Medicare Under Attack

Floor Speech

Mr. COURTNEY. Thank you, Mr. Tonko.

I want to thank Congressman Garamendi, who did great service as the insurance commissioner in the State of California. He understands these issues intimately.

I think this is really a generational gut check for our country in terms of whether or not this attempt to butcher Medicare, one of the most successful programs in American and world history, is going to succeed or not. John described very powerfully the public wards in the public hospitals and the third-tier status that seniors had prior to 1965. Kaiser Permanente actually did a study in terms of just reminding us of what this country faced when President Johnson signed that legislation on Harry Truman's porch step. At the time Medicare passed, only 50 percent of seniors over 65 in America had health insurance of any sort whatsoever. Part of it was class. Part of it was the underwriting rules. But part of it is, just as Mr. Garamendi said, age is a factor which carries risk. And there is no insurance company that evaluates risk within its own book of business that can really take all comers when you're talking about a population of 65 and up. Life expectancy was 70 in 1965.

So we passed Medicare, and what happened is we created a guaranteed benefit. The genius of Medicare is that we pooled the risk, and we actually made an affordable system financed through payroll taxes, premiums. The system has had its ups and downs financially over the past 45 years. The fact of the matter is we now have a life expectancy of 78 in this country. It has worked. We have also alleviated the crushing out-of-pocket costs that seniors faced in 1965, and we have elevated the status of people in that demographic in a way that the private insurance market just was totally incapable of doing it.

Last year, we passed the Affordable Care Act, which modified Medicare and made some important improvements and changes. We now have annual checkups covered. We now have cancer screenings. We now have extended prescription drug benefits. And one of the things that the Republicans claim, in trying to sell this measure with snake oil, frankly, is that somehow people who are 55 and above today will not be affected by the passage of the Ryan plan. In fact, we know that if you look at that plan, it cancels all of those new benefits in year one.

So seniors who now--hundreds of thousands--have gotten their annual checkups in the last 8 or 9 months since the new benefit kicked in, cancer screenings that kicked in, prescription drug assistance that's now providing health for seniors in the doughnut hole, all of that would be canceled today, and any prospective change that is proposed in this system, which again, starting for individuals 55 and under, now will be left in a private insurance market with a totally inadequate voucher, as Mr. Garamendi said. Again, that's where the real butchering of Medicare takes place. But there is no question for anyone who's listening tonight that if you are a senior citizen on Medicare, the false claim that you are somehow insulated from this measure because of the fact that you're already in the program, that is something that people have got to recognize and understand. That new benefits that are making this a smarter, more effective program are going to be canceled in year one if this measure, God forbid, ever is enacted.

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Mr. COURTNEY. Right, and thank you.

Because there was so much, almost, fear language surrounding this debate in terms of whether Medicare is bankrupt, whether Medicare is going broke, whether Medicare is running out of money, it's important for people to go back and read the trustees' report, which was just issued a few weeks ago. It is a report that is issued on an annual basis. It has been since 1966 when Harry Truman was the first Medicare beneficiary to sign up for the program with his wife, Bess; but it has had its ups-and-downs over the years.

The report that just came out said that Medicare is fully solvent, can pay all of its bills through 2024 and that it can pay 90 percent of its bills through 2045.

Now, there is no question that, compared to last year's report, there was some deterioration in terms of that projection, but the trustees were careful to point out the fact that that slippage in terms of some of the years of lost solvency was due to the economy and due to payroll tax collection. It had nothing to do with overuse or certainly nothing to do with the Affordable Care Act. In fact, they said the opposite, which was that the Affordable Care Act actually extended the solvency of the Medicare program by a factor of 8 years. Thank God we had passed that legislation, because we really would almost be bumping up into a cliff at this point if we hadn't done it.

But again, I think it's important for people to remember that, going back in time to 1970, the Medicare solvency report that came out for the trustees projected 2 years of solvency as to when it was going to hit that tipping point. When Ronald Reagan was President in 1983 and came to the Congress, seeking an increase in the debt limit to avoid default, Medicare solvency was half of what it is today. So the fact is that it has had its challenges.

As you point out, there are good ideas about using bulk purchasing, and there are good ideas about revisiting the subsidized insurance program in terms of the size of the insurance company subsidies. We can deal with that 10 percent shortfall between 2024 and 2045 without butchering the program. That really is, in my opinion, the wolf in sheep's clothing surrounding this debate in that somehow people are using solvency reports as an excuse to basically eliminate the guaranteed benefit.

Again, it is our duty as Members of Congress to make sure that we protect for the next generation the benefit that our parents enjoyed and that pushed out solvency from age 70 in 1965 to age 78 today. That is a Medicare success, and we cannot go backwards as a Nation.

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Mr. COURTNEY. We had a town hall meeting in my district, talking about the Medicare program. We had Dr. Rebecca Andrews--she's a primary care doc at the University of Connecticut Health Center--and she was talking about the new annual screening coverage where she had one of her patients who was kind of a big husky guy, kind of. They used to kind of razz each other. But she had 45 minutes with him. She did the soup-to-nuts checkup. She ordered a urine test, which she normally wouldn't with the old system. She found a tiny, microscopic spec of blood, or they did at the lab, which they were a little concerned about. She called him back in, did a follow-up. It turned out he had bladder cancer.

Because they were able to detect it so quickly because of that annual checkup and the cancer screening tests that are now covered under Medicare, it was a day surgery, in and out, a really very nonintrusive event that cost a fraction of what it would have been if he had not had that checkup to detect that cancer early. And she had at least two other patients, because of the new Affordable Care Act annual checkup, where they detected cancer and again were able to intervene at a low cost compared to what it would have been if it had been a full-blown case.

Mr. TONKO. Representative Courtney, I think what we're talking about here is legitimate reform in a way that bends that cost curve and takes a sound economic program like Medicare for our Nation's seniors and allows for that benefit and pulls the resources from coast to coast to serve our Nation's seniors well.

The concern here is, Representative Garamendi, they want to give their friends with deep pockets more opportunity for business. End Medicare to provide more business for the private sector insurance industry. Privatize Social Security, right?

Mr. GARAMENDI. It was the bill they introduced.

Mr. TONKO. I think you have a chart there that talks about another special interest.

Mr. GARAMENDI. Before we go to this other issue--and we've got another 7 or 8 minutes here--another major program that is targeted by our Republican friends is Medicaid. Medicaid is a program for impoverished Americans. Seventy percent of Medicaid is for seniors and nursing homes. They want to take some $700 billion out of Medicaid. In California, that's called MediCal, but in each State they have their own program. But $700 billion goes directly to seniors that are in nursing homes. What will come of those people that are now in nursing homes when this program, Medicaid, is reduced as proposed in the budget that was passed today?

But, having said that, let's turn to the other side of the coin.

You want to make cuts, but do you want to cut Medicare? Do you want to cut Medicaid?--or do you want to cut the subsidies that exist in American business today?

This is just one of hundreds of subsidies, tax breaks, given to American businesses that they don't need.

Big Oil receives my tax money, your tax money, and the American taxpayers' money to the tune of--I don't know--$5 billion, $6 billion, $7 billion a year. Yet look at their profits. Look at their profits here. This is just 1 year. You add up these profits over the last decade. Exxon last year, $10 billion; Conoco $2.1 billion; Chevron, $6 billion; BP, infamous BP, $7.2 billion. Yet they receive our tax subsidies. You take this and you apply it over the last decade, and it is just $950 billion of profit--$50 billion less than a trillion dollars of profit.

And yet defending the oil companies are our Republican colleagues, saying no, no, no. You can't touch Big Oil. You can't take away their tax subsidies, but you can surely go after seniors and take $6,000 out of the pocket of every senior with this Medicare program.

Mr. TONKO. It's very obvious from the polls being taken by many, many organizations out there that the American public said it's about jobs. We need jobs in the economy in order to make things work. It will reduce the deficit. It will put people to work. It will start growing the economic engine of neighborhoods and States and the entire country.

But what we're seeing is that there's this Republican assault on the middle class. They're cutting programs that serve the middle class. They're cutting programs that create jobs and invest in a new economy. But they're leaving alone these groups that are actually not--they're earning record profits, and we're still giving them hard-earned taxpayer dollars in the form of handouts and subsidies to the oil industry, to various industries that are just befriended by those in the House that want to play off the middle class and end Medicare, which is a very dangerous precedent that will be set.

Representative Garamendi, you wanted to make a point.

Mr. GARAMENDI. Mr. Courtney just pointed back to me. I was going to pass it to him.

We just talked about Big Oil, the subsidies to Big Oil that are being protected by our Republican colleagues, making sure that Big Oil gets their money. That's not the only thing.

They are fiercely fighting, fighting fiercely to maintain the Bush-era tax cuts for the superwealthy. We're talking about millionaires.

So what does it mean for millionaires to hang on to that tax cut that occurred in 2003, I believe? For millionaires, that tax cut is worth $200,000 a year if you have an income of $1 million. Now, there are folks

out there that have incomes of a billion. So you can kind of expand that, add five zeroes. You get close to what it might be for a billionaire, and there are billionaires out there. What does it mean for seniors? It means it's going to cost them some $6,000 a year in what will be their Medicare costs in the future.

Mr. TONKO. And that's equaling 33 seniors.

Mr. GARAMENDI. Thank you. You read the chart better than I do.

Mr. TONKO. Thirty-three seniors paying $6,000 more per year. So we're making happy one millionaire and we're economically distressing 33 seniors who are going to pay at least $6,000 more to have the health care coverage if they, in fact, can get it.

Mr. COURTNEY. If I can just sort of finish, the point is that we were talking about two programs right now that did not create the deficit issue that is facing this country.

We had two massive tax cuts for the super-rich. We have two wars that haven't been paid for and a prescription drug benefit which was passed during the last administration which was never paid for, which we dealt with in the Affordable Care Act to offset that. The Trustees report says that we've got 100 percent solvency through 2024, 90 percent solvency through 2045, and 100 percent solvency for the Social Security system until 2037.

Mr. TONKO. And, Representative Courtney, when you talk about all of those costs, they were never put in the budget. They were off-budget. So that meant that those two wars, the pharmaceutical deal for Medicare part D, and the tax breaks for millionaires and billionaires all had to be borrowed money, and so we borrowed from China, Saudi Arabia, all to make it happen.

This was dishonest budgeting, and it was favoring deep pockets over, evidently, seniors. And now the solution? End Medicare, block grant Medicaid, privatize Social Security. This is an assault on middle class values on our Nation's seniors.

Representative Garamendi, we'll move to you.

Mr. GARAMENDI. Representative Tonko, thank you so very much for bringing us together tonight to talk about Medicare and the Republican proposal to terminate Medicare and significantly reduce Medicaid programs for seniors in nursing homes.

This is a pivotal moment in this Nation. It really speaks to our values. It speaks to who we are as Americans, who we care for, and what we are concerned about.

Mr. COURTNEY. I'll just say, I'm sure your offices are like mine. This is the number one issue that we're getting calls, emails, and mail on: Are you guys going to stand up and live up to your sacred duty to protect these programs--Medicare, Social Security, and Medicaid--that our middle class depends on?

Mr. TONKO. At least nine of every 10 comments we get either through the mail or on the phone are: Save Medicare. Don't let them mess with it.

We're fighting the good fight here. America needs to know there is a risk of losing Medicare. There are those who want to end it. We saw another vote here tonight.

With that, I yield back the balance of my time.

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