Medicare

Floor Speech

Mr. PALLONE. Mr. Speaker, I wasn't planning on coming to the floor this evening; but when I heard my Republican colleagues' Special Order that was just completed, I couldn't help but come down because I think I have to correct the record on many of the statements that they made this evening about Medicare and their efforts with regard to Medicare.

First of all, I have to point out that when Medicare was first adopted in the House and in the Senate back in the sixties when President Johnson was in office, the Republicans overwhelmingly opposed it. They were opposed to Medicare. They voted against it. It would never have passed if it was for their votes. It only passed as a Democratic initiative. And over the years, Democrats have been the ones to protect Medicare.

Republicans have consistently opposed Medicare, tried to repeal it, tried to privatize it, voucherize it. And basically as a Republican Speaker once said--I was here at the time when Newt Gingrich became the Speaker back in the mid-nineties--he said that we want Medicare to wither on the vine. And that's basically what the Republican leadership has been doing consistently in the 20-something years that I have been in Congress.

Certainly, if you look at the budget that was adopted by the Republicans last year, it does exactly that. The Republican budget would end the Medicare guarantee, replacing it with a voucher in 2022. And what that essentially means is that right now and under the Medicare program, when you get to be 65, you immediately become eligible for Medicare, which is a government program; and you are guaranteed that you have your health insurance through the government, through Medicare.

But if you establish a voucher, which is what the Republicans tried to do in their budget last year--fortunately, they didn't succeed--they would simply give you a voucher or a set amount of money for you to go out into the private sector and try to buy health insurance for that amount. And of course the amount that would be available wouldn't keep up with inflation. So even if you were able to buy health insurance when you were over 65 as a senior--which many people would not be able to--eventually you would not be able to; and you would simply have to pay more and more money out of pocket in order to buy the health insurance. In fact, we estimate that the Republican budget would double out-of-pocket costs by 2022 and cost an additional $6,000 for each senior, and out-of-pocket costs would triple by 2030.

So what I want my constituents and everyone to understand is, the reason that Democrats started Medicare in the sixties under President Johnson was because people over 65 were not able to get health insurance privately. They weren't able to go out and buy health insurance because, basically, insurers didn't want to cover seniors. They had too many disabilities, too many times that they had to go to the hospital or see the doctor. So it was impossible to get health insurance if you were over 65.

And I would maintain that if you let the Republicans move forward with their voucher proposal, which they still talk about constantly--the chairman of the Budget Committee, Mr. Ryan, keeps talking about it--the same thing would happen again. Seniors simply wouldn't be able to buy health insurance with a voucher or without one. The cost of it would get so prohibitive. And the consequence is that Medicare would disappear, both as a guaranteed health insurance plan for seniors, and many seniors would simply not have health insurance at all.

The other thing that my colleagues tried to suggest tonight is that Medicare was going broke. They tried to convince you that Medicare is going broke. But if you believe that, then that sets the stage for the fact that you should either get rid of Medicare or voucherize Medicare because the notion is that somehow the government isn't going to continue with the program or can't afford the program; and, therefore, we need to change it drastically. I would maintain that's simply not true.

Actually, right now there are 40 million seniors and 8 million people with disabilities below age 65 who have Medicare. Medicare is efficient, per capita spending at nearly half the per capita increase for comparable benefits provided by private insurers. And the fact of the matter is that the Medicare trust fund could certainly use some more money, but the way to deal with that is essentially to solve the economic crisis. In other words, as more people are employed, as unemployment goes down and the economy grows and more people pay into the Medicare trust fund, the Medicare trust fund would be just fine. The same thing goes for Social Security.

The problem with the trust funds, whether it be Medicare or Social Security, is that in a slow economy, in a recession, less and less people who are working pay into the trust funds. So the answer is not to get rid of the trust funds and not allow people to have a pension, which Social Security provides, or allow people to have Medicare and health insurance when they're over 65, but, rather, to grow the economy, reduce the unemployment, have more people pay into the trust funds, and they become financially solvent for a long time in the future. And that's what the Democrats have proposed.

Our answer to the Medicare program is to try to put more money into the trust fund, grow the economy, and keep Medicare as a Federal guarantee, as a Federal program that's guaranteed to all seniors.

Now, I also heard my Republican colleagues tonight talk about how the Affordable Care Act, that's the health care reform--some people call it ObamaCare--the health care reform, the Affordable Care Act, that somehow that was going to destroy Medicare. Nothing could be further from the truth.

The reality is that the Affordable Care Act strengthens Medicare. The only cuts in the Affordable Care Act are to providers. There are no cuts to beneficiaries. In fact, programs for beneficiaries and benefits for senior citizens are actually expanded under the Affordable Care Act, and many seniors have already seen that.

First of all, the hallmark of the Affordable Care Act, the health care reform, is prevention. And so what the Affordable Care Act says is that if you have some kind of health care, whether it's a mammogram or some kind of diagnostic test, you don't pay a copay. All prevention methods under the Affordable Care Act are provided without a copay. That's mammogram, testing for prostate cancer, any kind of diagnostic test or any kind of prevention program. And the reason for that is because we don't want people to go to the hospital. We don't want people to get sick. We want them to be diagnosed at an early stage. And so we know that if people have to pay a copay, a lot of times they won't have the test done. So that's number one.

The other major benefit expansion under the Affordable Care Act or the health care reform is with regard to part D and prescription drug benefits. Many seniors know that when the Republicans passed Medicare part D, they left a huge, what we call, hole or doughnut hole so that when you pay out of pocket up to a certain amount, in other words, when you incur Medicare expenses up to a certain amount in the course of the year, it was $2,000, now $2,500, whatever the figure is, then everything that you incur beyond that is not covered, and then you have to go to a catastrophic level, something above $5,000, to get your coverage again.

So many senior citizens, when they start the year, are getting their prescription drugs, but by August, September, or October, sometimes even earlier, they reached that threshold or doughnut hole and their Medicare prescription drugs were not covered under the original Medicare part D proposal.

So what the Democrats did in the Affordable Care Act, what the President did in the Affordable Care Act, or ObamaCare, if you will, was to gradually fill in that doughnut hole over the life of the program. So the first year, there was a $250 rebate, and then prescription drugs in the doughnut hole were discounted 50 percent. And gradually, over the next few years, that doughnut hole will disappear so your prescription drugs will be completely covered and you won't have the doughnut hole.

Again, these are benefit expansions under the Affordable Care Act. So when the suggestion is made by the Republicans that somehow the Affordable Care Act is going to hurt or destroy Medicare, nothing could be further from the truth. The fact of the matter is that the Affordable Care Act strengthens Medicare, strengthens the benefit, expands benefits, whether it be for prescription drugs or diagnostic testing or prevention. It also provides a free wellness test every year where there is no copay. It actually pays money back into the trust fund.

So the life of the Medicare program, if you go along with what the Democrats are proposing, whether it is their proposals to improve the economy, grow the economy, would actually shore up the Medicare program, contrary to what some of my colleagues said here tonight.

You know, they mentioned different organizations. There was a group of doctors, they mentioned AARP. Most of the organizations, and I didn't listen to the whole hour, but most of the organizations that they mentioned, the American Medical Society, specialty doctor groups, the AARP, these are the groups that supported the Affordable Care Act, that supported the health care reform, because they knew that it was strengthening Medicare and making Medicare more viable for the future and expanding benefits for seniors and the disabled that are covered by Medicare.

This is part of the historic nature of the Democrats and Medicare. We started Medicare. We strengthened Medicare. We have done everything we can to make Medicare more secure as a guaranteed Federal program. Republicans opposed Medicare from the beginning, continue to try to either repeal it, or, in the words of Speaker Gingrich, make it wither on the vine. And now in the latest proposal, the Republican budget here in the House of Representatives, my very Republican colleagues that spoke tonight all voted for the Republican budget that would essentially get rid of Medicare, make it into a voucher, not provide the Federal guarantee, and make it so the seniors were essentially thrown out with a voucher or a certain amount of money and had to go out and buy private health insurance, which they'll never find.

So I had to come to the floor tonight, Mr. Speaker, and really tell the truth about the parties and where they stand on Medicare. The fact of the matter is that the Democrats started the Medicare program and continue to make it viable.

I yield back the balance of my time.

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