Floor Statement- Cuts to Medicare and Medicaid

Mr. BRADLEY. Mr. President, I come to the floor today to express my very serious concerns about the cuts to Medicare and Medicaid which are contained in the budget resolution.

Mr. President, my colleagues across the aisle have stated repeatedly that they are not touching Social Security. But at the same time over a third of the cuts which they have proposed, including over 40 percent of the cuts in the year 2002, come from Medicare and Medicaid. Mr. President, I would like to spend a few minutes discussing what the proposed Medicare and Medicaid cuts will mean to our most vulnerable citizens. As I discuss these impacts, I would like my colleagues to ask themselves how they can credibly claim that this budget does not reduce these people's security.

Let me start with Medicare. This budget cuts spending for the Medicare program by $256 billion over 7 years. I would like to spend a minute discussing what these numbers mean in human terms. They mean that seniors will have to find an average of $3,447 more to pay for their health care over the next 7 years. In my home State of New Jersey, seniors will have to come up with an additional $932 in the year 2002 alone just to pay for the additional Medicare costs which this budget imposes on them. For many seniors across the country, these new costs will be extremely difficult to bear. In 1992, the median income of seniors in this country was only about $17,000 a year, and about a quarter of elderly households had incomes under $10,000. Of these incomes, seniors already spend more than one of every five dollars on medical costs. For the millions of seniors across the country who live on fixed incomes, finding an additional $3,447 over 7 years will mean having to give up something else which is important to them. It is estimated that there are already nearly 8 million seniors nationwide who are forced to choose each month between paying for their medications and paying for food. I can't help wondering how many millions more seniors will be faced with this horrible choice once the proposed cuts go into place.

An increased financial burden on seniors is only one of the negative consequences which will result from the proposed Medicare cuts. Along with having to pay more, seniors will likely find that their ability to choose their own doctor is restricted-perhaps not explicitly, but because financial limitations leave them with no choice but to join a managed care plan. Also, doctors, hospitals, and others providers are all likely to face reduced payments. They already receive far lower payments from Medicare than from private insurers, and if Medicare rates are reduced much further some may find that they can no longer afford to take Medicare patients. Those who do keep accepting Medicare will be forced to shift even more costs onto their privately insured patients, creating a hidden tax on employers and individuals.

And that's just Medicare. In addition, this budget cuts Medicaid by $175 billion. That's an 18 percent cut, relative to what spending would be if there were no change in law. I think it is very important that we all understand exactly who these cuts will affect. Medicaid now insures about one of every four American children. It pays for roughly one of every three births in this country. And it pays for over three-fifths of the people who need long-term care services, either in nursing homes or at home. Over half of Medicaid funds go for persons who are either elderly, blind, or disabled. Most elderly recipients of Medicaid are people who spent their whole lives as members of the middleclass. But when faced with nursing home costs averaging almost $40,000 a year, it doesn't take long for their entire life savings to disappear. Once they reach this point, these people have nowhere else to turn. Thank goodness Medicaid has been there to provide a safety net for them.

This resolution caps Federal Medicaid spending at an average annual growth rate of 5 percent. We all know that Medicaid spending is expected to grow much faster than that in the future. By setting a 5 percent cap, the Federal Government is essentially saying to the States: "It's all your problem now. We can't figure out how to deal with the growing number of uninsured and the rising costs of health care, so you do it. We wash our hands of any responsibility to help you deal with these critical needs." But, if we are honest with ourselves, we must admit that States can't cope with these problems alone.

So, Mr. President, let me tell you what is expected to happen once these proposed Medicaid cuts go into effect. By the year 2002, the number of uninsured children in American is predicted to rise by more than 6 million. By that same year, there will be an additional 3 million persons who need-but can not get assistance with-the costs of long-term care. These will be people who will be required to leave nursing homes, or will never be able to enter one, despite the fact that they need more care than their family and friends are able to provide, either financially or physically. As I stated earlier, many of these people are now members of the middle-class, but the astronomical costs of long-term care will impoverish them rapidly. For those persons who are able to enter and remain in nursing homes the picture is not much brighter. Medicaid now pays significantly less than the private sector for long-term care. When Medicaid cuts these payments even further-as it will have to do in response to the budget cuts-nursing homes will have to do even more with less. This means that staff will be stretched even thinner, and each resident will receive even less personal attention. The proposed cuts will mean that the quality of life of nursing home residents will deteriorate even further.

Mr. President, I hope that my remarks have helped put a human face on all the numbers which have been floating around the floor of this chamber the last few days. I recognize that reducing the deficit will require painful choices. But in making these choices, we can not ignore how these decisions, will impact the persons whom we have been elected to represent. My colleagues across the aisle claim that they are concerned about the impact of deficit reduction on our oldest and most vulnerable citizens. They have stated repeatedly that Social Security is "off the table" - that it has not been cut. To them I respond:

Medicare and Medicaid are vital parts of our social security system. They provide security at a time when people are most vulnerable-when they are sick. To take over a third of your proposed cuts out of Medicare and Medicaid is to deny security when it is most needed.