[Congressional Record (Bound Edition), Volume 160 (2014), Part 4]
[House]
[Pages 5602-5605]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     PROTECTING MEDICARE ADVANTAGE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2013, the gentleman from Florida (Mr. Murphy) is recognized 
for 60 minutes as the designee of the minority leader.


                             General Leave

  Mr. MURPHY of Florida. Madam Speaker, I ask unanimous consent that 
all Members have 5 legislative days to revise and extend their remarks 
and include extraneous material on the subject of my Special Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. MURPHY of Florida. Madam Speaker, there are currently many 
concerns regarding health insurance in our country, especially among 
our Nation's seniors. At this time of major transition in our Nation's 
health care industry, it is critical that seniors enrolled in 
traditional Medicare and Medicare Advantage can keep the coverage on 
which they depend.
  Unfortunately, proposed cuts to Medicare Advantage are putting these 
important benefits at risk. This is a very serious situation across the 
country, and it is of great concern to me, with Florida being home to 
over 4 million seniors. My district alone has over 160,000 seniors, 
with more than one-third of them choosing a Medicare Advantage plan 
whose coverage would be severely impacted by the proposed cuts released 
in the draft rule that CMS put out in February.
  We are already seeing what last year's cuts to Medicare Advantage 
have meant: smaller networks of doctors, cuts to add-on benefits, and 
higher out-of-pocket limits. The additional proposed cuts to the 
program released in February have raised great concerns from my 
constituents about their coverage and about the potential of having to 
pay more and having fewer benefits. That is why we are here today, 
urging the administration to reverse course and keep rates flat for 
2015.
  At this point, I would like to yield to my good friend Ms. Sinema 
from Arizona, who has been fighting tirelessly to protect the seniors 
in her area as well.
  Ms. SINEMA. Thank you, Congressman Murphy, for hosting this Special 
Order so that we can stand up and speak out for seniors in our 
districts. We are here today because CMS, the Centers for Medicare and 
Medicaid Services, has proposed cuts to Medicare Advantage.
  Next week, CMS will publish its final rule. I urge CMS to not cut 
Medicare Advantage. These cuts will decrease choice, create 
uncertainty, and undermine access to care for our seniors.
  I oppose these cuts. Like Mr. Murphy and many of our colleagues 
participating in this Special Order, I have repeatedly called on the 
Federal Government to reconsider its proposal and make no further cuts 
to Medicare Advantage.
  Medicare Advantage is a popular and effective alternative to 
traditional fee-for-service Medicare, especially in Arizona, where 
statewide, 38 percent of Medicare-eligible beneficiaries choose a 
Medicare Advantage plan. In my district, nearly 43 percent of Medicare-
eligible beneficiaries choose a Medicare Advantage plan.
  Medicare Advantage plans consistently receive high customer 
satisfaction ratings and are helping to control cost, drive innovation, 
and improve health outcomes for beneficiaries. I keep saying 
``beneficiaries.'' But what I should say is, our parents, our 
grandparents, and our loved ones. These plans provide affordable, high-
quality care for our loved ones.
  Bonnie Grant, a proud Arizonan in my district, is in her sixties and 
lives in Phoenix. Through her Medicare Advantage plan, she has access 
to a transportation system called Van Go. Bonnie uses the service to go 
shopping and to go other places ``instead of being stuck at home.'' She 
said that it helps because ``instead of being holed up in your home,'' 
she can be engaged in the community and enjoy her life. The Van Go 
benefit is the type of creative service offered by Medicare Advantage 
plans that improves the well-being of enrollees.
  Joseph Ford, another constituent, lives in suburban Phoenix. He was 
disabled in a car accident. The hands-on managed care he receives 
through his Medicare Advantage plan, including in-home visits, allows 
Mr. Ford to stay in his home and live a fuller life. Keeping 
individuals like Mr. Ford in his home instead of in institutional care 
facilities is better for the beneficiary and presents a significant 
cost savings to the Medicaid and Medicare programs.
  I am concerned that the proposed payment reductions for 2015 will 
undermine the choices made by my fellow Arizonans, by Ms. Grant, by Mr. 
Ford, and by others in my congressional district by causing our loved 
ones to lose needed services and to experience increases in premiums. 
These cuts could also have the unintended and costly consequence of 
putting our seniors at risk of being placed in institutions, rather 
than staying in their homes.
  Instead of cutting funding for these popular plans, we should work 
together to find reasonable solutions that drive down cost, increase 
choice, address waste, fraud, and abuse, spur innovation, and 
ultimately improve the quality of life provided to our seniors.
  Again, I urge CMS to maintain payment levels for Medicare Advantage 
so that our loved ones do not experience increased out-of-pocket costs, 
negative disruptions, or confusion in 2015.
  Thank you, Congressman Murphy, for working with me on this important 
issue and for hosting this Special Order today.
  Mr. MURPHY of Florida. I thank the gentlelady from Arizona for her 
comments and for reminding us that these aren't simply numbers on a 
ledger, that all of these beneficiaries are folks we know. These are 
our parents. These are our grandparents. They are more than just 
numbers.
  And like Ms. Sinema, I am constantly hearing from residents in my 
district about the negative impact these cuts would have on the well-
being of their spouses, their parents, or personally, including Cheryl 
from Palm Beach Gardens, in my district.
  After doing everything right to plan for her retirement, like many 
seniors do, Cheryl and her husband saw their savings cut in half during 
difficult economic times. Now they are seeing their health care options 
limited and their out-of-pocket costs going up. These are changes they 
simply cannot afford.
  I agree with Cheryl that it is unfair to shift the burden onto those 
on fixed incomes, those who have little resources to make up the 
difference. Seniors cannot afford further cuts and the negative 
consequences if these misguided proposals move forward.
  At this point, I would like to take a moment to yield to the general, 
Mr. Enyart from Illinois, and thank him for his leadership in fighting 
for seniors on behalf of Illinois and the rest of our country.
  Mr. ENYART. I thank the gentleman from Florida.
  Madam Speaker, I rise today to show support for the 50 million 
Americans

[[Page 5603]]

enrolled in Medicare. Medicare is vital not only to my district, like 
Mr. Murphy's district in Florida, but our entire Nation, which is why 
my fellow colleagues and I should support its promise to all our 
citizens who have earned it, who have paid for it through their taxes, 
and who now rely on it for a stable health care system and for their 
medical care.
  Medicare has a long and valued history since its inception in 1965. 
Social Security recipients have consistently benefited from the 
opportunity to access quality, affordable health care, a right now 
guaranteed to those who worked hard for that privilege.
  There are 122,380 constituents from the 12th District of Illinois who 
participate in the Medicare program. That is one out of every seven 
citizens in my district.

                              {time}  1645

  Many of these constituents are disabled, and almost all are on a 
fixed or limited income. Medicare gives these citizens the opportunity 
to receive essential medical care and to take part in preventive care 
programs designed to maintain good health, which lowers the cost of 
health care--lowers the cost of health care.
  Of those 122,000 southern Illinoisans, over 28,000 also participate 
in Medicare Advantage. That is one in four of those Medicare 
participants taking part in a program specifically designed for those 
seniors who have high rates of chronic disease. Medicare Advantage 
focuses on prevention and on disease management, which reduces the need 
for unnecessary hospitalizations--keeping our most vulnerable 
populations healthier and out of the hospital waiting room.
  Medicare and Medicare Advantage serve our seniors, low-income 
families, and those susceptible to disease. I ask, are these the 
populations we want to cast aside? Are these the citizens that we need 
not care for? I say no. Yet, the proposed budget unveiled this week 
virtually eliminates Medicare for future enrollees. It includes plans 
to shift health care costs to seniors. It removes the guarantees 
provided by our current Medicare system to make quality, affordable 
health coverage available for those who need it most. It undermines the 
promise our Nation made to its citizens--that if you work hard and you 
pay your taxes, some day, should you need it, your health care needs 
will be met.
  The recently proposed budget also implements what they label a 
premium support system. That is a plan to move Medicare to a voucher 
program. I vehemently oppose this proposition. Our seniors don't need a 
health care coupon--they need health care.
  They need the ability to choose their own doctor. They need the 
ability to access billions in savings for prescription drugs. They need 
access to wellness visits--all of which are in jeopardy under this 
Republican budget plan.
  I am tired of hearing proposals to eliminate vital government 
services simply because of party ideology. Let us not govern blindly 
through rhetoric and sound bites, but rather, let us work for our 
constituents to better serve those who have paid into the Medicare 
system their entire working life and now need it most.
  Medicare serves those who have earned it, who have paid for it, and 
who deserve it. Should we take away that service, I fear what the 
future may hold for our seniors--seniors like Carolyn Morgan from Du 
Quoin, Illinois. Carolyn needed Medicare's help in March of 2013, when 
she became ill and hospitalized, put on oxygen, and given a daily 
regimen of prescription drugs.
  I hold her letter to my office in my hand.
  Carolyn states:
  I cannot afford out-of-pocket health care. My supplemental insurance 
is useless without Medicare, so it would have been wasted money every 
month.
  I know I will be spending the remainder of this congressional term 
fighting for Carolyn and fighting for our seniors and disabled to make 
sure that the health care promises we made so many years ago are not in 
danger from partisan budget cuts.
  My fellow colleagues, I urge you to join me. Let's avoid a grim 
future for the elderly, for the disabled, and the fixed-income citizens 
of this great Nation. Let's help Carolyn and the many more American 
citizens just like her. Let's fight to keep Medicare.
  Mr. MURPHY of Florida. I want to thank the gentleman from Illinois 
for his generous words and reminding us of the importance of Medicare 
and Medicare Advantage and what it means to so many folks across our 
great country.
  At this point, I would like to take a minute to let the gentleman 
from Georgia talk about what is happening in his district. Mr. Barrow 
has been fighting for years up here in D.C. for Medicare and seniors 
across the country.
  Mr. BARROW of Georgia. I thank the gentleman.
  Madam Speaker, I would like to thank my colleague, Mr. Murphy, for 
gathering us all here to talk about this important issue. This is an 
issue that affects folks in every part of this country, and in my view, 
is one of the most important issues facing seniors in our communities 
today.
  I applaud all of my colleagues gathered here for taking a leadership 
role in our efforts to fight proposed reductions to the Medicare 
Advantage program.
  Nearly 15 million seniors across the country are enrolled in Medicare 
Advantage, including more than 300,000 in my home State of Georgia. 
This program serves our seniors well, particularly those with high 
rates of chronic disease. Nearly 30 percent of all Medicare 
beneficiaries turn to Medicare Advantage to cover their health care 
costs.
  By focusing on prevention and disease management, Medicare Advantage 
plans reduce the need for hospitalization, and that, in turn, reduces 
health care costs. It is a proven program that folks in my district 
have come to rely on.
  The Centers for Medicare and Medicaid Services recently proposed a 
5.9 percent cut to this program, which could result in a reduction of 
benefits and increased premiums on Medicare beneficiaries by $35 to $75 
a month. That is an added cost that many seniors simply cannot afford 
to pay every single month.
  My colleague from the other side of the aisle, Dr. Bill Cassidy, and 
I have been leading the charge to urge the Federal Government to take 
any and all steps necessary to preserve this program. Just last month, 
more than 200 Members of Congress from this House joined us in our 
effort to urge the Centers for Medicare and Medicaid Services to 
preserve the standard of care that seniors are currently getting. I, 
for one, do not want to put our seniors, men and women who have worked 
their entire lives, in the financial trouble these reductions would 
cause.
  I have urged the administration to take a long, hard look at how 
these cuts would affect everyday lives of our seniors. If the goal here 
is to save money, there are better, more suitable ways to do it than on 
the backs of our seniors.
  Again, I would like to thank my colleague for getting folks together 
to talk about how we can work together to make sure Medicare Advantage 
isn't jeopardized. It is an issue that isn't for Democrats or 
Republicans, but one that we all need to address. I have been proud to 
work on this issue in a bipartisan fashion with Dr. Cassidy, and it is 
my hope that all of our colleagues will get on board and help us 
preserve Medicare Advantage.
  Mr. MURPHY of Florida. I thank the gentleman from Georgia for sharing 
your thoughts and stories and reminding us that this isn't a partisan 
issue. It shouldn't be a Republican, Democratic, or Independent issue. 
These are seniors. These are folks that built this great country, many 
of whom are veterans who fought for our country and laid the foundation 
which we have today.
  So thank you for reminding us of that and being here today and taking 
a moment out of your busy schedule to share your thoughts.
  I would now like the gentleman from Arizona, who has been championing

[[Page 5604]]

this issue back home, to talk about what he is doing with Medicare 
Advantage and why he is here today. Mr. Barber, thank you.
  Mr. BARBER. I want to thank the gentleman for bringing us together 
tonight to talk about the importance of preserving and protecting 
Medicare Advantage.
  I rise today, Mr. Speaker, on behalf of the citizens that I represent 
all across southern Arizona--thousands and thousands of seniors who 
have come to rely on Medicare Advantage to keep them in their homes, to 
keep them well, and to provide them with the support that they so 
dearly need as they age in place.
  They live in communities all across my district, from Tucson to 
Sierra Vista, to Douglas, to Benson, to Bisbee, to Willcox, and to 
``the town too tough to die,'' Tombstone. And I am determined to fight 
on their behalf to make sure that Medicare Advantage continues to serve 
them and does not disappoint the delivery of services by losing 
funding, as is proposed by the President this month.
  Medicare Advantage offers seniors and individuals with disabilities 
quality and affordable health care that they can depend on. And they 
depend on us--those of us who represent them--to fight for their right 
to continue this program.
  Medicare Advantage focuses on prevention and innovation. It is a 
proven fact that this program improves health outcomes and contains 
costs. Isn't that what we should be doing for our seniors and for 
everyone in America? But now, as I said, the President is proposing 
harmful cuts to Medicare Advantage.
  So let's examine what these cuts would mean if they go into effect. 
They will mean fewer benefits, fewer doctors, and less choice. This is 
wrong, and we cannot let it happen. I oppose these cuts, and I have 
called upon the President to reverse course and protect this critical 
program.
  For the people in my Second District of Arizona and for seniors all 
across this great Nation, there are over 390,000 Medicare Advantage 
enrollees or recipients in the State of Arizona alone, and it is 
working for them. They will attest to that, and they have to me. They 
have contacted my office in person and by phone, they have met with me 
in community gatherings all across the district over the last several 
weeks, and they have expressed their deep concerns that they will lose 
this valuable program that they have come to rely upon that keeps them 
well and keeps them in their homes.
  Before I came to the Congress and before I worked for Congresswoman 
Giffords, I administered a regional and then a State program for people 
with disabilities that focused on the same kinds of services that are 
provided to seniors and individuals with disabilities under the 
Medicare Advantage program--cost effective, in-home support, keeping 
people well, and preventing more illness. This makes sense. It makes 
sense for them, it makes sense for our country, and it makes sense for 
the appropriations that we are trying to protect in this Congress.
  I certainly urge the President to reverse course and stop these cuts. 
We cannot stand for it. I will not stand for it, and I will not back 
down until we are successful in reversing this impossible and 
irresponsible decision.
  Mr. MURPHY of Florida. I want to thank the gentleman from Arizona for 
his leadership and for continuing to fight for seniors back home and 
continuing to be a champion here in Washington, D.C., for those folks. 
Thank you, also, for reminding us that this is a successful Medicare 
program that has already had a solid success record at reducing 
hospital readmissions and improving health outcomes, and continues to 
be a popular option for seniors, reducing annual out-of-pocket expenses 
from traditional Medicare and offering expanded benefit packages that 
include important dental, hearing, vision, and chiropractic care.
  Medicare Advantage plans also normally include the successful and 
cost-saving part D prescription drug plan and come without an annual 
deductible. By offering great coordinated care and innovative health 
care approaches, this program is highly effective at keeping seniors 
out of the hospital. But, if they do end up in the hospital, Medicare 
Advantage helps them recover more quickly and with less chance of 
returning. We should be building on this success, not stifling it.
  At this time, I would like to take a moment to yield to the gentleman 
from Florida who, similar to myself, has many seniors in the great 
State of Florida and will continue to be a champion for the seniors and 
is going to share with us some stories.
  Mr. GARCIA. I would like to thank my colleague from Florida and my 
good friend, Mr. Murphy, for his fight for seniors.
  I rise today to express my strong support for Medicare and my 
opposition to any cuts to Medicare. Medicare is one of our Nation's 
greatest achievements. For half a century, this program has lifted 
millions of seniors out of poverty and provided seniors with the health 
care they need, they have earned and they deserve.
  In Congress, we have a responsibility to strengthen and modernize 
Medicare to ensure that it continues to provide seniors who have worked 
all their lives to receive those Medicare benefits they have earned and 
they depend on.
  Medicare Advantage serves over 1 million seniors in Florida, and it 
provides innovative treatments and care. In my district, I hear 
firsthand from so many seniors how well Medicare is serving them.
  This is not a political issue. This is not a partisan issue. While 
outside groups have been misleading my constituents and others on my 
record on Medicare, I have been working with my colleagues on both 
sides of the aisle to oppose cuts to Medicare.
  My colleagues and I are strongly advocating against changes to 
Medicare that would disrupt the lives of seniors.

                              {time}  1700

  I have spoken to the President about this. I have spoken to the 
Secretary and CMS about this issue. We have written letters to the 
administration, and we stand here today. I am committed to continuing 
to do everything I can to protect Medicare for our Nation's seniors.
  With that, I want to again thank Mr. Murphy for all of his efforts. 
He has been a leader in our caucus, he has been a leader in this 
Congress in fighting for seniors, and I am proud to stand by his side, 
just as I am sure that Mr. Murphy will fight against cuts like the ones 
proposed in the Ryan budget, which cuts over $800 billion from seniors 
and Medicare, which puts the hole back in the doughnut, and I just want 
to thank him again for his leadership.
  Mr. MURPHY of Florida. I want to thank the gentleman from Florida for 
continuing to fight for seniors and reminding us of what proposals on 
the other side might entail.
  The political games being played are not necessary in today's 
environment. These are real people. These are seniors. They are not 
just numbers on a spreadsheet. These are our grandparents and parents. 
These are folks who fought for our country and fought for our freedoms.
  Thank you for reminding us not to make this a political puck. This is 
serious, and we must work together as a Congress and the United States 
Government to ensure seniors are protected.
  I want to take a second to look at another scenario, gym memberships. 
A common add-on benefit for Medicare Advantage plans is free or 
discounted gym memberships. Cut Medicare Advantage too deeply, too 
quickly, and gym memberships are gone. Some think that is a good thing. 
I disagree.
  A recent study found that regular balance exercise for seniors 
reduces falls that cause injuries by 37 percent and broken bones by 61 
percent. Most elderly Americans survive a broken hip, but it often 
undercuts confidence and diminishes quality of life.
  If a fall robs an elderly woman of her independence, it is a 
financial and emotional hardship. Whether it is the cost of Medicare of 
a hospitalization or 2 months of therapy, the cost to Medicare and 
Medicaid for a nursing facility, or most importantly, the cost to the 
senior of her quality of life and independence, Silver Sneakers doesn't

[[Page 5605]]

seem like much of a cost at all in comparison.
  That is why, even during a time of great partisanship and gridlock in 
Congress, there is a growing bipartisan coalition calling on the 
administration to keep the rates flat for this year, putting the well-
being of our Nation's seniors before party lines.
  Together, we are making several recommendations for changes to CMS' 
proposals that we believe could contribute to stabilizing the program 
while preventing devastating impacts on the program and the 
beneficiaries it serves.
  For example, providing more care at home, CMS could narrow the 
proposals on in-home health risk assessments and protect the benefit of 
medication management and continuity of care. If the visits are an 
important component of the disease management and provide value to 
seniors and taxpayers, they should be maintained. This is exactly the 
type of innovation we need.
  At this point, I would like to take a moment to yield to the 
gentleman from California who has been a champion for seniors in his 
great State. He will share with us his leadership and what he has heard 
back home.
  Mr. PETERS of California. I thank you, Mr. Murphy. I appreciate you 
and your work on behalf of seniors in Florida and around the country on 
this important issue.
  I just want to recognize you and the bipartisan group we have here 
standing up for our seniors and Medicare Advantage. I was honored to be 
part of a group of freshmen in our party who met with Secretary 
Sebelius yesterday, and we were able to, with the help of our 
leadership, express to the Secretary our concern about the proposed 
cuts.
  Part of what we told her was that Medicare Advantage continues to 
offer seniors and individuals with disabilities additional choices for 
high-quality, coordinated care in their communities.
  With a focus on innovative services, prevention, and disease 
management, these plans have consistently delivered improved health 
outcomes while containing costs and requiring copayments or deductibles 
from beneficiaries.
  Further, consistent with the goals of HHS, these plans reduce 
hospitalizations and readmissions, decrease the length of stay in 
nursing facilities, and manage high-risk, high-need patients more 
effectively.
  I thank the gentleman for letting me add my voice to folks who don't 
want to see us do something that is pennywise and pound foolish. We 
have a system that is incentivizing well-being and focusing on 
prevention.
  It can really add a lot for the benefit of our seniors, and we all 
want to see it preserved as it is. Thank you very much for the time.
  Mr. MURPHY of Florida. I thank the gentleman from California for 
taking a minute out of his busy schedule to come and talk about how 
important Medicare and Medicare Advantage plans are to you and your 
constituents back home.
  Finding ways to collect better and more thorough health information 
allows for better coordinated care with convenience to our seniors. We 
should also continue to reward programs that are performing the highest 
and providing the best care to seniors.
  To do that, CMS should also increase the percentage of rebates to 
reward and promote higher quality while averting negative consequences 
for beneficiaries.
  Other recommendations include keeping beneficiary stability and 
continuous plan improvement paramount when Medicare Advantage's 
benchmark calculations and bidding rules.
  By rewarding performance, while taking into account the challenges 
faced in low-income populations, Medicare would accelerate delivery 
system innovation and keep Medicare Advantage as a viable option.
  These are just a few of the smart changes that we should be making to 
build off the success of this program, instead of cutting these 
beneficial plans to the detriment of our Nation's seniors.
  I am proud to stand with my colleagues today to once again call on 
the administration to preserve the Medicare Advantage choice for 
beneficiaries after a lifetime of hard work.
  Madam Speaker, we could be facing a serious situation throughout the 
country. Both sides of the aisle are concerned about the proposed cuts 
to Medicare Advantage.
  Further cuts not only risk new health care efficiencies and 
innovation, but the health and well-being of seniors who depend on 
these plans. Simply put, these cuts are counterproductive if it means 
more hospital readmissions and worse health outcomes.
  Cuts already happening this year have resulted in a 10 percent 
increase in overall out-of-pocket costs for seniors relying on Medicare 
Advantage, with the annual maximum for these expenses increased by 
$560.
  For seniors on fixed incomes, that can mean the difference between 
being able to fill a needed prescription, making a mortgage payment, or 
putting food on the table.
  If further cuts are made to this important program, it would be even 
worse, costing seniors an estimated $50 more a month in out-of-pocket 
expenses. It is wrong to shift this burden onto seniors.
  From Cheryl and her husband from Palm Beach Gardens to Walter from 
Tequesta to Robert from Palm City to Gary from Port St. Lucie to 
Lorraine from Fort Pierce, this touches the lives of seniors across my 
district and across this country.
  They deserve better after a lifetime of hard work than having to 
worry about losing their doctor or the affordable health coverage that 
works for them.
  This doesn't just impact my constituents across the Treasure Coast 
and palm beaches, but seniors and families across this great Nation.
  I thank my colleagues who stood with me today to urge the 
administration to protect seniors from further cuts, keeping rates flat 
for this year.
  I am committed to fighting for the well-being for seniors on the 
Treasure Coast and palm beaches, the great State of Florida, and across 
our Nation, protecting their earned benefits.
  Madam Speaker, I yield back the balance of my time.

                          ____________________