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Public Statements

Medicare

Floor Speech

By:
Date:
Location: Washington, DC

Mr. FRANKEN. Mr. President, I have come to the floor to talk about Medicare. My esteemed colleague from Alabama just talked about Medicare reform. The Presiding Officer and I--all of us--pay into Medicare every month, so we are entitled to Medicare benefits when we reach age 65. The fact that we are entitled to these benefits is not bad. In fact, it is very good for so many millions of American seniors. The fact that many call it an entitlement only means we have a right to expect to get the benefits we paid in for. Entitlements, in this case, should not be a pejorative.

We have heard a lot about entitlement programs recently and about the place of Medicare in the conversation about our Federal deficit. We just heard the Senator from Alabama talk about that. He said there is no discussion of reform of Medicare. But in these discussions sometimes I think a critical component is missing, which is we already reformed Medicare, and these reforms extended the life of Medicare by 8 years while expanding benefits for seniors.

During the recent campaign, as the Presiding Officer has pointed out, we saw a lot of ads about the so-called $716 billion in cuts to Medicare and how terrible that was, is, and will be. I would like to take just a few minutes to explain what these savings were, what they are, and what they will be.

The two biggest sources of the $716 billion are, one, insurance companies overcharging the government for Medicare Advantage and savings in payments to hospitals.

First, Medicare Advantage. As the Presiding Officer knows, as people watching no doubt know, seniors can choose to get their Medicare benefits directly from the Medicare Program or get them through a private insurance program that gets paid by Medicare, which is called Medicare Advantage.

Before we passed the Affordable Care Act, we were overpaying those private insurers by 14 percent. These insurers were getting much more than they should have based on the benefits they were providing to seniors. So we cut what Medicare gives to these private insurance companies. Over the next 10 years, we are going to cut these insurance payments by 14 percent, which CBO scored in 2010 as saving Medicare $136 billion over 10 years.

We were told by some of our colleagues that insurance companies were going to leave the market, that we were not going to have Medicare Advantage anymore. So far, enrollment in Medicare Advantage has gone up by 11 percent. That is many billions of dollars we were able to take--instead of overpaying insurance companies--to extend the life of Medicare.

Second is the lower reimbursements to hospitals. Why does this work out for hospitals? When we insure 31 million more people, and those 31 million people go to the emergency room, go to the hospital, the hospital is no longer on the line to pay for that.

They are not left holding the bag. Those 31 million people now have insurance that pays for it. So the hospitals are now able to take lower reimbursements for Medicare patients. That is why it works out. So when people talk about the $716 billion, this is a huge part of what they are talking about. It is not cuts to benefits. It is not shifting costs to seniors. It is streamlining the program and making it more efficient.

We took these savings and we reinvested the savings in the program. We overall extended the life of Medicare by 8 years. That is entitlement reform, extending the life of the program. That is what we are talking about when we talk about reforming Medicare. That is what we did. But not only that, we actually expanded benefits for seniors.

I go to a lot of senior centers around Minnesota, nursing homes. I have to tell you seniors are very happy we expanded their benefits. They are happy about the new free preventive care they get, wellness checkups, colonoscopies, mammograms. They know an ounce of prevention is worth a pound of cure. This saves us all money and keeps people healthier.

What else are we doing with this money in addition to expanding the solvency by 8 years? We are closing the doughnut hole, the prescription drug doughnut hole. I have to tell you, seniors are very happy about that too. For more than one-third of seniors, for them, Social Security provides more than 90 percent of their income. For one-quarter of elderly beneficiaries, Social Security is the sole source of retirement income. So when they hit their doughnut hole, that is serious.

Sometimes they have to make choices between food and heat and medicine. Because we are closing the doughnut hole, in many cases, people do not have to make that choice anymore. This is important stuff. When I was running for the Senate, a nurse who worked in Cambridge, MN, a town north of the Twin Cities, came to me and told me that in the hospital she worked in very often they would admit a senior who was very sick and the doctors would treat this senior and get them back on their feet and send them home with their prescriptions.

As this started happening, they would call the drug store, the pharmacy a few days later, 1 week later, and say: Has Mrs. Johnson filled these prescriptions? The pharmacist would say: No; because she was in her doughnut hole. A couple weeks later, Mrs. Johnson would be back in the hospital. How wasteful is that? How wise? That costs a tremendous amount of money to our system. This is saving money. This is health care reform. This is Medicare reform. It is improving people's health and saving money at the same time. So we have increased benefits. We have extended the life of Medicare. That was done as part of health care reform. That is Medicare reform.

In the election we had a discussion about this. There were a lot of ads about it. We know what Governor Romney would have done to Medicare. He said very explicitly that--and again the Presiding Officer has quoted this. He said very explicitly he would restore those billions and billions of dollars in overpayments to private insurance companies for no reason, for no good effect, just so, I guess, these insurance companies could have more profit. Instead, we reinvested this money into Medicare. But he would have given it to the insurance companies. He would have replaced this health care law. He would have made the 8 years we extended Medicare vanish. Governor Romney supported raising the Medicare eligibility age. If we raise the age from 65 to 67 as he suggested, that means hundreds of thousands, if not millions, of seniors would no longer have access to Medicare.

They would end up receiving Federal subsidies in the exchanges and some of them would go to Medicaid. They would be--these 65- to 67-year-olds--by definition, older and as a population sicker than the other people in the exchanges and in Medicaid. So they would make both these programs more expensive.

They would also make Medicare more expensive because they would be the youngest and least sick and be taken out. Although this sounds like a reasonable compromise, trust me, it is a bad idea. It would cost the health care system twice as much as it would save Medicare. This is exactly the kind of bad idea which explains why we pay twice as much as other developed countries around the world for our health care and in many, if not most, cases with worse outcomes.

Medicare reform was an issue in the campaign because we already did it. We extended the program by 8 years. It is not like it was a secret. It was part of the conversation during the election. In the election, the American people voted to keep those reforms. As we continue this conversation about our fiscal future, I would love to hear from my colleagues across the aisle about how they would reform Medicare, how they would expand its life by 8 years while expanding or at least, at the very least, not cutting benefits. How would they do it? Because we extended its life for 8 years and increased benefits--very meaningful benefits.

I would ask my colleagues why, before the election--and this is the very point the Presiding Officer made a few days ago on this floor--why they were attacking us--incorrectly I might add, inaccurately--for making cuts in Medicare, but since the election they have been insisting we make cuts to Medicare.

Going forward, I think we need to move from talking points to taking a thoughtful look at policies and working together to tackle our Nation's fiscal challenges and do it based on a little bit deeper look at what we have done and what the health care reform was that we passed in the Senate and the House, now the law of the land, what that does.

I yield the floor.


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