Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014 - Motion to Proceed

Floor Speech

Mr. CORNYN. Mr. President, I see the Senator from North Carolina is here on the floor. I know he is likely here to respond to the Senator from Vermont and the Senator from Washington on the veterans bill that is on the floor, and what I believe is a much better alternative for us in dealing with the needs of our veterans in a way that is fiscally responsible.

But what I would like to do is to turn to another story that continues to unfold worse and worse news over time, that unfortunately we tend to get distracted from because there are so many other things that are happening. But when the President's signature health care bill, the Affordable Care Act, was signed into law 4 years ago, we knew that it did not just create a brand new health care entitlement. It actually weakened existing programs like Medicare and Medicaid.

For people who do not deal with these programs on a day-in and day-out basis, of course, Medicare is for seniors, for health care for seniors; Medicaid is a separate program which is shared by the States and the Federal Government to provide the safety net health care program for low-income Texans in my State.

But because of the massive new burdens that ObamaCare is placing on the health care safety net, which is already failing the neediest members of society, the share of physicians accepting new Medicaid patients in Texas has fallen from 67 percent in 2000 to only 32 percent in 2012. So in 2000, 67 percent of physicians would accept a new Medicaid patient. Today it is roughly one-third, one out of every three.

Of course, the reason for that is the Federal Government continues to pay less and less. Now I think it is roughly 50 cents on the dollar compared to private insurance to a physician who treats a Medicaid patient. So we know that many Texas physicians, including a majority of established primary care physicians, are not accepting new Medicaid patients at all because they are being asked essentially to work for 50 cents on the dollar, something they cannot afford to do.

Yet the architects of ObamaCare thought that it was a good idea to add millions more people to a broken program, one that already was not providing access to quality health care. This, of course, will further reduce the quality of Medicaid, which is one reason why many State Governors refused the Federal Government's request to actually expand the coverage of Medicaid absent reforms to fix it and make sure that it would work more fairly and better and more cost effectively. Of course, the consequence of that is it will make it even harder on the poorest and most vulnerable Americans to gain access to quality health care.

As for the Medicare program, of course that is for seniors, ObamaCare created a new panel of unelected bureaucrats known as the Independent Payment Advisory Board. What an innocuous bureaucratic-sounding name. Some people call it the IPAB. These are unelected bureaucrats who will decide whether your health care is worth a cost-benefit analysis.

What they will end up doing is slashing Medicare payments to doctors so that many physicians can no longer afford to see new Medicare patients and provide the treatment that those patients and their doctors believe they need and that they want. So it has become abundantly clear that the goal of ObamaCare is to make Medicare more like Medicaid. We know what that means. We know it is not hard to predict, that fewer and fewer doctors will treat Medicare patients and some will leave the program all together.

Why do we know that? Well, we have seen the experience with these new major cuts to Medicare Advantage. Not to confuse things too much, but Medicare Advantage is actually a private insurance alternative to traditional Medicare which pays doctors based on the services they provide. Medicare Advantage is a remarkably successful program that covers roughly 30 percent of all Medicare beneficiaries, close to 16 million people.

The funds to those programs, to those 30 million, to that program that benefits 30 million beneficiaries, are being slashed by approximately $308 billion as a result of ObamaCare. This is another one of these hidden problems with ObamaCare that is now just coming to light, even though we talked about it a lot back in 2009 and 2010. Now it is coming to fruition.

The truth is, these cuts in Medicare Advantage will force many seniors to pay higher premiums and further undermine their existing health care arrangements. You remember the President said: If you like what you have, you can keep it. If you like your doctor, you can keep your doctor.

We are now learning that is absolutely not true in many cases. Just to give you a sense, though, of Medicare Advantage's popularity, according to the Wall Street Journal, about one of two people newly eligible for Medicare chose Medicare Advantage and enrollment is growing at a rate of roughly 10 percent per year.

Why is Medicare Advantage so popular compared to traditional Medicare fee for service? Well, for all the

reasons you might expect. The program offers a lot more flexibility and much more patient choice than traditional Medicare based on a number of different performance measures that also deliver better results than traditional Medicare. It has become the primary driver of innovation within the Medicare system.

Yet we know, and we have known now for 4 years, and we are now seeing that the reality is the administration is trying to undermine Medicare Advantage to help pay for ObamaCare. Neither one is working the way the beneficiaries of those programs expected and were promised they would work.

Earlier this month I joined with 39 of my colleagues here in the Senate to send a letter to CMS Administrator Marilyn Tavenner urging her to ``maintain payment levels that will allow Medicare Advantage beneficiaries to be protected from disruptive changes in 2015.'' Our letter described Medicare Advantage as ``a great success,'' noting that one study published in the American Journal of Managed Care found that ``the hospital readmission rates for [Medicare Advantage] enrollees are 13-20 percent lower than for Medicare [fee-for-service] enrollees.''

In other words, it is more effective delivering quality care, keeping seniors healthy and reducing dramatically the need to have them readmitted to hospitals once they are discharged.

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