Hearing of the Senate Finance Committee - The President's Budget for Fiscal Year 2015

Hearing

This morning, we are here to discuss the health care proposals in the President's fiscal year 2015 budget. Madame Secretary, thank you for joining us this morning to testify.

This discussion will undoubtedly trigger some debate about the Affordable Care Act. Certainly there will be some reasonable differences of opinion, but I'd like to start with a handful of overlooked facts that are not in dispute about what's happened since the Affordable Care Act became law.

First, with the passage of the law, health care in America is no longer just for the healthy and the wealthy. Before the law was enacted insurance companies could discriminate against people with pre-existing conditions. That meant that those who were healthy had nothing to worry about; those who were well off could pay their bills; and, everybody else went to bed worried they could be wiped out financially.

Second, the rate of growth in Medicare is slowing. The fact is that according to Health and Human Services data, annual Medicare spending per senior grew by 1.9 percent over a two-year period -- slower than overall economic growth and much slower than historic growth. Over the previous three decades, per-senior spending grew 2.7 percentage points faster than the economy. This has the potential to be great news for seniors who want lower premiums, and for taxpayers who want to extend Medicare without breaking the bank.

Third, there are some important reforms that have been launched over the past few weeks. For example, building on work members of this committee have done to open the Medicare database to Americans, the Obama Administration yesterday made public unparalleled amounts of information that will help Americans make choices about their health care.

This will help fight fraud, promote competition for Medicare Services and be a useful tool for the private sector. This information can be used by private employers and others to bring down the cost of insurance.

Another recent and promising announcement helps provide patients with life threatening illnesses with more choices in care. For the first time, patients will have access to hospice care without having to give up the prospect of curative treatment. This puts patient and families first, and it's high time.

Fourth, Congress now has a bipartisan, bicameral game plan for dealing with chronic disease. Senator Isakson and I have legislation focused on improving care for seniors with multiple chronic conditions. It's the most-expensive and fastest-growing portion of the Medicare population, and these seniors deserve better care.

Fifth, there's plenty of debate about which Americans enrolled in the Affordable Care Act and when, but the independent data shows that the number of uninsured is significantly lower than it has been in years. For example, a Gallup poll released this week shows that the rate of uninsured Americans fell to the lowest level since 2008.

Finally, Congress has made real progress on permanently repealing and replacing the broken and dysfunctional Medicare physician payment formula. The reforms agreed to would push Medicare to be driven by the quality and value of care. Today's volume-driven care isn't good for seniors, their doctors or Medicare itself. The President's budget proposal endorses the bipartisan, bicameral reform package, and I work forward to working with Secretary Sebelius to help push this over the finish line by year's end.

Madame Secretary, the last time you were here before the Finance Committee, I compared the rollout of the Affordable Care Act to the expansion of Medicare to provide prescription drugs to America's seniors during the Bush Administration. Like the Affordable Care Act, it zeroed in on the same concerns: expanding: expanding coverage, financial assistance to the needy, increased marketplace choices.

Medicare Part D has been a huge success, a God-send to millions of seniors, and it's cost 30 percent less than the Congressional Budget Office predicted. However, it had a very bumpy start and many of the news stories from those early days of Part D resemble what we've seen with the Affordable Care Act.

But with Congress working across the aisle to make it work, Medicare's prescription drug program was able to get off the ground and become the success it is today.

And, like the Medicare drug benefit, millions of Americans now have the economic security of health insurance they didn't have just a few years ago. Regardless of politics or feelings about this law, that's something that's good for the economy, and for the country.

Let me turn now to Senator Hatch for his comments. And also, again, I want to express our thanks to Secretary Sebelius for her appearance. Senator Hatch

Source