Health Insurance Marketplace Modernization And Affordability Act Of 2006--Resumed

HEALTH INSURANCE MARKETPLACE MODERNIZATION AND AFFORDABILITY ACT OF 2006--Resumed -- (Senate - May 11, 2006)

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Mr. SALAZAR. Mr. President, access to affordable, quality health care is on the minds of virtually every American. As I travel across my State of Colorado and this nation, people urge me and my colleagues in Congress to solve our health care crisis. I rise today to again add my voice to the millions calling for meaningful, comprehensive health care reform--reform that allows Americans to get the health care that they need; reform that will stop the crippling effect that the rising costs of health care has on our citizens, businesses and economy.

Last year, Senator McCain and I introduced the National Commission on Health Care Act, S. 2007. Its purpose is simple and bold--to fix our broken health care system.

The need to reform our health care system could not be more compelling. An astounding 46 million Americans lack health insurance. They come from every community, every walk of life, and every race and ethnic group. But the most telling part about them is that they come from working families who struggle to put food on their tables and pay their bills. They live in constant fear of getting sick. When they get sick, they often go without medical care and get sicker.

For those fortunate enough to have health insurance, the picture is also grim. Health insurance premiums for family coverage have risen by over 59 percent since 2000, with the average annual premiums for employer-sponsored family coverage costing nearly $11,000. Rising premiums place working families at risk of joining the ranks of the uninsured.

Rising health care coverage has also threatened the ability of American businesses to maintain insurance coverage for their employees and compete on a global level.

Congress must act now to reform our system. We need much more than a week of gimmicks or piecemeal bills. We need comprehensive reform. S. 2007 reflects that need. The act creates a bipartisan commission of 10 elder states men and women. I want to stress that this is a bipartisan commission. Our health care crisis is not a Democratic or Republican problem. It is a national problem that we must solve together.

The members will conduct a thorough investigation into our health care system, building on the work of others to comprehensively look at availability, affordability, quality and costs relating to our health care system. It will look at the uninsured, the small business insurance market, the increases in premiums and health care costs, and the problems that businesses face in maintaining insurance coverage.

The commission will study our government programs and the private health insurance industry. And, most importantly, the commission will develop comprehensive proposals and recommendations to actually solve problems associated with our Nation's health care system. It is not enough to chip away at the problem by enacting policies related to one aspect of our health care system. We need a comprehensive study and comprehensive solutions.

The National Commission on Health Care will not duplicate the very important work that has already been done by other commissions and think tanks. What it will do is study the proposals from a comprehensive perspective, engage business, labor, health care, consumer, insurance and other groups to develop workable policies that if enacted will solve the crisis we face today.

I look forward to working with my colleagues on both sides of the aisle to pass the Commission Act to reform our broken health care system.

Mr. President, I want to take a few minutes to talk about the Medicare prescription drug program. I want to talk about the need to extend the deadline for seniors and people with disabilities and I want to talk about the rural, independent pharmacies that have suffered because of implementation problems with the drug program.

I was not a member of this esteemed body when the Medicare Modernization Act creating this program was enacted. I therefore have no political stake in defending or criticizing the drug program. I have every interest, however, in making sure that the program is properly implemented and that our seniors and people with disabilities have adequate time and accurate resources with which to make decisions about what plans best meet their health care needs. I strongly support Senator Bill Nelson's legislation extending the deadline for seniors and people with disabilities to enroll in the program. I want to thank Senator Bill Nelson for his commitment to ensure that seniors and people with disabilities have adequate time and accurate information to make wise decisions about their prescription drug insurance.

In less than 1 week, seniors will face the deadline for enrollment in the prescription drug program. For many seniors and their family members, selecting an appropriate prescription plan is a difficult and challenging endeavor. I know firsthand how time-consuming and difficult it is to navigate through the various plans to select the plan that meets the needs of an individual senior.

Several weeks ago, I helped my 82-year-old mother select a prescription drug program. In Colorado, there are over 42 plans to choose from--each covering different drugs or formularies as they are known, each with different monthly premiums; each with different copayments, each with different drug prices, and each with different participating pharmacies. I speak from experience--the process is daunting.

My offices have been helping many Coloradans with questions on Medicare prescription drug program. Often, individuals have called my office in exasperation, trying to find a friendly voice to help them through this process. My staff has assisted these individuals. However, many seniors continue to put off signing up for the program because they are confused and nervous. In Colorado, there are still over

100,000 individuals who are eligible to enroll in the plans who have not. Coloradans consistently tell me that they need more time to make sure they review reliable accurate information to select the right plan. They should have that time.

The complexity of the plans and the importance of the choice that seniors and the disabled must make dictate that we allow them more time to make these important decisions regarding their health. Beyond the complexity of the program, seniors and people with disabilities need more time because of the government's own inability to provide reliable information and available help to navigate the choices they are being asked to make.

Just this month the Government Accountability Office released a report that highlighted the government's own shortcomings with respect to the implementation of the drug benefit. The report highlighted that the Medicare help-lines were not providing accurate information for beneficiaries with questions about enrollment. Posing as seniors and senior advocates, the GAO made calls to the Medicare help-line with questions about how the program works. Astonishingly, the GAO often could not get through to an operator!

When the GAO staff did finally get through to an operator, the information specialists often could not answer their questions about the drug benefit, could not help them with questions about specific plans, and could not provide the detailed information that seniors need to enroll. If the government that administers this program could not provide timely, adequate information to beneficiaries, how can we hold them to an artificial deadline? Our seniors and people with disabilities deserve better. They certainly do not deserve to be penalized.

Individuals who miss the approaching deadline will not have an opportunity to enroll until November. In turn, they will face increased premiums and co-pays. And these costs increase the longer the individual waits. Seniors should not be punished for the government's inability to provide them with information with which to make a choice regarding their health. We need to help our seniors in this process, by giving them the time and resources needed to make the best decision for them.

I also want to speak in support of Senator Lautenberg's Pharmacists Medicare Relief Act of 2006 to modify the Medicare drug benefit to allow pharmacies to get timely payment from prescription drug plans. As we all know, pharmacies operating in rural towns and communities, like my hometown in Colorado, are important components of the community's already fragile health care delivery system. Because rural residents tend to be older and have more chronic conditions, pharmacy services to rural residents are particularly important.

The Medicare drug program has threatened the very survival of some rural pharmacies because of the manner in which the plans pay the pharmacies. These pharmacies must pay their wholesalers on a weekly or biweekly basis. Unfortunately, the prescription drug plans reimburse the pharmacies every 6 weeks. The discrepancy in payment has seriously affected the business of many pharmacies, and particularly pharmacies in rural communities.

Fortunately, there is a simple fix: require the plans to reimburse the pharmacies every 14 days. That is exactly what Senator Lautenberg's legislation will do. This legislation would require the plans to pay pharmacists within 14 days if the claims are submitted electronically, and 30 days if the claims are submitted by paper. The legislation also prohibits plans from cobranding Medicare beneficiaries eligibility cards--which means that it bans brands or names of pharmacies from being printed on the prescription drug cards, so that large pharmacies cannot use this advertising advantage at the expense of small operations.

These simple fixes will enable pharmacies in rural areas to continue to serve beneficiaries. Our rural pharmacies and the seniors and disabled people they serve deserve our best efforts to correct problems with the drug benefit plan to enhance health care delivery. I urge my colleagues to support this small but very important fix.

One thing that we can all agree on is that our health care system is in crisis, and that crisis is harming health care providers and patients who need health care services. It is clear that we need real reform. The time for enacting piecemeal legislation that chips away at the massive health care problems is over. Our healthcare crisis will persist long after this healthcare week in the Senate is over. I pledge to put partisanship aside and work with all of my colleagues toward real health care solutions.

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