[Congressional Record (Bound Edition), Volume 157 (2011), Part 8]
[House]
[Pages 11449-11453]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  2040
                         MEDICARE UNDER ATTACK

  The SPEAKER pro tempore (Mr. Stutzman). Under the Speaker's announced 
policy of January 5, 2011, the gentleman from New York (Mr. Tonko) is 
recognized for half the remaining time until 10 p.m. as the designee of 
the minority leader.
  Mr. TONKO. Thank you, Mr. Speaker.
  It is our pleasure during the next 40-or-so minutes to express 
concerns about a Medicare program that has served this Nation's seniors 
so very well for 45 years and is at risk of being ended.
  Tonight, we witnessed on this floor the third such vote to end 
Medicare by the Republican majority. We know that our seniors would be 
forced to shop in a private market. The certainty of a guaranteed 
program that has been available to our Nation's seniors since 1966 is 
at risk. The money that the government would kick in for coverage would 
not keep pace with the costs for those health care policies, and so our 
seniors would be forced to dig into their pockets, reach into those 
pockets and perhaps have their costs, their contributions, more than 
doubled. This is an unnecessary step that is being taken against our 
Nation's seniors that is irresponsible.
  We believe that what we have seen since that threshold in time in 
1965 when we approved such a measure, the impact from the private 
sector health care industry has witnessed a growth of over 5,000 
percent in the cost of premiums in that time since 1965. The impact on 
seniors has been certainly far less than that. We have seen the 
containing of administrative costs, we avoid marketing requirements 
with the Medicare program, and we have been able to share benefits with 
our Nation's seniors in a way that protected their health care 
coverage, that enabled them to enjoy a quality of life.
  It can easily be documented that when our Nation's seniors retired 
back in the sixties, they would see their economic durability 
challenged. Their strength, their economic opportunity to grow forward 
into retirement was oftentimes impacted by the cost of medical needs. 
There was cherry-picking going on, there were opportunities that were 
denied our Nation's seniors, and they were asked to absorb an 
inordinate amount of pressure in order to continue forward in 
soundness, in wellness and certainly to have the coverage that was 
required to meet their health care needs.
  All of this now is at risk with several proposals. We've seen a Ryan 
plan, a budget that Republicans produced. The Ryan Road to Ruin, as 
we've designated it, would cause severe hardship on our Nation's 
seniors. We saw the Republican Study Committee come up with a vote that 
again ended Medicare. And today, when we witnessed this attempt to play 
with the United States Constitution, to make it very easy to end 
Medicare while making it even more difficult to address those deep 
pockets that get favorable treatment by some go continuing on because 
it would be more difficult to end that opportunity.
  So what we have here tonight is an opportunity to discuss the assault 
on America's working families, the assault on her seniors, the Nation's 
seniors, by ending Medicare, ending Medicare that puts the private 
sector insurance industry in control. They put them in the driver's 
seat, they require our seniors to shop with a voucher that won't nearly 
cover the cost of those premiums, and, again, require them to pay 
double as we go forward.
  We are joined by Representative Garamendi from California here this 
evening and Representative Joe Courtney from Connecticut. The three of 
us will share thoughts about how to better address the economic 
pressures on this Nation today without ending Medicare. It has been a 
lifesaver for so

[[Page 11450]]

many of our Nation's seniors and has provided a sense of security, of 
predictability in their budgeting as they go forward in retirement 
years.
  Representative John Garamendi from California, thank you for joining 
us this evening. You witnessed it here tonight, as Mr. Courtney and I 
both did, Representative Courtney from Connecticut and I, witnessed yet 
another vote that would mean the end for Medicare, because it's an 
attempt to play with the Constitution, mess with our Constitution in a 
way that would really focus on hardship for our Nation's seniors.
  Mr. GARAMENDI. Thank you very much, Representative Tonko. Thank you 
for bringing this issue alive this evening and for giving us this time 
to discuss this.
  Many, many thoughts went through my mind today as this vote and the 
debate went along. As it was debated by our Republican colleagues, I 
just couldn't understand where they were coming from. What would 
motivate them to want to destroy Medicare? And Medicaid? Why would they 
do that? The thoughts just reeled through my mind, and I'm going, I 
guess maybe they had had a different experience than I did.
  I was a young boy in the 1950s, and there was no Medicare, and there 
was no Medicaid. My father was a rancher. We grew up in a ranching area 
up in the foothills of California, in the Mother Lode Gold Country. He 
took me one day to the county hospital. It was one of the most horrible 
moments I can remember as a child, because the wards, there was just a 
ward, maybe 20 or 30 very elderly men, and then on the other side 
elderly women, who were dying. Their medical care wasn't available to 
them.
  Sometime later, maybe another month after that, we were out chasing 
cattle that had gotten loose--I was just a young man--and one of our 
neighbors, we came upon the neighbor and asked where the cattle might 
be, and he said they were down that way. He had this huge growth on his 
mouth, and my dad asked about that, and he said, it's cancer. He had no 
insurance. He had no care. He was probably 70, 75, 80 years old. He 
died shortly thereafter.
  In 1965, this country did a remarkable, beautiful, wonderful thing. 
We gave to every senior in America medical care, doctor and hospital 
care, the opportunity to live longer, to have that cancer treated, to 
eliminate those wards in the county hospital where people simply were 
warehoused to die. And here today, for the third time since January of 
this year, the Republicans have put forth a proposal--and hopefully it 
will never become law--to terminate Medicare.
  Have no doubt about it, Mr. Tonko, they would terminate Medicare. As 
you said, they would turn it over to the private insurance companies, 
with a voucher, insufficient to pay for medical care insurance from an 
insurance company today. The discrimination that exists in insurance 
for people with preexisting conditions, and the paramount preexisting 
condition in America is age. If you're 55, 60, 65, you have a 
preexisting condition. It's called age. What will come of those people?
  What is this Nation all about? Who are we as Americans? Who are we as 
Americans that on this floor in a charade, in a falsehood, brought to 
America today, and twice previously, legislation that doesn't deal with 
the fundamental issues of the budget, the tax issues, the revenue side 
of it, real reform in the programs, whether it's Medicare or the 
military. Real reforms. No, no, no. Just cut, slash, burn, and take 
your seniors, toss them aside.
  This is not the America that I want to live in. This is the America 
of the 1950s when there was no Medicare and when seniors were in wards 
left to die, or in no care at all. Every American 65 years of age is 
guaranteed a comprehensive health care benefit. It's called Medicare. 
Whatever else we stand for, that's where the Democrats stand. We will 
fight this fight. We will not lose this fight.

                              {time}  2050

  This is about the very heart and soul of this Nation.
  Mr. Tonko, thank you for these moments.
  Mr. TONKO. I think it's important for us to share with the American 
public what's happening on this floor in the House of Representatives. 
So many suggest that the history that drove Medicare to be developed, 
the dynamics that were so impacting on the senior community across this 
country coast-to-coast, could be revisited if their proposal to end 
Medicare--the Republican proposal to end Medicare--were to take hold. 
And I know Representative Courtney, Joe Courtney from Connecticut, 
understands that. He has shared those concerns over and over again, 
that we could go back and revisit history of 45 years ago, 46 years 
ago, when people literally were impacted by cherry-picking going on, 
where they couldn't afford policies even if they were offered to them, 
and many times they couldn't get policies written to cover them.
  Representative Courtney, thank you for joining us this evening on 
what is an important bit of information exchange for America. They need 
to know that the seniors are at risk.
  Mr. COURTNEY. Thank you, Mr. Tonko.
  I want to thank Congressman Garamendi, who did great service as the 
insurance commissioner in the State of California. He understands these 
issues intimately.
  I think this is really a generational gut check for our country in 
terms of whether or not this attempt to butcher Medicare, one of the 
most successful programs in American and world history, is going to 
succeed or not. John described very powerfully the public wards in the 
public hospitals and the third-tier status that seniors had prior to 
1965. Kaiser Permanente actually did a study in terms of just reminding 
us of what this country faced when President Johnson signed that 
legislation on Harry Truman's porch step. At the time Medicare passed, 
only 50 percent of seniors over 65 in America had health insurance of 
any sort whatsoever. Part of it was class. Part of it was the 
underwriting rules. But part of it is, just as Mr. Garamendi said, age 
is a factor which carries risk. And there is no insurance company that 
evaluates risk within its own book of business that can really take all 
comers when you're talking about a population of 65 and up. Life 
expectancy was 70 in 1965.
  So we passed Medicare, and what happened is we created a guaranteed 
benefit. The genius of Medicare is that we pooled the risk, and we 
actually made an affordable system financed through payroll taxes, 
premiums. The system has had its ups and downs financially over the 
past 45 years. The fact of the matter is we now have a life expectancy 
of 78 in this country. It has worked. We have also alleviated the 
crushing out-of-pocket costs that seniors faced in 1965, and we have 
elevated the status of people in that demographic in a way that the 
private insurance market just was totally incapable of doing it.
  Last year, we passed the Affordable Care Act, which modified Medicare 
and made some important improvements and changes. We now have annual 
checkups covered. We now have cancer screenings. We now have extended 
prescription drug benefits. And one of the things that the Republicans 
claim, in trying to sell this measure with snake oil, frankly, is that 
somehow people who are 55 and above today will not be affected by the 
passage of the Ryan plan. In fact, we know that if you look at that 
plan, it cancels all of those new benefits in year one.
  So seniors who now--hundreds of thousands--have gotten their annual 
checkups in the last 8 or 9 months since the new benefit kicked in, 
cancer screenings that kicked in, prescription drug assistance that's 
now providing health for seniors in the doughnut hole, all of that 
would be canceled today, and any prospective change that is proposed in 
this system, which again, starting for individuals 55 and under, now 
will be left in a private insurance market with a totally inadequate 
voucher, as Mr. Garamendi said. Again, that's where the real butchering 
of Medicare takes place. But there is no question for anyone who's 
listening tonight that if you are a senior citizen on Medicare, the 
false

[[Page 11451]]

claim that you are somehow insulated from this measure because of the 
fact that you're already in the program, that is something that people 
have got to recognize and understand. That new benefits that are making 
this a smarter, more effective program are going to be canceled in year 
one if this measure, God forbid, ever is enacted.
  Mr. TONKO. Very well said, Representative Courtney.
  What I think upsets all three of us is the fact that, with the 
Affordable Care Act, where we found savings by reining in some of the 
profit margins of insurance companies that were used--those savings 
were used to fill the doughnut hole that you just talked about--they're 
now taking those savings and sharing them in a way that's not going to 
benefit seniors, and they're not going to fill that doughnut hole. So 
when seniors come to us and say, Look, what is this talk about 
Medicare? they're saying, You destroyed Medicare. No. We were working 
to make it stronger. We're working to fill the doughnut hole so that 
prescription costs that are impacting seniors--my gosh, with the 
passage of time, we have seen advancements in pharmaceutical research 
that provides more opportunity for wellness or for cure. That has 
stretched opportunities galore for our seniors. But they would raid 
those savings and pull them away again from our senior community and 
use those in other ways, which we find very offensive.
  This ending of Medicare with this third vote tonight, how much more 
do we need to challenge the security of seniors out there? They're 
disturbed every time they hear of this effort to end Medicare. We want 
to make it stronger. We're talking about all sorts of efforts to bulk 
purchase pharmaceuticals for the Medicare program, which would make it 
stronger. They forecast $156 billion or $157 billion of savings to the 
Federal Government that would provide correspondingly some $27 billion 
in savings for individual seniors just by doing that.
  So there's an all-out effort here to strengthen Medicare, not to end 
it. And it's sad that tonight we witnessed the third vote cast here, 
with the majority's support so that it passed in the House, to move 
forward and include in that packaging the ending of Medicare.
  Representative Garamendi, you have a chart up there.
  Mr. GARAMENDI. I have this chart. We've used it before as we've 
discussed Medicare. It brings this whole thing right into focus. This 
is a tombstone. Medicare. 1966-2011. Created by LBJ. Destroyed by the 
GOP. It may be a little harsh, but this is really the reality of what 
is going on here. It's the end of Medicare as we know it. It's the end 
of the guaranteed benefit program, and it does turn everyone who is 55 
years and younger over to the insurance industry.
  I spoke to this briefly before--and Mr. Courtney, thank you for 
reminding me that I was the insurance commissioner in California for 8 
years. I fought tooth and nail with the insurance industry over health 
care and automobile and homeowner and other kinds of insurance. In the 
health care sector, the private health insurance companies are about 
profit. That's their goal. They are profit-making organizations. And to 
enhance their profits, they do a variety of things. Deny coverage. 
You've got a policy? Oh, but that was a preexisting condition, and 
therefore we're not going to cover it. Or, gee, that kind of treatment 
is not covered.
  There was a lot of talk about death panels. I'll tell you where the 
death panel is--and I saw this as insurance commissioner. I saw 
insurance companies denying treatment that led to the death of numerous 
individuals over those 8 years. The real death panels have been the 
private insurance companies. In Medicare, I know of no case where that 
has happened. Maybe it did, but I'm unaware of it, and I had the 
biggest State--California. Also, there is this kind of discrimination 
that takes place.
  Let me just put this additionally to it. The private health insurance 
company is grossly inefficient. It is inefficient. It has enormous 
additional costs that Medicare does not have. By comparison, Medicare 
is a very efficient operation. It takes about 2 percent to raise the 
money and another, maybe, 2 or 3 percent to pay the bills and, on the 
provider side, maybe another 10 percent to do the billing also. Maybe 
the total cost is somewhere at about 15 percent in administrative 
costs. The private insurance companies run somewhere near 30 percent in 
administrative costs when you consider profit, when you consider the 
advertising, sales commissions. And they have thousands of different 
policies covering this, but not covering that, this deductible, that 
deductible. And when it gets to the provider, the ultimate chaos. So 
the administrative cost in the private system is about twice what it is 
in Medicare. Medicare is a very efficient, very effective, universal 
program that raises the money in a very fair way.

                              {time}  2100

  All of us pay for it, and all of us should be getting that benefit 
when we get to be 65--but not so in the private sector. Our Republican 
colleagues want to take all of this money and hand it over to the 
private insurance market and say, ``Okay. You guys take care of it.'' 
It's less efficient. It's certainly deadly in denying coverage and 
benefits. Just compared to Medicare, it's very inefficient.
  Mr. TONKO. Representative Garamendi, earlier you had talked about the 
impact on the 55-year-old or 54-year-old. If you look at a 54-year-old 
today, that individual is advised to save some $182,000 to $190,000 so 
as to have that available cash to cover the deficiency that's going to 
come with this end to Medicare, where you shop with this voucher, and 
it's only going to cover 32 cents on the dollar. So that 54-year-old is 
already impacted, but there is more to the picture than that.
  When you draw the line in the sand and say, ``look, we end Medicare, 
and so those under 55 today will have to fend for themselves,'' they'll 
shop out in the private sector market, but when you don't have the 
newly entering senior community as they turn 65 enter into the mix, 
there is a correlation of age with the drawdown of the health care 
system. As you take the younger senior population, they provide for 
that ebb and flow within the pooling that Representative Courtney 
talked about earlier. The beauty of the program is that you pool 
seniors from the very youngest of seniors to ``senior'' seniors, and as 
that need for health care grows with age, the newly entering help 
provide that balance. So the stability of the program and the 
durability of that program is at risk, I believe, because we're 
changing the dynamics.
  Representative Courtney, you have talked about the security of that 
program, of the stability that we can provide, and how we in this 
House, as Democrats, have been working to strengthen the Medicare 
program: to build the trust fund so that there is this underpinning of 
support that will enable the program to continue to meet the needs of 
the upcoming population of baby boomers.
  Mr. COURTNEY. Right, and thank you.
  Because there was so much, almost, fear language surrounding this 
debate in terms of whether Medicare is bankrupt, whether Medicare is 
going broke, whether Medicare is running out of money, it's important 
for people to go back and read the trustees' report, which was just 
issued a few weeks ago. It is a report that is issued on an annual 
basis. It has been since 1966 when Harry Truman was the first Medicare 
beneficiary to sign up for the program with his wife, Bess; but it has 
had its ups-and-downs over the years.
  The report that just came out said that Medicare is fully solvent, 
can pay all of its bills through 2024 and that it can pay 90 percent of 
its bills through 2045.
  Now, there is no question that, compared to last year's report, there 
was some deterioration in terms of that projection, but the trustees 
were careful to point out the fact that that slippage in terms of some 
of the years of lost solvency was due to the economy and due to payroll 
tax collection. It

[[Page 11452]]

had nothing to do with overuse or certainly nothing to do with the 
Affordable Care Act. In fact, they said the opposite, which was that 
the Affordable Care Act actually extended the solvency of the Medicare 
program by a factor of 8 years. Thank God we had passed that 
legislation, because we really would almost be bumping up into a cliff 
at this point if we hadn't done it.
  But again, I think it's important for people to remember that, going 
back in time to 1970, the Medicare solvency report that came out for 
the trustees projected 2 years of solvency as to when it was going to 
hit that tipping point. When Ronald Reagan was President in 1983 and 
came to the Congress, seeking an increase in the debt limit to avoid 
default, Medicare solvency was half of what it is today. So the fact is 
that it has had its challenges.
  As you point out, there are good ideas about using bulk purchasing, 
and there are good ideas about revisiting the subsidized insurance 
program in terms of the size of the insurance company subsidies. We can 
deal with that 10 percent shortfall between 2024 and 2045 without 
butchering the program. That really is, in my opinion, the wolf in 
sheep's clothing surrounding this debate in that somehow people are 
using solvency reports as an excuse to basically eliminate the 
guaranteed benefit.
  Again, it is our duty as Members of Congress to make sure that we 
protect for the next generation the benefit that our parents enjoyed 
and that pushed out solvency from age 70 in 1965 to age 78 today. That 
is a Medicare success, and we cannot go backwards as a Nation.
  Mr. GARAMENDI. Mr. Courtney, thank you for pointing out that very, 
very important fact that seems to have been totally overlooked in 
today's debate, at least by our Republican colleagues.
  There is another factor here, and that is that Medicare, like all 
medical services across the United States, whether you are in Kaiser or 
in Blue Cross, Anthem or Medicare--all of these programs are carried 
along on the inflationary wave in health care, which actually runs two 
or three times the general inflation of our economy. So health care is 
growing very, very rapidly overall. It turns out that the inflation 
rate in Medicare is about one half the inflation rate in the general 
health care system. Now, if Medicare is part of the health care system 
and takes care of the most expensive part of the population, how is it 
that Medicare is not inflating--the costs are not going up--as fast as 
the costs are in the private health insurance sector?
  The reason is, as I discussed before, Medicare is very efficient. It 
is a very, very efficient program: a universal benefit across the 
Nation, uniform; clear deductibles, clear co-pays; and in Medicare part 
B, cost sharing. All of that is there and it's understood. The private 
insurance has 1,000 different policies--chaos throughout the 
marketplace.
  Now, we've talked about this a little bit. We really need to have 
Americans understand that the Affordable Health Care Act had a whole 
series of very, very important legislative activities that will reduce 
the overall cost of health care.
  An example is electronic medical records, not written records by a 
doctor or a nurse--either legible or illegible, stacked in a great big 
stack of papers--and all of us have seen those. Electronic medical 
records. It's a very, very important way to reduce problems, to reduce 
misunderstandings, a back-and-forth with drugs and the like.
  Another very important factor is hospital infection rates. Hospitals 
have a very high infection rate, and don't get paid a second time for 
retreating the original illness when that person comes in. It has a 
very, very important impact on reducing the cost of medical services. 
There were many other things you talked about--the drug benefit.
  By the way, how is it that during the Bush period when the Medicare 
part D, the drug benefit, went into place that the pharmaceutical 
industry was so powerful that they denied American taxpayers the 
opportunity for the government to negotiate for the price of drugs?
  Mr. Tonko, you raised that point. To this day, we've not had our 
Republican colleagues come along and say, ``Oh, yeah. There's a good 
way to save money. We'll just negotiate for the drugs.'' It turns out, 
as to the military and the health care services provided by it, they 
can negotiate for drugs, but Medicare cannot.
  So it costs us, you said, $150 billion over 10 years. Is that the 
number you came up with?
  Mr. TONKO. I believe it's $157 billion, right. It's a benefit that 
ought to be shared on behalf of our Nation's seniors.
  To the points made earlier in this discussion as to the efforts for 
prevention, for screenings, that do not require co-payments or 
deductibles--the annual checkups--these are all elements that were 
introduced and imbedded into our reform package to contain costs, to 
bend that cost curve.
  The real concern that so many have raised from the Democratic 
membership in this House is that we're not providing the sorts of 
savings for our seniors, that we're not bending that cost curve. When 
you send them out to shop and don't even give them adequate coverage--
32 cents--and then the indexing into the future is not keeping pace 
with the projected inflation of health care costs, we're putting them 
at risk. We're targeting them for defeat. They're saying, Well, you're 
going to have 13 or 15 plans from which to choose as you shop in the 
open market.--That isn't bending the cost curve.
  So the economic consequences here are, first and foremost, the 
hardship that seniors will have to embrace, that they'll have to 
endure. Then also, when we look back at 1966 and 1965, the available 
cash--the economic vitality of a senior household--was drained. It went 
south because medical costs were usurping their retirement funds.

                              {time}  2110

  Think of it. Those dollars not only help provide stability and 
security for our Nation's seniors, but that's available cash that they 
can use to perhaps have a meal out at a restaurant in their local 
community. There are dollars that are made available that get spun into 
the regional economy that allow for the comeback. So this is very 
interesting.
  The programs, the cuts that they're suggesting, are all in areas that 
can help create jobs and improve economic viability.
  Mr. COURTNEY. We had a town hall meeting in my district, talking 
about the Medicare program. We had Dr. Rebecca Andrews--she's a primary 
care doc at the University of Connecticut Health Center--and she was 
talking about the new annual screening coverage where she had one of 
her patients who was kind of a big husky guy, kind of. They used to 
kind of razz each other. But she had 45 minutes with him. She did the 
soup-to-nuts checkup. She ordered a urine test, which she normally 
wouldn't with the old system. She found a tiny, microscopic spec of 
blood, or they did at the lab, which they were a little concerned 
about. She called him back in, did a follow-up. It turned out he had 
bladder cancer.
  Because they were able to detect it so quickly because of that annual 
checkup and the cancer screening tests that are now covered under 
Medicare, it was a day surgery, in and out, a really very nonintrusive 
event that cost a fraction of what it would have been if he had not had 
that checkup to detect that cancer early. And she had at least two 
other patients, because of the new Affordable Care Act annual checkup, 
where they detected cancer and again were able to intervene at a low 
cost compared to what it would have been if it had been a full-blown 
case.
  Mr. TONKO. Representative Courtney, I think what we're talking about 
here is legitimate reform in a way that bends that cost curve and takes 
a sound economic program like Medicare for our Nation's seniors and 
allows for that benefit and pulls the resources from coast to coast to 
serve our Nation's seniors well.
  The concern here is, Representative Garamendi, they want to give 
their friends with deep pockets more opportunity for business. End 
Medicare to

[[Page 11453]]

provide more business for the private sector insurance industry. 
Privatize Social Security, right?
  Mr. GARAMENDI. It was the bill they introduced.
  Mr. TONKO. I think you have a chart there that talks about another 
special interest.
  Mr. GARAMENDI. Before we go to this other issue--and we've got 
another 7 or 8 minutes here--another major program that is targeted by 
our Republican friends is Medicaid. Medicaid is a program for 
impoverished Americans. Seventy percent of Medicaid is for seniors and 
nursing homes. They want to take some $700 billion out of Medicaid. In 
California, that's called MediCal, but in each State they have their 
own program. But $700 billion goes directly to seniors that are in 
nursing homes. What will come of those people that are now in nursing 
homes when this program, Medicaid, is reduced as proposed in the budget 
that was passed today?
  But, having said that, let's turn to the other side of the coin.
  You want to make cuts, but do you want to cut Medicare? Do you want 
to cut Medicaid?--or do you want to cut the subsidies that exist in 
American business today?
  This is just one of hundreds of subsidies, tax breaks, given to 
American businesses that they don't need.
  Big Oil receives my tax money, your tax money, and the American 
taxpayers' money to the tune of--I don't know--$5 billion, $6 billion, 
$7 billion a year. Yet look at their profits. Look at their profits 
here. This is just 1 year. You add up these profits over the last 
decade. Exxon last year, $10 billion; Conoco $2.1 billion; Chevron, $6 
billion; BP, infamous BP, $7.2 billion. Yet they receive our tax 
subsidies. You take this and you apply it over the last decade, and it 
is just $950 billion of profit--$50 billion less than a trillion 
dollars of profit.
  And yet defending the oil companies are our Republican colleagues, 
saying no, no, no. You can't touch Big Oil. You can't take away their 
tax subsidies, but you can surely go after seniors and take $6,000 out 
of the pocket of every senior with this Medicare program.
  Mr. TONKO. It's very obvious from the polls being taken by many, many 
organizations out there that the American public said it's about jobs. 
We need jobs in the economy in order to make things work. It will 
reduce the deficit. It will put people to work. It will start growing 
the economic engine of neighborhoods and States and the entire country.
  But what we're seeing is that there's this Republican assault on the 
middle class. They're cutting programs that serve the middle class. 
They're cutting programs that create jobs and invest in a new economy. 
But they're leaving alone these groups that are actually not--they're 
earning record profits, and we're still giving them hard-earned 
taxpayer dollars in the form of handouts and subsidies to the oil 
industry, to various industries that are just befriended by those in 
the House that want to play off the middle class and end Medicare, 
which is a very dangerous precedent that will be set.
  Representative Garamendi, you wanted to make a point.
  Mr. GARAMENDI. Mr. Courtney just pointed back to me. I was going to 
pass it to him.
  We just talked about Big Oil, the subsidies to Big Oil that are being 
protected by our Republican colleagues, making sure that Big Oil gets 
their money. That's not the only thing.
  They are fiercely fighting, fighting fiercely to maintain the Bush-
era tax cuts for the superwealthy. We're talking about millionaires.
  So what does it mean for millionaires to hang on to that tax cut that 
occurred in 2003, I believe? For millionaires, that tax cut is worth 
$200,000 a year if you have an income of $1 million. Now, there are 
folks out there that have incomes of a billion. So you can kind of 
expand that, add five zeroes. You get close to what it might be for a 
billionaire, and there are billionaires out there. What does it mean 
for seniors? It means it's going to cost them some $6,000 a year in 
what will be their Medicare costs in the future.
  Mr. TONKO. And that's equaling 33 seniors.
  Mr. GARAMENDI. Thank you. You read the chart better than I do.
  Mr. TONKO. Thirty-three seniors paying $6,000 more per year. So we're 
making happy one millionaire and we're economically distressing 33 
seniors who are going to pay at least $6,000 more to have the health 
care coverage if they, in fact, can get it.
  Mr. COURTNEY. If I can just sort of finish, the point is that we were 
talking about two programs right now that did not create the deficit 
issue that is facing this country.
  We had two massive tax cuts for the super-rich. We have two wars that 
haven't been paid for and a prescription drug benefit which was passed 
during the last administration which was never paid for, which we dealt 
with in the Affordable Care Act to offset that. The Trustees report 
says that we've got 100 percent solvency through 2024, 90 percent 
solvency through 2045, and 100 percent solvency for the Social Security 
system until 2037.
  Mr. TONKO. And, Representative Courtney, when you talk about all of 
those costs, they were never put in the budget. They were off-budget. 
So that meant that those two wars, the pharmaceutical deal for Medicare 
part D, and the tax breaks for millionaires and billionaires all had to 
be borrowed money, and so we borrowed from China, Saudi Arabia, all to 
make it happen.
  This was dishonest budgeting, and it was favoring deep pockets over, 
evidently, seniors. And now the solution? End Medicare, block grant 
Medicaid, privatize Social Security. This is an assault on middle class 
values on our Nation's seniors.
  Representative Garamendi, we'll move to you.
  Mr. GARAMENDI. Representative Tonko, thank you so very much for 
bringing us together tonight to talk about Medicare and the Republican 
proposal to terminate Medicare and significantly reduce Medicaid 
programs for seniors in nursing homes.
  This is a pivotal moment in this Nation. It really speaks to our 
values. It speaks to who we are as Americans, who we care for, and what 
we are concerned about.
  Mr. COURTNEY. I'll just say, I'm sure your offices are like mine. 
This is the number one issue that we're getting calls, emails, and mail 
on: Are you guys going to stand up and live up to your sacred duty to 
protect these programs--Medicare, Social Security, and Medicaid--that 
our middle class depends on?
  Mr. TONKO. At least nine of every 10 comments we get either through 
the mail or on the phone are: Save Medicare. Don't let them mess with 
it.
  We're fighting the good fight here. America needs to know there is a 
risk of losing Medicare. There are those who want to end it. We saw 
another vote here tonight.
  With that, I yield back the balance of my time.

                          ____________________