H.R.3200: America’s Affordable Health Choices Act of 2009

HATCH: CUTTING MEDICARE BY $465 BILLION TO FUND NEW GOVERNMENT PROGRAM ‘IRRESPONSIBLE’
Reid Bill Will Hurt 43 Million American Seniors and Disabled, Senator Says

WASHINGTON – Sen. Orrin Hatch, R-Utah, spoke out today against the $465 billion cuts in Medicare that are proposed in the misnamed Patient Protection and Affordable Care Act (H.R. 3590) now under consideration in the Senate.

Speaking on the Senate floor, Hatch said taking money from Medicare, which is already headed toward insolvency, and using that money to fund another government program “is irresponsible.”

“Again, the Reid bill cuts Medicare to create a new government entitlement program,” Hatch added. “More specifically, the Reid bill will cut nearly $135 billion from hospitals; $118 billion from Medicare Advantage; almost $15 billion from nursing homes; more than $40 billion from home health care agencies; and close to $8 billion from hospice providers. These cuts will threaten beneficiary access to care as Medicare providers find it more and more challenging to provide health services to Medicare patients …

“I cannot support any bill that would jeopardize health care coverage for Medicare beneficiaries and I truly believe if the bill before the Senate becomes law, Medicare beneficiaries’ health care coverage could be in serious trouble,” Hatch continued. “We owe it to the 43 million Americans – seniors and the disabled who depend on Medicare to reject the nonsensical Medicare cuts included in the Reid bill. We must have better solutions that will not hinder their ability to see the doctor of their choice.”

Sen. Hatch’s complete remarks on the Senate floor follow:

Mr. President, I rise in support of Senator McCain’s motion to recommit the Reid health care bill in order to eliminate the Medicare cuts contained in the legislation.

Throughout the health care debate, we have heard the President pledge not to “mess” with Medicare. Unfortunately, that is not the case with the bill before the Senate, H.R. 3590, the Patient Protection and Affordable Care Act. To be clear, the Reid bill reduces Medicare by $465 billion to fund a new government program. Unfortunately, our seniors and the disabled are the ones who suffer the consequences as a result of these reductions.

Medicare is very important to the 43 million seniors and disabled Americans covered by the program. Throughout my Senate career, I have fought to preserve and protect Medicare for both beneficiaries and providers. Medicare is already in trouble today – the program faces tremendous challenges in the very near future –the Medicare trust fund will be insolvent by 2017 and the program has more than $37 trillion in unfunded liabilities. The Reid bill will make a bad situation much worse.

Why is that the case? Again, the Reid bill cuts Medicare to create a new government entitlement program. More specifically, the Reid bill will cut nearly $135 billion from hospitals; $118 billion from Medicare Advantage; almost $15 billion from nursing homes; more than $40 billion from home health care agencies; and close to $8 billion from hospice providers. These cuts will threaten beneficiary access to care as Medicare providers find it more and more challenging to provide health services to Medicare patients.
In addition, the proposed legislation permanently cuts all annual Medicare provider payment updates; hospitals, home health agencies and hospice facilities would face even more annual reductions over the next 10 years. Advocates of these reductions, known as “productivity adjustments,” will argue that today, Medicare is overpaying certain providers because current payment updates do not take into account increases in productivity (which actually reduces the cost of providing beneficiaries health care services). To me, these permanent productivity adjustments will make it harder for Medicare providers to remain profitable as Medicare payments fail to keep up with the cost of providing health care services.

As result of these payment reductions, I believe that many doctors and other Medicare providers will stop seeing Medicare patients. In Utah, low Medicare reimbursement rates are already a serious problem for beneficiaries and their health care providers – these additional reductions will only make it more difficult.

I want to stress to my colleagues that cutting Medicare to pay for a new government program is irresponsible. Any reductions to Medicare should be used to preserve the program, not create a new government bureaucracy. I believe it makes more sense to target the Medicare savings for paying off Medicare’s unfunded liabilities or preventing the program’s future insolvency.

I would like to take a few minutes to talk about the Medicare Advantage program and how it is affected by the Reid bill. As I stated previously, the Reid bill reduces Medicare by close to $500 billion – almost $120 billion comes out of the Medicare Advantage program.

During the Finance Committee’s consideration of the Baucus health bill, I offered an amendment to protect extra benefits currently enjoyed by Medicare Advantage beneficiaries. Unfortunately, my amendment was defeated. In other words, the President’s pledge assuring Americans that they would not lose benefits was not met by either the Finance Committee bill or the Reid bill currently being considered by the Senate.

And here is how supporters of the Finance bill justified the Medicare Advantage reductions. They argued the extra benefits that would be cut – such as vision care, dental care, reduced hospital deductibles, lower copayments and premiums – were not statutory benefits offered in the Medicare fee-for-service program. Therefore, those extra benefits did not count.

A few weeks back, our President once again assured the American people they could keep their current health plan. “The first thing I want to make clear is that if you are happy with the insurance plan that you have right now, if the costs you’re paying and the benefits you’re getting are what you want them to be, then you can keep offering that same plan. Nobody will make you change it.”

I believe that promise should apply to all Americans, including those participating in the Medicare Advantage program. Congress is either going to protect existing benefits or not – it is that simple. Unfortunately, under the Reid bill, if you are a beneficiary participating in Medicare Advantage, that promise does not apply to you.
I have some history with the Medicare Advantage program — I served as a member of the House-Senate Conference Committee which wrote the Medicare Modernization Act of 2003. Among other things, this law created the Medicare Advantage Program.

When conference committee members were negotiating the conference report, several of us insisted that the Medicare Advantage program was necessary in order to provide health care coverage choices to Medicare beneficiaries. At that time, there were many parts of the country where Medicare beneficiaries did not have choice in coverage. In fact, the only choice offered to them was traditional, fee-for-service Medicare, a one size fits all government run health program.

By creating the Medicare Advantage program, we provided beneficiaries with choice in coverage and then, empowered them to make their own health care decisions as opposed to the federal government. Today, every Medicare beneficiary may choose from several health plans for his or her coverage.

Medicare Advantage works. Medicare + Choice and its predecessors did not because many plans in across the country, especially in rural areas were reimbursed at very low rates by the Medicare program. And I fear history could repeat itself if we are not careful.

Let me take a minute to talk about the Medicare + Choice program. I represent a state where Medicare managed care plans could not exist due to low reimbursement rates. To address that concern, Congress included language, which was signed into law, establishing a payment floor for rural areas. But, it was not enough. In fact, in Utah, all of the Medicare + Choice plans eventually left because they were operating in the red.

And this happened after promises were made that Medicare + Choice plans would be reimbursed fairly and that all Medicare beneficiaries would have access to these plans.

So, during the Medicare Modernization Act conference, we fixed the problem. First, we renamed the program Medicare Advantage. Second, we increased reimbursement rates so that all Medicare beneficiaries, regardless of where they lived – be it Fillmore, Utah or New York City –had choice in coverage. Again, we did not want beneficiaries stuck with a one-size fits all government plan.

Today, Medicare Advantage works. Every Medicare beneficiary has access to a Medicare Advantage plan. And close to 90 percent of Medicare beneficiaries participating in the program are satisfied with their health coverage. But that could all change should the health care reform legislation currently being considered become law.

Choice in coverage has made a difference in the lives of more than 10 million individuals nationwide. The extra benefits that I mentioned earlier are being portrayed as gym memberships as opposed to lower premiums, copayments and deductibles. And to be clear, the Silver Sneakers program is one that has made a difference in the lives of many seniors because it encourages them to get out of their homes and remain active. It has been helpful to those with serious weight issues and has been invaluable to women suffering from osteoporosis and joint problems. In fact, I have received several hundred letters telling me how much Medicare Advantage beneficiaries appreciate the program. Additionally, these beneficiaries receive other services such as coordinated chronic care management, dental coverage, vision care, and hearing aids.

Mr. President, in conclusion, I cannot support any bill that would jeopardize health care coverage for Medicare beneficiaries and I truly believe if the bill before the Senate becomes law, Medicare beneficiaries’ health care coverage could be in serious trouble.

We owe it to the 43 million Americans – seniors and the disabled who depend on Medicare to reject the nonsensical Medicare cuts included in the Reid bill. We must have better solutions that will not hinder their ability to see the doctor of their choice.

Look, I have been in the Senate for over 30 years. I pride myself for being bipartisan. I have co-authored many, many bipartisan health care bills since I first joined the Senate in 1977. Let me be clear – I want a health reform bill to pass this chamber but I want it to be a bipartisan bill that passes the Senate by 70 to 80 votes. If we could do it in 2003 when we considered the Medicare Prescription Drug legislation, we can do it today! There has never been a bill of this magnitude affecting so many American lives that has passed this chamber on a straight party-line vote. In the past, the Senate has approved many bipartisan health care bills that have eventually been signed into law. The Balanced Budget Act in 1997 which included the CHIP Program, the Ryan White Act, the Orphan Drug Act, The Americans with Disabilities Act, and the Hatch-Waxman Act are just a few of these success stories.

If the Senate passes this bill in its current form with a razor thin margin of 60 votes – this will be yet one more example of the arrogance of power since the Democrats secured a 60-vote majority in the United States Senate.

There is a better way to handle health care reform. First and foremost, it must be bipartisan. And second, we cannot erode the existing system that has provided quality and affordable health care to most Americans for decades. While we all agree that the current system should be improved, this bill is certainly not the answer.

If the Senate passes the McCain motion to recommit, we can begin work on a bipartisan health bill that will eliminate the overwhelming Medicare payment reductions, and, at the same time, address the serious issues facing the Medicare program in the near future.

I urge my colleagues to support the McCain motion to recommit this bill.

Source:
HATCH: CUTTING MEDICARE BY $465 BILLION TO FUND NEW GOVERNMENT PROGRAM ‘IRRESPONSIBLE’