Medicare Prescription Drug, Improvement, and Modernization Act of 2003-Conference Report
MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003-CONFERENCE REPORT
Mr. VOINOVICH. Mr. President, I rise before the Senate in support of the conference report accompanying the Medicare Prescription Drug and Modernization Act. While the conference report before the Senate is not a perfect bill, it is a good bill that will finally provide seniors a voluntary prescription drug benefit through Medicare.
After years of having to carry the burden of high prescription drug costs without any assistance from Medicare, the bill that is before the Senate now, which has the full support of the AARP, will finally provide 40 million Medicare beneficiaries nationwide, 1.6 million in Ohio, access to affordable prescription drugs.
I would like to applaud the work of our Leader, Senator Frist; our Finance Committee Chairman, Senator Grassley; and the Finance Committee Ranking Member, Senator Baucus. Through their leadership, the Senate is poised to finally move past politics and provide seniors with a real prescription drug benefit.
Unfortunately, we have fiddled around with the issue of Medicare reform for far too long in Washington. The truth is, even if the Senate passes the bill before us today, its full implementation will not occur until 2006. For those of my colleagues who have said that we are moving too quickly in adding a prescription drug benefit, the fact of the matter is that the Senate has not moved quickly enough.
As with the rest of the Nation, currently, Ohio's seniors are paying too much out-of-pocket for their prescription drugs. The cost of these life-saving drugs is increasingly becoming a large burden for seniors, with some even traveling to Canada to find cheaper drugs. Seniors should not have to go to a foreign country to receive the drugs that their doctors prescribe. It is time seniors receive access to affordable prescription drugs in the United States.
This legislation will finally provide Medicare beneficiaries with a voluntary prescription drug benefit. This is especially important to the 400,232 Medicare beneficiaries in Ohio that currently have no public or private prescription drug coverage.
For those beneficiaries that already have coverage through another source, such as through a former employer, and would like to keep that coverage, this legislation supports that choice as well.
As my colleagues know, approximately 12 million of the 40 million Medicare beneficiaries currently have prescription drug coverage through former employer-based retiree health plans.
Many Ohioans that I have spoke to have concerns that the creation of a new Medicare drug benefit may cause many of them to lose their retiree coverage. However, the bipartisan conference report encourages employers to continue to provide coverage to their retirees by providing assistance for retirees' health care costs, including their prescription drugs costs.
In fact, the conference report provides $86 billion in subsidies to assist employers who continue to provide their retirees with health care coverage. This is critical because scores of retirees have lost their health care benefits over the past several years. The bottom line is that this bill will help employers to continue to provide their retirees with health care security.
Not only will seniors have access to affordable prescription drugs with this bill, they will have access to benefits that a modern health plan should have, such as preventive care and disease management-options that Medicare currently does not provide.
Moreover, these additional benefits are provided by giving seniors a choice and control over their prescription drug plans and health care providers.
While the Senate is on the brink of finally strengthening and modernizing Medicare, I would be remiss if I did not take a step back and point out the roadmap that has lead us to this point.
The President has led the way to providing seniors with access to affordable prescription drugs. If my colleagues recall, at the beginning of the year, the President provided in his budget $400 billion for Medicare reform, which included adding a prescription drug benefit. This substantial amount illustrated his commitment to our nation's seniors. That was the first step.
Following the President was the action taken by Congress to lay out a blueprint for Medicare. During the prescription drug debate in 2002, the Senate operated without a budget resolution-the first time the Senate has not done so since 1974. However, this year Congress operated under a budget resolution.
Through these efforts, and those of the Finance Committee, a bill stands before the Senate that strikes a balance between providing seniors and the disabled access to needed prescription drugs today and doing so in a fiscally sensible way that will allow benefits to extend to future generations.
And while opponents of the bill claim that the benefits provided are not large enough, $400 billion does buy an awful lot.
Beginning in 2004, seniors will receive a prescription drug discount card that will provide immediate savings of 10 to 25 percent on most prescription drug purchases. On top of these discounts, the Federal Government would annually purchase the first $600 in prescription drug costs for those seniors below 135 percent of poverty.
The implementation of the full program, which will include a new Medicare Part D and a Medicare Advantage program, will begin in January 2006. All Medicare beneficiaries will receive substantial subsidies through these new benefits. However, low-income seniors will receive additional assistance on top of these subsidies. In Ohio, this means 624,416 seniors will receive additional assistance.
For the 152,470 neediest seniors in my State of Ohio, those who qualify for both Medicare and Medicaid, under this bill they would pay: nothing in premiums; nothing in deductibles; and a nominal cost-share of no more than $1 for a generic drug and no more than $3 for a name-brand drug.
For the 492,872 seniors in my State of Ohio with incomes below 135 percent of poverty, and assets of no more than $6,000 per individual and $9,000 per couple, under this bill they would pay: nothing in premiums; nothing in deductibles; and A nominal cost-share of $2 for a generic drug and $5 for a name-brand drug.
For those 131,544 seniors in my State of Ohio with incomes between 135 and 150 percent of poverty, and assets of no more than $10,000 per individual and $20,000 per couple, under this bill they would pay: premiums based on a sliding scale but NO MORE than $35 per month; $50 annual deductible; and 15 percent co-payments up to $3,600 after $3,600, seniors would pay a nominal cost-share of $2 for a generic drug and $5 for a name-brand drug.
For seniors over 150 percent of poverty, the standard subsidized benefit would include: $250 annual deductible; $35 average monthly premium; the government would pick up 75 percent of beneficiary out-of-pocket costs for drug expenses up to $2,250; between $2,251 and $3,600, beneficiaries cover all drug expenses out-of-pocket; and the government would pick up 95 percent of beneficiary out-of-pocket costs for drug expenses above $3,600.
In addition to the stand-alone benefit under traditional Medicare, the conference report would establish the Medicare Advantage program. All Medicare Advantage plans will be required to offer at least the standard drug benefit established in H.R. 1 and would be encouraged to offer beneficiaries enhanced access to the latest in health care technology through disease management, chronic care, and quality improvement programs.
These plans have the opportunity to provide seniors with better coverage at affordable prices. To help ensure participation in rural and urban areas equally, Medicare Advantage plans would submit bids to the Centers on Medicare and Medicaid Services on a regional basis. The Federal Government will share the risk with insurance companies and these plans.
It should also be noted that while the thrust of this bill is to provide seniors with access to affordable prescription drugs, the bill also ensures that seniors will continue to have access to current Medicare benefits as well.
For instance, while the relationship between a senior and their physician is paramount, last year, Medicare was scheduled to cut physician payments by 4.4 percent, which threatening seniors' access to their doctors. Physicians had already received a 5.4 percent cut in 2002.
Congress temporarily fixed the formula in 2003 and doctors received a modest increase of 1.6 percent instead of a cut. For 2004, physicians were again scheduled to take a 4.5 percent cut. However, to ensure that seniors have access to their physician of choice, this bill includes modest increase in payments of 1.5 percent for both 2004 and 2005.
Additionally, physicians and their staffs have become increasingly inundated with regulations and paperwork from Medicare. Provisions are included in the bill to streamline some of this paperwork so that doctors can spend more time with their patients rather than filling out reams and reams of Government forms.
Seniors in rural areas will also be assured of continual access to Medicare benefits. One of the most important aspects of the bill is the rural provider provisions. Through the bill, providers in rural areas will be placed on an equal footing to that of their urban counterparts. Some of the specific rural provisions include: equalization of the urban and rural payments for inpatient hospital services under Medicare; revision of the labor-related share of the wage index used in Medicare's payment system. Rural hospitals, because their local wage levels are lower than urban areas, are adversely affected by a high labor-related share; increase in payments to home health agencies by five percent for services furnished in rural areas; and increase in payment for physicians that serve beneficiaries in counties where there are a scarcity of physicians.
The House of Representatives has already acted and the President is waiting to sign the bill into law. It is time that the Senate act and pass the Medicare Prescription Drug and Modernization Act.