[Public Papers of the Presidents of the United States: George W. Bush (2003, Book II)]
[December 8, 2003]
[Pages 1694-1698]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks on Signing the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003
December 8, 2003

    Good morning. Thanks for the warm welcome. In a few moments I will 
have the honor of signing an historic act of Congress into law. I'm 
pleased that all of you are here to witness the greatest advance in 
health care coverage for America's seniors since the founding of 
Medicare.
    With the Medicare Act of 2003, our Government is finally bringing 
prescription drug coverage to the seniors of America. With this law, 
we're giving older Americans better choices and more control over their 
health care, so they can receive the modern medical care they deserve. 
With this law, we are providing more access to comprehensive exams, 
disease screenings, and other preventative care, so that seniors across 
this land can live better and healthier lives. With this law, we are 
creating Health Savings Accounts. We do so so that all Americans can put 
money away for their health care tax-free.
    Our Nation has the best health care system in the world, and we want 
our seniors to share in the benefits of that system. Our Nation has made 
a promise, a solemn promise to America's seniors. We have pledged to 
help our citizens find affordable medical care in the later years of 
life. Lyndon Johnson established that commitment by signing the Medicare 
Act of 1965. And today, by reforming and modernizing this vital program, 
we are honoring the commitments of Medicare to all our seniors.
    The point man in my administration on this issue was Secretary Tommy 
Thompson, and he and his team did a 
fabulous job of working with the Congress to get this important piece of 
legislation passed. Tommy, I want to thank you for your leadership.
    This bill passed the Congress because of the strong leadership of a 
handful of Members, starting with the Speaker of the House, Denny 
Hastert. Mr. Speaker was joined by Senator 
Bill Frist, the Senate majority leader of the 
Senate, in providing the leadership necessary to get this bill done. I 
want to thank you both.
    I appreciate the hard work of the House majority leader, Tom 
DeLay, in seeing that this bill was passed. I also 
appreciate the hard work of the chairman of the Ways and Means 
Committee, Chairman Bill Thomas, for his 
good work. The chairman of the Finance Committee in the Senate, Senator 
Chuck Grassley, did a noble job, and he 
was joined in this task by the ranking member of the Finance Committee, 
Senator Max Baucus of Montana.

[[Page 1695]]

    And the entire Senate effort was boosted by the efforts of a man 
from Louisiana, Senator John Breaux. And 
speaking about Louisiana, Billy Tauzin 
of the House of Representatives did great work on this bill. Senator 
Orrin Hatch from Utah made a significant 
contribution. Nancy Johnson, the House 
Member from Connecticut, did a great job. Mike Bilirakis from Florida worked hard on this piece of 
legislation. I want to thank all the other Members of the Congress and 
the Senate who have joined us. Thank you all for taking time out of your 
busy schedules to share in this historic moment.
    I appreciate Tom Scully, the 
Administrator of the Centers for Medicare & Medicaid Services, for his 
good work. The Director of the CDC, Julie Gerberding, is with us today. Julie, thank you for coming. The Food 
and Drug Administration Commissioner, Mark McClellan, is here. Jo Anne Barnhart, 
the Commissioner of the Social Security Administration, is with us. 
Thank you for coming, Jo Anne. Kay James, 
who is the Director of the Office of Personnel Management, is with us. 
Thank you for coming, Kay.
    A lot of this happened--this bill happened because of grassroots 
work. A lot of our fellow citizens took it upon themselves to agitate 
for change, to lobby on behalf of what's right. We had some Governor 
support around the country. Governor Craig Benson from New Hampshire is with us today. Governor, thank 
you for coming.
    But the groups that speak for the elderly did fantastic work on this 
legislation. See, there was a lot of pressure not to get something 
done--for the wrong reasons, I might add. But Bill Novelli, the CEO of AARP, stood strong in representing the 
people he was supposed to represent and worked hard to get this 
legislation passed. And Bill, I want to 
thank you for your leadership. And you were joined by Jim 
Parkel, who is the president of the AARP. 
Jim, I want to thank you as well for doing what was right, for focusing 
on the needs of the seniors of our country.
    Jim Martin, the president of 60 Plus 
Association, worked hard. Charlie Jarvis, 
the chairman and CEO of United Seniors Association, worked hard. Mike 
Maves, the executive vice president and CEO 
of the AMA, worked hard on this piece of legislation. Mary 
Martin, the chairman of the board of the Seniors 
Coalition, worked hard. The truth of the matter is, a lot of good people 
worked hard to get this important legislation done, and I thank you for 
your work.
    Medicare is a great achievement of a compassionate Government, and 
it is a basic trust we honor. Medicare has spared millions of seniors 
from needless hardship. Each generation benefits from Medicare. Each 
generation has a duty to strengthen Medicare, and this generation is 
fulfilling our duty.
    First and foremost, this new law will provide Medicare coverage for 
prescription drugs. Medicare was enacted to provide seniors with the 
latest in modern medicine. In 1965, that usually meant house calls or 
operations or long hospital stays. Today, modern medicine includes 
outpatient care, disease screenings, and prescription drugs. Medicine 
has changed, but Medicare has not--until today.
    Medicare today will pay for extended hospital stays for ulcer 
surgery; that's at a cost of about $28,000 per patient. Yet Medicare 
will not pay for the drugs that eliminate the cause of most ulcers, 
drugs that cost about $500 a year. It's a good thing that Medicare pays 
when seniors get sick. Now, you see, we're taking this a step further: 
Medicare will pay for the prescription drugs so that fewer seniors will 
get sick in the first place.
    Drug coverage under Medicare will allow seniors to replace more 
expensive surgeries and hospitalizations with less expensive 
prescription medicine. And even more important, drug coverage under 
Medicare will save our seniors from a lot of worry. Some

[[Page 1696]]

older Americans spend much of their Social Security checks just on their 
medications. Some cut down on the dosage to make a bottle of pills last 
longer. Elderly Americans should not have to live with those kinds of 
fears and hard choices. This new law will ease the burden on seniors and 
will give them the extra help they need.
    Seniors will start seeing help quickly. During the transition to the 
full prescription benefit, seniors will receive a drug discount card. 
This Medicare-approved card will deliver savings of 10 to 25 percent off 
the retail price of most medicines. Low-income seniors will receive the 
same savings plus a $600 credit on their cards to help them pay for the 
medications they need.
    In about 2 years, full prescription coverage under Medicare will 
begin. In return for a monthly premium of about $35, most seniors 
without any prescription drug coverage can now expect to see their 
current drug bills cut roughly in half. This new law will provide 95-
percent coverage for out-of-pocket drug spending that exceeds $3,600 a 
year. For the first time, we're giving seniors peace of mind that they 
will not have to face unlimited expenses for their medicine.
    The new law offers special help to one-third of older Americans with 
low incomes, such as a senior couple with low savings and an annual 
income of about $18,000 or less. These seniors will pay little or no 
premium for full drug coverage. Their deductible will be no higher than 
$50 per year, and their copayment on each prescription will be as little 
as $1. Seniors in the greatest need will have the greatest help under 
the modernized Medicare system.
    I visited with seniors around the country and heard many of their 
stories. I'm proud that this legislation will give them practical and 
much needed help. Mary Jane Jones from 
Midlothian, Virginia, has a modest income. Her drug bills total nearly 
$500 a month. Things got so tight for a while she had to use needles 
twice or 3 times for her insulin shots. With this law, Mary Jane won't 
have to go to such extremes. In exchange for a monthly premium of about 
$35, Mary Jane Jones would save nearly $2,700 in annual prescription 
drug spending.
    Hugh Iverson from West Des Moines, Iowa, 
just got his Medicare membership. And that's a good thing, because he 
hasn't had health insurance for more than 3 years. His drug bills total 
at least $400 a month. Within 2 years, with the $35-a-month coverage, he 
will be able to cut those bills nearly in half, saving him about $2,400 
a year.
    Neil LaGrow from Culpeper, Virginia, takes 
15 medications, costing him at least $700 a month. To afford all those 
medications, Neil has to stay working. And thanks to this law, once he 
is enrolled in the drug benefit, he will be able to cut back his work 
hours and enjoy his retirement more because he'll have coverage that 
saves him about $4,700 a year.
    I promised these seniors when I met with them that we would work 
hard to give them the help they need. They are all here today. So I am 
happy to report to them in person: Mary Jane, Hugh, and Neil, we are keeping our promise.
    In addition to providing coverage for prescription drugs, this 
legislation achieves a second great goal. We're giving our seniors more 
health care choices, so they can get the coverage and care that meets 
their needs. Every senior needs to know, if you don't want to change 
your current coverage, you don't have to change. You're the one in 
charge. If you want to keep your Medicare the way it is, along with the 
new prescription benefit, that is your right. If you want to improve 
benefits, maybe dental coverage or eyeglass coverage or managed care 
plans that reduce out-of-pocket costs, you'll be free to make those 
choices as well.
    And when seniors have the ability to make choices, health care plans 
within

[[Page 1697]]

Medicare will have to compete for their business by offering higher 
quality service. For the seniors of America, more choices and more 
control will mean better health care. These are the kinds of health care 
options we give to the Members of Congress and Federal employees. They 
have the ability to pick plans to--that are right for their own needs. 
What's good for Members of Congress is also good for seniors. Our 
seniors are fully capable of making health care choices, and this bill 
allows them to do just that.
    A third purpose achieved by this legislation is smarter medicine 
within the Medicare system. For years, our seniors have been denied 
Medicare coverage--have been denied Medicare coverage for a basic 
physical exam. Beginning in 2005, all newly enrolled Medicare 
beneficiaries will be covered for a complete physical.
    The Medicare system will now help seniors and their doctors diagnose 
health problems early, so they can treat them early and our seniors can 
have a better quality life. For example, starting next year, all people 
on Medicare will be covered for blood tests that can diagnose heart 
diseases. Those at high risk for diabetes will be covered for blood 
sugar screening tests. Modern health care is not complete without 
prevention, so we are expanding preventive services under Medicare.
    Fourth, the new law will help all Americans pay for out-of-pocket 
health costs. This legislation will create health savings accounts, 
effective January 1, 2004, so Americans can set aside up to $4,500 every 
year, tax-free, to save for medical expenses. Depending on your tax 
bracket, that means you'll save between 10 to 35 percent on any costs 
covered by money in your account. Our laws encourage people to plan for 
retirement and to save for education. Now the law will make it easier 
for Americans to save for their future health care as well.
    A health savings account is a good deal, and all Americans should 
consider it. Every year, the money not spent would stay in the account 
and gain interest tax-free, just like an IRA. And people will have an 
incentive to live more healthy lifestyles because they want to see their 
health savings account grow. These accounts will be good for small-
business owners and employees. More businesses can focus on covering 
workers for major medical problems such as hospitalization for an injury 
or illness. And at the same time, employees and their families will use 
these accounts to cover doctors visits or lab tests or other smaller 
costs. Some employers will contribute to employee health accounts. This 
will help more American families get the health care they need at the 
price they can afford.
    The legislation I'm about to sign will set in motion a series of 
improvements in the care available to all America's senior citizens. And 
as we begin, it is important for seniors and those approaching 
retirement to understand their new benefits. This coming spring, seniors 
will receive a letter to explain the drug discount card. In June, these 
cards, including the $600 annual drug credit for low-income seniors, 
will be activated. This drug card can be used through the end of 2005. 
In the fall of that year, seniors will receive an information booklet 
giving simple guidance on changes in the program and the new choices 
they will have. Then in January of 2006, seniors will have their new 
coverage, including permanent coverage for prescription drugs.
    These reforms are the act of a vibrant and compassionate Government. 
We show our concern for the dignity of our seniors by giving them 
quality health care. We show our respect for seniors by giving them more 
choices and more control over their decisionmaking. We're putting 
individuals in charge of their health care decisions. And as we move to 
modernize and reform other programs of this Government, we will always 
trust individuals and their decisions and put personal choice at the 
heart of our efforts.

[[Page 1698]]

    The challenges facing seniors on Medicare were apparent for many 
years, and those years passed with much debate and a lot of politics and 
little reform to show for it. And that changed with the 108th Congress. 
This year we met our challenge with focus and perseverance. We 
confronted problems, instead of passing them along to future 
administrations and future Congresses. We overcame old partisan 
differences. We kept our promise and found a way to get the job done. 
This legislation is the achievement of Members in both political 
parties. And this legislation is a victory for all of America's seniors.
    Now I'm honored and pleased to sign this historic piece of 
legislation, the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003.

Note: The President spoke at 11:10 a.m. at DAR Constitution Hall. H.R. 
1, approved December 8, was assigned Public Law No. 108-173. The Office 
of the Press Secretary also released a Spanish language transcript of 
these remarks.