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Mr. MORAN. I appreciate the opportunity to be on the floor today, especially with the Senator from Wyoming, a doctor who is such an expert on the topic of really not just the moment, not just the day, but the topic of what our country faces.
I will say that I do spend a lot of time in hospitals across our State talking to health care providers, talking to patients, doctors, to administrators, trustees. In fact, there are 128 hospitals in our State. I have visited all of them, and there is genuine concern about the future of the ability for health care to be delivered in communities across our State. And you add to that the physician and other health care provider community, and this health care reform act is creating significant challenges.
My interest in public service started a long time ago with the belief that we live our lives in rural America, in my State of Kansas, in a pretty special way. When I came to Congress, it became clear to me that if our communities were going to have a future, it was dependent upon the ability to deliver health care close to home. And those rural communities across our Nation often have high proportions of senior citizen populations where Medicare is the primary determining factor of whether they can access health care.
When the affordable care act was passed, many promises were made, but one of the things that was told to the American people--or at least the attempt was made to sell to the American people--was that there would be greater access. And I would certainly say that one of the promises that is not being kept about the affordable care act is the likelihood that there is going to be greater access for Americans across our country to health care because this bill is underfunded, it is not paid for. The consequences are that the administration is already proposing and Congress will always be looking for ways to reduce spending when it comes to health care, and the most likely target is the payment Medicare makes to health care providers, which in many instances already doesn't cover the cost for providing the service. So when we look for access to health care, every time we make a decision, every time a decision will be made in order to try to make this more affordable, we are going to see fewer and fewer providers able to provide the services necessary to folks across the country but especially in rural communities where 60, 70, 80, even 90 percent of the patients admitted to the hospital are on Medicare.
So one of the problems with the affordable care act is the reality that it will reduce access to health care for people who live in rural America and we will see fewer physicians accepting patients on Medicare, we will see fewer hospital doors remain open; as this bill takes $500 billion out of Medicare to begin with, the Congress that passed and the President who signed this legislation set the stage for there to be less affordable health care available to Americans across the country but especially for constituents of mine who live in a rural State such as Kansas.
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Mr. MORAN. That is true. The point made earlier about the goal of the legislation bending the cost curve down--it didn't do it, it doesn't do it, and it cannot do it. That created the problem we all face now. How can we have access to affordable health care if we are not reducing the cost of health care?
The end result, in my view, is that Americans will have less options for their own plans. As employers, they will provide either less options or no options for their employees. So the idea that people are going to get to keep what they have, that begins to disappear. If they are a senior citizen and Medicare has been their primary provider, we go back to the idea that we didn't bend the cost curve. So in order to make health care affordable--when the legislation fails to do that, we find other gimmicks to do that. One of the things this bill creates is IPAB, an independent agency that will make decisions about what is covered by people's health care plans. The goal will not be to have better quality health care; the goal of the IPAB will be to reduce expenditures.
As the promise was made that people get to keep what they have, it becomes totally different than what they have experienced in their health care plans--either in their own private health care insurance or as a beneficiary of Medicare. Even the President's own Medicare Actuary estimates that the law will increase overall national health care expenditures by $311 billion during the first 10 years alone, and that private health care insurance premiums will rise 10 percent in 2014.
So if we are complaining today about the increase in premium costs, there is more to come. In 2014, the Medicare Actuary says there will be another 10 percent increase in your health care premiums. At the Center for Medicare and Medicaid Services, their economists found the increasing growth rate in health care spending will occur in every sector of health care. More recently, the Congressional Budget Office, our neutral provider of analysis, says the cost of the health care law may be substantially higher than earlier estimated.
One of the things I would suggest we should have done and that never happened--if we want folks to be able to keep what they have, if we want access to health care in rural and urban and suburban places in the country--we should have done something about fixing permanently the reduction of payments to physicians--the so-called doc fix. One would have thought, in health care reform, that would have been front and center. Because if we don't have a physician providing a service, we don't have health care. Yet we have a Medicare system that is going to reduce the payments. In fact, expected this year, the reduced payments to physicians was going to be 30 percent.
The reality is, no longer will physicians accept Medicare patients. The option the American people were promised about keeping what they have disappears one more time. In fact, at a townhall meeting in Parsons, KS, this year, a physician in the front row said: Senator, you need to know I no longer accept Medicare and Medicaid. I will take cash, but I cannot afford to provide the services based upon the Medicare reimbursement rate I get. When you add in all the paperwork, trying to comply with Medicare and Medicaid, it is no longer financially feasible for me in this small town to provide the services my patients need under Medicare.
So we are going to see a lot less access because, once again, this is a failure. The promise that was made to bend down the cost curve, to reduce health care costs, to reduce premiums was totally false.
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