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President Obama Breaks Promise Not to Mess With Medicare

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Guest Heather

Cutting Medicare to Pay for New Government Health Care Program is Wrong


WASHINGTON – Sen. Orrin Hatch (R-Utah) once again took to the Senate floor tonight to remind the country of the dangers of cutting Medicare to pay for a new government program proposed in the ridiculously named Patient Protection and Affordable Care Act currently being debated in the Senate.


Hatch repeated his commitment to preserve and protect Medicare for both beneficiaries and providers – the former consisting of 43 million seniors and disabled currently covered by the program. In addition he pointed out President Obama’s broken pledge to “not mess” with Medicare, saying “once again, this is another straightforward pledge that has been broken over the last 11 months.


The litany of facts is staggering:


• The Medicare trust fund will be insolvent by 2017 and the program has more than $37 trillion in unfunded liabilities.

• The Reid Bill reduces Medicare by $465 billion to fund more Washington spending and create a new entitlement program.

• The Reid Bill will cut:

• Nearly $120 billion from Medicare Advantage

• $135 billion from hospitals

• Almost $15 billion from nursing homes

• More than $40 billion from home health care agencies

• And close to $8 billion from hospice providers

Hatch stated: “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, Hatch discussed working to protect seniors and stated: “Let me make this point as clearly as I can – when we promise American seniors that we will not reduce their benefits, let us be honest about that promise. So we are either going to protect benefits or not – it is that simple and under this bill, if you are a senior with Medicare Advantage, the unfortunate answer is no.”


Sen. Hatch’s complete remarks, along with excerpts from Utah constituent letters on the issue follow:


Mr. President, let me once again take a few minutes to talk about the Medicare provisions in the Democratic health care bill.


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. To be clear, the Reid bill reduces Medicare by $465 billion to fund a new government program. Unfortunately, seniors and the disabled in the U.S. are the ones who suffer the consequences as a result of these reductions.


Everyone knows, 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 fund the creation of a new government entitlement program. More specifically, the Reid bill will cut nearly $135 billion from hospitals; $120 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.


Let me 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.


As I just said, the President has consistently pledged: We’re not going to mess with Medicare. Once again, this is another example of a straightforward pledge that has been broken over the last 11 months.


This bill strips more than $120 billion out of the Medicare Advantage program that currently covers 10.6 million seniors or almost one out of four seniors in the Medicare program. According to the Congressional Budget Office, under this bill the value of the so-called “additional benefits” like vision care and dental care will decline from $135 to $42 by 2019. That is a reduction of more than 70 percent in benefits. You heard me right – 70 percent.


During the Finance Committee’s consideration of health care reform, I offered an amendment to protect these benefits for our seniors, many of whom are low-income Americans and reside in rural states. However, the majority party would not support such an important amendment. The majority chose to skirt the President’s pledge about no reduction in Medicare benefits for our seniors by characterizing the benefits being lost – vision care, dental care and reduced hospital deductibles – as “extra benefits.”

Let me make this point as clearly as I can – when we promise American seniors that we will not reduce their benefits, let us be honest about that promise. So we are either going to protect benefits or not – it is that simple and under this bill, if you are a senior with Medicare Advantage, the unfortunate answer is no.


All day today, we had members on the other side of the aisle claim that Medicare Advantage is not part of Medicare. This is absolutely unbelievable. I would invite every member making this claim to turn to page 50 of the 2010 Medicare and You Handbook. It says: “A Medicare Advantage is another health coverage choice you may have as part of Medicare.”


Let me repeat that again: “A Medicare Advantage is another health coverage choice you may have as part of Medicare.”


So the bottom line is simple. If you are cutting Medicare Advantage benefits, you are cutting Medicare.”


I have also heard Senator Dodd this morning mention that the bureaucrat- controlled Medicare Commission will not cut benefits in Part A and Part B. Well, once again, my friends on the other side are only telling you half the story. So much for transparency.


On page 1,005 of this bill, it states in plain English: “Include recommendations to reduce Medicare payments under C and D.” I am just waiting for members on the other side of the aisle to come down and now claim that Part D is also not a part of Medicare.


It is also important to note that the Director of the nonpartisan Congressional Budget Office has told us in clear terms that this unfettered authority given to the Medicare Commission would result in higher premiums. It is important details like these, that the majority does not want us to discuss and debate in full view of the American people. They call it slow-walking. They call it obstructionism. Making sure that we take enough time to discuss a 2,074-page bill that will affect every American life and every American business is the sacred duty of every senator in this chamber. We will take as long as it takes to fully discuss this bill.


I have heard several members from the other side of the aisle characterize the Medicare Advantage program as a give-away to the insurance industry.


Let me give everyone watching at home a little history lesson on the creation of Medicare Advantage. 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 adequate choices 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.


We learned our lessons from Medicare + Choice and its predecessors. These plans collapsed, especially in rural areas, because Washington decided to set artificially low payment rates. In fact, in Utah, all of the Medicare + Choice plans eventually ceased operations because they were operating in the red.


And I fear history could repeat itself if we are not careful.

During the Medicare Modernization Act conference, we fixed the problem. 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 Americans nationwide. The so called “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.


Let me read you some letters from my constituents. These are real lives being affected by the cuts contemplated in this bill.


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.


Look, I have been in the Senate for over 30 years. I pride myself on being bipartisan. I have co-authored many, many bipartisan health care bills since I first joined the Senate in 1977.


As almost everyone in this chamber, I want a health reform bill to be enacted this year, but I want it to be done right. History has shown that to be done right, it needs to be a bipartisan bill that passes the Senate with a minimum of 75 to 80 votes. We did it in 2003 when we considered the Medicare Prescription Drug legislation, and I believe we can do it again today.

I doubt there has never been a bill of this magnitude affecting so many American lives that has passed this chamber on an almost straight party-line vote. The U.S. Senate is not the House. This body has different Constitutional mandate than the House. We are the deliberative body. We are the body that has in the past, and should today, be working through these difficult issues to find clear consensus. True bipartisanship is what is needed here.


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 become one more example of the arrogance of power being exerted since the Democrats secured a 60-vote majority in the United States Senate, and took over the House and the White House. There are essentially no checks or balances found in Washington today, just an arrogance of power, with one party ramming through unpopular and devastating proposals – one after another.


There is a better way to handle health care reform. For months, I have been pushing for a fiscally responsible and step by step proposal that recognizes our current need for spending restraint while starting us on a path to sustainable health care reform.


There are several areas of consensus that can form the basis for sustainable, fiscally responsible and bipartisan reform. These include:


* Reforming the health insurance market for every American by making sure that no American is denied coverage simply based on a pre-existing condition.


* Protecting the coverage for almost 85 percent of Americans who already have coverage they like by making it more affordable – this means reducing costs by rewarding quality and coordinated care, giving families more information on the cost and choices of their coverage and treatment options, discouraging frivolous lawsuits and promoting prevention and wellness measures.


* Giving states flexibility to design their own unique approaches to health care reform. Utah is not New York and New York is not Utah. Actually, what works in New York, will most likely not work in New York, let alone Utah.


As we move forward on health care reform, it is important to recognize that every state has its own unique mix of demographics and each state has developed its own institutions to address its challenges. And each has its own successes.


There is an enormous reservoir of expertise, experience, and field-tested reform. We should take advantage of that by placing states at the center of health care reform efforts, so they can use approaches that best reflect their needs and challenges.

My home state of Utah has taken important and aggressive steps towards sustainable health care reform. The current efforts to introduce a defined contribution health benefit system and implement the Utah Health Exchange are laudable accomplishments.


A vast majority of Americans agree a one-size-fits-all Washington solution is not the right approach. And that is what this bill is bound to foist on us. Unfortunately, the path we are taking in Washington right now is to simply spend another trillion dollars of taxpayer money to further expand the role of the federal government.


I just wish the majority would take a step back, put their arrogance of power in check and truly work on a real bipartisan bill that all of us can be proud of.


* * * * * * * * * * * * *

Excerpts from Utah constituents’ letters on this issue:


Constituent from Layton, Utah


I recently received my healthcare update for 2010. I am in a Med Advantage plan with Blue Cross/Blue Shield. Thanks to the cuts in this program by Medicare, my monthly premiums have risen by 49 percent and my office visit co-pay has increased 150 percent. Senator Hatch, I am on a fixed income and this has really presented a problem for me and many others I know on the same program. And, at my age I certainly can’t find a job that would help cover the gap. I worked all my life to enjoy my retirement and thanks to the current economy I have lost a lot of those monies that were intended to help supplement my income.


Constituent from Logan, Utah


Please stop the erosion of Medicare Advantage for seniors. A very many of us are already denied proper medical and dental care not to mention those who cannot afford needed medications. Hardest hit are the ones on Social Security who are just over the limit for extra help but cannot keep up with the rising medical costs that go way beyond the so called “cost of living increases” which we are not getting this year anyway. If those in government who make these decisions had to live as we do day today, I think we would find better conditions for seniors. The difference in decision making changes when you are hungry and cold your own self.


Constituent from Pleasant Grove, Utah


Please do not phase out Medicare Advantage program, senior citizens need it. Our supplement insurance rates go up every year and our income does not keep pace with the cost of living.


Constituent from Salt Lake City, Utah


We met with our insurance agent this morning about the increased costs of our Medicare Advantage plans due to the health care reform bill now before Congress. Our premium costs have already been significantly increased with the coverage substantially decreased. We are in our 80s and cannot afford these increases and are hurt by the decreased coverage. We are writing to have you stop the cuts and restore coverage to Medicare Advantage plans. This is an issue that is very important and very real to us at this point in our lives. Please stop the cuts and restore coverage.

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Under the Senate bill, payments hospitals receive from Medicare will be tied to the quality -and then to the cost-effectiveness -of the care they provide. Individual doctors and hospitals will not only be incentivized to report quality data, but they will finally receive data letting them know how their care compares to that of their peers. Quality reporting and reimbursement programs would also be implemented for other components of the healthcare system, such as home health agencies and skilled nursing facilities. Because Medicare is the largest insurance program in the nation, changes directed at Medicare patients eventually impact the broader healthcare system.

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  • 2 weeks later...

On health-care costs, the Congressional Budget Office projects that the Senate bill will raise premiums in the individual market by 10 percent to 13 percent but have a limited effect on workers in small or large firms.


The White House and other boosters of health-care reform, such as the Commonwealth Fund and the liberal Center for American Progress, project premium savings of $2,000 per family and reduced national health spending of $683 billion over 10 years.


But a study released by the Blue Cross Blue Shield system — and savaged by the White House — made a compelling case that premiums will surge by 54 percent for individual buyers and 20 percent for small firms.


That’s because taxes on providers and Medicare payment cuts imposed on them will be passed on to private payers.



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