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Mr. KERRY. Mr. President, approximately one in five Medicare beneficiaries--or 9 million people--purchase a Medigap supplemental insurance policy to protect against high out-of-pocket costs and to make health care costs more predictable. Current law includes a `guaranteed issue right' to Medigap for beneficiaries age 65 or older, which means they cannot be denied Medigap coverage or charged a higher Medigap premium because of their medical condition.
Unfortunately, current law discriminates against Medicare beneficiaries with disabilities who are under age 65, as well as beneficiaries with kidney failure, End Stage Renal Disease or ``ESRD'' by denying them the same right that seniors have to guaranteed issuance of Medigap policies. This exposes individuals with disabilities and kidney failure to substantial out-of-pocket costs and poses a significant barrier to health care services. In the absence of equal opportunity and access to Medigap policies at the Federal level, 29 States have enacted guaranteed issue rights to disabled and ESRD beneficiaries.
Individuals with kidney failure are subject to an additional discriminatory provision in federal law that prohibits Medicare ESRD beneficiaries from joining Medicare Advantage plans. They are the only group of Medicare beneficiaries currently denied the same Medicare choices as other Medicare beneficiaries.
Today I am introducing the Equal Access to Medicare Options Act, a bill that improves coverage options to Medicare beneficiaries. My legislation would eliminate discriminatory treatment in the supplemental insurance market, bring more financial stability to Medicare beneficiaries with disabilities and ESRD with high out-of-pocket health care costs, and reduce reliance on Medicaid as the payer of last resort. Specifically, it would extend guaranteed issue of Medigap policies to all Medicare beneficiaries, including beneficiaries with disabilities and ESRD. It would ensure equal access to supplemental insurance for all Medicare beneficiaries, regardless of age, disability or ESRD status.
Additionally, my legislation recognizes that Medicare beneficiaries need flexibility to adjust their coverage as changes to their plans are made. It would give guaranteed issue rights to Medicare Advantage enrollees if they decide to switch to traditional Medicare during an enrollment period. Today, if a Medicare Advantage enrollee learns of premium increases or benefit reduction in their plan, they have the option of returning to traditional Medicare but they have no assurance they can buy Medigap coverage if they do so.
The Equal Access to Medicare Options Act would provide guaranteed issue to dual-eligibles who lose their Medicaid coverage and find themselves in traditional Medicare without the cost protections of Medicaid and without supplemental coverage options. Finally, this legislation would--for the first time--give beneficiaries with end-stage renal disease the option of enrolling in Medicare Advantage plans.
I would like to thank the nearly 50 organizations who have been integral to the development of the Equal Access to Medicare Options Act and who have endorsed it today, including the California Health Advocates, Center for Medicare Advocacy, Dialysis Patient Citizens, Fresenius Medical Care, Medicare Rights Center, and the National Kidney Foundation.
The Affordable Care Act prohibits discrimination based on health status in the private health insurance market, beginning in 2014. It is inconsistent and unconscionable for federal law to allow insurers to discriminate based on health status in the Medigap market. All individuals, regardless of their health status, deserve the same access to comprehensive and affordable coverage options.
The reforms included in this legislation would finally end discriminatory Medicare policies in Federal law and would ensure that all Medicare beneficiaries regardless of their disability or age have equal opportunity and access to affordable Medicare options. I look forward to working with my colleagues in the Senate to achieve these goals in the context of health care reform.
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