Mr. Speaker, I thank the gentleman from Maryland (Mr. Cummings) for yielding, and I thank him for hosting this Special Order today. I would have come here to primarily discuss H.R. 3459, the Healthcare Equality and Accountability Act of…
Mr. Speaker, I thank the gentleman from Maryland (Mr. Cummings) for yielding, and I thank him for hosting this Special Order today.
I would have come here to primarily discuss H.R. 3459, the Healthcare Equality and Accountability Act of 2003, which is a very important piece of legislation that the four caucuses that we have heard have introduced with our Democratic leadership in both this and the other body.
The bill, which I call the Heal America Act, would do just that: heal America, because the health of people of color is inextricably linked to that of all Americans. So the provisions that are included, which would expand Medicaid to include pregnant women, young people to the age of 20, and legal immigrants, which provides that Federal program set standards and pay for translation services; that includes programs for young people of color to enter the health professions at all levels, and even for older ones to enter the
health professions by changing their profession as long as they practice in underserved communities; which would strengthen the safety net facilities like our hospitals and our community health centers; fully funds and strengthens the Office of Civil Rights within the Department of Health and Human Services, as well as the Office of Minority Health which creates empowerment zones so the communities themselves, which face high disparities, will get the resources and technical assistance that they need to address their health care challenges. This bill would finally bring this country to the top of the list of nations in the world for our health, reverse the global statistics that we have heard from our chairman and, instead of being the thirty-ninth of all of the nations of the world, it would reduce the premature deaths and disabilities that exist in the people of color here; would begin to reduce the skyrocketing health care costs, and also to restore the greatness of this country, which has indeed been tarnished by our recent history here and in the world.
But tonight I want to focus more on an imminent threat to the equality and accountability in health care for millions of Americans. After years of promising a prescription drug benefit, and my knowing from experience as a family physician how badly it is needed, it is a painful task to come to this floor this evening to oppose what we understand is going to be brought to the floor as a Medicare reform bill, perhaps tomorrow. I, like many of my physician colleagues, was tempted to support it, just so we could get something done to alleviate the burden of health care for our patients. But the lives, the health, and the needs of our seniors and the disabled people in this country are too important to just take anything, no matter how defective it might be, just to do something. It would not be fulfilling our promise of a comprehensive prescription drug benefit; it would be reneging on that promise.
We who are here tonight have too much respect for our constituents. We know that we have to continually earn the trust that they have placed in us with their vote. So we are here tonight to oppose the Medicare conference agreement, and to tell our colleagues why.
Despite all of the carrots; for example, the rural provisions which themselves seem to be little more than smoke and mirrors, and the increased payments for physicians which, if the leadership believes, as I do, that it needs to be done, we can do that separately. The bottom line for me is that this bill begins to destroy a program that has provided real health security, that has kept many seniors and disabled persons out of poverty, and which has provided access to health care for them for over 30 years. I cannot in good conscience be a part of dismantling this important safety net program. Yes, I know that some provisions, like premium support, are just demonstration programs, but that is opening a door that should just remain shut.
This conference report goes against what we have been working towards in our caucus: the elimination of disparities in health care for African Americans and other people of color. African Americans are 8 percent of Medicare recipients, and 32 percent of African Americans who have some insurance, have Medicare. While 40 percent of all Medicare beneficiaries are below 200 percent of poverty, 65 percent of African American beneficiaries are. Thirty-three percent are below the poverty level period.
We are then disproportionately among the very poor, and this bill will increase cost-sharing for people who fall in that category. While it may start out relatively low in the first year, it can be counted on to increase with increasing drug prices which average 10 percent an increase a year.
I am also very concerned that there is a very strict means test that will be applied to even these poor beneficiaries: $6,000 for individuals and $9,000 for a couple, which means that many seniors and disabled who need this benefit will be left out.
All of this will mean that even the little that the bill does to provide for low-income Medicare beneficiaries will not be available for as many as up to 2.8 million individuals. This is not, Mr. Speaker, what we promised.
Let us look at what happens to beneficiaries who have prescription drug coverage. Not only will this bill jeopardize the retiree prescription drug benefit, and 22 percent of African Americans with Medicare have a retiree prescription drug benefit, as well as 17 percent of Latino beneficiaries, but how could we, in good conscience, also worsen the already bad situation this report would create for the very poor dual-eligible who would also lose benefits that they have under Medicaid because this bill would eliminate the wrap-around provisions.
Lastly, let me mention the potential cap on Medicaid, the potential cap on this Medicare prescription drug benefit if we pass the conference report. It goes to cost containment. We all know what cost containment has done for us thus far. It has filled the coffers of managed care corporations and, for the most part, has done so by reducing access to needed medical care for those who are enrolled and, virtually, it has left out the sicker, many of whom are poor, who are people of color, or who live in our rural areas. And has the cost of health care gone down in this country because of that cost containment? No, it has not. Have insurance premiums gone down or even stayed steady? No. They are increasing in double digits. So what we would be likely to see would be the rationing of care where we have just begun to see some minor changes. Cost containment would just expand the 2- and 3-tiered health care system where the sickest get the least care. This is not what we promised.
I want to take this opportunity to answer one of my constituents, Rosalee Dance from Saint Thomas. She asked the question, because she is confused like many seniors are in this country. She asks me two questions. She asks, is it true that the bill creates a situation where people either pay sharply increased premiums to stay in traditional Medicare where they can choose their doctors, or be forced out into an