected as well.
       Passage of the Medicare Premium Fairness Act is necessary 
     to protect older Americans from unfair Medicare Part B 
     premiums. If we can be of assistance, please contact Richard 
     Fiesta, Director of Government and Political Affairs, at the 
     Alliance. The Alliance for Retired Americans is committed to 
     enacting legislation that improves the quality of life for 
     retirees and all Americans.
           Sincerely yours,
                                                  Edward F. Coyle,
     Executive Director.
                                  ____

                                       National Active and Retired


                                Federal Employees Association,

                               Alexandria, VA, September 23, 2009.
     Hon. Charles B. Rangel,
     Rayburn House Office Building,
     Washington, DC.
       Dear Chairman Rangel: On behalf of the National Active and 
     Retired Federal Employees Association (NARFE), I am writing 
     to endorse H.R. 3631, the ``Medicare Premium Fairness Act,'' 
     which you and Reps. Henry A. Waxman, Fortney ``Pete'' Stark, 
     Frank Pallone, Chris Van Hollen and Dina Titus have 
     introduced to protect all Medicare beneficiaries from an 
     increase in their Part B premium in 2010 when they are 
     unlikely to receive any cost of living adjustment (COLA).
       Under current federal law, about 75 percent of Medicare 
     beneficiaries do not have to pay for the increase in Part B 
     premiums in any year when they receive no Social Security 
     COLA. However, there are four groups of older Americans who 
     are not protected by the `hold harmless' provision, including 
     over a million federal, state and local government retirees 
     who are not eligible to receive Social Security benefits. 
     Absent a change in law, they would not only have to pay the 
     higher Part B premiums without a COLA, but also absorb the 
     costs of other Medicare beneficiaries currently `held 
     harmless.'
       We support your bill because it shields all older Americans 
     from the Part B premium increase in 2010, including 
     government retirees who are not eligible for Social Security. 
     That means no one will pay the Part B increase next year. We 
     appreciate that the legislation is fully financed through the 
     Medicare Improvement Fund.
       NARFE applauds you and Reps. Waxman, Stark, Pallone, Van 
     Hollen and Titus for protecting all retirees--public and 
     private--from premium increases in Medicare in a year when 
     they are unlikely to receive the inflation protection needed 
     to shoulder the rate hike. For that reason, we urge your 
     colleagues to vote for this important legislation when it is 
     considered by the House.
           Sincerely,
                                             Margaret L. Baptiste,
                                                        President.

[[Page 22522]]

     
                                  ____
                                    National Committee to Preserve


                                 Social Security and Medicare,

                               Washington, DC, September 23, 2009.
     Hon. Charles B. Rangel,
     Chairman Committee on Ways and Means, House of 
         Representatives, Washington, DC.
       Dear Mr. Chairman: On behalf of the millions of members and 
     supporters of the National Committee to Preserve Social 
     Security and Medicare, I am writing to express our support 
     for your legislation, H.R. 3631, the Medicare Premium 
     Fairness Act, which will protect certain Medicare 
     beneficiaries from an increase in their Part B premiums in 
     2010.
       As you know, Social Security's Trustees are currently 
     projecting that, for the first time in thirty-five years, 
     seniors will not see a Cost-of-Living Adjustment (COLA) in 
     2010, despite experiencing increases in their out-of-pocket 
     health care costs. In this circumstance, current law contains 
     a ``hold harmless'' provision that prevents reductions in 
     Social Security checks for about three-quarters of 
     beneficiaries by prohibiting an increase in their Part B 
     premiums. We share your concern that this ``hold harmless'' 
     provision does not protect new enrollees, higher-income 
     enrollees, enrollees whose premiums are not deducted from 
     their Social Security checks, and low-income dual-eligible 
     beneficiaries whose premiums are paid for through state 
     Medicaid programs.
       It is my understanding that your legislation would extend 
     the current ``hold harmless'' policy to these remaining 
     categories of Medicare enrollees so that their 2010 Part B 
     monthly premiums will also remain at the current $96.40. This 
     is an important first step toward protecting America's 
     millions of seniors who are burdened with high health care 
     costs even with Medicare and we thank you for your leadership 
     on this important issue. We look forward to working with you 
     on legislation to further protect our nation's seniors by 
     restoring the 2010 Social Security COLA.
           Cordially,
                                              Barbara B. Kennelly,
     President and CEO.
                                  ____



                           Center for Medicare Advocacy, Inc.,

                               Washington, DC, September 23, 2009.
       To the Members of the House Committee on Ways and Means: 
     The Center for Medicare Advocacy, Inc. is pleased to support 
     H.R. 3631, the ``Medicare Premium Fairness Act,'' sponsored 
     by Representative Titus. This bill would extend the current 
     hold harmless policy to all Medicare enrollees, meaning that 
     2010 Part B premiums will remain at $96.40 and no Social 
     Security recipients will see a decrease in their Social 
     Security checks.
       Although Social Security benefits will not increase in 
     2010, many of the fixed expenses faced by Medicare 
     beneficiaries will go up. For example, premiums for Medicare 
     Part D drug plans are expected to increase in 2010, as are 
     the costs for prescription drugs and the cost for other 
     medical expenses. Adults living on fixed incomes, 
     particularly those with limited resources, are unlikely to 
     meet their increased costs. All Social Security recipients 
     should be protected against increased Part B premiums in 
     these circumstances. Beneficiaries should be protected again.
       We thank you for your efforts on behalf of Medicare 
     beneficiaries. We look forward to working with you on this 
     issue.
       Sincerely,
                                                   Vicki Gottlich,
                                           Senior Policy Attorney.

  I reserve the balance my time.
  Mr. HERGER. Mr. Speaker, I yield the gentleman from Michigan, the 
ranking member of the Ways and Means Committee, Mr. Camp, the remaining 
time.
  Mr. CAMP. I thank the gentleman for yielding.
  The majority wants you to think we are here today to help seniors. 
This bill will help some seniors, and I intend to vote for it.
  But seniors shouldn't sleep well tonight, for they are facing massive 
cuts in Medicare benefits in pending health legislation proposed by the 
Democrats and the President. That's what I want to talk about today.
  The reality is the majority's health care bill will slash Medicare 
Advantage benefits for millions of seniors, and the administration is 
abusing its regulatory powers to keep that fact from seniors. This week 
we learned that the Centers for Medicare and Medicaid Services has 
initiated an investigation into at least one provider of Medicare 
Advantage health care plans for accurately informing its enrollees that 
Medicare cuts proposed in pending health care legislation could alter 
their benefits.
  CMS has since banned all Medicare Advantage health plans from 
providing similar information to beneficiaries, and let me just read to 
you the phrase that was communicated: If the proposed funding-cut 
levels become law, millions of seniors and disabled individuals could 
lose many of the important benefits and services that make Medicare 
Advantage health plans so valuable.
  Frankly, this is government intimidation, pure and simple. Seniors 
know the President's Medicare cuts will impact their benefits. The 
Congressional Budget Office has confirmed these cuts could negatively 
impact Medicare benefits and increase seniors' costs. But when health 
care plans try to share that information with their enrollees, the 
administration slaps a gag order on them. It is an abuse of power, 
plain and simple.
  So while the government is intimidating Medicare health care plans, 
shockingly, no such pressure has been applied to those supportive of 
the President's Medicare cuts. AARP, which boasts the largest Medicare 
Advantage plan, for example, has directly communicated with its members 
via e-mail, a Web site and letters. However, their pro-Medicare cut 
stance has apparently received no scrutiny from the administration. 
CMS' selective use of its regulatory authority threatens the integrity 
of the agency and our democracy.
  In fact, CMS' unprecedented action is in direct conflict with its own 
guidance issued during the Clinton administration. The then-director of 
what was called HCFA at that time, Center for Health Plans and 
Providers, instructed health plans in 1997 that ``Prohibiting such 
information would violate basic freedom of speech and other 
constitutional rights of the Medicare beneficiary as a citizen. As long 
as member materials that discuss the rights and responsibilities of the 
member and the HMO with regard to HMO membership are not misrepresented 
in the context of this article, we see no reason for prohibiting the 
distribution of information.''
  This policy reversal by CMS is also at odds with Supreme Court 
decisions in the area. We need to get to the bottom of this, and we 
need to make sure all Americans, and especially seniors, know the facts 
about what the President and the congressional Democrats health care 
bill will mean for them.
  Mr. STARK. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from New York (Mr. Higgins).
  Mr. HIGGINS. I thank the gentleman for yielding.
  Mr. Speaker, I rise in strong support of H.R. 3631, the Medicare 
Premium Fairness Act. For nearly four decades, Medicare has improved 
the quality of life for our Nation's seniors. Because of Medicare, 
Americans no longer live in fear of not having health care when they 
retire.
  Yet keeping Medicare affordable for seniors is consistently a 
challenge. Under the Medicare formula, most seniors will see no 
increase in their premiums. However, unless we act, some will.
  Our economy is beginning to turn around but is not yet fully 
recovered. We must ensure that next year seniors living on a fixed 
income are not forced to pay more for the Medicare that they depend on.
  H.R. 3631 will ensure that premiums will not increase for necessary 
medical services like doctor's visits and imaging scans.
  I urge my colleagues to support this legislation and keep the promise 
of quality, affordable health care for American seniors.
  Mr. HERGER. I yield back the remainder of my time.
  Mr. STARK. Mr. Speaker, I am delighted to yield 1 minute to the 
gentlelady from Nevada (Ms. Berkley).
  Ms. BERKLEY. I thank the gentleman from California for yielding.
  Mr. Speaker, I want to single out and say how much I appreciate the 
work of Congresswoman Dina Titus from the State of Nevada, as well as 
Chairman Rangel and Chairman Waxman and Subcommittee Chairman Stark on 
this very important issue.
  The economic downturn has hit many parts of this country very 
dramatically, but none more dramatically than in the State of Nevada, 
and certainly in the southern part of the State that I represent. I 
have 100,000 Social Security recipients in my congressional district, 
many of whom will be

[[Page 22523]]

impacted by the increase in the Medicare part B premiums next year.
  Since this increase is not going to be offset by the normal cost-of-
living increase in their Social Security checks, I think this is a very 
important way and a very necessary way of helping to keep my seniors, 
who rely on Social Security and who will be harmed with this additional 
payment, keep them whole.
  So I want to thank my colleague again and join with her in protecting 
the seniors in the State of Nevada and throughout the country.
  Mr. STARK. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from Maryland, the majority leader of the House, Mr. Hoyer.
  Mr. HOYER. I thank the gentleman for yielding.
  First of all, I want to congratulate Congresswoman Titus for her 
leadership on this issue. She is an extraordinary Member of this House, 
very able, and, as Congresswoman Berkley, her colleague from Nevada 
just indicated, this will be directed at helping a lot of seniors.
  I rise in opposition to this suspension bill.
  I have, for a number of years, spoken about how difficult it will be 
for us to get a handle on entitlements. If we don't get a handle on 
entitlements, my friends, we will be spending nothing more in another 
50 years than money on entitlements and payment on the national debt, 
and our children will not be happy. They will not congratulate us.
  Now, there is no speaker who will speak today who will not speak on 
behalf of those seniors who, as my colleague Shelley Berkley just 
referenced, rely on Social Security to support themselves. We 
anticipated that concern when we adopted the legislation relating to 
this subject. And as a result of anticipating that, we said if there is 
not a cost-of-living increase, we will exempt approximately three-
quarters, actually 73 percent, of seniors from any premium increase.
  Why? Because we rightfully concluded, as many speakers on this floor 
have observed, that those seniors would be put under stress because of 
no cost-of-living increase but having an increase in their premium.
  Now, ladies and gentlemen, I don't know how many of you go to sleep 
at night worried about whether Ross Perot can pay his premium, but this 
will freeze Ross Perot's basic premium from going up. This will affect 
every premium payer, including those who make individually $85,000 or 
more, and, as a couple, $170,000 or more.
  Now, the problem with doing that is not that we don't have some 
empathy for those folks--by the way, every one of us who votes on that 
bill falls in that category. Now, we may not be 65 or above, as I am, 
but we are in that category.
  Now, the issue is, at a time of stress, of fiscal challenge, do we 
say to Ross Perot, we feel your pain and so we are going to exempt you 
from an increase? Hear me, we have exempted all of those $85,000 and 
below under present law.
  My friends, I think that as well meaning as this legislation is, it 
is not about poor seniors. It's not about those who are less well off 
who are having greater stress, because they are taken care of.
  There are four categories of people who aren't taken care of under 
present law.
  First of all, there are some 2.1 million who are the $85,000 and 
above crowd.
  There are a lesser number, 1.3 million, who are Medicare newly 
eligible folks, and they have never paid a premium, so their premium 
won't go up; their premium will be what it is.
  There are 7.3 million who are dual-eligibles, and the dual-eligibles, 
of course, will not pay anything more because that will be the 
responsibility of the States. Is this an additional burden on the 
States? It is. We will either borrow the money or the States will pay 
it. Our children will pay off our debt. But our law anticipated that if 
this was the case, that for the 7.3 million dual-eligibles, the States 
would pick up the difference. People say, well, what if the States 
don't pick up the difference? The States have an option. I understand 
that. We don't control that. We could change the law and say they don't 
have an option, but we haven't done that.
  Then there are some 850,000 who did not participate in Social 
Security.
  There are the four categories.
  Because they didn't participate in Social Security, they are not 
covered here and they get a State pension. Now, I tried to get the 
average of the State pension or the board of education pension or 
whatever, and I don't have that. I haven't been able to get that 
information. This bill was considered by the committee yesterday, 
reported out today.
  Do I stand here happy that some seniors around the country are going 
to say Steny Hoyer was against them? I am not happy about that.
  But I have felt it my responsibility to come to this floor, as 
someone who speaks about entitlement reform, as someone who believes we 
have got to exercise fiscal discipline, as someone who believes we 
ought to take care of the less well-off in our country, which are taken 
care of by the present law, 73 percent, under $85,000. We take care of 
that. That's an individual; $170,000 for a couple.
  At some point in time, my friends, we have to buck up our courage and 
our judgment and say, if we take care of everybody, we won't be able to 
take care of those who need us most. That's my concern. If we take care 
of everybody, irrespective of their ability to pay for themselves, the 
Ross Perots of America, frankly, the Steny Hoyers of America, then we 
will not be able to take care of those most in need in America.

                              {time}  1215

  Mr. STARK. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from Oregon (Mr. Blumenauer).
  Mr. BLUMENAUER. I appreciate the gentleman's courtesy. I reflect on 
what the distinguished majority leader just said. I agree with much of 
what he advanced. But my concern, I guess, is that what we have done is 
symbolic of how we have sort of jerry-rigged a system.
  We have the entire burden fall upon 27 percent of the population, 
some of whom perhaps can afford it, others who may not; and we are at a 
time when there is great stress on a number of these 27 percent. They 
will bear the entire burden.
  I would hope that this would be the last time that we are dealing 
with a fix of this nature that is surgical, trying to deal with the 
inherent complexity that we have.
  One of the reasons I am supporting comprehensive health care reform 
and Medicare modernization is so that we can tease out these anomalies; 
that we can provide an underpinning for all--not just our seniors 
citizens--but for all our citizens.
  I agree this is suboptimal, but from my vantage point, this is the 
best that we can do in an unpleasant situation.
  Mr. STARK. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from Michigan (Mr. Levin).
  Mr. LEVIN. I think this debate has framed the issues very well. I 
very much share the concern of our majority leader about entitlement 
reform. I think part of that will have to be consideration of this 
issue.
  But let's look at what the impact of a failure to act will mean. For 
the States, they will carry a large bulk of this because of the dual-
eligibles. So, essentially, by doing nothing, we would say to the 
States, When you're in unusual circumstances, we're doing nothing. And 
for the many new-eligibles, they would, regardless of income, bear the 
weight here in times of real stress for them.
  These are unusual circumstances for the States and for those who are 
receiving the benefits, and I think we have no choice now but to vote 
for this bill and tackle the issues of reform of our entitlements in 
the future.
  So I urge support of this legislation.
  Mr. VAN HOLLEN. Mr. Speaker, I rise in strong support of the Medicare 
Premium Fairness Act, which will protect millions of seniors and people 
with disabilities from unfair increases in their 2010 Medicare Part B 
premiums.
  Because of very low inflation, it is expected that there will not be 
a cost-of-living-adjustment (COLA) in Social Security benefits next

[[Page 22524]]

year. The current law has built-in protections for approximately 
seventy-five percent of Medicare Part B enrollees in which they will 
not see an increase in their Part B premiums as a result of not 
receiving a COLA on their Social Security checks. However, the 
remaining twenty-five percent of Medicare Part B enrollees will not be 
held harmless from an increase in their Part B premiums and will 
instead be responsible for shouldering the entire burden of next year's 
Part B program cost increase.
  This bill, quite simply, would extend the current hold harmless 
policy to all Medicare enrollees. By taking this action, it will ensure 
that no senior will face Medicare Part B premium increases next year--
including federal and state government retirees who do not pay their 
Part B premiums out of a Social Security check and so would have been 
disproportionately burdened without this change.
  The legislation is fully paid for and meets PAY-GO requirements. I 
strongly urge my colleagues to support this very important bill that 
will help seniors and people with disabilities.
  Mr. GENE GREEN of Texas. Mr. Speaker, I rise today as a proud 
original cosponsor of H.R. 3631, the Medicare Premium Fairness Act.
  Many of us heard from our senior citizens over the August recess that 
they would not be receiving a Social Security cost of living increase 
because of the economic downturn.
  This will cause a problem for many seniors because Medicare Part B 
premiums will still increase as they do yearly to cover the cost of the 
program. A ``hold harmless'' policy in existing law ensures that most 
seniors will not have a decrease in their Social Security checks if the 
Part B premium increase is projected to be greater than the Social 
Security cost of living adjustment.
  The hold harmless policy will protect most seniors from an increase 
in their 2010 Medicare premium, but the 27 percent of our seniors will 
not be protected by these hold harmless provisions and because of the 
way the law is written, premiums for these enrollees will be 
disproportionally increased to $110-$120 a month.
  The Medicare Premium Fairness Act will extend the current hold 
harmless policy to all Medicare enrollees. Ensuring that no Medicare 
beneficiary will see a decrease in their social security check due to 
the 2010 Part B premium increase and they will not see decrease in 
their Social Security checks.
  Our seniors live on a fixed income and any decrease in their monthly 
social security check puts them in jeopardy of not being able to afford 
food and medicine. We need to ensure that even when we cannot increase 
the cost of living for Social Security we protect our seniors from a 
reduction in their monthly check.
  I urge my colleagues to support his legislation which is fully offset 
and has the support of the AARP, the National Committee to Preserve 
Social Security and Medicare, the Center for Medicare Advocacy, the 
Alliance for Retired Americans, the Medicare Rights Center, and the 
National Active and Retired Federal Employees Association.
  Mr. LARSON of Connecticut. Mr. Speaker, I rise today in strong 
support of H.R. 3631--Medicare Premium Fairness Act. I commend 
Congresswoman Titus for her efforts on this issue and also would like 
to recognize Chairmen Rangel, Waxman, Stark, Dingell and Pallone for 
their tireless work.
  Today Congress acted to ensure that some of our nation's most 
vulnerable citizens do not face a dramatic increase in their Medicare 
Part B premiums. During these difficult economic times we must make the 
right choices to protect our senior citizens and individuals with 
disabilities. Without this measure that we are acting on today, many of 
my constituents in the First Congressional district and individuals and 
families across the country would be faced with an increase in the cost 
of their health care that they simply can't afford.
  I am pleased that there is bipartisan consensus on this legislation 
and hope to build upon this effort to protect and strengthen Medicare 
as we move forward with health care reform. Once again I thank my 
colleagues for their hard work on this issue and urge the bill's 
passage.
  The SPEAKER pro tempore. All time has expired. The question is on the 
motion offered by the gentleman from New Jersey (Mr. Pallone) that the 
House suspend the rules and pass the bill, H.R. 3631.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. HERGER. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 406, 
nays 18, not voting 8, as follows:

                             [Roll No. 737]

                               YEAS--406

     Abercrombie
     Ackerman
     Aderholt
     Adler (NJ)
     Alexander
     Altmire
     Andrews
     Arcuri
     Austria
     Baca
     Bachmann
     Bachus
     Baldwin
     Barrow
     Bartlett
     Barton (TX)
     Becerra
     Berkley
     Berman
     Berry
     Biggert
     Bilbray
     Bilirakis
     Bishop (GA)
     Bishop (NY)
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[[Page 22525]]



                                NAYS--18

     Akin
     Baird
     Bean
     Broun (GA)
     Chaffetz
     Flake
     Garrett (NJ)
     Hensarling
     Hill
     Hoyer
     Jordan (OH)
     Lamborn
     McClintock
     Pence
     Price (GA)
     Ryan (WI)
     Shadegg
     Smith (WA)

                             NOT VOTING--8

     Barrett (SC)
     Buyer
     Delahunt
     Doyle
     Graves
     Israel
     Moran (VA)
     Speier

                              {time}  1245

  Messrs. HILL and JORDAN of Ohio changed their vote from ``yea'' to 
``nay.''
  Messrs. FRANK of Massachusetts, FRANKS of Arizona, and COFFMAN of 
Colorado changed their vote from ``nay'' to ``yea.''
  So (two-thirds being in the affirmative) the rules were suspended and 
the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________