Equal Access to Medicare Act of 2005

Mr. President, On a September morning 4 years ago nearly 3,000 lives were lost on American soil, and our lives as Americans changed in an instant. In the aftermath of the 9/11 attacks, Congress moved swiftly to pass anti-terrorism legislation. The fires were still smoldering at Ground Zero in New York City when the USA PATRIOT Act became law on October 30, 2001, just 6 weeks after the attacks.

Many of us here in the Senate today worked together in a spirit of bipartisan unity and resolve to craft a bill that we had hoped would make us safer as a nation. Freedom and security are always in tension in our society, and especially so in those somber weeks after the attacks, and we tried our best to strike the right balance.

One of the fruits of that bipartisanship was the PATRIOT Act's sunset provisions. These key provisions set an expiration date of December 31, 2005, on certain government powers that had great potential to affect the civil liberties of the American people. Republican House Majority Leader Dick Armey and I insisted on these sunsets to ensure that Congress would revisit the PATRIOT Act within a few years and consider refinements to protect the rights and liberties of all Americans more effectively, and we prevailed.

Sadly, the Bush administration and the Republican congressional leadership have squandered key opportunities to improve the PATRIOT Act. The House-Senate conference report filed last week by Republican lawmakers falls short of what the American people expect and deserve from us. The bipartisan Senate bill, which the Senate Judiciary Committee and then the Senate adopted unanimously, struck a far better balance.

The reauthorization of the PATRIOT Act must have the confidence of the American people. The Congress should not rush ahead to enact flawed legislation to meet a deadline that is within our power to extend. We owe it to the American people to get this right.

The way forward to a sensible and workable bipartisan bill is clear. Today I am pleased to join with Senator Sununu and others to introduce a bill to extend the sunsets on the expiring PATRIOT Act powers until March 31, 2006. Our bill also extends for three

months the so-called ``lone wolf'' FISA surveillance authority, which Congress enacted last year as part the Intelligence Reform and Terrorism Prevention Act.

The deadline that Congress imposed to ensure oversight and accountability should not now become a barrier to achieving bipartisan compromise and the best bill we can forge together. This is a vital debate, and these are vital issues to all Americans. If a brief extension is needed to produce a better bill that will better serve all of our citizens, then by all means, let us give ourselves that time. I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today to introduce the Equal Access to Medicare Act of 2005 to combat the growing practice of health care often called ``concierge'' medicine. As my colleagues may recall I introduced similar legislation in the past two sessions of Congress to deal with the growing problem of doctors shutting down their practices and opening new ones, only accepting those patients willing to pay a membership fee. These fees range from $60 to $15,000 annually. By charging these extraneous and unwarranted dues or requiring patients to purchase non-Medicare covered services, doctors can shrink their practices, maintain a high profit margin, and continue billing Medicare, all on the backs of low and middle-income beneficiaries.

This is a dangerous model that causes significant disparities in the care available to Medicare beneficiaries. A doctor receiving Medicare reimbursement should not be allowed to turn away Medicare beneficiaries who cannot or choose not to pay membership fees or fees for other non- Medicare covered services. My bill simply prevents Medicare from providing payments to doctors who charge their patients membership fees or any other incidental or extraneous fees, or who require the purchase of non-Medicare covered services as a condition for the provision of Medicare covered services.

Since the introduction of this bill in 2001, the practice has been expanding with versions in many States. According to a recent GAO report, the number of physicians practicing concierge medicine has increased by more than 10 times in the past 5 years. As an increasing number of Medicare beneficiaries voice their concerns, it is time for Congress to act. Should this practice proliferate, a doctor shortage for low and middle-income Medicare beneficiaries is likely, exacerbating an already ailing health care marketplace.

I must emphasize that this bill does not interfere with the ability of doctors to limit the size of their practices or to be adequately compensated; it simply applies the same standard private insurance companies apply to their providers--that doctors may not select patients based upon willingness or ability to pay an entrance fee.

I hope my colleagues will join me in helping Medicare keep its promise of accessibility to seniors who have paid a lifetime of ``premiums.''

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today to introduce the Equal Access to Medicare Act of 2005 to combat the growing practice of health care often called ``concierge'' medicine. As my colleagues may recall I introduced similar legislation in the past two sessions of Congress to deal with the growing problem of doctors shutting down their practices and opening new ones, only accepting those patients willing to pay a membership fee. These fees range from $60 to $15,000 annually. By charging these extraneous and unwarranted dues or requiring patients to purchase non-Medicare covered services, doctors can shrink their practices, maintain a high profit margin, and continue billing Medicare, all on the backs of low and middle-income beneficiaries.

This is a dangerous model that causes significant disparities in the care available to Medicare beneficiaries. A doctor receiving Medicare reimbursement should not be allowed to turn away Medicare beneficiaries who cannot or choose not to pay membership fees or fees for other non- Medicare covered services. My bill simply prevents Medicare from providing payments to doctors who charge their patients membership fees or any other incidental or extraneous fees, or who require the purchase of non-Medicare covered services as a condition for the provision of Medicare covered services.

Since the introduction of this bill in 2001, the practice has been expanding with versions in many States. According to a recent GAO report, the number of physicians practicing concierge medicine has increased by more than 10 times in the past 5 years. As an increasing number of Medicare beneficiaries voice their concerns, it is time for Congress to act. Should this practice proliferate, a doctor shortage for low and middle-income Medicare beneficiaries is likely, exacerbating an already ailing health care marketplace.

I must emphasize that this bill does not interfere with the ability of doctors to limit the size of their practices or to be adequately compensated; it simply applies the same standard private insurance companies apply to their providers--that doctors may not select patients based upon willingness or ability to pay an entrance fee.

I hope my colleagues will join me in helping Medicare keep its promise of accessibility to seniors who have paid a lifetime of ``premiums.''

I ask unanimous consent that the text of the bill be printed in the Record.