Medicare Prescription Drug And Modernization Act Of 2003
Mr. Speaker, pursuant to House Resolution 299, I call up the bill (H.R. 1) to amend title XVIII of the Social Security Act to provide for a voluntary program for prescription drug coverage under the Medicare Program, to modernize the…
Mr. Speaker, pursuant to House Resolution 299, I call up the bill (H.R. 1) to amend title XVIII of the Social Security Act to provide for a voluntary program for prescription drug coverage under the Medicare Program, to modernize the Medicare Program, and for other purposes, and ask for its immediate consideration.
Mr. Speaker, I yield myself such time as I may consume.
As we begin the 3 hours of debate on the primary bill and an additional hour on the substitute, I do want to indicate that this day, in my opinion, has been too long in coming.
I want to thank President Bush for his position during the campaign that Medicare needed to be modernized and we were overdue for putting prescription drugs in Medicare.
I believe he has continued to be firm in his resolve that both the House, and the Senate now for the first time, pass legislation so that we can conference a common bill and send it to him for his signature.
I also want to thank the Speaker of the House. The gentleman from Illinois (Mr. Hastert) was involved in these discussions prior to our becoming the majority and, of course, prior to his becoming Speaker. If you examine H.R. 1, you will find that the Speaker has been willing to be the lead author. I think it is entirely proper and appropriate that the Speaker of the House lead the House through the most fundamental and important change in Medicare since its inception.
I especially want to thank my colleague and friend and chairman of the Committee on Energy and Commerce, the gentleman from Louisiana (Mr. Tauzin). In this institution, where jurisdictions are guarded with a pretty vicious willingness to have turf wars whenever necessary to hang on to your jurisdiction, the working relationship with the shared jurisdiction of the Committee on Energy and Commerce and the Committee on Ways and Means has been a very pleasant experience, and the working relationship between the staff, of which I will have more to say a little bit later, could not have been better.
And, frankly, the product we have before us, although the gentleman from Louisiana (Mr. Tauzin) joined me in the initial sponsorship of legislation, we could not have gotten it through both committees and back together again in the Committee on Rules to present to you here today as H.R. 1 without complete and open and very comradely behavior between the chairman of the Committee on Energy and Commerce and this committee, and I thank him for that.
I especially thank the gentlewoman from Connecticut (Mrs. Johnson), who is the chairman of the Subcommittee on Health of the Committee on Ways and Means. The members of that committee have been very, very helpful in holding the hearings and continuing to shape this legislation. This bill, as it rightly should be, is the best piece of legislation that we have offered this House, notwithstanding the fact that twice previously we have passed Medicare modernization with prescription drugs.
And let me say that I do want to single out two members of the Committee on Ways and Means, the gentleman from Iowa (Mr. Nussle), who also happens to be the chairman of the Committee on the Budget, and the gentleman from North Dakota (Mr. Pomeroy), who offered together a bipartisan amendment which was very significant in helping us redress the failure to provide those Americans especially in middle America but in principally rural areas with a fair and equitable Medicare program.
I want to thank, and I do not want to go through every staff member, but I do want to thank the chief of our Subcommittee on Health staff John McManus for the enormous number of hours he and the staff have put in. You cannot produce as complex and difficult a piece of legislation as you have in front of you without the dedicated staff. And I mean not just on the committees, but the Congressional Budget Office, and I will mention from Leg Counsel Ed Grossman, who is an institutional glue. He is the one who spends the hours to make sure that the language makes sense in the legislative language that we have before us. He is absolutely indispensable to the functioning of this institution, and I want to personally thank him once again for the hours of commitment that he has put in to produce this piece of legislation.
There are organizations and associations who have very strong feelings about the direction of Medicare and the changes that might be made, and I want to thank all of them for their openness and willingness to present comments upon which we reacted. Most recently, I think one of the more prominent organizations, formerly known as the American Association of Retired Persons, now AARP, and I am indebted to my colleague, the gentlewoman from California (Mrs. Capps), for circulating the letter from AARP, because I think it is very instructive. It provides us with an example of how these organizations point with pride and view with alarm some of the changes that are being made.
For example, the opening paragraph in the letter addressed to me says, and I quote, ``AARP is encouraged by the advancement in the House of legislation to add prescription drug coverage to Medicare. Relief from the high cost of drugs is long overdue. Our members and all older Americans and their families expect and need legislation this year. We appreciate your efforts and leadership toward this end.''
But they go on to say in the letter, in terms of a number of additional points, that they think certain areas need to be strengthened and perhaps some changes need to be made. For example, under low-income protections, they say, ``We are encouraged by the bill's inclusion of all Medicare beneficiaries, including dual eligibles.'' We spend $43 billion over the next decade picking up these low-income seniors. We believe they should be classified as seniors first in the Federal Medicare program and not low-income first, as they currently are today.
But they go on to say that they are concerned because eligibility is limited by a restrictive assets test. And we took that letter to heart and we have examined that provision, notwithstanding the fact that the original bill doubled the assets provision under the SSI, Social Security provisions for low-income eligibility. The bill had doubled it. We examined it, we determined that perhaps we should go that extra mile. Under the bill before you today we have tripled it. We have tripled the SSI standards in terms of low-income protections. These are the kinds of exchanges that improved this legislation as we move forward.
And let me say lastly that I am very pleased that the Senate, I believe, will pass legislation and join the House finally in conference to craft a piece of legislation that will become law. Mr. Speaker, I understand the rules of the House in terms of the very narrow line we must tread, and I am not allowed to mention a Senator, but just let me say that a senior Senator, who has been a leader in health care debate for a number of years, frankly needs to be commended, because without his courageous step forward I do not believe the Senate would have moved as quickly or as rapidly as they have to a conclusion on their legislation.
I have enjoyed my conversations that I have had with him over the years, obviously more frequently as I have moved into a position to help effect adding prescription drugs to Medicare. Although we have profound differences in terms of our view oftentimes of the role of the Federal Government and assistance, we have never ever left the focus of policy, and although we may differ, the differences have always been over policy.
Never, ever has he mentioned Jim Jones, Kool-aid, mass suicide. Never, ever in our discussions has he mentioned the Holocaust. Never, ever has he mentioned blacks or slavery. He has always carried on the discussion on the basis of substance and the differences that we have on substance and the fact that in this society, in this civil society, the debate ought to be over choices of a legislative nature rather than trying to create an atmosphere of fear. For that I am grateful for his friendship and the fact that we will meet in conference and, finally, seniors, who are the last bastion of paying the price of retail for drugs, that will no longer be the case. And for that, all of us will be grateful. Policy will have triumphed over politics.
Mr. Speaker, I reserve the balance of my time.
Announcement by the Speaker Pro Tempore
Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Foley), a member of the Committee on Ways and Means.
Mr. Speaker, I yield myself 15 seconds.
Mr. Speaker, Members will find periodically during this 3-hour debate that we will take a very short segment of time to make sure that when an outlandish, outrageous, untrue statement has been made, we will correct the record immediately.
Mr. Speaker, I yield 1 minute to the gentlewoman from Connecticut (Mrs. Johnson), the chairman of the Subcommittee on Health for the Committee on Ways and Means.
Mr. Speaker, I yield 2 minutes to the gentleman from Illinois (Mr. Crane), chairman of the Subcommittee on Trade, a long time member of the Committee on Ways and Means.
(Mr. CRANE asked and was given permission to revise and extend his remarks.)
Mr. Speaker, I yield myself such time as I may consume.
This is the first mention of the quote that I made, and it is not surprising that the quote is certainly truncated. Perhaps a journalism spot on The New York Times might be available to some of my colleagues given their ability to take reality and distort it. Here is my quote:
``Some of our friends on the other side of the aisle are saying that if this bill becomes law, it will be the end of Medicare as we know it. Our answer to that is, We certainly hope so. Why should seniors be the last group that pays retail prices for drugs?'' We have not heard that from the other side.
``Old-fashioned Medicare isn't very good. Why should the insurance for seniors be called MediGap? I think that indicates just how good the insurance is.'' We have not heard that from the other side.
But what I did say was, you will hear scare tactics. But seniors with extremely high drug costs when this becomes law will save more than 60 percent of their current costs if they spend $10,000 a year on prescription drugs today. That is real change. That is real progress, making Medicare a real day-to-day benefit. I would say to my colleagues, if you really think that current Medicare should not end, why in the world did you put up such a fit to have a substitute so that if we accept your bill, current Medicare as we know it will end as well? Half quotes are not going to get it done. Try the full quote, because if you do, you will vote ``yes'' on this bill.
Mr. Speaker, it is my pleasure to yield to the gentleman from Pennsylvania (Mr. Gerlach) to enter into a colloquy.
I will tell the gentleman from Pennsylvania that we have a generous amount, and we believe it will be appropriate; but certainly as we get to conference, our intent is to provide a seamless transition for beneficiaries and States and that will be done.
Mr. Speaker, it is my pleasure to yield 2 minutes to the gentleman from Pennsylvania (Mr. English), a member of the Committee on Ways and Means.
Mr. Speaker, I yield myself such time as I may consume. If it has been very, very good, why did the Democrats fight for a substitute which will change the structure significantly?
Mr. Speaker, I yield 1 minute to the gentlewoman from Connecticut (Mrs. Johnson) to point out once again an absolutely outrageous statement that cannot go unchallenged.
Mr. Speaker, I yield myself 1 minute.
You know, it just kind of makes you wonder what the Democrats did for 30 years when they were the majority, because, you know, when Republicans became the majority in 1995, there was literally no prevention and wellness in Medicare. We are the ones that are supposed to be destroying Medicare? We are the ones that added diabetes. We are the ones that added osteoporosis. We are the ones that added prostate and colorectal screening. We are the ones that added the mammography. In fact, in this bill that they continue to speak against, we provide for the first time every new beneficiary should have a physical.
I want to underscore that. Every new beneficiary should have a physical. In addition to that, we believe that cholesterol screening has now been advanced, and it should be provided as well.
I find it amazing that they go back to the same old scare statements.
Read the bill. It is an enhanced and an improved Medicare. What in the world were you doing for 30 years? The fact of the matter is you did not have a competent challenge.
What we have done is provide real change, and they are afraid those old frayed bumper stickers will not work anymore.
Mr. Speaker, I yield 3 minutes to the gentlewoman from Washington (Ms. Dunn), a very valued member of the Committee on Ways and Means.
Mr. Speaker, I yield 3 minutes to the gentleman from Florida (Mr. Shaw), a valued member of the Committee on Ways and Means.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, well, I guess, if all of the innovations are going to fail, what will be left is the current Medicare. I find it interesting that one of the reasons the gentleman from Wisconsin (Mr. Kleczka), my friend, is going to vote against the bill is because there is no government ultimate negotiation of the price.
Let me tell my colleagues a story, and I believe before I give my colleagues the punch line, they will know the story. We have government negotiation of price. And as is typically the case, currently, in law, in the Medicaid program, it is called ``best price.'' That is where government determines how much the drug is going to cost. It is going to be the best price.
When we looked at ways to change Medicare, we looked at the ``best price'' concept. Guess what? We sat down with the Congressional Budget Office and we said, what would happen if we did not use best price? They sat down and calculated and they said, you know, if you actually had competition for the drugs, instead of putting in the government phony floor of ``best price,'' you could save $18 billion. Do my colleagues know why we do not have government negotiating the price? It would cost us tens of billions of dollars over a real negotiation on drugs. Yet, here we are, hearing the same old same old: I am going to vote ``no'' because we do not have government dictating the price. That is what has gotten us into the problem in the first place.
Mr. Speaker, it is my real pleasure to yield 3 minutes to the gentleman from Illinois (Mr. Weller), a member of the Committee on Ways and Means.
(Mr. WELLER asked and was given permission to revise and extend his remarks.)
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I will tell my friend from Georgia, we do not intend to turn our backs on seniors. Indeed, we intend to reach out our hand. If someone wants to stay in yesterday's Medicare, they can tomorrow. We want to make sure of that, because in 1965 and yesterday, there were no drugs, there was no preventive care, there was no disease management, that by passage of this legislation, tomorrow there will be.
But Mr. Speaker, as we have carried on this debate about improving Medicare, and I know that to my friends on the other side of the aisle $400 billion does not look like much to them. I understand they are going to offer a substitute that proposes spending $1 trillion, rather than the $400 billion.
But at some point in this debate, we ought to realize that we are in the middle of the greatest intergenerational transfer of wealth in the history of the world. Because while we strive to provide a decent and appropriate health program for seniors, we all know someone else is going to be paying for it. And so we really ought to focus on what we are trying to do to make sure that the young people who are going to be carrying this bill understand that while we are providing additional benefits to seniors, we want to make sure that the program stays within the reasonable bounds of the $400 billion that we are proposing to add to Medicare.
Mr. Speaker, to insist on focusing on that, it is my real pleasure to yield 4 minutes to the gentleman from Louisiana (Mr. McCrery), the chairman of the Subcommittee on Select Revenue of the Committee on Ways and Means.
Mr. Speaker, I ask unanimous consent to place in the Record an exchange of letters between myself as chairman of the Committee on Ways and Means and the gentleman from Virginia (Mr. Davis), chairman of the Committee on Government Reform.
Mr. Speaker, I yield myself 15 seconds.
I see the gentleman from Texas (Mr. Doggett) had two quotes connected with a description of myself, rather than the continuation of the real quote, and I can understand why he would fabricate the quote in that way. Because what I said was, why should seniors be the last group that pays retail prices for drugs? That really did not fit the intention of the gentleman's thrust, but that is simply the truth.
Mr. Speaker, I yield 2 minutes to the gentleman from Iowa (Mr. Nussle), the chairman of the Committee on Budget, but I proudly say also a member of Committee on Ways and Means.
Mr. Speaker, I yield myself 15 seconds.
If the gentlewoman would go to page 260, line 19, from the legislation before us now, I quote, ``Nothing in this part or the amendments made by this part shall be construed as changing the entitlement to defined benefits under part A and B of title XVIII of the Social Security Act.''
Mr. Speaker, I have one speaker to close.
Mr. Speaker, I yield the remaining time to the gentlewoman from Connecticut (Mrs. Johnson), to close for our side, to continue to talk about the bill that for the first time in the history of Medicare provides low-income help, and she is the chairwoman of the Subcommittee on Health of the Committee on Ways and Means.