Medicare Access and Chip Reauthorization Act of 2015

Floor Speech

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I rise on behalf of Chairman Paul Ryan, chairman of the Ways and Means Committee, in support of H.R. 2, a bill led by Dr. Michael Burgess, and I am joined by many of our colleagues, both here in the House and throughout the country.

This bill is critical because of this problem. Imagine you are a senior. You desperately need to see a doctor, but you learn that there are no local doctors who can treat you because they simply can't afford to treat Medicare patients. Or they have been throughout the years faced each year with a 10, 20, 30 percent cut in their reimbursements and, as the sole practitioner or as a small business, have rethought their relationship with Medicare and are no longer, frankly, able to do that. That scenario has been played out across this country for far too long. If there is any group in America who needs to see doctors they know and who know them, it is our seniors.

This bill takes the first real permanent step to ensuring our seniors can see local doctors when they need to see them, and it takes the first real step in saving Medicare not just for these seniors, not just for the next generation, but for generations to come.

I commend the work that has been done by the leaders of the Ways and Means Committee; Chairman Ryan; Chairman Fred Upton of the Energy and Commerce Committee; our physicians caucus, led by Dr. Phil Roe and Dr. John Fleming; as well as those in this Chamber who have come together to make this historic step today.

So this is about helping our seniors. This is about taking those first reforms permanently to save Medicare. And it really is about ending a formula and a reimbursement that simply works against our seniors.

The flawed--they call it the ``sustainable growth rate,'' it dictates huge cuts to our physicians through Medicare. Congress had to intervene 17 times in recent years to stave off these cuts with short-term fixes. This flawed formula regularly threatens access to care for seniors and really distracts Congress from making real reforms that are needed.

The bipartisan agreement that we face today would repeal that SGR once and for all and replace it with a value-based system that provides certainty to our seniors and, really, finally reimburses doctors not on the number of procedures but on the quality they provide, and determined not by Washington but by our local physicians and practitioners themselves.

This reform alone, if that was the only thing this did, is significant. It begins to move its way from that flawed fee-for-service system. And it does in a way. The sole practitioner in rural Pennsylvania, as well as a doctor in a major institution in downtown Houston, can both practice to their highest capability and continue to practice until they decide to retire, not until Medicare or some flawed formula encourages them to retire early.

In addition, this bill has two important reforms, and I think critical reforms, to strengthen the Medicare Program and offset the costs of this measure. Similar reforms have been included in the House Republican budget for years. This is a bipartisan effort to work together with absolute dedication to make sure Medicare is around for our seniors.

First, it restricts first dollar coverage in Medigap plans. These are bipartisan recommendations experts believe will help reduce unnecessary costs and really strengthen programs over the years.

Second, the agreement includes increased means testing for premiums in Medicare parts B and D, our doctors, and our medicines, with the wealthiest seniors paying higher premiums. And then there are savings from a broad range of other healthcare providers.

I want to make clear, this bipartisan reform alone will not save Medicare, but it takes us in the right direction for the very important first step, and the savings from this will grow over the long term.

The alternative we refuse to pass is yet another cycle of short-term fixes, leaving behind bipartisan structural reforms to Medicare and delaying the opportunity to actually save this program for our seniors.

So, today, we end the SGR, we begin the important reform, and we stand up for seniors who need to see doctors.

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Mr. Speaker, there is nothing wrong with being passionate about your ideas and principles, and nowhere is that more evident than in health care. When you can find, though, common ground on those principles that help our seniors, encourage our doctors to treat them, and make the first reforms to really save Medicare for the long term, we ought to do that. That is what this bill does.

But it just isn't a common ground as far as our lawmakers. We have dedicated staff who came together to work out the tough issues for us as well. On behalf of the Committee on Ways and Means Chairman Paul Ryan and myself, I would like to thank our staff on the Ways and Means Subcommittee on Health--Matt Hoffmann, Brett Baker, Amy Hall, and Erin Richardson--for their tremendous work.

The Speaker and former Speaker Pelosi also led the effort to find this common ground, and for Speaker Boehner, Charlotte Ivancic, and for Leader Pelosi, Wendell Primus, we thank you, as well as legislative counsel; and for the Congressional Budget Office, Tom Bradley and Holly Harvey contributed greatly to this day.

The other day, my neighbor, who has just retired from Continental, now United, walked over to my front porch and told me that after years of seeing his local doctor, his local doctor can't see him anymore because he can't afford to treat Medicare patients.

The other day--it was a tough winter for illnesses--I had an ear infection, and my local doctor I have known since he started his practice snuck me in at 6 at night. His staff had been there since 8 in the morning working and just looked frazzled. He just said, look, he doesn't drive a fancy car, doesn't live in a fancy home; he doesn't have a fancy office; he just wants to help treat patients. But this formula just makes it harder and harder for him. My main physician, who is 66, told me the other day that he would like to practice for 5 more years. He said: I think probably just 1 more year. He said: I can't handle the way Medicare pays today.

Look, we can't allow that to continue. Today, a simple question on this bill: Will you stand with our seniors, who need to see a local doctor and a doctor they know? Will you stand with our doctors, who want to treat our seniors, who don't want to retire early or sell out to larger institutions? Will you take the first real step to save Medicare for the long term? That is the question we face today.

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