Mr. Speaker, I offer a motion to instruct. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, the motion we are debating tonight instructs the Medicare conference committee to reject the controversial plan of premium…
Mr. Speaker, I offer a motion to instruct.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, the motion we are debating tonight instructs the Medicare conference committee to reject the controversial plan of premium support and reallocate the money saved to increase payments to disproportionate share hospitals.
As a representative of an area with multiple DHS hospitals, I feel it is vitally important to provide them with the maximum Federal funding possible. However, let me first discuss the issue of premium support, and why I am concerned that this plan could potentially dismantle Medicare.
Under premium support, in the year 2010, private insurance companies and traditional fee-for-service would compete against each other to provide services to beneficiaries. Monthly premiums would be set according to an average and beneficiaries would then be given something similar to a voucher for which they could purchase coverage.
However, premium support will create a system where seniors' benefits can vary widely from county to county, State to State, and their choice in doctors can be restricted, vital services may not be covered, and their monthly premium can radically fluctuate. That is if the private plans even participate at all.
We need to look no further than the administration to find proof that this is an impending problem. A recent report by the Department of Health and Human Services actuary showed radical disparities in the monthly premiums by region. For example in Davidson County, North Carolina, Medicare beneficiaries would only pay $53 a month under premium support. However, my constituents in Stanislaus County would be forced to pay a whopping $117 per month, so more than double.
I am very concerned about subjecting a trusted health care system like Medicare to the uncertainty of the private market. I am especially hesitant about a system that relies on HMOs and other private insurance plans to administer services to our seniors. In my hometown of Merced County, there is not one, not one Medicare+Choice plan that my constituents can participate in, not one. However, for someone residing in Los Angeles County, 200-250 miles down the road, they have a pick of 11 different plans. HMOs have made it abundantly clear that serving rural America is not profitable, and, therefore, they have pulled out of those regions in a mass exodus. Now, the House bill relies on these plans to provide services for Medicare beneficiaries.
Mr. Speaker, to me it just does not make sense. So let us not take a gamble with our seniors. Instead, let us spend our resources on something far more tangible, disproportionate share hospitals. These are America's safety net hospitals caring for the sickest and poorest of our citizens, and they must not be abandoned in their time of need. Currently, there are over 40 million Americans without health insurance, and the number continues to rise. DHS hospitals accept every patient, regardless of their financial status, and provide the best possible care available day in and day out.
In my district, my hospitals fall between the cracks of not quite big enough to be considered urban, and just a little too large to be considered rural; but we have one of the largest uninsured populations in the country and increasing DHS funds are absolutely essential for their survival. Mercy Hospital in Merced County is facing severe financial shortages because of a lack of payments in this area and because of a high indigent population.
My motion not only directs the conferees to use funds saved by premium support for DSH hospitals but it also insists that the final legislation retain the most generous DSH provisions from the House and Senate versions of the Medicare legislation.
As we all know, DSH hospitals are facing the possibility of falling off a proverbial cliff due to the drastic reduction in Federal funding as directed by the Balanced Budget Act of 1997. Section 1001 of this bill increases DSH allotments in fiscal year 2004 to that of 120 percent of fiscal year 2003. Section 602 of the Senate bill increases the floor for low DSH States from 1 percent to 3 percent of total Medicaid spending. This provision is extremely important for States of Alaska, Arkansas, Delaware, Idaho, Iowa, Kansas, Maryland, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, Wisconsin, and Wyoming who are bound by law not to spend more than 1 percent of their Medicaid dollars on DSH hospitals. Hospitals in these States are suffering as well, and we cannot let them fail, either.
Mr. Speaker, I urge every Member of this body to support my motion to instruct the Medicare conferees. America's seniors deserve a guaranteed Medicare benefit and America's safety net hospitals deserve our assistance.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
I would say to the gentleman from Texas that it is my understanding that we have never offered a proposal that costs three times as much. In fact, the gentleman alluded to the fact that he favored a plan much like the plan that Members of Congress currently have. That is something that we have proposed. We have never heard that plan from the Republicans. We would certainly be willing to entertain a plan that was something similar to what Members of Congress have for our seniors, without a doughnut hole.
Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Stenholm), the ranking member of the Committee on Agriculture and the cochair of the Blue Dog Coalition.
Mr. Speaker, I yield 3 minutes to the gentleman from Ohio (Mr. Brown), a member of the Committee on Energy and Commerce, who has over the years become a leader in this body on health care in America.
Mr. Speaker, I yield myself such time as I may consume.
I would like to first assure the gentleman from Texas that I have not attempted to score debating points since I graduated from high school, and I think this issue dealing with Medicare for our seniors, prescription drugs for our seniors, is far too important to consider debating points. What we are concerned about is the fact that we have been excluded, predominantly, from a conference committee that is critically important to the vast majority of our seniors in this Nation. So this is the only method we have to have input into that conference process. I would also like to make the point that administrative costs in private plans are approximately 15 percent and under the Medicare system that we have in this country is probably one of the most efficient possible ways of delivering health care to our seniors. We only have a 2 percent administrative cost.
Mr. Speaker, I yield 3 minutes to the gentlewoman from California (Mrs. Capps), my friend and colleague who has been a leader on the Committee on Energy and Commerce in fighting for maximum Federal dollars for Medicaid DSH hospitals.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would respond to the gentleman from Texas by saying that those seniors in my district are already scared. They are scared about the fact that they cannot afford prescription drugs now. They are scared about the fact that all of the HMO+Choice plans have pulled out. They are scared about the fact that, in some parts of this country, it will be $53 a month, and in my district the administration says it will be $117 a month, which they do not know where it is going to come from.
I yield to the gentleman from Texas.
Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Sandlin), my fellow Blue Dog and a member of the Committee on Ways and Means.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would respond to the gentleman from Texas by saying it is my understanding that we have offered to do the Congressional plan both in committee and here on the floor, and I would just say to the gentleman from Texas that I would be happy to join with him in this. In fact, the gentleman from Texas is in the majority, and he could propose that proposal tonight, if he so chooses.
Mr. Speaker, I yield 3 minutes to the gentlewoman from Indiana (Ms. Carson), whose district is faced with a growing problem of uninsured.
Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Strickland).
Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Texas (Ms. Jackson-Lee).
Mr. Speaker, I yield myself such time as I may consume.
I would first like to thank all of my colleagues who spoke on behalf of this motion today. I would like to thank my colleague from Texas (Mr. Brady) from across the aisle for participating in this debate. We may differ in our opinions about which way is the best way to reform Medicare, but I appreciate his willingness to engage, in any case.
I would like to urge my colleagues on both sides of the aisle to consider supporting my motion to instruct. The premium support provisions in both the House and Senate versions of this bill are a recipe for disaster for our seniors. If premium support is enacted, our seniors will be subjected to vastly different premiums and benefits depending on where they live, they will be forced to assume all the risks associated with health care, and they will most likely lose their ability to choose their preferred doctor and hospital, that is, if the private plans even participate.
In my district, all but one of the supplemental private insurance plans we have once had have pulled out of our area, leaving my constituents in a serious lurch. Let us not take this giant risk again, Mr. Speaker. Let us instead spend our resources helping our safety net hospitals survive. DSH hospitals are the backbone of our communities, and the number of uninsured continue to grow, as do their responsibilities to serve these populations. My motion retains the best provisions from both the House and Senate, and allocates any monies saved from dropping premium support to DSH hospitals across the United States.
Mr. Speaker, I urge an ``aye'' vote.
Mr. Speaker, I yield back the balance of my time.
Mr. Speaker, on that I demand the yeas and nays.