Welch Unveils Bipartisan Initiative Encouraging Seniors to Plan for Debilitating Illnesses

Press Release

Rep. Peter Welch (D-VT) today announced the introduction of his bipartisan legislation encouraging Medicare beneficiaries to make their treatment preferences known to families and providers should they be unable to make their own decisions due to a debilitating or terminal illness. The announcement took place at the University of Vermont Medical Center's Adult Primary Care facility in South Burlington.

Welch was joined at the announcement by Cathy Frank, former chair of Vermont Ethics Network, Dr. Bob Macauley, Director of Clinical Ethics at the University of Vermont's College of Medicine, and Asaad Trina, a third year UVM medical student. The legislation has been endorsed by a broad coalition, including the American College of Physicians, the National Right to Life Committee, the American Nurses Association, and the Coalition to Transform Advanced Care.

"Advance directives empower seniors to specify their health care preferences well in advance of a debilitating or terminal illness," said Congressman Welch. "Having this important discussion with families and doctors in advance will give them peace of mind knowing that their wishes will be met should they not be able to make their own treatment decisions."

"By the time major medical decisions need to be made, patients are often so sick that someone else has to decide for them. Advance directives are the best way to communicate your goals and values to your family and your doctors. This bill is an important step forward in making sure patients' wishes are respected," said Dr. Macauley.

The Medicare Choices Empowerment and Protection Act offers a one-time financial incentive to Medicare beneficiaries who complete an advance directive, which would provide clear guidance to their family and medical providers should they be unable to make their own treatment decisions. This new Medicare benefit would complement the announcement late last year by the Centers for Medicare and Medicaid Services (CMS) that physicians can now be reimbursed for time spent with patients on advance care planning.

Seniors choosing to participate in this program would, working with their doctor and family members, create and register online a certified and secure advance directive. In addition, the legislation would create a website with model advance directives representing a range of options.

According to a 2006 study by the Pew Research Center, 70 percent of Americans have thought about their health care preferences should they be faced with a life-threatening illness or injury, but only one-third have completed an advance directive. Advance directives would be maintained online by organizations certified by CMS and could be modified or terminated by the beneficiary at any time. The directives would include any written statement that outlines the kind of treatment and care a beneficiary wants or does not want under certain conditions, and can include identification of a health care proxy.

Welch's legislation (H.R. 4059/S. 2297) is cosponsored in the House by Representatives Diane Black, RN (R-TN), Mike Thompson (D-CA), and Chris Collins (R-NY). Senators Chris Coons (D-DE) and Bill Cassidy, M.D. (R-LA) introduced identical legislation in the Senate. The legislation is estimated by Third Way to save the federal government up to $15.2 billion over 10 years.

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