“But health reform is not only saving money – it’s saving lives.”

“In the richest nation in the world no insurance company will ever again put a price tag on a human life.”

Washington, D.C. – Senate Majority Leader Harry Reid spoke on the Senate floor today regarding Saturday’s anniversary of the Affordable Care Act. Below are his remarks as prepared for delivery:

Three years ago, President Barack Obama signed into law the greatest single step in generations toward ensuring access to quality, affordable healthcare for every American – the Affordable Care Act.

Millions of Americans are already benefitting from Obamacare. Insurance companies can no longer set arbitrary lifetime caps on benefits, putting millions of Americans one car accident or heart attack away from bankruptcy. Today children can no longer be denied insurance because they are born with a disease or a disability, a protection that will soon extend to all Americans. And soon being a woman will no longer be considered a pre-existing condition.

In less than a year, 129 million Americans with preexisting conditions such as high blood pressure or diabetes can rest assured they’ll have access to affordable insurance and life-saving care – regardless of their health or how much money they make.

In Nevada alone, tens of thousands of seniors have saved tens of millions of dollars on medicines because the Affordable Care Act closed the gap in prescription drug coverage.

But health reform is not only saving money – it’s saving lives.

Just ask 26-year-old Sarah Coffey, a native of Gardnerville, Nevada. Sarah was halfway through her first year of law school at the University of Connecticut when she was diagnosed with stage 4 Hodgkin’s disease.

Sarah had done everything right. When she enrolled at UConn, she bought the best student insurance plan money could buy and paid for it a year in advance. But her cancer – and the difficult treatment to fight it – made returning to school last fall impossible.

Since Sarah was no longer a student, she no longer qualified for student health insurance. And her policy was about to expire. Without an expensive bone marrow transplant, she might die.

Before the Affordable Care Act became law, Sarah would have been one of the tens of millions of Americans who desperately needed life-saving care, but didn’t have insurance to pay for it. Before the Affordable Care Act, Sarah might even have become one of the 45,000 Americans who died each year because they lacked health insurance.

But thanks to Obamacare, Sarah was able to sign on to her parents’ insurance plan. Sarah is one of 3.1 million young people – including 33,000 young Nevadans – who have benefited from a provision in the law that allows children to stay on their parents’ health plans until they are 26 years old.

And I’m pleased to report that Sarah’s story has a happy ending. She got the treatment she needed. Her most recent PET scan was clear. And Sarah plans to return to law school in September.

Sarah’s mother, Sue, sent me a letter in January. She wrote that Obamacare and the dedicated doctors at Stanford Hospital saved her daughter’s life.

This is the legacy of the landmark law: that no American will end up in an emergency room because he has no insurance, that no American will live in fear of losing her insurance because she loses her job and that in the richest nation in the world no insurance company will ever again put a price tag on a human life.

Thomas Jefferson wrote that, “The care of human life and happiness… is the first and only object of good government.” I am gratified that the Affordable Care Act meets that standard. And I am proud that this law, which we worked so hard to pass, is already ensuring the care of human life remains the first object of this government.

Congress Can’t Afford To Waste Time Refighting Old Battles And Should Renew Focus On Creating Jobs

Washington, D.C. – Nevada Senator Harry Reid spoke on the Senate floor today regarding the Supreme Court’s decision on the Affordable Care Act and Congress’ plan to refocus on creating jobs for the American people. Below are his remarks as prepared for delivery:

Yesterday the United States Supreme Court reaffirmed that no family should live one illness or accident away from bankruptcy.

The Court’s decision isn’t a victory for Democrats or for President Obama – it’s a true victory for the American people.

Let me give you a few reasons why.

Since President Obama signed the Affordable Care Act into law, more than 6 million young people have signed up for their parents’ health plans.

Because children can now stay on their parents’ insurance until they’re 26, no young person will have to defer his or her dreams to take a job that offers insurance.

Since health reform took effect, 5 million seniors have already saved about $600 each on prescription drugs. Millions more have gotten free wellness checks and cancer screenings.

That means millions of seniors have more money in their pockets for food, gas and the electric bill.

And, hundreds of thousands of businesses that already offer their employees health insurance are getting tax credits for doing the right thing.

Since Congress passed this law, insurance companies can no longer put profits ahead of people.

They can no longer discriminate against children with preexisting conditions.

They can no longer raise your rates for no reason.

They can no longer drop your coverage if you get sick.

Millions of Americans are already seeing the benefits of this law.

And soon, 30 million more who can’t afford health insurance will have access to reasonably priced insurance and quality care.

Here’s how it works. Each state will set up its own health insurance marketplace, called an exchange, which will offer a menu of private insurance plans from which people can choose.

Once these exchanges are in place, insurance companies will no longer be able to discriminate against any American with a preexisting health condition.

They won’t be able to deny you insurance because you’re sick.

They won’t be able to charge you more just because you’re a woman or because you don’t already have insurance.

And if you can’t afford the premiums, you’ll get a tax credit to help pay them.

But what if you’re one of the 250 million Americans who already has insurance? Nothing will change.

Nothing will change except that you’ll no longer have to worry that if you lose your job, you’ll lose your insurance.

Nothing will change except that if you get cancer or have a stroke, your insurance company won’t be allowed to deny life-saving care because you reach some arbitrary lifetime cap.

Nothing will change except that your checkups and preventive care will be free – a provision that’s already helped 54 million Americans with private insurance.

You’ll be able to keep your plan and keep your doctor. But now you – not the insurance company – will be in control.

And by August, almost 13 million people will get a rebate check from their insurance company because it spent too much on administrative costs and not enough on health care.

The Affordable Care Act is already helping millions of Americans – seniors on Medicare, children with heart conditions, students following their dreams.

And in the coming months many millions more will benefit from this law.

That’s doesn’t mean the law is perfect. Democrats have already shown we’re willing to work with Republicans to improve it.

But now that the Supreme Court has spoken, it’s time to renew our focus on the most pressing challenge facing this nation: the high unemployment rate.

Too many Americans are still struggling. And Congress can’t afford to waste time refighting old battles.

Now we need to work together to put Americans back to work.

Thanks to cooperation on both sides, I am glad to say the Senate will vote today on the transportation jobs bill conference report.

This package also includes an extension of student loan rates and flood insurance legislation.

Passing these three very important job-creating measures is a real accomplishment for Congress.

Extending the flood insurance program will allow millions of home closings to go forward at a time when our real estate market is just beginning to rebound.

Preventing interest rates from doubling on 7 million students was a major priority for Democrats and for President Obama.

And passing the two-year transportation bill will create or save 2.8 million American jobs – many of them in the hard-hit construction industry.

It will also restore millions of miles of crumbling roadways, railways and bridges.

This has been an incredibly productive week. And it tops off a fruitful session.

This month we passed a bipartisan farm bill that will give certainty to an agriculture industry that supports 16 million jobs.

I am optimistic the Senate will maintain a spirit of collaboration during the next work period, when we will consider a number of other job-creation measures.

I hope all my colleagues have a constructive week in their home states, and a safe and happy Fourth of July.

And I hope they come back rested and ready to work on in July, because we have a lot to get done next month to ensure this country’s economic future.

I look forward to taking on that challenge together.

“Today’s decision by the Supreme Court to uphold the Affordable Care Act is a win not only for the millions of Vermonters and other Americans who have long been victimized by a deeply flawed health care system, but for all Americans who will benefit as we continue to implement this landmark law.

“Over much of the last century, generation after generation has unsuccessfully grappled with how to answer complex and increasingly urgent questions about how to let every American have access to quality, affordable health insurance.  Out of control costs were eating our economy alive and forcing many employers to drop insurance for their workers.  The Affordable Care Act at last answered those questions.  Though no bill is perfect, these are good reforms, long needed by the American people, by American businesses and by the American economy.

“The nation and every American household now would be best served if this historic decision puts an end to the years of partisan attacks and obstruction of efforts to help the millions of Americans who have fallen through the cracks, and millions more who worry with good reason that they may fall through the cracks of our broken health insurance system.  The Court has spared the American people a return to those decades of spiraling problems and uncertainty that reached into every American household.

“The Court’s decision reaffirms what I have believed since the Senate debated and passed this law: Congress has the power under the Constitution and the Court’s own, long-standing precedent to protect Americans from abuses by health insurers and to help give all Americans with access to affordable health care, including some of the most vulnerable among us like children and older Americans.

“In passing the Affordable Care Act, Congress built on the cornerstones of modern America like Social Security, Medicare and Medicaid, to strengthen the Nation’s social safety net and help protect hardworking Americans.  I have served in the Senate for 37 years, through seven presidencies.  I am one of the few people in the Senate today who can say that I served alongside representatives who voted to create our nation’s Social Security system, voted for the G.I. bill, passed the Voting Rights Act, and created Medicare, Medicaid, and Head Start.  Congress has come together to refine the laws establishing these programs.  We should similarly come together to further improve the Affordable Care Act where needed.  It’s time to stop the political posturing.  Congress works best for the American people when we are able to come together to solve national problems.  America is stronger when we do.”

Statement Of Senator Max Baucus (D-Mt.)
Chairman, Senate Finance Committee

“This is a win for millions of American families, small businesses, and seniors who are getting more affordable health care, tax cuts, and protections from insurance company abuses thanks to this law.  Now it’s time to put politics aside.  We need to move forward and find ways to work together to put America back on track.”

Statement Of Senator Tom Harkin (D-Ia.)
Chairman, Senate HELP Committee

 “Today’s decision by the Supreme Court is a rigorous, resounding confirmation of the constitutionality of the Affordable Care Act.  It is great news for America’s families and businesses, and for our economy.  This decision keeps consumers, rather than insurance companies, in the driver’s seat, and protects the more than $1 trillion in deficit reduction included in the ACA. Today’s decision allows us to continue our work replacing the current sick care system with a genuine health care system – one focused on wellness, prevention, and public health, keeping people out of the hospital in the first place.

“I am heartened to see that the hundreds of millions of corporate dollars poured into the effort to kill the Affordable Care Act did not win. This law is a critical step in the right direction; I have likened it to a starter home, suitable for improvement.  I look forward to working with my colleagues to make sensible changes as we continue to implement the law.  I invite them to bring their tool kits, rather than their sledgehammers, so we can work together to improve the law.

“The choice is to go forward, or be dragged backward.  I believe the great majority of Americans want to go forward – and today the Supreme Court made clear what we have long known: that the opposition is standing on the wrong side of history.  Now let’s get back to work building a health care system that works not only for the healthy and wealthy, but for all Americans.”

Soon, every man woman & child in America will have access to health insurance they can afford & vital care they need: bit.ly/OzwFbs

— Senator Harry Reid (@SenatorReid) June 28, 2012

Today’s #SCOTUS ruling on #ACA is a victory for the health care security and stability of Washington families. –PM #HCR

— Senator Patty Murray (@PattyMurray) June 28, 2012

A great day for America! #ACA

— Tom Harkin (@SenatorHarkin) June 28, 2012

#SCOTUS ACA decision shows the time for fighting over healthcare validity is over. Congress shd focus on #1 issue: jobs

— Chuck Schumer (@ChuckSchumer) June 28, 2012

More on @msnbctv “I hope Democrats and Republicans will continue to work together to provide affordable healthcare for all Americans. “- Ben

— Senator Ben Cardin (@SenatorCardin) June 28, 2012

Today’s decision creates a clear path forward. We must now focus on how to best deliver affordable, high-quality care for every American.

— Senator Jeff Merkley (@SenJeffMerkley) June 28, 2012

#SCOTUS #ACA decision is a big win for #VTers and millions of Americans who have long been victimized by a flawed health care system

— Sen. Patrick Leahy (@SenatorLeahy) June 28, 2012

All Americans should have access to health care. Today, the Supreme Court validated that principle by upholding the Affordable Care Act.

— Sheldon Whitehouse (@SenWhitehouse) June 28, 2012

The #SCOTUS decision today is great news for America’s families, who deserve affordable health care. #ACA

— Sen. Barbara Boxer (@SenatorBoxer) June 28, 2012

#SCOTUS #ACA ruling is a #victory for lower health care costs and greater access to quality care for all New Jerseyans and all Americans.

— Sen. Robert Menendez (@SenatorMenendez) June 28, 2012

The #ACA is already making #healthcare more affordable, accessible, and reliable for thousands of Arkansans: healthcare.gov/law/resources/…

— Senator Mark Pryor (@SenMarkPryor) June 28, 2012

Today #ObamaCare became #AmericaCare & I will fight GOP efforts to turn back the clock on affordable, accessible health care 4 all Americans

— Sen. Robert Menendez (@SenatorMenendez) June 28, 2012

Impt scotus decision/now critics need to end scare tactics/propose something! bit.ly/N7mpRU #ACA #SCOTUS

— John Kerry (@JohnKerry) June 28, 2012

Historic Supreme Court decision means access to affordable health insurance is finally a reality for Californians. bit.ly/LRyBHf

— Sen Dianne Feinstein (@SenFeinstein) June 28, 2012

I applaud today’s decision to uphold the health care reform law. This is a huge win for South Dakotans and the nation. johnson.senate.gov/public/index.c…

— Senator Tim Johnson (@SenJohnsonSD) June 28, 2012

Carl statement on SCOTUS ruling: “Important step toward universal health care.” FULL STATEMENT: levin.senate.gov/newsroom/press…

— Senator Carl Levin (@SenCarlLevin) June 28, 2012

Now, after #ACA decision, let’s come together 2 solve problems, strengthen the economy and create more jobs leahy.senate.gov/press/press_re…

— Sen. Patrick Leahy (@SenatorLeahy) June 28, 2012

“today’s decision ensures middle class families will have access to invaluable patient protection”- Ben twitter.com/SenatorCardin/…

— Senator Ben Cardin (@SenatorCardin) June 28, 2012

Glad #SCOTUS affirmed the constitutionality of #ACA. Now, let’s get back to focusing on #jobs. bit.ly/MVBVnl #HCR #COPolitics #COjobs

— Mark Udall (@MarkUdall) June 28, 2012

#SCOTUS upholding #HCR is a victory for all Americans that will give #RI families access to more affordable coverage. bit.ly/LiOVRU

— Senator Jack Reed (@SenJackReed) June 28, 2012

Thanks to #ObamaCare, 3.3 million in #NJ no longer have lifetime limit on their health benefits. #Upheld

— Frank R. Lautenberg (@FrankLautenberg) June 28, 2012

Today is a good day for millions of Americans who have pre-existing conditions who can no longer be rejected by insurance companies. -B #ACA

— Bernie Sanders (@SenSanders) June 28, 2012

I am proud of my work to make #ACA a reality. Its benefits are clear: ↓ deficit, ↑ access and affordability & improves health outcomes

— Mary Landrieu (@SenLandrieu) June 28, 2012

Statement from Senator Coons on #SCOTUS decision on Affordable Care Act bit.ly/NRW6Uj #netDE

— Office of Sen. Coons (@SenCoonsOffice) June 28, 2012

#SCOTUS #ACA decision also helps the Latino community keep the benefits they gained under the law #AmericaCare twitter.com/SenatorMenende…

— Sen. Robert Menendez (@SenatorMenendez) June 28, 2012

Today’s health care ruling ushers in a new era of affordable and accessible healthcare for all Americans…. fb.me/1Uozb8gXZ

— Ben Nelson (@SenBenNelson) June 28, 2012

This law is already helping thousands of people in #NH and it’s going to help thousands more #SCOTUS #ACA on.fb.me/N7IgbT

— Sen. Jeanne Shaheen (@SenatorShaheen) June 28, 2012

“This decision preserves not only the health care law, but also the Supreme Court’s position as an institution above politics. Just as Speaker Boehner vowed not to spike the football if the law was overturned, Republicans should not carry on out of pique now that the law has been upheld. Democrats remain willing to cooperate on potential improvements to the law, but now that all three branches of government have ratified this law, the time for quarreling over its validity is over. Congress must now return its full-time focus to the issue that matters most to the public, and that is jobs.”

I’m pleased to see the Supreme Court put the rule of law ahead of partisanship, and ruled the Affordable Care Act constitutional.

Millions of Americans are already seeing the benefits of this law.

Seniors are saving money on their prescriptions and checkups.

Children can no longer be denied insurance because they have a preexisting condition, a protection that will soon extend to every American.

No longer will American families be a car accident or heart attack away from bankruptcy.

No longer will they live in fear of losing their health insurance because they lose their job.

No longer will tens of millions of Americans rely on emergency room care – or go without care entirely – because they have no insurance at all.

Soon, virtually every man, woman and child in America will have access to health insurance they can afford and the vital care they need.

Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every American – regardless of where they live or how much money they make.

Unfortunately, Republicans in Congress continue to target the rights and benefits guaranteed under this law.

They would like to give the power of life and death back to insurance companies.

But the United States Supreme Court has spoken. This matter is settled.

No one thinks this law is perfect. But Democrats have proven we’re willing to work with Republicans to improve the Affordable Care Act.

Millions of Americans are still struggling to find work. Our first priority must be to improve the economy.

It’s time for Republicans to stop refighting yesterday’s battles.

Now that this matter is settled, I hope we can work together to create jobs and secure this country’s economic future.

As a Result, 30 Million Americans Could Get Kicked Off Medicaid – Forcing Seniors to Be Denied Critical, Life-Saving Care

New State-by-State Analysis of Impact of Extreme GOP Budget Found HERE

Washington, DC—The Democratic Policy and Communications Center (DPCC) today released new national and state-by-state reports (see below) revealing the devastating impact the Republican Medicare-ending budget would have on seniors, families, and nursing home residents.  The report shows that, on top of ending Medicare as we know it and increasing seniors’ out-of-pocket health care costs by nearly $6,000, the GOP budget would also cut $1.7 trillion in Medicaid benefits for seniors, families, and those in nursing homes, which could force as many as 30 million Americans off of the program.

The GOP budget cuts $550 billion in health care benefits specifically for seniors and the disabled, which could lead to them being denied access to life-saving care and shutting nursing homes down across the country.  With state governments across the country already cash-strapped, the reduced federal support and increased burdens included in the GOP proposal would require them to drastically slash benefits, increase taxes, or both.

Report Highlights:

• The Republican plan could force as many as 30 million Americans off of Medicaid.
• The Republican plan cuts over $1.7 trillion from health care services provided through Medicaid, including $550 billion in health care for seniors and the disabled.  As a result, nursing homes across the country could be forced to slash services, turn away seniors, or close their doors.
• The Republican plan would shift costs to state taxpayers at a time when 41 states already face a budget crisis.  This could lead to huge tax hikes on taxpayers in states across the country.

The Republican budget also doubles-down on their effort to end Medicare as we know it. Under their plan, over 45 million soon-to-be seniors would be forced out of Medicare’s guaranteed benefits and onto a voucher, and out-of-pocket costs for the typical senior could go up by nearly $6,000.  The DPCC national report and state-by-state breakdown on the impact on Medicare can be found below:

National
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

HEALTH EQUITY AND ACCESS REFORM TODAY ACT (1993)

In 1993, Senate Republicans offered the “Health Equity and Access Today Act” as an alternative to President Clinton’s healthcare proposal. The centerpiece of this proposal was a provision mandating individuals to purchase private health insurance. It had 19 Republican cosponsors, including three Republican senators still in office today.

WYDEN-BENNETT BILL (2007-2009)

The bipartisan Wyden-Bennett bill—introduced in 2007 and then again in 2009—contained an individual mandate. At least 10 Republicans sponsored one of the two versions of the proposal, including four still serving today.

ROMNEYCARE IN MASSACHUSETTS (2006)

In 2006, then-Gov. Mitt Romney signed a universal health care in Massachusetts that included an individual mandate. Sen. Jim DeMint, who endorsed Gov. Romney for President in 2007, said of the Massachusetts law: “I think that’s something we should do for the whole country.”

Budget Will Immediately Reopen Prescription Drug ‘Donut Hole’, Costing Current Seniors Over $10,000 by 2020

New State-By-State Reports Showing Devastating Local Impact on Seniors

Washington, D.C. – The Democratic Policy and Communications Center (DPCC) today released new state-by-state reports that outline the devastating impact of the new Republican budget. Instead of strengthening Medicare, the new Republican budget would end Medicare as we know it, raise the eligibility age to 67, and turn guaranteed benefits for over 45 million seniors into a voucher that will shift higher costs to seniors over time. Under the proposal, set to receive a vote in the House next week, seniors would see their out of pocket costs increate by as much as $5,900 per year.

In addition to ending Medicare as we know it, the Republican budget would also force millions of current seniors across the country back into the prescription drug “donut hole,” costing them more than $10,000 over the next 10 years. A county-by-county breakdown of what seniors saved in prescription drug costs in 2012 can be found here. Seniors would lose all of that money out of their pockets going forward if the GOP budget was enacted into law.

Report Highlights:

• Over 45 million Americans who are in 47-56 “near retirement” age group would be forced onto health care “vouchers” when they retire, starting in 2023.
• The Republican plan could increase out-of-pocket health care costs for a typical 67 year-old senior by $5,900.
• Nationwide, over 3.2 million seniors saved more than $2.1 billion in prescription drug costs last year. The GOP budget would eliminate those savings in the years to come.
• Over 35 million seniors could pay more for preventative services this year.

• Alabama
• Alaska
• Arkansas
• Arizona
• California
• Colorado
• Connecticut
• Delaware
• District of Columbia
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• New Hampshire
• New Jersey
• New Mexico
• New York
• Nevada
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Virginia
• Vermont
• Washington
• Wisconsin
• West Virginia
• Wyoming

Two years ago tomorrow, President Obama signed the Patient Protection and Affordable Care Act into law.

It was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every American – regardless of where they live or how much money they make.

Millions of Americans have already felt the benefits of this law.

Seniors are saving money on their prescriptions and checkups.

Insurance companies can no longer set arbitrary lifetime caps on benefits, putting millions of Americans one car accident or heart attack away from bankruptcy.

Children can no longer be denied insurance because they have a preexisting condition, a protection that will soon extend to all Americans.

And in two shorts years, virtually every man, woman and child in America will have access to health insurance they can afford and the vital care they need.

No longer will hundreds of millions of Americans live in fear of losing their insurance because they lose their job.

And no longer will tens of millions more rely on emergency room care – or go without care entirely – because they have no insurance at all.

Unfortunately, Republicans continue to target the rights and benefits guaranteed under this law.

If Republicans have their way, insurance companies will once again be allowed to deny care to a sick child because he or she has asthma or diabetes.

In Nevada, thousands of children with preexisting conditions would once again be at the whim of insurance companies that care more about making money than about making people better.

If Republicans have their way, young adults just out of college will be kicked off their parents’ insurance plans.

Almost 23,000 young adults in Nevada would once again have to defer their dreams to take jobs that offer health insurance – or else risk going without care.

If Republicans have their way, seniors will pay more for prescriptions and checkups.

More than 230,000 Nevada seniors would once again be forced to pay for wellness visits, cancer screenings and other preventive services.

And tens of thousands of seniors, who saved $12 million on prescription drugs last year, will once again be forced to choose between buying food and buying medicine.

If Republicans have their way, taxes will increase for small businesses. And so will the deficit.

Repealing health care reform would add $1.5 trillion to the federal debt.

But when Democrats undertook healthcare reform, it wasn’t just about saving money – it was about saving lives.

And while the numbers I’ve just discussed are very important, there is one number that matters more than all the others: 45,000.

That is the number of Americans who die every year because they lack health insurance.

That doesn’t include the tens of thousands more who are sick or dying because they have health insurance, but still can’t afford the care they need.

After the rest of the Affordable Care Act has taken effect over the next two years, no American will have to bear what President Lyndon Johnson called “the injustice which denies the miracle of healing to the old and to the poor.”

President Johnson knew that living in a country with the best medical care in the world doesn’t matter if you can’t access that care.

That’s why, almost 47 years ago, he signed Medicare into law.

On that day in July, President Johnson celebrated an American tradition that “calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.”

I am pleased to say the Affordable Care Act continues that tradition.

This law makes certain that the richest nation in the world never again turns its back on the despair, helplessness and suffering of the least among us.

And it guarantees that no insurance company will ever again put a price tag on a human life.

“Families, seniors and small businesses in Nevada and across the country are reaping the benefits of health insurance reform. Prescription drug costs for seniors are falling as the Medicare ‘donut hole’ closes, insurance companies can no longer deny coverage to children with pre-existing conditions, and business owners are taking advantage of tax breaks. Just last week, a conservative judge appointed by President Reagan ruled that this legislation is Constitutional, and I am confident the high court will do the same.”

Democrats Are Committed to Improving Access to Cancer Prevention and Treatment Services for Seniors.

The Affordable Care Act provides seniors with new cancer prevention and treatment tools, including free screenings like mammograms and colonoscopies.  In 2008, 43% of female Medicare beneficiaries did not receive a mammogram.  Studies suggest that 3,700 lives could be saved if 90% of women 40 and older receive a mammogram.  The Affordable Care Act eliminated cost sharing requirements for mammograms and other prevention tools, dramatically improving access to important lifesaving services.  [HHS, 3/16/11; HHS, 7/14/10]

Under the Republican Budget, More Than 7 Million Seniors Will Be Required to Pay More for Cancer Prevention Starting Next Year. The Republican budget will require seniors to pay a 20% co-insurance for many cancer prevention services, including screenings like mammograms and colonoscopies.  By forcing seniors to pay the 20% co-insurance, the Republican budget could result in beneficiaries paying an additional $160 out-of-pocket. These increased costs could force thousands of seniors to forego mammograms and colonoscopies, thus possibly putting their lives at greater risk.  [HHS, 3/16/11]

Despite Republican claims that their budget will not impact current seniors, the GOP budget will increase costs for cancer prevention immediately and require:

• More than 7,800,000 senior women pay a 20% co-insurance for breast cancer screening
• More than 2,000,000 senior women pay a 20% co-insurance for cervical cancer screening (pap test)
• More than 1,200,000 senior women pay a 20% co-insurance for cervical cancer screening (pelvic examination)

Cancer Patients Have Already Saved More Than $32 Million on Their Medication This Year, But The Republican Budget Eliminates Those Discounts, Making Lifesaving Drugs Unaffordable for Many Seniors. By re-opening the donut hole, the Republican budget will force seniors with cancer to pay millions more for their life-saving medications. By providing significant discounts on prescription drugs to seniors in the donut hole, Medicare saved seniors with cancer $32 million for cancer drugs in the first part of this year alone.  In fact, nearly 20% of the discounts to date have been for cancer medication. The House budget would eliminate these savings moving forward. According to a recent report, 16 percent of Medicare patients did not fill their cancer drug prescriptions due to the high costs. The Republican budget imposes new costs on seniors with cancer starting in 2012, thereby risking the health of our most vulnerable senior population. [HHS, 5/24/11; Journal of Clinical Oncology, 5/11]

Click here for state-specific data on how the Republican budget will force seniors in your state to pay more for life-saving preventive health services in 2012.

Republicans’ Reckless Plan Would Jeopardize Seniors’ Current Benefits and Double Their Out-of-Pocket Costs, Leaving Them At The Mercy Of Private Insurance Companies

In Letter to Vice President Biden, Senators Bill Nelson, Cardin, Brown, McCaskill and Tester Urge “Unwavering Opposition” to Medicare-Ending Proposal During Deficit Discussions

Washington, DC— Senators Bill Nelson (D-FL), Ben Cardin (D-MD), Sherrod Brown (D-OH), Claire McCaskill (D-MO) and Jon Tester (D-MT) today called for Republicans to take the House-passed plan to dismantle Medicare off the table in bipartisan deficit reduction talks. In a letter to Vice President Joe Biden, who is leading these discussions, the senators urged the administration to continue to oppose any GOP efforts to insert their plan to dismantle Medicare into a deficit reduction package.

“As the working group moves beyond areas of consensus and into parts of the budget that will require the toughest choices, we wish to identify in advance one proposal that we cannot support in any form—the House-passed plan to dismantle Medicare,” the senators wrote.

“For the good of the nation’s seniors, it must remain off the table,” the senators continued.

Despite the public’s overwhelming rejection of the GOP proposal to dismantle Medicare, many Republican leaders are insisting that the plan be part of a package to lower the debt.  House Budget Chairman Paul Ryan recently declared that the plan to dismantle Medicare is “part of the debt ceiling talks.” And last week, Senate Republican Leader Mitch McConnell echoed that it is “on the table.”  Further, the House majority recently reaffirmed its commitment to this plan through the adoption of a rule that declares the House-passed budget shall have “force and effect.”

Numerous reports have revealed the devastating impact the GOP’s Medicare-ending budget would have on the nation’s seniors.  Across the country, the GOP’s reckless plan would cost 2 million private sector jobs over the next five years and increase seniors’ out-of-pocket health care costs by $6,359 in 2022 – more than double what they would otherwise pay.  Analyses also show that starting next year if the GOP plan is law, nearly four million seniors nationwide will be forced to pay $2.2 billion more in prescription drug costs, and at least one million seniors will have to pay more than $110 million more for annual wellness visits in 2012.

The senators called the GOP plan to end Medicare unacceptable, saying: “Our nation’s seniors are not responsible for the fiscal challenges we face, and they should not be responsible for shouldering the burden of reducing our deficits.”

A copy of the letter appears below.

The White House

Vice President Joe Biden

1600 Pennsylvania Avenue, NW

First Floor, West Wing

Washington, DC 20500

Dear Vice President Biden,

It has come to our attention that the bipartisan working group you are leading is making considerable progress in identifying ways to reduce the deficit. We are encouraged by the progress being made in these negotiations and stand ready to work with you towards the passage of a responsible deficit reduction package that will set our nation on a healthy fiscal course.

But as the working group moves beyond areas of consensus and into parts of the budget that will require the toughest choices, we wish to identify in advance one proposal that we cannot support in any form—the House-passed plan to dismantle Medicare.

As you know, the House-passed budget would end Medicare as we know it by destroying the guaranteed-benefit system and instead requiring seniors to enter the private insurance market. Despite the public’s overwhelming rejection of this proposal, and even after the Senate vote against it, many top congressional leaders are now saying they want the plan included as part of a package to reduce the deficit. Just last week, House Budget Chairman Paul Ryan declared that the plan to dismantle Medicare is “part of the debt ceiling talks.” Then on Sunday, Senate Republican Leader Mitch McConnell echoed that it is “on the table.”

This proposal would never pass Congress on its own, and it does not belong in a larger deal either. It would be devastating for America’s seniors, who would see their out-of-pocket costs for health care double and the benefits they currently enjoy jeopardized.  Under this risky proposal, insurance company bureaucrats would decide what care seniors get.

We are aware the administration has rejected this proposal since its passage by the House, and we applaud your efforts to educate the American people about its serious implications. We encourage you to remain unwavering in opposition to this scheme. For the good of the nation’s seniors, it must remain off the table.

We share the goal of ensuring the long-term health of Medicare. We hope to identify delivery system reforms and other sources of savings that can extend the life of Medicare in its current form. But we will never allow any effort to dismantle the program and force benefit cuts upon seniors under the guise of deficit reduction.  Our nation’s seniors are not responsible for the fiscal challenges we face, and they should not be responsible for shouldering the burden of reducing our deficits.

Thank you again for your leadership in these budget talks and for your continued work standing up on behalf of the nation’s seniors.

Sincerely,

Senator Bill Nelson

Senator Ben Cardin

Senator Sherrod Brown

Senator Claire McCaskill

Senator Jon Tester

Having grown up in a family that could not afford health care, I know how difficult it can be to go to a doctor when you need one.

That’s one of the reasons I worked on health insurance reform. No person in the United States should go without care when they need it.

I remember an afternoon in October 1951 when my 10-year-old brother Larry fell off his bike and broke his leg. There was no money for a doctor. His leg was never set, and it eventually healed crooked.

Doctor visits were not an option in my home — not for us kids and not for my parents either. My mother’s teeth fell out one by one because she never could pay to see a dentist. She had to gum her food and couldn’t eat the meat we had, so we ate a lot of beans and rice.

Last year’s health insurance reform law provides benefits to seniors on Medicare, people with preexisting and chronic conditions, and small businesses. We have eliminated lifetime limits and made preventive care more affordable.

When writing the law, we knew it would take time to implement, and we worked to minimize the number of people who would have lost coverage before health insurance reform was fully enacted. We provided funding for employers to continue early retiree coverage and gave tax credits to small businesses — both groups were susceptible to losing coverage in the current system.

And we wanted to ensure that low-income children, the elderly, and people with disabilities would be protected, so we included an important provision requiring states to keep Medicaid and the Children’s Health Insurance (CHIP) strong. It prevents states from cutting Medicaid coverage for adults prior to January 1, 2014 and protects children’s coverage in Medicaid and CHIP through 2019.

Unfortunately, my Republican colleagues have introduced a bill that would unravel these stability protections, possibly denying hundreds of thousands of women and children access to health care provided through Medicaid and eliminating or cutting the Children’s Health Insurance Program, depending on the state.

Republicans argue that cutting kids and parents from Medicaid saves money. In fact, such cuts would prove quite costly. Hospitals, community health care centers, and other providers would have increasing rates of uncompensated care, leading to increased costs for everyone else.

By 2013, 400,000 deserving people — two-thirds of them children — would lose vital health care services under the Republican plan, according to the Congressional Budget Office.

The stakes get even higher in 2014. That’s when Medicaid will expand. The lowest-income citizens will be eligible for Medicaid coverage. We will truly see a decline in the uninsured in this country. But if the Republican plan becomes law, the Congressional Budget Office estimates 1.7 million children would lose health insurance by 2016. Half the states could entirely eliminate their CHIP programs, while remaining states would dangerously roll back coverage.

Medicaid and CHIP provide care for Americans who cannot afford it. Most recipients are women and children. The Republican plan would let states drastically limit enrollment and eligibility rates — and must be opposed.

There are a lot of people today who are just like my mother and brother — people who cope with unnecessary pain because they lack money. In Nevada, for instance, nearly 250,000 people rely on health services through Medicaid that they otherwise could not afford.

Medicaid and CHIP exist to provide mothers and children, among others, the safety net they need. These programs have helped reduce the child uninsured rate by more than half, to less than 10 percent, over the last decade. Without them, the health of low-income Americans would be much worse.

Helping people treat conditions that may become life-threatening is far less costly than helping people whose conditions have already reached a critical stage.

This July marks the 46th anniversary of Medicaid, an opportunity to reflect on the millions of Americans whose lives are supported or saved, thanks to its existence.

There is no better way to mark this anniversary than by making sure we keep Medicaid strong and viable, and oppose attempts to weaken it.

“Republicans are holding the United States’ credit hostage to ram through their plan to end Medicare. They are now saying they won’t accept any plan to reduce the deficit unless it also cuts Medicare. Voters have resoundingly rejected this ideological agenda. Republicans should drop it and move on.”

###

McConnell: I Won’t Agree To Raise The Debt Limit Without Medicare Cuts

Brian Beutler | May 27, 2011, 12:17PM

Senate Minority Leader Mitch McConnell (R-KY) says substantial Medicare cuts must be part of a spending and deficit cut package to get his support to raise the debt limit.

In a Capitol briefing with reporters Friday, McConnell declared affirmatively that unspecified Medicare cuts are on the table in bipartisan debt limit negotiations, led by Vice President Joe Biden, and, he expects, will be part of the solution. But in response to a question from TPM, he went further than he has in the past in laying down a marker on that issue. Medicare cuts must be part of that deal to get his support — even if negotiators manage to find trillions of dollars in savings elsewhere, even if his other priorities are met.

“To get my vote, for me, it’s going to take short term [cuts, via spending caps]… Both medium and long-term, entitlements.,” McConnell said. “Medicare will be part of the solution.”

To clarify, I asked “To clarify, if [the Biden group] comes up with big cuts, trillions of dollars worth of cuts, but without substantially addressing Medicare, it won’t get your vote?”

“Correct,” McConnell said.

That’s not a filibuster threat, but it is a clear indication of what the GOP is demanding in private deliberations. McConnell repeatedly cited Bill Clinton and House Minority Whip Steny Hoyer, who this week acknowledged — as have many Democrats — that resolving the long-term deficit problem will require addressing Medicare. Hoyer in particular said that Medicare will be on the table in current debt negotiations, and with revenues off the table — that means they’re talking politically dangerous cuts. And for Republicans, that’s the point.

Here’s how McConnell described it, in response to a different question about the political cost to Republicans of having voted already to privatize Medicare.

“I think the 2012 election will take care of itself — it’s about a year and a half from now,” he said. “I would think that we will hopefully have done something significant in this area by then, and the American people can decide whether they want to punish both sides for having done that, because it will take both sides to do it. It will come out of the conversations that are going on now led by the Vice President.”

Of course, not all Medicare cuts are created equal, and Medicare spending can be reduced without necessarily cutting seniors’ benefits. But the idea here is clear: if the country’s to avoid defaulting on its debt, there has to be a bipartisan vote to cut Medicare. And the hope for McConnell and the GOP is that this will obscure the test vote they took on phasing the program out entirely.

The question now is whether Democrats will be on board with this, or whether they’ll try to call the GOP’s bluff.

http://tpmdc.talkingpointsmemo.com/2011/05/mcconnell-medicare-must-be-cut-to-raise-debt-limit.php

“Republicans need to wake up and smell the coffee: people in Nevada and across the country oppose the Republican plan to kill Medicare. We saw people’s opposition on full display during Tuesday’s special election in New York, where the central issue was the Republican plan to put insurance company bureaucrats between patients and their doctors. Last night, the Senate also sent a strong message that the Republican proposal is a nonstarter. Yet the author of this proposal, Rep. Paul Ryan, seems tone deaf on this issue, and just last night said that there will be ‘no retreat’ for Republicans on their plan to end Medicare.

“Democrats want to work with Republicans to address the challenges facing our country, including the deficit. But we will never support a plan to balance the budget on the back of America’s seniors. It’s time for Republicans to listen to the American people, drop their plan to end Medicare and work with Democrats on more responsible ways to reduce our deficit.”

For weeks, Americans old and young have been speaking out against the Republican plan to kill Medicare.

It’s not just Democrats.  Republicans have been speaking out against it, too.  Newt Gingrich called it a radical plan and “right-wing social engineering.”  Several Republican Senators have similarly spoken out, calling it what it is: a plan that would shatter a cornerstone of our society and break our promise to the elderly and the sick.

Last night, though, the most important voices were heard: American voters had their first chance to do something about it.  They went to the polls and resoundingly rejected that plan, and the candidate who ran on the promise to dismantle Medicare.

In a special Congressional election in upstate New York, the Republican plan to kill Medicare was the number-one issue.  It’s what the voters most cared about – and were most scared about.  As well they should be.

Here’s what it would do: It would turn over seniors’ health to profit-hungry insurance companies.  It would let bureaucrats decide what tests and treatments seniors get.  And it would ask seniors to pay more for their health care in exchange for fewer benefits.  That’s a bad deal all around.

What’s telling is not just that voters rejected this plan.  It’s that the Republican candidate pushing the Republican plan to kill Medicare was rejected in a very Republican district.

The district, which stretches from Buffalo to Rochester, has been in Republican hands for four decades.  It’s produced influential Republicans like Jack Kemp, who served in Congress, the Cabinet and ran on a Presidential ticket.  Last night’s special election was held to replace a Republican congressman who had won his seat by a 3-to-1 margin.

John McCain won the district in 2008.  George W. Bush won the district four years earlier.  Last year’s Republican candidate for Governor in New York lost in a landslide – but he won big in this district.  That’s how conservative it is.

Democrats in Congress – and even some candid Republicans – know the Republican plan to kill Medicare is irresponsible and indefensible.  Last night, voters showed the country and the Congress they know it, too.

Cornyn: “I will say that Republicans do not want to end Medicare as we know it.  That is an intentional Falsehood. That is a Lie.” [Cornyn Floor Speech, 5/25/11]

…But The Wall Street Journal Does Not Agree.

“The [Republican] plan would essentially end Medicare.”  [Wall Street Journal, 4/4/11]

…But That Just Isn’t True. The GOP Plan to end Medicare Would Re-Open the Donut Hole, Forcing Millions of Seniors to Pay More for Prescription Drugs From Day One.

Nationwide, nearly four million seniors would pay $2.2 billion more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

In Wisconsin, more than 69,100 seniors would pay $39 million more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

The Republican plan could force at least 20,400 Wisconsin seniors to pay over $2.1 million more for annual wellness visits in 2012. [DPCC Report]

This vote is about more than public policy.  It is about priorities.  It is about whether we hold fast to our values, or break our promises.

There is a lot wrong with the House Republican budget on which each Senator is about to cast a vote.  But among the most irresponsible and indefensible ideas in it is the radical plan to end Medicare as we know it.

Doing so would break a solemn promise between our society and our seniors.  It’s a promise that for more than four decades has saved seniors from poverty, illness and worse.

The promise of Medicare is this: if you work hard and contribute, America will make sure you are protected in retirement from the hardships of affording health care.

The Republican budget would break this promise.  It would make life significantly more difficult and painful for America’s seniors.  It’s as simple and as serious as that.

The Republican plan would kill Medicare.  Even the conservative Wall Street Journal admitted this – even if most Republican Senators still refuse to face this reality.

Here’s what it would do: It would turn over seniors’ health to profit-hungry insurance companies.  It would let bureaucrats decide what tests and treatments seniors get.  And it would ask seniors to pay more for their health care – charging every senior $6,000 more every year – in exchange for fewer benefits.  That’s a bad deal all around.

Those voting for this Republican plan would be forcing seniors in Nevada to pay more than twice as much as they pay today in out-of-pocket costs.

Those voting for the Republican plan to kill Medicare would be voting to re-open the doughnut hole that we closed to help seniors afford expensive prescription drugs.  Opening the doughnut hole would send drug prices through the roof, costing 27,000 Nevada seniors thousands of dollars between now and the year 2020.

Those voting for the Republican plan to kill Medicare would also be forcing our seniors to pay almost a million dollars more for annual wellness visits.  They would make it harder for seniors to access nursing homes and long-term care, and would make at least 34 million more Americans uninsured.

The Republican plan to kill Medicare was written in the name of saving money.  But it costs seniors so much money, that it doesn’t even do that.  One study found that seniors would spend $14 more for every dollar the government saves.  That’s not effective economics – and it’s certainly not worth endangering the health of our seniors.

The Republican plan to kill Medicare is a plan that tries to balance the budget on the backs of America’s seniors.  That is a clear window into the other party’s priorities.  While it asks seniors pay more and more, it allows the wealthiest to pay less and less.  It gives even more tax breaks to those who need it the least: oil companies, billionaires and multinational companies that ship jobs overseas.

It comes down to this: The Republican plan to kill Medicare is a plan to make the rich richer and the sick sicker.

A well-worn metaphor characterizes the Senate as a saucer – as the deliberative body that cools the intense heat and occasional zeal of the House of Representatives.  In voting today down the radical Republican House-passed plan to end Medicare – in keeping our nation’s priorities straight and keeping our promise to our seniors – we are bringing our Founding Fathers’ image to life.

“This will be a busy week in the Senate.  We have to renew the Patriot Act.  It’s not a perfect law, but it plays an important role in keeping our country safe.  We also have to reauthorize the Federal Aviation Administration.

“But we all know what will be the focus of this week’s biggest debate and biggest headlines.  The primary conversation this week will be about the Republican plan to kill Medicare.

“People are talking a lot about that plan because there’s a lot in there to fear.  The Republican plan would shatter a cornerstone of our society, and would break our promise to the elderly and the sick.

“It would turn over seniors’ health to profit-hungry insurance companies.  It would let bureaucrats decide what tests and treatments seniors get.  And it would ask seniors to pay more for their health care in exchange for fewer benefits.  That’s a bad deal all around.

“So it’s easy to understand why the American people don’t support it.  I won’t support it, either.  And though Republican in the House supported this Medicare-killing plan almost unanimously, sometimes it’s difficult to tell where the Republican Party stands on the issue.

“We all saw how quickly one prominent Republican Presidential candidate spun himself into circles last week.  First he called the plan for what it is: radical.  He said it was ‘right-wing social engineering.’  Hours later, after Republicans jumped all over him, he reversed course and said he supports the plan to kill Medicare.

“Another prominent Republican, one who serves in this body, has been all over the map as well.  First he said – in his words – ‘Thank God’ for the Republican plan to kill Medicare.  Then he said he was undecided.  Now he says he opposes it.  We’ll tune in tomorrow to see if he changes his mind again.

“Our Republican colleagues can’t seem to believe the same thing today that they said yesterday.  But when Democrats talk about Medicare, we still believe today the same thing we believed years ago, decades ago and generations ago: We believe in our responsibility to each other.

“Forty-six years ago this summer, President Lyndon Johnson, a former Majority Leader of this Senate, signed Medicare into law.  As he did so, he said the following:

‘Few can see past the speeches and the political battles to the doctor over there that is tending the infirm, and to the hospital that is receiving those in anguish, or feel in their heart painful wrath at the injustice which denies the miracle of healing to the old and to the poor.’

“Because of Medicare, those injustices don’t exist as sharply as they did then – but they still exist.  The old and the poor among us still seek help and healing.  And it is still our responsibility to act not on political impulses, but with human concern and compassion.  It is still our responsibility not to be motivated by short-term politics, but to be moved by the people who need Medicare – the people who count on this safety net to keep them from poverty, illness or worse.

“If we pay attention to those people, we’ll notice something else, too.  While Republicans are tripping over themselves and trying to decide whether or not they want to kill Medicare, you know who hasn’t changed their mind at all?  The American people.

“They haven’t wavered one inch.  They have been as constant as Republicans have been erratic.  They have been consistent, and they have been clear: They don’t want us to destroy their Medicare.  We owe it to them to listen.”

The non-partisan Congressional Budget Office has estimated that a typical 65-year-old Medicare beneficiary in 2022 would see their out-of-pocket health care costs increase from $6,154 to $12,513 under the Republican budget.  Using that data along with cost-sharing data from the Centers for Medicare and Medicaid Services, the JEC has estimated out-of-pocket costs on a state-by-state basis.  While the increase varies by state, residents in all states will see their out-of-pocket expenses more than double when they turn 65 in 2022.  Residents in Florida face the largest increase –$7,383.

The report also shows that current Medicare beneficiaries will be harmed by the GOP budget, immediately losing preventive services such as mammograms and facing higher prescription drug costs.

“This new JEC analysis helps to fill in the picture on just how disastrous and costly the Republican Medicare plan is for our older Americans,” said Senator Bob Casey (D-PA), Chairman of the JEC.  “If Republicans have their way, traditional Medicare will no longer exist in 2022.   Instead, our elderly will get a voucher to purchase private insurance, but the voucher won’t keep pace with health care costs.   The result would be a staggering increase in out-of-pocket costs beginning in 2022.  In my state of Pennsylvania, someone turning 65 in 2022 would face a $6,300 increase in their health care expenses.  Our elderly Americans cannot afford to have their health care expenses double, but that’s exactly what the Republican plan delivers.”

The increased out-of-pocket costs result from older Americans bearing a larger share of health care costs under the Republican plan and the increase in total health care costs that results from shifting from traditional Medicare to a less efficient, more expensive voucher program.

“The Republican Medicare plan doesn’t rein in health care costs,” continued Casey.  “Instead, it simply shifts the costs onto the backs of our elderly.  The Republican ‘solution’ is providing our elderly with dramatically higher costs and less care.   Current beneficiaries will suffer and the next generation will face retirement without Medicare and without the peace of mind it offers.”

Current Medicare beneficiaries will lose key benefits under the GOP budget, the report notes.  The Republican plan reopens the donut hole – the gap in Medicare Part D that had forced beneficiaries to pay 100 percent of their drug costs after they exceeded an initial coverage limit and until they qualified for catastrophic coverage.  Additionally, the Republican plan eliminates the free annual wellness exam beneficiaries currently receive and forces older citizens to pay for preventive services such as mammograms.

Please click here for the state-by-state breakdown of the increase in out-of-pocket health care costs.

###

The Joint Economic Committee, established under the Employment Act of 1946, was created by Congress to review economic conditions and to analyze the effectiveness of economic policy.

www.jec.senate.gov

From Day One, Republicans’ Reckless Plan Will Force Millions of Seniors to Pay More for Prescription Drugs and Wellness Visits

New Interactive State-by-State Map, With Data, Can Be Found at http://democrats.senate.gov/gop-budget/

Washington, DC— The Democratic Policy and Communications Center (DPCC) today released national and state-by-state data revealing the devastating effect the Republicans’ Medicare-ending budget would have on the economy and seniors’ health care costs.  Across the country, the GOP’s reckless plan would cost 2 million private sector jobs over the next five years and increase seniors’ out-of-pocket health care costs by $6,359 in 2022 – more than double what they would otherwise pay.

The report also shows that starting next year if the GOP plan is law, nearly four million seniors nationwide will be forced to pay $2.2 billion more in prescription drug costs, and at least one million seniors will have to pay over $110 million more for annual wellness visits in 2012.  The Republican budget could also cut more than $503 billion in federal health care funding for seniors and the disabled through Medicaid, including life-saving nursing home coverage.

The DPCC national report and state-by-state breakdown can be found here.  Earlier today, the Joint Economic Committee (JEC), chaired by Senator Bob Casey (D-PA), released a state-by-state report detailing how the GOP budget will more than double seniors’ out-of-pocket costs by 2022.  That analysis can be found here.

Report Highlights:

• The Republican plan to end Medicare will increase out-of-pocket health care costs for a typical 65 year-old senior by $6,359 in 2022 – more than double the cost under current law.

• The Republican plan could force at least one million seniors to pay over $110 million more for annual wellness visits in 2012.

• Nationwide, nearly four million seniors would pay $2.2 billion more for prescription drugs in 2012 alone under the Republican plan.

• By turning Medicaid into a block grant program, the Republican plan could cost America more than two million private-sector jobs over the next five years.

• Nationwide, the Republican plan could cut more than $503 billion in federal health care funding for seniors and the disabled through Medicaid, including life-saving nursing home care.

Millions of Seniors In “Donut-Hole” Would Pay over $9,300 more for Rx Drugs by 2020

Senate Dems Release New National And State-by-State Report on Increased Cost Current Enrollees Would Face in Coming Years Under Republican Budget

Washington, DC— Today, Health and Human Services Secretary Kathleen Sebelius and Sens. Jay Rockefeller (D-WV), Barbara Mikulski (D-MD), Sherrod Brown (D-OH), and Sheldon Whitehouse (D-RI) revealed the immediate and devastating impact the extreme House Republicans’ budget plan would have on at least four million seniors across the country.  The Republican budget would reopen the prescription drug donut hole, costing each of the four million seniors who fall into the coverage gap up to $9,300 by 2020.  In total, it would cost seniors $44 billion in prescription drug costs over this time period, including $2.2 billion next year alone.  It would also force at least one million seniors and people with disabilities to pay over $110 million more for their annual wellness visits in 2012.

The Senators released a state-by-state report detailing the number of seniors who would be thrown back into the prescription drug donut hole, the additional costs seniors would pay for prescription drugs, and the number of Medicare enrollees who would pay more for their annual wellness visit under the Republican budget [LINK].

“There’s a right way to preserve Medicare, and that’s by improving it,” Secretary Sebelius said. “President Obama has begun to do just that. The Republican plan would end Medicare as we know it and impose significant costs on today’s seniors and tomorrow’s seniors. That is clearly the wrong way.”

“Since passing their reckless budget plan, Republicans have continued to make the false claim that their plan protects Medicare benefits for seniors – this is simply not true,” Senator Rockefeller said.  “Medicaid is just as important for seniors as Medicare and Social Security, and we ought to be asking Republicans why they want to slash our country’s only long-term care program.”

“The Ryan budget jeopardizes women’s health at all stages of life – it is devastating to seniors, women of child-bearing age, and even children,” Senator Mikulski said. “It continues the assault on women that House Republicans began in H.R. 1. It decimates Medicare and Medicaid, but gives a bailout to rich insurance companies. This budget is so ridiculous that it’s hard to take seriously, but I know they are serious. And I’m serious about stopping them.”

“The Republican budget would pull the rug out from under seniors in order to finance extra tax cuts for millionaires,” Senator Brown said. “If enacted, seniors would see their prescription drug costs explode and would lose access to no-cost annual wellness visits and preventive care. It would hand an $89 million prescription drug tab to split among 159,000 Ohio seniors in the first year alone. Meanwhile, seniors would see an end to Medicare as we know it through privatization. They would be handed vouchers that wouldn’t cover the cost of the health services they count on – doubling their out-of-pocket costs in the first year alone.”

“With Rhode Island seniors struggling to keep up with rising costs at the pharmacy, grocery store, and gas pump, this is not the time to tamper with Medicare by reopening the doughnut hole and taking away access to free preventive screenings,” Senator Whitehouse said.  “I will stand strong against efforts to increase the out-of-pocket health expenses of Rhode Island seniors.”

The Republican budget would also require that seniors pay deductibles, co-insurance, and copayments for many preventive services currently covered by Medicare, including mammograms; colorectal, cervical and prostate cancer screening; cholesterol and other cardiovascular screenings; diabetes screening and flu shots.

Background:

Under the Republican Plan, Nearly Four Million Seniors Will Be Forced to Pay $2.2 Billion More for Prescription Drugs in 2012. The Republican budget would “reopen” the prescription drug donut hole and cost the average senior who falls into the coverage gap approximately $9,300 between 2012 and 2020. Over that time, the Republican budget will cost seniors an estimated $44 billion in prescription drug costs, including $2.2 billion next year alone.  [HHS, 11/4/10; CBO, 3/18/11]

Under The Republican Plan, At Least One Million Seniors and People With Disabilities Will Pay Over $110 Million More For Their Annual Wellness Visits In 2012. At least 1,000,000 seniors are expected to see their physician for an annual wellness visit in 2012. These visits are critical to positive health outcomes for seniors across the country. As a result of the Republican plan, these seniors would each pay an additional $160 for the first visit and $105 for a subsequent visit. [HHS, 3/16/11; Kaiser State Health Facts, accessed on 5/5/11]

All Seniors Enrolled In Medicare Will Be Forced to Pay More for Health Care Services Under the Republican Plan. The Republican plan will require that seniors pay deductibles, co-insurance, and copayments for many preventive services currently covered by Medicare; including cancer screenings such as mammograms and colonoscopies as well as annual wellness visits. Seniors could be forced to pay for many other health services that Medicare currently covers free of charge to the patient, including mammograms; colorectal, cervical and prostate cancer screening; cholesterol and other cardiovascular screenings; diabetes screening and flu shots. [HHS, 11/4/10]

“The Medicare Trustees’ report projects that Medicare will remain solvent through 2024.  This is a slight reduction from last year’s projection, caused largely by the pace of economic recovery.  Without the Affordable Care Act (ACA), Medicare would have gone bankrupt in 2016.

“Clearly, the ACA extended the solvency of Medicare.  It also laid the foundation for system-wide savings and quality improvement through reforms to our delivery system.  We should build upon that foundation by implementing those delivery system reforms that reward quality, promote prevention, simplify administrative processes, realign payment systems, and encourage information technology.  This approach will save money by improving quality of care: a win-win for our health care system and the American people.  We owe it to our country to reach for those savings – not compromise the care on which millions rely.

“Unfortunately, some of my Republican colleagues have proposed to privatize Medicare and shift the rising cost burden to seniors, rather than strengthen Medicare and put our entire health care system on a sustainable path. They have misdiagnosed the problem, and their remedy will do more harm than good.”

Schumer: GOP Tried To Throw Medicare Privatization Plan Overboard But It Is An Anchor Still Tied Around Their Ankles

WASHINGTON, DC—Earlier this week, there were reports that House Republicans might remove their plan to end Medicare from their budget proposal. But Republicans in both the House and Senate quickly defended the original plan, which would end Medicare as we know it and double out-of-pocket costs for millions of seniors.

“House Republicans tried throwing their Medicare plan overboard, but it is still an anchor tied around their ankles. They may not want to embrace the plan anymore, but they still own it,” U.S. Senator Charles E. Schumer said.

Below is a round-up of top Republicans who raced yesterday to double down in support of their plan to privatize Medicare.

Speaker Boehner: Plan to End Medicare “Absolutely Not” Off the Table.Speaker John Boehner tweeted, “Saving Medicare off the table? Absolutely not.” [Boehner Tweet, 5/5/11]

Majority Leader Eric Cantor’s Position “Is the Ryan Budget, Period.” Including Plan to End Medicare. “Eric made very clear that our position is the Ryan budget which — as you know — assumes a debt limit increase and includes Medicare, Medicaid and $715 billion in mandatory savings,” Cantor spokesman Brad Dayspring told POLITICO. “Whether the Democrats will agree to the proposals we’ve outlined is yet to be seen, but that is our starting point so we don’t continue to kick the can down the road and make real cuts and real reforms this year.” “To be clear, the Republican position is the Ryan budget, period,” spokeswoman Laena Fallon said in an email to reporters. [Politico, 5/4/11; The Hill, 5/5/11]

Rep. Joe Walsh: “I Would Be Very Disappointed If We Didn’t Follow Through” With Plan to End Medicare. “I would be very disappointed if we didn’t follow through,” said Representative Joe Walsh. “We have spent, gosh, a month or two now trying to educate the American people to a pretty good reception. I appreciate the chairman’s notion, but I would continue to respectfully challenge him to get this thing through committee.” [New York Times, 5/6/11]

Sen. Rob Portman: “It’s Not a Wise Strategy to Be Taking Things Off the Table.” “It’s not a wise strategy to be taking things off the table today before we’ve begun any discussion to find consensus. I would hope that instead of talking about what’s not on the table we’d be talking about how to find consensus,” Sen. Rob Portman (R-Ohio), a former director of the Office of Management and Budget in the George W. Bush administration, told reporters Thursday. [Washington Post, 5/5/11]

Sen. Ron Johnson “Disappointed”If Plan to End Medicare Isn’t in GOP Budget. After it was reported that Medicare would be removed from the Republican plan, Sen. Ron Johnson said he was “disappointed” by the report. [Financial Times, 5/6/11]

Rep. Jeff Flake: “Surprised”to Hear Rumors of GOP Pulling Back on Medicare. “I don’t know how you can continue to exclude entitlement spending,” said Rep. Jeff Flake (R., Ariz.), who said he was “surprised to hear the talk of pulling back” GOP expectations. [Wall Street Journal, 5/6/11]

Schumer: GOP Tried To Throw Medicare Privatization Plan Overboard But It Is An Anchor Still Tied Around Their Ankles

WASHINGTON, DC—Earlier this week, there were reports that House Republicans might remove their plan to end Medicare from their budget proposal. But Republicans in both the House and Senate quickly defended the original plan, which would end Medicare as we know it and double out-of-pocket costs for millions of seniors.

“House Republicans tried throwing their Medicare plan overboard, but it is still an anchor tied around their ankles. They may not want to embrace the plan anymore, but they still own it,” U.S. Senator Charles E. Schumer said.

Below is a round-up of top Republicans who raced yesterday to double down in support of their plan to privatize Medicare.

Speaker Boehner: Plan to End Medicare “Absolutely Not” Off the Table.Speaker John Boehner tweeted, “Saving Medicare off the table? Absolutely not.” [Boehner Tweet, 5/5/11]

Majority Leader Eric Cantor’s Position “Is the Ryan Budget, Period.” Including Plan to End Medicare. “Eric made very clear that our position is the Ryan budget which — as you know — assumes a debt limit increase and includes Medicare, Medicaid and $715 billion in mandatory savings,” Cantor spokesman Brad Dayspring told POLITICO. “Whether the Democrats will agree to the proposals we’ve outlined is yet to be seen, but that is our starting point so we don’t continue to kick the can down the road and make real cuts and real reforms this year.” “To be clear, the Republican position is the Ryan budget, period,” spokeswoman Laena Fallon said in an email to reporters. [Politico, 5/4/11; The Hill, 5/5/11]

Rep. Joe Walsh: “I Would Be Very Disappointed If We Didn’t Follow Through” With Plan to End Medicare. “I would be very disappointed if we didn’t follow through,” said Representative Joe Walsh. “We have spent, gosh, a month or two now trying to educate the American people to a pretty good reception. I appreciate the chairman’s notion, but I would continue to respectfully challenge him to get this thing through committee.” [New York Times, 5/6/11]

Sen. Rob Portman: “It’s Not a Wise Strategy to Be Taking Things Off the Table.” “It’s not a wise strategy to be taking things off the table today before we’ve begun any discussion to find consensus. I would hope that instead of talking about what’s not on the table we’d be talking about how to find consensus,” Sen. Rob Portman (R-Ohio), a former director of the Office of Management and Budget in the George W. Bush administration, told reporters Thursday. [Washington Post, 5/5/11]

Sen. Ron Johnson “Disappointed”If Plan to End Medicare Isn’t in GOP Budget. After it was reported that Medicare would be removed from the Republican plan, Sen. Ron Johnson said he was “disappointed” by the report. [Financial Times, 5/6/11]

Rep. Jeff Flake: “Surprised”to Hear Rumors of GOP Pulling Back on Medicare. “I don’t know how you can continue to exclude entitlement spending,” said Rep. Jeff Flake (R., Ariz.), who said he was “surprised to hear the talk of pulling back” GOP expectations. [Wall Street Journal, 5/6/11]

Voters Dislike GOP Plan to Change Medicare, Medicaid

By Patrick O’Connor

Republicans have some selling to do.

Changes to Medicare and Medicaid remain wildly unpopular and more than two-thirds of registered voters want to repeal Bush-era tax cuts for households that make more than $250,000 a year, according to the latest Quinnipiac University poll.

More than twice as many voters oppose efforts to change Medicare than those who favor limiting benefits under the popular health-care program for seniors. And a distinct majority opposes new limits on Medicaid, the federal-state health program for the poor.

What’s worse for the GOP, the numbers don’t change much when voters were told how much federal spending Medicare and Medicaid consume.

Quinnipiac told half of the 1,408 registered voters the university polled that Medicare, Medicaid, Social Security and defense spending consume 60% of the budget. The other half weren’t. Among those who were told, 70% opposed efforts to change Medicare, compared with the 75% who weren’t told. For Medicaid, 57% of the first group opposed limits, compared with the 59% of the control group that also opposed changes. The only significant change came on the question of defense spending, with support for cuts increasing by 7% when voters were told how much the government spends on the military.

“So much for the idea that if the public only understood the budget numbers they would be much more amenable to reductions,” said Peter Brown, assistant director of polling at the Quinnipiac University Polling Institute. “Except for defense spending.”

The House Republicans’ budget would turn Medicaid into a system of block grants to the states and transform Medicare from a fee-for-service program to a menu of subsidized private insurance plans for people under the age of 55. Many GOP lawmakers got an earful from their constituents about the budget blueprint during a recently concluded two-week recess.

In addition, 69% of the voters polled favor repealing Bush-era tax breaks on households than earn more than $250,000. Republicans would keep the current rates indefinitely, while President Barack Obama has promised to raise them for people whose income exceeds $250,000.

http://blogs.wsj.com/washwire/2011/05/04/voters-dislike-gop-plan-to-change-medicare-medicaid/

“After Senate Republican leaders spent weeks embracing House Republicans’ plan to end Medicare to give tax breaks to millionaires, why are they suddenly afraid to vote on it? They’ve already praised this plan to end Medicare as we know it, so they shouldn’t be afraid to put it in the record.”

McConnell Called Ryan Budget A “Serious And Detailed Plan.”In a statement Senator McConnell said: “Today, the Chairman of the House Budget Committee, Congressman Paul Ryan, is releasing a serious and detailed plan for getting our nation’s fiscal house in order. Congressman Ryan’s plan would put us on a path to reducing the national debt. It would strengthen the social safety net so we can keep the promises we’ve made to America’s seniors… It’s my hope that our friends on the other side recognize this effort for what it is — a serious, good-will effort to do something good and necessary for the future of our nation and that, for the good of the nation, they’ll join in the effort at some point before it’s too late.” [McConnell Floor Speech, 4/5/11]

Kyl Praised Ryan Budget, An “Effective Blueprint.” Kyl said in a statement, “House Budget Committee Chairman Paul Ryan, who authored the budget, believes it could reverse Washington’s trend of spending beyond its means and passing the debt onto our children and grandchildren.  I believe he’s right on target…I think Congressman Ryan’s budget proposal is an effective blueprint for economic growth.” [Kyl Release, 4/11/11]

Scott Brown Praised Ryan Plan. “Brown also praised a budget plan crafted by Wisconsin U.S. Rep. Paul Ryan that would slash federal spending by about $5 trillion over 10 years while revamping health programs for the elderly and poor. Brown credited Ryan’s budget for its fresh approach, adding that it forced Obama to come up with his own spending plan.  ‘I think, ultimately, if you think that if we can do nothing and you think Medicare and Medicaid and Social Security are going to be viable in years to come, then you’re wrong,’ said Brown. ‘We need to do something.’”  [Lowell Sun, 4/28/11]

Cornyn Praised Ryan Budget, “Filled a Leadership Void.” In a statement Senator Cornyn said, “Congressman Paul Ryan and the House Republicans stepped up and filled a leadership void that the President and Senate Democrats have steadfastly refused to fill. The House Republican budget proposal speaks directly to the frustrations of the American people and addresses the long-term fiscal challenges that we all know we have to face. Instead of demagoguing this serious proposal, I hope President Obama and Congressional Democrats take this opportunity to engage in a constructive debate to get our nation’s fiscal house back in order.” [Cornyn Release, 4/5/11]

Sessions Called Ryan Plan “Honest, Responsible, Serious.” In an interview with radio host Hugh Hewitt, Senator Sessions said, “And it’s never easy to make changes, but Hugh, this thing is, we’re in a deeper hole than in ’94. This is a deep hole, and Paul Ryan’s plan is an honest, responsible, serious plan to get us out of this fix.” [Hugh Hewitt Show, 4/7/11]

Johanns: “Ryan Budget Is A Serious Effort.” In a statement, Senator Johanns said, “Chairman Ryan’s budget is a serious attempt to address our ballooning debt in a responsible way, and I applaud his leadership.” [Johanns Release, 4/5/11]

Hatch Said Ryan Plan Put “Serious Ideas On The Table,” Hatch said in a statement,“…Paul Ryan has put serious ideas on the table to reform Medicare and Medicaid, streamline our tax code, cut spending, and confront our debt. He rightly includes a proposal to kick Fannie Mae and Freddie Mac off the government dole, fully repeal the budget-busting $2.6 trillion health law, and extend the 2001 and 2003 tax relief permanently, while reducing our corporate tax rate.” [Hatch Release, 4/5/11]

CNN: Crowd Turns Loud At Town Hall Session For Freshman GOP Rep. “House Republicans back home for congressional recess have been getting some tough questions about plans to overhaul Medicare, but GOP freshman Daniel Webster’s town hall meeting in Orlando, Florida, Tuesday was beyond tough – it turned into a chaotic scene. Webster used charts and graphs to try to explain the controversial House GOP budget he voted for, but he could barely be heard over angry yelling – mostly about the Medicare proposal. As one man held a sign saying ‘keep your hands off my Medicare,’ another woman screamed that the congressman voted to give corporations a tax cut ‘but take away Medicare for people like me.’”  LINK

Washington Post: Republicans Facing Tough Questions Over Medicare Overhaul In Budget Plan. “Anxiety is rising among some Republicans over the party’s embrace of a plan to overhaul Medicare, with GOP lawmakers already starting to face tough questions on the issue at town hall meetings back in their districts. … Democrats, eager to win back the seniors and independents who abandoned the party in last year’s midterm elections, have declared the vote a ‘moment of truth’ and this week launched a media campaign accusing GOP House members of dismantling Medicare and endangering retirees. The assault has taken some Republicans by surprise, prompting concerns that the party is ceding ground in a policy debate that GOP strategists already viewed as perilous.” LINK

USA Today: Republicans In Congress Get Earful On Medicare. “Some Republicans in Congress are getting an earful back home over their votes to dramatically revamp Medicare for seniors. House Budget Committee Chairman Paul Ryan, R-Wis., who proposed changing the federal entitlement into a voucher program, got booed at such a meeting in his district last week. LINK

Los Angeles Times: House Republicans Face Backlash At Home Over Budget Plan. “Congress is on its first recess since Republican leaders unveiled a plan to end the federal deficit by dramatically changing Medicare, cutting other government programs and reducing taxes. With members of the House returning home to meet with constituents, politicians have been anxiously looking for signs of trouble. … A similar argument broke out among voters at a knitting circle in the Southern California district of Rep. Mary Bono Mack (R-Palm Springs). …’I don’t trust these guys,’ said Barbara Walden, 77. Once Republicans begin ‘stripping away’ Medicare and Medicaid benefits for the younger generation, she said, they will eventually renege on their promise to protect the program for current seniors. ”  LINK

ABC News: Republican Lawmakers Face Angry, Confused Constituents on Medicare, Budget Cuts. “Americans are particularly concerned, and somewhat confused, about the proposal to overhaul Medicare, a central feature of the Wisconsin congressman’s proposal.” LINK

TIME: The Ryan Budget Vote: An Upstream Swim for Charlie Bass. “Bass spent a lot of time at his town hall trying to explain why it’s not, in his characterization, a voucher system. But he didn’t convince Spitzbarth and Loomis. ‘I like Medicare the way it is,’ Spitzbarth told Bass to applause from the audience, ‘don’t screw it up.’”  LINK

National Journal: Republicans In Swing Districts Take Heat For Supporting Ryan’s Medicare Plan. “Republicans who used seniors’ rage over health care changes to sweep into office last fall are now facing the same type of heat over the same issue: Modifications in Medicare and Medicaid. Many who voted for the plan House Budget Chairman Paul Ryan, R-Wis., laid out to privatize the programs in future years have been in constituents’ crosshairs during Easter recess town-hall meetings. Others have simply avoided meeting with constituents.” LINK

Politico: Freshmen Feel The Heat Back Home. “Any lawmaker in a swing district can expect to take criticism from his right flank at a town hall meeting. But at an American Veterans outpost tucked deep in the Pocono Mountains this week, freshman Republican Rep. Lou Barletta took heat from every direction — from Democrats angry with the tax cuts in the GOP budget, to conservatives who thought he caved on the last continuing resolution vote, to a precocious 16-year-old critical of the lawmaker’s environmental record.” LINK

Orlando Sentinel: Angry Crowd At Town-Hall Meeting Could Be The Norm For Dan Webster. “A town-hall meeting held in Orlando by U.S. Rep. Dan Webster degenerated into bedlam Tuesday, with members of the crowd shouting down the freshman Republican congressman and yelling at one another.. … Tuesday at the Orange County Agricultural Extension office in Orlando, boos and shouts of ‘liar’ were mixed with angry accusations that Ryan’s plan to change Medicare would leave those now younger than 55 without health insurance in their retirement. There also were calls to eliminate the tax cuts first put in place by then-President George W. Bush and to raise corporate taxes rather than cut entitlement programs.” LINK

Politico: Overflow Crowds For Ryan Town Halls. “Record crowds of supporters and opponents flooded town hall meetings throughout southeastern Wisconsin on Tuesday to hear Budget Committee Chairman Paul Ryan (R-Wis.) defend his plan to trim government spending — including controversial changes to the Medicare program. In the district’s Democratic stronghold of Kenosha, at least 200 people were left outside once the 300-seat auditorium filled to capacity. The people in the crowd largely opposed the Ryan plan, holding signs such as ‘RyanCare = Dying Bare,’ ‘Leave Medicare Alone’ or simply, ‘Save Medicare!’ … ‘The problem is, under your program, when you want to give me X amount of dollars, with the insurance companies, the way they operate … if I can’t afford insurance, then where am I going to be?’ asked one 62-year-old woman with a history of cancer who worried she wouldn’t qualify for private insurance coverage under Ryan’s plan.” LINK

Chicago Daily Herald: Dold Faces Tough Questions At Town Hall Meeting. “Fresh off voting for the so-called Paul Ryan budget plan on Friday, newly-elected Congressman Robert Dold returned to Buffalo Grove Saturday where constituents questioned him about several elements of the Republican budget. …But Dold couldn’t even get to the end of the presentation before audience members began peppering him with questions about the Ryan budget, named after House Budget Committee Chairman Paul Ryan, a Republican from Wisconsin. It began with audience members telling Dold they don’t believe chopping 10 percentage points off the highest corporate tax rate will create jobs. A handful of people in the audience identified themselves as business owners and accountants who said their effective corporate income tax rate is already lower than the lowest rates proposed in the Ryan plan.” LINK

Allentown Morning Call: Barletta Town Hall Gets Heated Over Medicare. “Reminiscent of the August 2009 town halls when members of Congress faced angry constituents over health care reforms, a public forum in Carbon County with Rep. Lou Barletta Wednesday night provided a glimpse of the strong emotions stirred by a Republican plan to alter Medicare benefits.” LINK

Huffington Post: GOP Town Halls: Reps Forced To Screen Questions, Duck Out Of Meetings In Secret. “The wave of town hall protests targeting House Republicans, and aided by labor and progressive groups, is forcing lawmakers to put restrictions on the forum’s traditionally open structure. On Tuesday night, Rep. Allen West’s office (R-Fl.) reportedly screened questioners during his town hall event by requiring individuals to fill out index cards which were then vetted by his staff. This was, the Boward County Sun Sentinel noted, different from ‘his usual practice at previous town hall meetings, where West took questions from people who lined up at microphones.’ Separately, House Budget Committee Chair Paul Ryan (R-Wisc.), who has chosen to publicly broadcast his town hall locations rather than avoid the protests, was forced to leave Tuesday night’s forum in a different car and from a different exit out of security concerns.” LINK

Since passing their reckless budget plan last week, Republicans nationwide have continued to make the false claim that their plan protects today’s seniors. But seniors need to know the facts about the GOP plan. The Republican-passed budget will force nearly four million seniors to pay an additional $2.2 BILLION for prescription drugs next year alone.

Wisconsin: On Sunday, House Budget Committee Chairman Paul Ryan said, “And Medicare, let me just tell you, no change would occur to anybody fifty-five years of age or above.” Rep. Sean Duffy (R-WI) claims, “The fact is, this plan does not affect today’s seniors, or anyone on the verge of retirement, 55 years or older.” Both ignore the fact that, under the Republican budget, 69,167 Wisconsin seniors will pay $39 million more for prescription drugs next year alone.

Virginia: House Majority Leader Eric Cantor said Friday, “To be clear, our plan will not touch benefits for today’s seniors and those nearing retirement.”  Cantor ignores the fact that, under the Republican budget, 91,377 Virginia seniors will pay $51 million more for prescription drugs next year alone.

Kentucky: Rep. Brett Guthrie (R-KY) “says the proposed changes to Medicare in the House bill will not affect anyone currently 55 or older.” Guthrie ignores the fact that, under the Republican budget, 74,669 Kentucky seniors will pay $42 million more for prescription drugs next year alone.

North Carolina: Rep. Renee Ellmers (R-NC) said, “This budget does not cut Medicare funding. It makes no changes to Medicare for anyone 55 or older.” Ellmers ignores the fact that, under the Republican budget, 122,598 North Carolina seniors will pay $69 million more for prescription drugs next year alone.

Pennsylvania: After voting for the budget on Friday, Rep. Mike Kelly (R-PA) said, “Under our proposal, seniors are safe, with no changes to the current program for those 55 and older.” Rep. Glen Thompson (R-PA) asserted, “Contrary to the misinformation, this plan keeps our current commitments to seniors, while ensuring the longevity of our social safety net programs for future generations.” And Rep. Bill Shuster (R-PA) said, “It’s extremely important that people 55 years and older know that there will not be one dime of change to what they’ve been promised.” All three ignore the fact that, under the Republican budget, 266,342 Pennsylvania seniors will pay $149 million more for prescription drugs next year alone.

New York: Rep. Michael Grimm (R-NY) said, “What I like about Ryan’s plan is that if you’re 55 and over — so if you’re about to become a senior or you are a senior — this will not affect you.” Grimm ignores the fact that, under the Republican budget, 273,223 New York seniors will pay $153 million more for prescription drugs next year alone.

West Virginia: Rep. Shelley Moore Capito (R-WV) said the GOP budget “does not affect anyone currently on Medicare or anyone 55 and older.” Capito ignores the fact that, under the Republican budget, 42,114 West Virginia seniors will pay $24 million more for prescription drugs next year alone.

Illinois: Rep. Adam Kinzinger (R-IL) said, “Those 55 years and older will see absolutely no change in their current Medicare plan.” Rep. Judy Biggert (R-IL) claimed, “There will be no changes to Medicare for those who are 55 and older.” Both ignore the fact that, under the Republican budget, 163,630 Illinois seniors will pay $92 million more for prescription drugs next year alone.

New Hampshire: Rep. Frank Guinta (R-NH) said, “The two most important things that I want seniors to be aware of is that if you’re 55 and older, there is no change in Medicare or Medicaid benefits.” Guinta ignores the fact that, under the Republican budget, 15,222 New Hampshire seniors will pay $8.5 million more for prescription drugs next year alone.

California: Rep. Dan Lungren (R-CA) said, “First of all, let’s make it clear, if we’re talking about someone 65 and older — anybody 55 and older will not be affected by any changes whatsoever.” Rep. Ed Royce (R-CA) said, “Americans now age 55 and older will not see a change.” Both ignore the fact that, under the Republican budget, 381,298 California seniors will pay $214 million more for prescription drugs next year alone.

Washington: Rep. Jaime Herrera Beutler (R-WA) said, “I’m not going to touch current seniors.” Herrera Beutler ignores the fact that, under the Republican budget, 67,379Washington seniors will pay $38 million more for prescription drugs next year alone.

Georgia: After voting for the House GOP budget on Friday, Rep. Lynn Westmoreland (R-GA) said, “if you are age 55 or over, these changes will not affect you at all.” Westmoreland ignores the fact that, under the Republican budget, 114,974 Georgia seniors will pay $64 million more for prescription drugs next year alone.

Arkansas: After voting for the House GOP budget on Friday, Rep. Tim Griffin (R-AR) said, “If you are 55 or over, there are no, zero changes to Medicare.”Rep. Donald Young (R-AK) stated, “If you are 55 and older your benefits are preserved.”  Both ignore the fact that, under the Republican budget, 2,503 Alaska seniors will pay $1.4 million more for prescription drugs next year alone.

Ohio: Rep. Jim Renacci (R-OH) said, “The budget plan secures Medicare without making any changes to those currently 55 and older.” Renacci ignores the fact that, under the Republican budget, 159,403 Ohio seniors will pay $89 million more for prescription drugs next year alone.

Florida: After voting for the House GOP budget on Friday, Rep. Gus Bilirakis (R-FL) said, “Make no mistake, those who are 55 years or older would see no changes to Medicare whatsoever.” After voting for the budget on Friday, Rep. Tom Rooney (R-FL) argued, “This is a bold plan to save Medicare for future generations without affecting seniors and anyone 55 and older.” Both ignore the fact that, under the Republican budget, 275,927 Florida seniors will pay $155 million more for prescription drugs next year alone.

Idaho: Rep. Mike Simpson (R-ID), said, “The House Republican plan reforms our ailing Medicare program so that it will be there for future generations without impacting the current benefits of anyone 55 or older.” Simpson ignores the fact that, under the Republican budget, 17,805 Idaho seniors will pay $10 million more for prescription drugs next year alone.

Indiana: After voting for the budget, Rep. Marlin Stutzman (R-IN) argued, “Persons that are 55 and older will not see changes to their Social Security and Medicare benefits.” Stutzman ignores the fact that, under the Republican budget, 96,422 Indiana seniors will pay $54 million more for prescription drugs next year alone.

Oklahoma: On Friday, after voting for the budget, Rep. John Sullivan (R-OK) stated, “This plan would not affect current Medicare beneficiaries, and those approaching retirement age – changes would apply only to people currently 54 years of age and younger.”  Rep. Tom Cole (R-OK) said, “The Ryan plan ensures these programs will be available for our children and grandchildren — without making any changes for those age 55 and above. That’s an important point that bears repeating: The Ryan Budget passed last week will not affect benefits for anyone 55 or older.” Both ignore the fact that, under the Republican budget, 61,466 Oklahoma seniors will pay $34 million more for prescription drugs next year alone.

Texas: After voting for the budget, Rep. Mac Thornberry (R-TX) stated that the Ryan plan, “Makes no changes to Social Security and Medicare benefits for those who are 55 years old or older.” Thornberry ignores the fact that, under the Republican budget, 238,072 Texas seniors will pay $133 million more for prescription drugs next year alone.

Minnesota: After voting for the budget on Friday, Rep. Erik Paulsen (R-MN) said, “This budget also strengthens the senior safety net by preserving Medicare for future generations without any disruptions for those at or nearing retirement.”  Rep. Michele Bachmann (R-MN) said, “So really, in a lot of ways, it should be called the ‘55 and under’ plan, because anybody 55 years of age or older will not be touched.”  Both ignore the fact that, under the Republican budget, 71,867 Minnesota seniors will pay $40 million more for prescription drugs next year alone.

Nevada: After voting for the budget on Friday, Rep. Joe Heck (R-NV) argued that the budget made, “no changes to those over 55.”  Heck ignores the fact that, under the Republican budget, 26,767 Nevada seniors will pay $15 million more for prescription drugs next year alone.

Republican Budget Protects Nearly $44 Billion in Tax Loopholes and Subsidies For Oil and Gas Companies While Forcing Seniors To Pay the Same Amount in Additional Costs for their Prescription Drugs. The Republican budget protects $44 billion in unnecessary and expensive tax breaks and subsidies for oil and gas companies, even as oil companies are reporting record profits. Meanwhile, The Republican proposal would “re-open” the prescription drug donut hole and cost the average senior who falls into the donut hole approximately $11,794 between 2012 and 2020. Over that time, Ryan’s budget will cost seniors an estimated $44 billion in prescription drug costs, including $2.2 billion next year alone.  [Reuters, 2/1/10; OMB, FY12 Budget Proposal; HHS, 11/4/10; DPCC Report, 4/14/11; Republican Budget Proposal, 4/15/11].

Republican Plans To Dismantle Medicare and Provide Tax Giveaways to Big Oil and Gas Companies Extremely Unpopular With Americans. According to a new ABC/Washington Post survey, 84 percent of Americans oppose the Republican plan to privatize Medicare and force seniors to pay twice as much for their health care. Meanwhile, a February 2011 NBC / Wall Street Journal poll found that 74% of Americans support eliminating tax credits for the oil and gas industries in order to reduce the deficit. [ABC/Washington Post Poll, 4/20/11; NBC/Wall Street Journal Poll, February 2011]

Former Big Oil Executive: “Such Subsidies Are Not Necessary.” Large oil companies don’t need tax subsidies when oil prices are high, a former CEO of Shell Oil said in February. “In the face of sustained high oil prices it was not an issue—for large companies—of needing the subsidies to entice us into looking for and producing more oil,” John Hofmeister told National Journal Daily…“The fear of low oil prices drives some companies to say that subsidies should be sustained,” Hofmeister said. “And my point of view is that with high oil prices such subsidies are not necessary.” [National Journal, 2/11/11]

Study: “Oil Production Is Among the Most Heavily Subsidized Businesses.” “An examination of the American tax code indicates that oil production is among the most heavily subsidized businesses, with tax breaks available at virtually every stage of the exploration and extraction process… According to the most recent study by the Congressional Budget Office, released in 2005, capital investments like oil field leases and drilling equipment are taxed at an effective rate of 9 percent, significantly lower than the overall rate of 25 percent for businesses in general and lower than virtually any other industry.” [New York Times, 7/4/10]

Biggest Oil Companies’ Profits Continue to Skyrocket. Exxon Mobil reported a 53 percent increase in its fourth-quarter 2010 profit. Exxon Mobil’s profit in the quarter was $9.25 billion compared with $6.05 billion in the period a year ago. Chevron’s fourth-quarter earnings surged 72 percent. Chevron reported a profit of $5.3 billion, up from $3.07 billion a year earlier. Royal Dutch Shell PLC reported that fourth quarter profit more than tripled from a year earlier. Fourth quarter net profit was $6.79 billion, up from $1.96 billion in the same period a year earlier. [New York Times, 1/31/11; Wall Street Journal, 1/28/11; Associated Press, 2/3/11]

Biggest Oil Companies Made Nearly $1 TRILLION in Profits Over the Last 10 Years. The big five oil companies—BP, Chevron, ConocoPhillips, ExxonMobil, and Shell—made a total profit of nearly $1 trillion over the past decade. [Center for American Progress, 1/31/11]

“Spin can’t change the fact that Republicans’ plan reopens the doughnut hole, costing seniors more than $2 billion next year alone. No matter what they say, the fact is the GOP wants to finance their tax breaks for millionaires and billionaires by hiking prescription drug prices for seniors.”

###

Myth: House Budget Committee Chairman Paul Ryan wrote, “The House Republican budget keeps America’s promises to seniors and those near retirement by making no changes to their current arrangements.”

Fact: Under the GOP budget, Wisconsin seniors will pay $39 million more for their prescription drugs next year alone.

Myth: House Majority Leader Eric Cantor said yesterday, “Now we are also saying for today’s seniors as well as those nearing retirement, we’re not touching your benefits because we know the political peril that is attached to that.”

Fact: Under the GOP budget, Virginia seniors will pay $51 million more for their prescription drugs next year alone.

Myth: “If you are 55 and older, it would mean no changes to Medicare whatsoever,” said U.S. Rep. Mario Diaz-Balart, R-Miami.

Fact: Under the GOP budget, Florida seniors will pay $155 million more for their prescription drugs next year alone.

Myth: “These programs would only affect people 54 and under,” said U.S. Rep Todd Rokita (R-IN).

Fact: Under the GOP budget, Indiana seniors will pay $54 million more for their prescription drugs next year alone.

Senator Jon Kyl: “So it’s simply incorrect to say that millions of seniors would be directly affected by the Ryan budget with respect to their Medicare coverage.”  [Kyl Floor Speech, 4/14/11]

CHASER

New Report: GOP Budget Would Immediately Repeal ‘Donut Hole’ Fix, Costing Seniors An Additional $2.2 Billion in Rx Drug Costs Just Next Year.

… Seems like another #notafactualstatement from Senator Kyl

New State-By-State Report Outlines Devastating Immediate Impact On Nation’s Seniors—Next Year Alone, Seniors Currently In Donut Hole Would Pay An Additional $2.2 Billion For Prescription Drugs

Senators: ‘Extreme GOP Budget Proposal Would Start Hurting Seniors From Day One’

Washington, D.C. – Today, Senate Democrats released a new report outlining how the House Republicans’ FY2012 budget proposal will begin harming seniors immediately if passed into law.  This contradicts GOP claims that the budget does not affect Medicare for anyone 55 or older.

If the budget—drafted by Representative Paul Ryan (R-WI)—is enacted into law, it will cost the average senior who currently falls into the “donut hole” approximately $11,794 between 2012 and 2020, according to a report issued by the Department of Health and Human Services.  In all, Ryan’s budget will cost seniors an estimated $44 billion in prescription drug costs over that period, including $2.2 billion next year alone.  In 2010, approximately 3.7 million seniors fell into the “donut hole.”

“If Congressman Ryan’s budget plan were to be enacted into law, it would immediately hurt senior citizens currently enrolled in Medicare,” said Senator Charles E. Schumer, Chairman of the Democratic Policy and Communications Center.  “The oft-repeated talking point that the Republican budget won’t impact current enrollees is simply not true.”

The Republican budget plan would repeal parts of the federal health care law, including measures to close the “donut hole.”  Health reform fixed a deficiency in the Medicare prescription drug program by addressing the gap in Medicare Part D that had forced beneficiaries to pay 100 percent of their drug costs after they exceeded an initial coverage limit and until they qualified for catastrophic coverage. That gap in coverage—which totaled $3,610 in 2010—has existed since the drug benefit’s creation in 2006.

Under the Patient Protection and Affordable Care Act, signed by President Obama in March 2010, seniors who get stuck in the “donut hole” will now see the costs of their brand name drugs discounted by 50 percent, phasing out the “donut hole” completely over the next ten years.

The DPPC projections for this report used data from the Department of Health and Human Services (HHS) and the Congressional Budget Office (CBO).

Click here to download the full state-by-state report (PDF).

20 Million Near-Elderly Will Not Have Medicare When They Retire. Starting in 2022, Medicare will be eliminated for new beneficiaries and converted instead into a voucher program. There are more than 20 million near-elderly Americans who are now ages 50-54 who would not get Medicare when they retire but instead only get a coupon to purchase private health insurance. This approach would transfer control of Medicare to insurers and there would be no guaranteed benefits, essentially ending Medicare. Moreover, the voucher will fail to keep pace with increases in the cost of health care so its value will decline every year, meaning that future seniors won’t be able to get the benefits they need or even end up uninsured. [CBPP, 4/7/2011; Census 2010 data]

CBO: Voucher Proposal Will Double Health Care Costs for Seniors. The voucher will fail to keep pace with increases in the cost of health care. As a result, seniors will be forced to pay higher premiums in order to access the same benefits they would receive under the current system. According to the CBO, a typical senior will spend more than twice as much of his or her own income on health services under the Ryan proposal as compared to the current Medicare system. [CBO, 4/5/11]

Under the Republican Plan, Seniors Will Lose Guaranteed Benefits. Under current law, all seniors have guaranteed access to life-saving health benefits, including screenings for colon cancer, diabetes, and prostate cancer, as well as flu shots. If the Republican plan becomes law, seniors that were eligible for guaranteed health benefits last year could lose their benefits. [Kaiser State Health Facts, accessed on 3/39/11]

Republican Proposal Could Force Seniors to Pay $44 Billion More for Prescription Drugs. The Republican proposal would “reopen” the prescription drug donut hole and cost the average senior who falls into the donut hole approximately $11,794 between 2012 and 2020. Over that time, Ryan’s budget will cost seniors an estimated $44 billion in prescription drug costs, including $2.2 billion next year alone. In 2010, approximately 3.7 million seniors fell into the “Donut Hole.” [HHS, 11/4/10]

CBO: Ryan Plan Means “Most Elderly People Would Pay More For Their Health Care.” In their initial analysis of the Ryan Medicare plan, the non-partisan Congressional Budget Office determined, “Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system… Under the proposal, the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the traditional program…That greater burden would require them to reduce their use of health care services, spend less on other goods and services, or save more in advance of retirement than they would under current law.” [CBO, 4/5/11]

“Even though the Republicans want to take women back to the Dark Ages, we will not go,” Senator Barbara A. Mikulski (D-MD) said. “We will fight them with every legislative tool at our disposal. Make no mistake: This entire process has not been about reducing the debt or the deficit – it’s been about reducing opportunity. The major constituencies that bear this burden are the women and children”

“I am proud to stand here with my Democratic women colleagues to send the message that we are not going to allow women to be thrown under the bus in this – or any other – budget debate,” said Senator Patty Murray (D-WA). “As a woman and a mother, I am angry that women’s health care is even up for debate right now. I truly hope that once we win these votes and put the issues behind us, Republicans stop playing ideological political games, and work with us in good faith on the serious issues facing our country.”

“This is simply an opportunity for the right wing to turn back the clock and really sock it to American women,” said Senator Dianne Feinstein (D-CA). “To be clear, to end federal funding for Planned Parenthood is to stop providing critical health care to millions of American women, the majority of whom are poor and cannot afford the range of preventative health services provided in California and around the country.”

“While claiming to be focused solely on deficit reduction, Republicans have been pushing an extreme ideological agenda that threatens the health and lives of American women,” said Senator Barbara Boxer (D-CA), We will continue to stand up for the millions of women and families who rely on these preventive and life-saving health care services.”

“While our budget hangs in the balance, Republicans have chosen to wage a war on women’s health, and we are the last line of defense,” said Senator Maria Cantwell (D-WA). “We should not be diverted by an extremist social agenda not supported by the majority of Americans. Let’s get back to putting Americans back to work, creating new jobs, and moving our economy forward.”

“Votes on unrelated political issues are a distraction from the real debate over the budget, which itself is a distraction from what we should be talking about–creating jobs,” said Senator Debbie Stabenow (D-MI). “It’s very troubling that a vote to cut cancer screenings and routine care for women was what the Republicans demanded in exchange for not shutting down the government.”

“Just days after a bipartisan budget agreement, I am frustrated that the Senate will spend valuable time on a partisan measure that threatens to take away vital health services for millions of vulnerable American women,” Senator Kay Hagan (D-N.C.) said. “Last year, North Carolina Planned Parenthood facilities performed more than 11,000 breast and cervical cancer screenings and 18,000 STD tests for women who could not otherwise afford these services. I hope my colleagues will stop playing political Russian Roulette with women’s health services and instead focus on a bipartisan, comprehensive plan to reduce our long-term debt.”

“In some parts of New Hampshire, Planned Parenthood is the only provider of preventive health care services to low-income women,” said Senator Jeanne Shaheen (D-N.H.). “It’s going to be far worse for patients and more expensive for the government if we eliminate this funding.”

“The election last November was not a mandate for any one political party or ideology,” said Senator Kirsten Gillibrand (D-NY). “It was a mandate for action – for solutions that will create jobs and get our country going again.  But what are the House Republicans focused on? Not creating jobs. Not growing our economy – but an assault on the rights of women, and health services for millions of American families. These votes to defund Planned Parenthood and repeal health care reform show a disregard for women. If Republicans continue their anti-woman agenda, they will continue to find a fight in the Senate.”

Schumer: When It Comes To Tackling Rising Medicare Costs, President Did It First—And Did It Better—In Healthcare Law

Senator Says President’s Speech on Deficit Reduction Will Draw Important Contrast with House GOP

Washington, DC—Today, U.S. Senator Charles E. Schumer said the Senate would never pass the House Republicans’ budget proposal that cuts Medicare and urged the plan’s architect, Congressman Paul Ryan, to go back to the drawing board and pursue a fairer proposal.

“The Ryan budget puts the middle class last instead of first. As a result, it will never pass the Senate,” Schumer said.

Schumer said Medicare is better reformed by pursuing broader changes to the health care delivery system like the healthcare law signed by President Obama last year did.

“If we are serious about reining in Medicare spending, there is a far better starting place than the Ryan budget. It is the healthcare law passed by Congress last year,” Schumer said. “Republicans are patting themselves on the back lately for leading on entitlement reform. But when it comes to reining in the runaway costs of Medicare, the truth is, the President did it first and he did it better.”

Ryan’s budget plan, which is expected to receive a vote in the House this week, would end traditional Medicare and replace it with a voucher system that would force seniors to find private insurance. The savings from the plan would fund tax code changes that would reduce rates on millionaires and billionaires to the lowest level since Herbert Hoover’s presidency.

A full copy of Schumer’s remarks, as prepared for delivery, appears below.

U.S. Senator Charles E. Schumer

Senate Floor Remarks

April 12, 2011

As Prepared for Delivery

Madam President, I rise to discuss the issue of our budget.

Later this week, the House will vote on its FY2012 budget resolution. Congressman Paul Ryan, the author of that blueprint, calls it the “Path to Prosperity.”

Madam President, it may be a path to austerity, but it is hardly a path to prosperity.

Nonetheless, with negotiations finished just days ago on last year’s budget, Congressman Ryan has succeeded in jumpstarting the debate about next year’s.

The President himself will join this conversation about how best to do long-term deficit reduction in a major address tomorrow at George Washington University.

This is a debate we must have, and the President’s entrance to it comes not a moment too soon. It will make for a powerful contrast with the House Republicans’ plan.

The contrast we will hear from our President tomorrow will likely not be in terms of commitment to deficit reduction. Paul Ryan’s goal in his budget is to trim the deficit by $1.6 trillion over the next 10 years. He does not succeed in meeting this target, according to CBO—in fact, budget experts say his proposal only achieves $155 billion in deficit reduction—but the number itself is not the issue. Without a doubt, we must be ambitious in setting a target for deficit reduction. We cannot be gun-shy about achieving fiscal discipline.

So no, the contrast will not be about how much we seek to reduce the deficit. It will be about how we go about doing so.

The Republicans would like the looming debate to be one about numbers, but it will instead be one about priorities. And, Madam President, the Ryan budget has all the wrong priorities.

The House Republican budget puts the entire burden of reducing the deficit on senior citizens, students and middle-class families. At the same time, it protects corporate subsidies for oil companies, lets waste at the Pentagon go untouched, and would give even more tax breaks to millionaires.

In short, the Ryan budget puts the middle class last instead of first. As a result, it will never pass the Senate.

In the days since he first rolled out his budget proposal, Congressman Ryan has been hailed for taking on the tough challenges. But a closer look at his proposal shows that it is not bold at all. In leaving Pentagon spending and revenues completely untouched, Ryan’s budget hews exactly to his party’s orthodoxy. It doesn’t gore a single Republican ox. It is a rigid, ideological document.

Consider what Congressman Ryan wants to do on Medicare. In the name of ideology, Paul Ryan’s budget proposes getting rid of Medicare as it exists today and replacing it with a private system that would cut benefits.

Madam President, we’ve seen this movie before. Five years ago, President Bush tried to sell the country on a plan to privatize Social Security. The public rejected it.

Well, if you didn’t like what President Bush tried to do to Social Security, just wait until you see what Paul Ryan and the House Republicans want to do to Medicare.

Their budget plan proposes putting the Medicare system into the hands of private insurance companies. That is a recipe for disaster. It would mean an end to Medicare as we know it.

Beginning in 2022, Americans turning 65 would no longer be enrolled in Medicare, but instead receive a voucher to go shopping for their own health insurance on the open market.

Insurance companies, however, would not be required to honor that voucher, which would average about $8,000. Many private insurance plans for seniors far exceed that price already today. But under the Ryan plan, seniors who cannot find an affordable plan at the value of their voucher will simply have to make up the difference themselves.

This problem would only worsen over time as health care costs rise. Ryan caps Medicare’s spending at the level of inflation even though historically, healthcare costs rise higher than that. As Ryan’s voucher covers a smaller and smaller fraction of actual healthcare costs, seniors would have to cover the gap out-of-pocket.

This is why Alice Rivlin, a Democrat and President Clinton’s former OMB Director who worked with Ryan on his approach for a time, has distanced herself from his final product. She told the Washington Post that she opposes the Ryan plan. She has said: “In the Ryan version, he has lowered the rate of growth and I don’t think that’s defensible. It pushed too much of the cost onto the beneficiaries.”

Other Medicare experts agree with Rivlin. Stephen Zuckerman, a health care economist at the non-partisan Urban Institute said, “The most serious flaw is that the focus of this approach is on limiting federal spending on Medicare, without being concerned about the potential of this change to shift costs to Medicare beneficiaries.”

A better way to rein in Medicare spending would be to trim waste and inefficiency out of the delivery system. But it turns out that Ryan’s plan not only does nothing to reduce overall health care costs, it increases them.

According to the non-partisan Congressional Budget Office, in 2030, traditional Medicare insurance would cost just 60 percent of a private policy purchased with Ryan’s proposed voucher. In other words, the Ryan health care plan would cost two-thirds more than traditional Medicare.

Not only would the Ryan plan increase insurance costs, it would force seniors to shoulder a higher share of those costs.

CBO said, “Under the proposal, most elderly people who would be entitled to premium support payments would pay more for their health care than they would pay under the current Medicare system.”

How much more, Madam President? It is staggering when you look at the numbers. Under the current system, the average senior on Medicare in 2022 will contribute about 25 percent of the cost of their healthcare. CBO found that under the Ryan plan, the share paid by seniors would go up to 68 percent.

This is a crippling burden that would drive the average Medicare recipient into poverty. It is not only too much to ask of our seniors, it destroys the foundation of our healthcare system.

The bottom line is, the House Republican budget would cause the cost of health insurance to rise, and then would make seniors pay a greater share of that higher cost. It is a cut in benefits, plain and simple.

If we are serious about reining in Medicare spending, there is a far better starting place than the Ryan budget. It is the healthcare law passed by Congress last year.

Republicans are patting themselves on the back lately for leading on entitlement reform. But when it comes to reining in the runaway costs of Medicare, the truth is the President did it first and he did it better.

In the healthcare law, Madam President, we made a good start on reducing waste, inefficiency, and duplication in the system. We started down the path of making delivery system reforms. We set up a system for studying the effectiveness of different methods and treatments so that care could be delivered more efficiently. We made a down payment on shifting the larger healthcare system away from a fee-for-service model towards a system that pays providers for episodes of care.

The Ryan proposal adopts none of these cost-cutting approaches. In fact, his budget calls for the repeal of the healthcare law altogether. Left unsaid is that this would have a side effect of re-opening the donut hole, another hit to Medicare beneficiaries.

Now, if the Ryan budget’s only goal was to end Medicare, that would be ample enough cause to work tooth and nail to defeat it. But the Ryan budget doesn’t even put most of its savings from ending Medicare towards deficit reduction. Instead, it puts the savings towards further tax breaks for the wealthiest Americans.

That’s right, Madam President. Ryan’s budget not only seeks to permanently extend the Bush tax cuts for millionaires. He wants to cut their taxes even lower than the Bush levels.

As unbelievable as it sounds, he wants to give millionaires and billionaires an extra tax break.

Ryan’s budget proposal would bring the top rate down from 35 percent to 25 percent. This would make for the lowest level since 1931 when Herbert Hoover was President.

This is the trade Congressman Ryan proposes we make: cut Medicare benefits for seniors so we can afford to give millionaires an extra tax break.

This is the exact opposite of what the public wants. They don’t think millionaires and billionaires should even be getting George Bush’s tax cut, let alone an extra one atop that.

In last month’s NBC/Wall Street Journal poll that asked Americans what proposals they most support to reduce the deficit, 81 percent of Americans said they would support a tax on millionaires. This was the highest-polling answer. One of the lowest-polling answers was—you guessed it—cutting Medicare benefits. So the Ryan budget has its priorities completely upside down.

Now, you may ask if Congressman Ryan puts all his savings from cutting Medicare into millionaire tax breaks, how does he propose to achieve any deficit reduction?

The answer is, by targeting the programs most important to middle class Americans. It turns out that the Republican plan to end Medicare is also a plan to end other important programs.

For example, the Republican plan to end Medicare is additionally a plan to cut tens of thousands of teachers. And the Republican plan to end Medicare is additionally a plan cut Head Start for kids. The Republican plan to end Medicare is additionally a plan to cut medical research on diseases like cancer. And the Republican plan to end Medicare is additionally a plan to cut clean energy projects that create jobs and help us become energy independent.

In all, the Ryan plan assumes a steady squeezing of government until by 2050, the total cost of everything save for Social Security and health care is shrunk from 12 percent of GDP to just 3 percent.

But he doesn’t spell out a single detail of how to achieve those cuts. He has a number, but no specifics. That is the definition of a meat axe approach as opposed to a smart, sharp scalpel.

But even though Ryan doesn’t spell out where the cuts would come from to meet his goal, it isn’t a total mystery. We can fill in the blanks. The just-completed debate on the FY2011 budget offers plenty of hints what the Republican approach to cutting spending is.

In the budget debate we just had, Republicans wanted to cut the very programs that create good-paying jobs and help the middle class. They targeted everything from cancer research to financial aid for college.

We fended off many of their worst cuts by successfully pushing to include $17 billion in cuts from the mandatory side. We also got them to agree to reduce Pentagon spending by nearly $3 billion compared to their original budget.

This was not the Republicans’ preferred way to reduce the deficit. Because of ideology, they disproportionately targeted the domestic discretionary part of the budget for cutting, even though it only represents only 12 percent of the total budget.

But our deficit problems weren’t caused by Head Start and cancer research, and we won’t fix them by going after Head Start and cancer research. In the budget debates to come, we need to broaden the playing field beyond domestic discretionary spending.

It should include, for instance, waste in the Department of Defense. The Pentagon makes up half of the discretionary side of the budget, but Republicans continue to treat it as off-limits. Ryan himself leaves it virtually untouched, save for a symbolic trim. To say there isn’t waste at the Pentagon like there is waste elsewhere in the budget is absurd.

The bottom line is, any budget that leaves defense and revenues off the table is ultimately not serious. We need an “all of the above” approach that puts all parts of the budget on the table. A dollar cut from mandatory spending or the Pentagon is just as good as a dollar cut from non-defense discretionary spending.

Deficit reduction is an important goal, but the sacrifice must be shared. The Ryan budget fails that test.

This Democratic Senate will not stand for any proposal that seeks to balance the budget on the backs of the middle class and seniors.

I look forward to hearing the President’s remarks tomorrow. As for Congressman Ryan, I would encourage him to go back to the drawing board and come up with a fairer, more balanced plan.

Thank you and I yield the floor.

“My wife and I have been married for more than 50 years.  We have one daughter and nine granddaughters.  I love these women.

“One day, one of them may need a cancer screening.  It’s not a pleasant thought, but that’s the reality of life.  Over their lives they’ll also need other tests like cholesterol and blood pressure screenings – tests that are less serious, but just as important.

“They should be able to get the tests that could save their lives.  So should every single woman in America.  I believe that – and frankly, that’s not so controversial of a belief.

“Some women, of course, have doctors.  Others, including many of the poorest among us, do not.  So where do they go to get blood pressure or cholesterol or cancer screenings?

“Thankfully, there is a little-known part of a little-known law that saves many lives.  It’s called Title X, and it’s part of a public health law.  And it means that women and girls can go to their local health department or a community clinic and get these tests.  More than five million women use centers funded by Title X every year.  Five million.

“Some watching us today – and we know the whole world is watching – may be asking why I’m talking about women’s health.  When the question before us is the budget of the biggest economy on the planet, some may ask why we’re talking about this smallest corner of it.

“With a government shutdown looming not weeks away, or days away, but just hours away – why are we talking about whether women can keep getting something as simple and as non-controversial as cancer screenings?

“The answer is that Republicans want to shut down our nation’s government because they want to make it harder for women to get the health services they need.

“And by the way, that does not include abortion.  It is illegal to use federal funds for abortion services.  So anyone who says this debate is over abortion isn’t being truthful.  It is about simple and important health services.

“Republicans want to shut down the government because they think there is nothing more important than keeping women from getting cancer screenings?  That is indefensible, and everyone should be outraged – women and men.  Republican leaders in the House have only a few hours left to look in the mirror, snap out of it and realize how positively shameful that would be.

“For months, this conversation has been about billions and trillions of dollars.  It has been about weighty issues and difficult decisions.  This debate used to be about saving money.

“No longer.  We have an agreement on the cuts and savings.  And that agreement includes a historic level of cuts.

“But now the Tea Party is trying to sneak through its extreme social agenda – issues that have nothing to do with funding the government.  They are willing to throw women under the bus, even if it means they’ll shut down the government.

“Their agenda is an extreme agenda.  I don’t agree with their ideas on social policy.  But in our democracy, those ideas, however radical, deserve a debate if they want one.

“But that debate does not belong in an urgent budget bill to keep the country running.  And it especially doesn’t belong here at this late hour.

“The consequences of letting our country’s funding expire would be devastating.  It would be devastating to our troops, to our small businesses and to Americans’ everyday lives – people who just want to get a home loan or get their tax refund or get their paycheck.  It would damage our image and credibility around the world.

“But Republicans are asking me to sacrifice my wife’s health, my daughter’s health and my nine granddaughters’ health.  They’re asking me to sacrifice the health of women in Nevada and across America.  I won’t do it.

“As a legislator, I’m frustrated.  And as an American, I’m appalled.  As a husband, a father and a grandfather, I’m personally offended.”

Sen. John Ensign: “We Just Have To Look At What We Can Do, What Is Achievable.” According to the Las Vegas Review-Journal, “Ensign said that while he opposes abortion, Republicans ‘have to face reality. The Democrats are in control of the Senate, in the White House. The Democrats will never allow to defund Planned Parenthood while they are in charge.’ ‘We just have to look at what we can do, what is achievable,’ Ensign said, ‘and right now I think one of the biggest moral issues that we face in this country is the debt.’” [Las Vegas Review-Journal, 4/8/11]

Sen. Pat Toomey: “There Are Other Bigger Battles We Can Be Fighting.” According to The Hill, “Republicans should ‘move on’ from insisting on defunding Planned Parenthood in a 2011 spending bill, a Republican senator said Friday. With less than 24 hours to go until a shutdown, Sen. Pat Toomey (R-Pa.) suggested that a rider to defund Planned Parenthood, a key sticking point in reaching an agreement, was expendable. ‘[We] just need to recognize,’ Toomey said on MSNBC. ‘We should aggressively go for everything we can get and move on’ … He said Republicans should be prepared to ‘move on, because there are other bigger battles we can be fighting.’” [The Hill, 4/8/11]

Sen. Johnny Isaakson: “If We Have Some Differences On Policy, Reserve Those On The Debate For The 2012 Budget Appropriations Act And Let’s Get Moving.” “It is time that we got the current agreement and I understand there is one on how much we cut done. If we have some differences on policy, reserve those on the debate for the 2012 budget appropriations act and let’s get moving everybody here — get moving.” [Congressional Record. 4/8/11]

Sen. Ron Johnson: “Get Past This Year’s Budget.” According to Roll Call’s David Drucker, “Tea Party fav Sen Ron Johnson (R-WI):’We need 2 get past this year’s budget & move’ 2 Rep Ryan’s fiscal ’12 budget plan.” [Roll Call, via Twitter, 4/8/11]

Sen. Mark Kirk: “Republicans Should Give On … The Extraneous Policy Riders So That Government Does Not Shut Down.” According to the Chicago Sun-Times, “With a shutdown looming, Illinois Republicans Sen. Mark Kirk and Rep. Mark Dold are on a conference call now–it started after 5 p.m. est–and each said Planned Parenthood should not be 100 percent defunded; Said Kirk, ‘Democrats should give on spending proposals because we need more discipline and Republicans should give on the the extraneous policy riders so that government does not shut down,’ a reference to the House GOP move to defund Planned Parenthood’s women health services. A shut down could still be averted, Kirk said. ‘There is precious little distance between the President and the Speaker over spending,’ Kirk said.” [Chicago Sun-Times, 4/8/11]

“This debate used to be about saving money. That is no longer the case.

“The Tea Party is trying to push through its extreme social agenda – issues that have nothing to do with funding the government.

“We are very close on the cuts and how we make them.  The only things – I repeat, the only things – holding up an agreement are women’s health and clean air.

“And what’s worse – when we were on the verge of an agreement, Republicans changed their tune overnight.

“This is the question: Do they really want to shut down the government because they want to make it harder for a woman to get a cancer screening?

“Do they really want to shut down the government because they don’t want scientists to make sure we can all breathe clean air?

“This is an extreme agenda that has no place in this bill. This is a budget.

“This is a bill to keep the country running. It’s not a women’s health bill. It’s not an environmental bill.

“We will not solve in one night disagreements this country has been having for 40 years. That is not realistic. Right now, we have to be realistic.

“While the Tea Party cheers for a shutdown – and I mean that literally – we will keep trying to reach an agreement.

“We have been reasonable. We care about the people a shutdown would hurt. We won’t stop working to avoid a shutdown.

“But we can’t do it alone. We have one day left. This isn’t the time – and we don’t have the time – to fight over the Tea Party’s extreme social agenda.

“This is the time to come together to keep the country running.”

Senator Susan Collins Supported Title X, Against House GOP Cuts To Program. Collins spokesman Kevin Kelley said, “Sen. Collins is a longtime supporter of the Title X family planning program, and she believes the House’s decision to completely eliminate the funding is unwise, The program has successfully reduced the number of unplanned pregnancies, therefore helping to reduce health care costs. Planned Parenthood receives Title X funding, which is defunded in the Republican spending bill. Planned Parenthood defunding was the subject of a separate amendment to the spending bill sponsored by Rep. Mike Pence (R-Ind.).” [Politico, 3/11/11]

Senator Olympia Snowe Called It A “Step Too Far” To Defund Planned Parenthood. Snowe said, “While confronting our serious economic challenges and fiscal realities will require difficult decisions to reach more sustainable levels of government spending, the outright elimination of funding for Planned Parenthood and Title X is a step too far and would have a significant impact on access to the preventive services and screenings that have benefited millions of women nationwide.” [The Hill, 3/27/11]

Senator Mark Kirk Has Always Supported Planned Parenthood. According to theThe Hill newspaper Senator Mark Kirk “has always supported Planned Parenthood and family planning efforts,” when looking at which Senators would not support the Pence Amendment. [The Hill, 3/27/11]

Seven House Republicans Voted Against Pence Amendment. Representatives Charlie Bass, N.H., Judy Biggert, Ill., Mary Bono-Mack, Calif., Charlie Dent, Pa., Robert Dold, Ill., Richard Hanna, N.Y., Rodney Frelinghuysen, N.J. voted against the Pence Amendment to H.R. 1 to defend Planned Parenthood. [Vote 93, 2/18/11]

·         Congressman Bass Said Title X Protects Health Of Woman, Against GOP Cuts. “Bass recently went against the majority of his party with a vote to preserve funding for Title 10 programs, which include Planned Parenthood. Bass was one of seven House Republicans to vote that way, but was on the losing side. ‘Title 10 does a lot of important functions to protect the health of young women in our society and I didn’t think it was appropriate to cut that fund to zero,’ Bass said.” [Keene Sentinel, 2/26/11]

·         Congressman Richard Hanna Called Cuts “Draconian,” Hopes Will be Restored. “You really have to hope that at the end of the day that this was part of the process, and that most of the draconian cuts will be restored as part of a compromise,” Hanna said. ‘I like National Public Radio. I don’t want to cut public television. I didn’t want to cut health care provided through Planned Parenthood.’” [The Post Standard, 2/20/2011]

·         Congressman Dold Called Defunding Planned Parenthood “Shortsighted.” “Dold went so far as to publicly voice his opposition to the Pence amendment on the House floor during last month’s debate, becoming the only one of the Republican dissidents to do so. He said blocking funding for Planned Parenthood would be ‘shortsighted and would negatively impact the lives of women who depend on these health care services.’” [Roll Call, 3/2/11]

·         Congresswoman Bono Mack Said Cutting Funding For Planned Parenthood Is A Big Mistake. Bono Mack said, “The Pence Amendment cuts off federal funding to Planned Parenthood for all services-not just abortions. I believe that is a big mistake and represents a threat to the health of tens of thousands of American women. Breast cancer screenings, pelvic exams, HPV tests and scores of other vitally important health care services-services that save lives-would be unfairly impacted.” [The Daily Best, 3/12/11]

“We’re now 38 hours away from the deadline.  We have fewer than two days to put politics aside, put the American people first and reach an agreement.

“Last night, Speaker Boehner and I met again with the President.  We met for more than an hour and a half.  The meeting was adequate.

“Then we worked through the night – my staff and the President’s people continue to work together.

“We are very close on the numbers.  Our differences are no longer over how much savings to get out of government spending.

“The only thing – the only thing – holding up agreement is that the Republicans are drawing the line on ideology.

“The Republicans are insisting on extraneous restrictions on women’s health in the name of abortion.  They want to roll back the Clean Air Act.

“These matters have no place on a budget bill.  This is a bill to keep the country running.  It is not a family planning bill or an environmental bill.

“The bottom line is this: I can see us sitting down at the negotiating table and coming away with an agreement on numbers.

“But no one can realistically think that we will walk out of a room and suddenly agree to roll back women’s access to health care or protections for the environment.  We will not solve in one night a disagreement this country has been having for four decades.  That’s not realistic.

“Right now, we have to be realistic.  We cannot be distracted by ideology.

“Speaking of distractions, the House is going to pass a short-term stopgap today.  As I said here last night, that is a non-starter in the Senate.

“It’s not just bad policy – it’s fantasy.  We all heard the President say that he won’t accept anything short of a full solution.

“The President is right.  We can’t keep funding the country with one stopgap after another.  The United States of America shouldn’t have to live paycheck to paycheck.”

“This budget proposal is more proof that Republicans have declared war on Medicare and Social Security, programs on which millions of seniors in Nevada and across the country depend. Americans rejected President George W. Bush’s attempt to privatize Social Security, and they will reject this latest plan from Republicans to end Medicare as we know it. The Republican’s plan is a boon to insurance companies at seniors’ expense. While we must cut wasteful spending and excess, Nevadans cannot afford this irresponsible proposal that will force seniors to pay more for health care at the same time that it gives tax breaks to millionaires and billionaires and protects government giveaways to big oil companies and corporations that ship American jobs overseas.”

REPUBLICAN PLAN TO SHUTDOWN MEDICARE WILL RAISE SENIORS’ PREMIUMS AND CUT BENEFITS FOR MORE THAN 20 MILLION AMERICANS

Democrats want to cut federal spending and require government to live within its means, and favor a responsible approach to reducing the deficit that will strengthen our economy.  The new Republican budget reflects upside-down priorities – it protects special interest subsidies and tax breaks for those at the top, and cuts deep into the heart of the programs that are essential to the health of our seniors.  The Republican budget ends Medicare as we know it– converting it into a voucher-type program. While providing a windfall for the health insurance industry, it would force seniors to pay much more for health care. If Republicans get their way, premiums for more than 20 million seniors will skyrocket and they will all lose their guaranteed health benefits. Democrats are committed to protecting Medicare benefits for all, and are focused on cutting waste, fraud and abuse in Medicare without hurting seniors.

20 Million Near-Elderly Will Not Have Medicare When They Retire. Starting in 2022, Medicare will be eliminated for new beneficiaries and converted instead into a voucher program.  There are more than 20 million near-elderly Americans who are now ages 50-54 who would not get Medicare when they retire but instead only get a coupon to purchase private health insurance.  This approach would transfer control of Medicare to insurers and there would be no guaranteed benefits, essentially ending Medicare.  Moreover, the voucher will fail to keep pace with increases in the cost of health care so its value will decline every year, meaning that future seniors won’t be able to get the benefits they need or even end up uninsured.  [CBPP 3/22/11; Census 2010 data]

CBO: Voucher Proposal Will Double Health Care Costs for Seniors. The voucher will fail to keep pace with increases in the cost of health care.  As a result, seniors will be forced to pay higher premiums in order to access the same benefits they would receive under the current system.  According to the CBO, a typical senior will spend more than twice as much of his or her own income on health services under the Ryan proposal as compared to the current Medicare system. [CBO, 4/5/11]

Under the Republican Plan, Seniors Will Lose Guaranteed Benefits. Under current law, all seniors have guaranteed access to life-saving health benefits, including screenings for colon cancer, diabetes, and prostate cancer, as well as flu shots.  If the Republican plan becomes law, seniors that were eligible for guaranteed health benefits last year could lose their benefits. [Kaiser State Health Facts, accessed on 3/31/11]

Republican Proposal Could Force Seniors to Pay $3,500 More for Prescription Drugs. The proposal would “reopen” the prescription drug donut hole, requiring that seniors pay full price for prescription drugs.  As a result, on average, seniors would pay $3,500 more for their medications over the next ten years.  Seniors and people with disabilities who have high prescription drug costs could pay an additional $12,300 over the next 10 years. [HHS, 11/4/10]

CBO: Ryan Plan Means “Most Elderly People Would Pay More For Their Health Care.” In their initial analysis of the Ryan Medicare plan, the non-partisan Congressional Budget Office determined, “Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system… Under the proposal, the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the traditional program…That greater burden would require them to reduce their use of health care services, spend less on other goods and services, or save more in advance of retirement than they would under current law.” [CBO, 4/5/11]

Wall Street Journal: Ryan Plan Would Mean “Higher Out-Of-Pocket Costs And Greater Limits To Coverage.” “The House Republican plan for overhauling Medicare would fundamentally change how the federal government pays for health care, starting a decade from now, likely resulting in higher out-of-pocket costs and greater limits to coverage for many Americans. … House Budget Committee Chairman Paul Ryan’s solution is to end the current Medicare program for people born in 1957 and after.”  LINK

Associated Press: CBO: GOP Budget Raises Health Costs For Retirees. “Most future retirees would pay more for health care under a new House Republican budget proposal, according to an analysis by nonpartisan experts for Congress that could be an obstacle to GOP ambitions to tame federal deficits.” LINK

Reuters: Ryan Plan Would “Shift Healthcare Costs To Elderly Recipients.” “The non-partisan Congressional Budget Office, in its analysis of the Ryan budget, cautioned that some of the Medicare proposals would shift healthcare costs to elderly recipients. Similarly, Medicaid changes would shift some costs to the states, which already are cash-strapped.” LINK

USA Today: GOP “Taking A Huge Political Risk,” Privatized Medicare “Would Cost Beneficiaries More Or Offer Them Less.” “Republicans unveiled a budget-cutting plan Tuesday that would dramatically revamp the twin health care pillars of the Great Society, taking a huge political risk that could reverberate all the way to November 2012 and beyond.Medicare, the government-run health insurance program covering about 47 million seniors and people with disabilities, would be run by private insurers and would cost beneficiaries more, or offer them less. Medicaid, the federal-state program covering more than 50 million low-income Americans, would be turned over to the states and cut by $750 billion over 10 years, forcing lesser benefits or higher co-payments. Social Security eventually would be cut, too.” LINK

Washington Post: Ryan Plan Would “End Medicare” As We Know It. “House Republicans announced a far-reaching vision for a leaner federal government on Tuesday, presenting a 2012 budget blueprint that would privatize Medicare for future retirees, cut spending on Medicaid and other domestic programs, and offer sharply lower tax rates to corporations and the wealthy… Starting in 2022, Ryan also would end Medicare as an open-ended entitlement for new retirees and begin slowly raising the age of eligibility from 65 to 67.” LINK

Politico: Prominent Expert Cited By Ryan As Validator Does Not Back His Plan. “Rep. Paul Ryan (R-Wis.) touted the help of former Clinton adviser Alice Rivlin — ‘a great, proud Democrat’— in promoting a key Medicare provision in his budget proposal Tuesday. The only problem? Rivlin said she told the Republican she doesn’t support the final version of the measure he wrote into his budget — a provision Ryan referred to generally as the ‘Ryan-Rivlin’ plan when rolling out his sweeping economic blueprint. ‘We talked fairly recently and I said, ‘You know, I can’t support the version that you have in the budget,’ Rivlin said in an interview with POLITICO. ‘I don’t actually support the form in which he put it in the budget.’” LINK

Los Angeles Times: Ryan Plan “Would Force Seniors To Pay More For Their Healthcare.” “The largest savings in their plan would come from slashing popular programs that cover about 100 million Americans. The GOP proposal would phase out direct payments to doctors and hospitals under Medicare, scale back the Medicaid program for the poor and disabled, and throw out government insurance subsidies that the new healthcare law is to make available to millions of Americans starting in 2014. That would force seniors to pay more for their healthcareand would likely make states cut back their Medicaid programs, the Congressional Budget Office concluded.” LINK

Roll Call: Ryan’s Plan “Would Still Add More That $8 Trillion To The National Debt.” “House Budget Chairman Paul Ryan’s budget blueprint released Tuesday morning cuts $6.2 trillion in spending and $1.8 trillion in taxes relative to President Barack Obama’s 10-year plan, setting up a major clash over Medicare, Medicaid and domestic spending.Still, while the plan envisions paying off the national debt sometime after 2050 principally by squeezing spending on health care and other programs, it would still add more than $8 trillion to the national debt over the next decade — reaching $23 trillion in 2021. Indeed, the plan does not come close to balancing the budget in any year over that span.” LINK

Dana Milbank, Washington Post: Ryan’s Proposal “Isn’t A Serious Budget,” “Fails At The Central Mission Of Ending The Deficit.” “The document released by the chairman of the House Budget Committee isn’t a serious budget proposal because it fails at the central mission of ending the deficit and taming the debt. Without question, Ryan makes some severe cuts: Taking hundreds of billions of dollars from Medicaid, ending the Medicare entitlement,and slashing planned spending on transportation, energy, education, veterans benefits, agriculture payments, counterterrorism and more. Yet for all these cuts, the Republicans’ plan increases the federal debt by more than $8 trillion over the next 10 years, and it continues federal budget deficits until nearly 2040. Under the proposed balanced budget amendment to the Constitution that Ryan and his Republican colleagues claim to support, Ryan’s budget wouldn’t be in compliance for at least the next quarter century.” LINK

Kaiser Health News: CBO: Seniors Would Pay Much More For Medicare Under Ryan Plan. “Seniors and the disabled would pay sharply more for their Medicare coverage under a new plan by House Republicans aimed at curbing the nation’s growing deficit, a Congressional Budget Office analysis shows. For example, by 2030, under the plan, typical 65 year olds would be required to pay 68 percent of the total cost of their coverage, which includes premiums, deductibles, and other out-of-pocket costs, according to CBO.  That compares with the 25 percent they would pay under current law, CBO said. The GOP budget proposal also would raise the eligibility age for the politically popular program – and repeal big chunks of the health care overhaul law approved by Congress last year.” LINK

Talking Points Memo: Paul Ryan’s Absurdly Optimistic Budget Projections Draw Widespread Ridicule. “Even as Rep. Paul Ryan (R-WI) proudly touted his ‘fact-based budget’ and decried Democrats’ ‘budget gimmicks’ yesterday, he prominently cited the think tank’s absurdly rosy numbers, drawing widespread mockery from economists, budget experts, and health care wonks. Even the developer of the model that Heritage used to crunch the numbers can’t figure out how Heritage reached its conclusions. ‘The Heritage numbers are insane,’ MIT economist Jonathan Gruber said in an interview with TPM. As Paul Krugman put it, Heritage’s take ‘depends an awful lot on unicorn sightings — a belief in the impossible.’” LINK

Politico: Ryan’s Plan A Predicament For GOP. “Either a sudden surge of studiousness is sweeping through battleground districts, or these Republicans can smell the danger. There’s plenty of reason to be cautious: An NBC News/Wall Street Journal poll last month showed fewer than a quarter of Americans supported cutting funds for Medicare and fewer than a third wanted to cut Medicaid — numbers that Republican pollster Bill McInturff called a ‘huge flashing yellow sign to Republicans.’” LINK

National Journal: GOP Hopefuls “Walking a Political Tightrope” Away from “Radical” Medicare Cuts. “Nowhere are the reforms more radical than on Medicare, and already the field of prospective Republican presidential candidates is walking a political tightrope in reaction to Ryan’s sweeping proposal to convert Medicare into a voucher-based system for people younger than 55. … a clear position on the Medicare reform proposal in 2011 could sink them and the party’s chances in 2012.” LINK

“In order to protect our long-term economic growth, we must get serious about cutting federal spending and ensuring the government lives within its means. However, a plan that puts our seniors’ safety and health at risk is not a plan about long-term security, but about political ploys and instigating fear. If Republicans would join me and my colleagues at the table, I am confident that we could get a real budget plan that not only reduces our deficit, but also ensures that the economy is growing, businesses are thriving and our seniors are protected.”

“The Ryan Republican budget has three pillars: reduce Medicare benefits by more than half; reduce Medicaid benefits for seniors in nursing homes; and reduce taxes on the wealthiest Americans. America can resolve its budget crisis without punishing the elderly and poor while rewarding the very rich.”

Full analysis:

http://www.cbo.gov/ftpdocs/121xx/doc12128/04-05-Ryan_Letter.pdf

“Independent experts agree the House Plan would make deep cuts to the Medicare benefits seniors count on. It would end Medicare as we know it and funnel Medicare dollars directly into private insurance companies’ pockets.  Under the House plan, seniors’ coverage would be cut drastically, benefits would no longer be guaranteed and seniors’ costs would skyrocket.  We can’t allow the House to balance the budget on the backs of seniors and we won’t – not on my watch.”

“Shutting down government is apparently not enough, now Republicans have taken aim at shutting down Medicare as we know it. The bottom line on the Republican plan is that it would dismantle Medicare for tens of millions of Americans. I’m also deeply concerned that the Republicans’ budget seeks to meet their ‘moral obligation’ to cut the deficit by cutting health care for children on Medicaid. We must do everything we can to responsibly reduce our nation’s debt and keep our economy on the path to prosperity, but we draw the line at penalizing seniors and children for an economic mess they did not create.”

“This morning one of my friends said that passing the health care bill was a miracle in his life and his family’s life. Those are his words, not mine,” Nevada Sen. Harry Reid said today on the Senate Floor. “They could not find insurance for their child who developed diabetes. Because of the health care bill, that child is fully insured now. That’s what the health care bill is about.

“Hundreds of thousands of students have health insurance because their parents have health insurance. The IRS sent notices to 4.4 million small businesses in America to let them know that they may qualify for reduced insurance premiums. And exchanges are being set up in Nevada and across the country that will mean every American has access to insurance plans similar to the ones members of Congress have. The health care bill is a milestone in the history of this country.”

Reid said Republicans who want to repeal health care reform also want to strip away those benefits, which have proven popular with people in Nevada and across America. Their plan would put Americans’ care back in the hands of big insurance companies, whose only concern is their bottom line.

In addition to costing small businesses and middle-class families, repealing the Affordable Care Act would also balloon our deficit.  In fact, the Congressional Budget Office estimated the law will reduce this country’s debt by $1.3 trillion–a savings that would disappear if Republicans get their way.

Myth: Health reform will cost $2.6 trillion over a ten year period

Reality: The nonpartisan analysis from CBO estimates that the Affordable Care Act will cost $930 billion and reduce the deficit by $210 billion over a ten year period.[CBO, 2/18/2011]

Republicans contend that CBO utilized a number of “gimmicks” to underestimate the cost of the law, overestimate the savings, and therefore misrepresent its impact on the budget.  Senate Republicans have gone as far to claim that the law will cost close to three times the CBO estimate, $2.6 trillion over a ten year period, and add $701 billion to the deficit. [GOP Report, 2/7/2011]  Republicans are misrepresenting facts and their claims are unfounded.  This DPCC Fact Sheet aims to address their most commonly cited arguments regarding the cost of the law.

Republicans incorrectly claim that CBO double-counts savings to Medicare. Republicans contend that CBO counts savings to Medicare both for extending the solvency of the Hospital Insurance (HI) trust fund and reducing the impact of new programs on the deficit.  As a result of their interpretation, Republicans claim that $398 billion in CBO projected savings are erroneous. [GOP Report, 2/7/2011]

• The Affordable Care Act slows the growth in Medicare spending while simultaneously extending the solvency of the HI trust fund for an additional 12 years.  [Berwick, 8/5/2010]
• In the past, CBO projected Medicare savings to both extend the solvency of Medicare and reduce the deficit for the Balanced Budget Act of 1997 and the Deficit Reduction Act of 2005.  The Republican controlled Congresses did not object to CBO scoring at that time or suggest that CBO was double-counting savings to Medicare [Center on Budget and Policy Priorities, 3/25/2010]

• The Center on Budget and Policy Priorities reiterated this point before the House Committee on the Budget:  “There’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds.  In the same way, when a baseball player hits a homer, it both adds one run to his team’s score and also improves his batting average.  Neither situation involves double-counting.”  [Center on Budget and Policy Priorities, 1/26/2011]

Republicans add the cost of permanently fixing the sustainable growth rate (SGR), commonly known as the “Doc Fix,” to the overall cost of the Affordable Care Act.As a result, Republicans add $208 billion to the cost of the law. [GOP Report, 2/7/2011]

• Over the past eight years, Republicans and Democrats have repeatedly enacted a number of temporary fixes for SGR.  These temporary fixes have historically been bipartisan efforts to ensure that seniors and military families have continued access to healthcare services.
• In 2003, President Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act into law following passage by a Republican Congress.  Although the law included a temporary SGR fix, Republicans did not include the cost of the fix as part of the new law. [CBO, 7/21/2004]
• On December 10, 2010, the Senate passed a one-year SGR fix costing $14.9 billion by unanimous consent.  [CBO, 12/7/2010] The House passed the same bill by a vote of 409 to 2 and the President signed it into law on December 15, 2010.
• Without any precedent, Republicans add the cost of permanently fixing SGR to the cost of the Affordable Care Act.  This cost would be incurred with or without health reform. If the Affordable Care Act had not been enacted, Democrats and Republicans still intended to fix SGR.
• Since 2007, when Democrats took control of Congress, every temporary SGR fix has been paid for with mandatory savings or revenue increases. Republicans are wrong to assume that the SGR costs should be added to the Affordable Care Act without assuming commensurate savings.
• During an interview with Ezra Klein, Rep. Paul Ryan reiterated his commitment to fix SGR, “Oh yeah! I think we should fix the thing. Don’t get me wrong.” [Ezra Klein, 3/5/2010] Rep. Ryan voted for the one-year SGR fix with 188 of his Republican colleagues less than ten months later. In fact, Rep. Ryan voted for temporary SGR fixes five times. [Ezra Klein, 3/5/2010]

Republicans exaggerate the costs of implementing and administering the Affordable Care Act.Republicans contend that an additional $115 billion over ten years will be required in discretionary spending to fully implement and administer the Affordable Care Act. [GOP Report, 2/7/2011]

• Republicans are selective in their interpretation of a CBO analysisregarding the discretionary funds required to implement Affordable Care Act.  Although the CBO analysis states that the law will require an additional $100 billion in discretionary funding over ten years, the analysis includes $85 billion are for “activities that were already being carried out underprior law or that were previously authorized and that PPACA authorized forfuture years.” [CBO, 2/18/2011]  Therefore, the law will require an additional $1.5 billion each year in discretionary funds, not $10.5 billion as the Republicans contend.

Republicans make misleading claims about the Community Living Assistance Services and Support (CLASS) program.CBO projects that the CLASS program will reduce the deficit by $86 billion between 2012-2021. [CBO, 2/18/2011]  These savings are a result of generating more revenue from premiums than spending on benefits.  Republicans contend that the program is not fiscally responsible because, over time, the surpluses initially generated by these additional revenues will be used to pay benefits.    They also claim that the program is not actuarially sound.  Both claims reflect misunderstandings about the program.

• The law is explicit in stating the CLASS program must be able to pay for benefits over the long-term only using the premiums it takes in.  Secretary Sebelius reiterated, “No taxpayer dollars will be used to pay for CLASS benefits.  This is non-negotiable, and it has been the starting point for every conversation we’ve had about this program.” [Kaiser Family Foundation, 2/7/2011]
• During debate on the legislation, CBO assumed premiums would be set to ensure the CLASS program is actuarially sound. To provide additional guarantees of its soundness, Secretary Sebelius and her team are currently considering a number of regulatory modifications—including adjusting the work and income eligibility requirements—to ensure that the program will be on solid financial footing.
• While today they complain about a program that will require not a single taxpayer dollar, many Republicans, in 2003, led an effort to expand health coverage while increasing the deficit: CBO scored the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 as adding $395 billion to the deficit during a ten year period.

This DPCC Fact Sheet addresses some of the flawed arguments made by Republicans to incorrectly increase the cost of the Affordable Care Act to $2.6 billion.  Please find additional resources related to these and other arguments below.

Center on Budget and Policy Priorities: http://www.cbpp.org/cms/index.cfm?fa=view&id=3134

Factcheck.org: http://factcheck.org/2011/01/a-budget-busting-law/

Ezra Klein: http://voices.washingtonpost.com/ezra-klein/2010/03/the_true_cost_of_the_health-ca.html

Myth: Health reform will kill 800,000 jobs over a ten year period

Reality: Independent, nonpartisan analyses demonstrate that ACA will grow our economy, empower small businesses, and benefit families.

Republicans are blatantly misrepresenting CBO Director Douglas Elmendorf’s recent testimony before the House Ways and Means Committee, claiming that the Affordable Care Act will “kill” jobs. Republicans are twisting his testimony for political gains. [GOP Report, 2/7/2011] These tactics come after months of Republicans ignoring other CBO projections demonstrating the benefits of the law, including that it will reduce the deficit by $210 billion between 2012 and 2021. [CBO, 2/18/2011]

I. Clarifying CBO Projections

The CBO analysis is more nuanced than the Republicans have articulated.CBO projects that that the Affordable Care Act will slow the growth rate of health care costs while providing access to affordable insurance coverage for individuals, families, and small businesses.  Because less of their hard-earned income will go to pay their insurance premium, the CBO tells us that millions of Americans will have increased financial resources by 2021.  Since they’ll be able to keep more of their own money, rather than paying it out in insurance premiums, some individuals may have decide to leave the labor market earlier than initially anticipated. [CBO, 8/1/2010]

• “The Congressional Budget Office (CBO) estimates that the legislation, on net, will reduce the amount of labor used in the economy by a small amount—roughly half a percent—primarily by reducing the amount of labor that workers choose to supply.” [CBO, 8/1/2010]

For the segment of the population considered in the CBO projection, the amount of labor that workers choose to supply will be impacted by subsidies reducing the cost of health insurance obtained through the state exchanges and the expansion of Medicaid eligibility.

• “The expansion of Medicaid and the availability of subsidies through the exchanges will effectively increase beneficiaries’ financial resources. Those additional resources will encourage some people to work fewer hours or to withdraw from the labor market.” [CBO, 8/1/2010]

New consumer protections, including prohibitions on insurance plans from varying premium prices based on age, will allow more older Americans to purchase plans outside of the workplace and retire earlier than they otherwise would. Additionally, individuals living with pre-existing conditions may no longer have to work two jobs in order to have access to health insurance.

• “As a result, some older workers will choose to retire earlier than they otherwise would.” [CBO, 8/1/2010]

At the same time, CBO projects that the Affordable Care Act could remove some disincentives for Medicaid beneficiaries to work.

• “In contrast, another feature of the Medicaid expansionremoves an existing disincentive to work formany low-income individuals…The health care legislation willallow parents to work and still qualify for Medicaiduntil their income exceeds 138 percent of the FPL.Moreover, parents whose income exceeds the new,higher threshold may be able to work and receive thetax credits and cost-sharing reductions for insurancepurchased through the exchanges.”  [CBO, 8/1/2010]

Although CBO does project that some employers’ decisions could be impacted by the legislation, they conclude that employers will be as likely to hire additional workers as not hire additional workers resulting from the law.

• “Employers with 50 or more employees will be required to pay a penalty if they do not offer insurance or if the insurance they offer does not meet certain criteria and at least one of their workers receives a subsidy from an exchange. … However, firms generally cannot reduce workers’ wages below the minimum wage, which will probably cause some employers to respond by hiring fewer low-wage workers. Alternatively, because firms are penalized only if their full-time employees receive subsidies from exchanges, some firms may instead hire more part-time or seasonal employees.” [CBO, 8/1/2010]
• “Since the law contains dual mandates that most individuals must obtain health insurance coverage and most employers must offer it by 2014, ‘the effect on employment is probably zero or close to it,’ said Amitabh Chandra, a professor of public policy at Harvard University.” [McClatchy Newspapers, 1/17/2011]

As discussed above, Republicans ignore important components of the CBO analysis.  Director Elmendorf had an opportunity to clarify his response during the House Ways and Means hearing.

• Rep. Chris Van Hollen (D-Md.), the ranking member on the Budget Committee, asked Elmendorf to explain clarify his response.  ‘One of the impacts you said was that there will be some individuals who, because they can get their health care through the exchange … would now have the freedom to choose to not get a job simply because they needed the health care,’ Van Hollen said, according to a transcript from CQ. ‘Isn’t that correct?’ ‘Yes, that’s right,’ Elmendorf replied.” [The Hill, 2/10/2011]

II. Independent, nonpartisan analyses demonstrate that ACA will grow our economy, empower small businesses, and benefit families.

ACA will grow our economy:

• Since the Affordable Care Act was signed into law, the economy has created over 1.5 million private sector jobs.  The unemployment rate in February 2011 was 8.9%, lower than it was in March 2010—9.7%. [WH, 3/4/2011]
• With the addition of 220,000 private sector jobs in February, sectors with the largest payroll employment growth were professional and business services (+47,000), and education and health services (+40,000).  [WH, 3/4/2011]
• By slowing the growth of healthcare costs for employers and individuals and increasing demand for healthcare goods and services, ACA could create as many as 400,000 new jobs this decade.  [CAP, 1/2011]
• In a letter to the House Education and Workforce Committee, prominent economists and distinguished scholars argue that, “leaving in place the Patient Protection and Affordable Care Act of 2010 will significantly strengthen our nation’s economy over the long haul and promote more rapid economic recovery in the immediate years ahead. Repealing the Affordable Care Act would cause needless economic harm and would set back efforts to create a more disciplined and more effective health care system.” [Letter to EW, 1/26/2011]

ACA will empower small businesses:

• Research from the Small Business Majority “shows that without reform, small businesses would pay nearly $2.4 trillion over the next 10 years in healthcare costs for their workers; 178,000 small business jobs, $834 billion in small business wages, and $52.1 billion in profits would be lost due to these costs; and nearly 1.6 million small business workers would continue to suffer from ‘job lock.’” [Small Business Majority, 1/26/2011]
• ACA “reduces small businesses’ health care expenses by giving them $40 billion worth of tax credits, and through the creation of new, competitive state-based insurance Exchanges.  Exchanges will enable individuals and small businesses to pool together and use their market strength to buy coverage at a lower cost, the same way large employers do today, giving them the freedom to launch their own companies without worrying whether health care will be available when they need it.” [WH, 1/7/2011]
• “Augustine Faucher, the director of macroeconomics at Pennsylvania-based Moody’s Analytics, said that the law’s deficit savings should ‘bring down interest rates and free up more capital for private firm investment, and therefore could boost long-run growth’ and create more jobs.”  [McClatchy Newspapers, 1/17/2011] It is estimated that 4 million small businesses that provide health care to their employees are eligible for tax credits through the Affordable Care Act starting this year. [WH, 4/1/2011]
• The Main Street Alliance, a national network of small business coalitions, supports the Affordable Care Act, writing that “rolling back the provisions of the Affordable Care Act would be bad business for small business.” [Main Street Alliance, 1/18/2011]

ACA will benefit families:

• “The law widely expands coverage to Americans, thereby reducing the hidden tax of about $1,000 that families with insurance pay each year in additional premium costs to cover the uncompensated costs of the uninsured.” [WH, 1/7/2011]
• “Caps what insurance companies can require families to pay in out-of-pocket expenses, such as co-pays and deductibles, prohibits lifetime limits on how much insurance companies cover if beneficiaries get sick, and regulates the use of annual limits to ensure access to necessary care, until 2014 when annual limits are prohibited.” [DPC, 4/1/2010]
• “Requires premium rate reviews to track any arbitrary premium increases, cracks down on excessive insurance overhead by applying standards on how much insurance companies can spend on non-medical costs, such as bureaucracy and advertising, and provides consumers a rebate if non-medical costs are too high. Provides sliding scale premium tax credits for families that cannot afford quality health insurance.”  [DPC, 4/1/2010]

This DPCC Fact Sheet demonstrates how Republicans blatantly misrepresent CBO Director Douglas Elmendorf’s testimony.  Please find additional resources related to these and other arguments below.

Washington Post: http://voices.washingtonpost.com/fact-checker/2011/02/playing_games_with_cbo_testimo.html

Factcheck.org: http://factcheck.org/2011/01/a-job-killing-law/

White House: http://www.whitehouse.gov/blog/2011/01/07/repealing-affordable-care-act-will-hurt-economy

Myth: Medicaid expansion under the Affordable Care Act will bust state budgets.

Reality: Independent, non-partisan analyses suggest that the Affordable Care Act will produce savings and increased revenues for states.

On March 1, 2011, Republicans released an erroneous report on the costs to states of the Medicaid expansion under the Affordable Care Act. The DPCC Fact Sheet provides information demonstrating how Republican projections are flawed and provides information on recent Administration efforts to ensure state flexibility during implementation.

I. Background on Medicaid Expansion:

The Affordable Care Act fixes our health insurance system while dramatically increasing access for families to affordable, high-quality coverage.  By 2021, the Affordable Care Act will reduce the number of Americans under age 65 without insurance by about 33 million, meaning that 95 percent of legal residents under age 65 will have health insurance coverage. Approximately 23 million of these newly insured Americans will purchase their health insurance through new health insurance Exchanges.  [CBO, 2/18/2011]

The remaining newly insured will obtain coverage through Medicaid and the Children’s Health Insurance Program (CHIP).  Under the Affordable Care Act, Medicaid will be expanded to all individuals under age 65 with incomes at or below 133% of the federal poverty level, thus creating a minimum standard eligibility across states.  All Americans over age 65 will continue to be covered by Medicare.

II. What Percent Do States Actually Pay?

The federal government will cover 100% of the costs to states for the newly eligible population for the first three years, between 2014 and 2016.  The federal government will then cover 95% of all costs costs in 2017, 94% in 2018 and 93% in 2019.  In 2012 and for every year following that, the federal government will pay 90% of all costs for the newly covered Americans.

States will only pay a tiny fraction of the costs to cover the newly insured population. According to the CBO, states will pay only eight percent of the total cost of the 18 million people who will be covered by Medicaid and the Children’s Health Insurance Program between 2012 and 2021, as a result of the new law.  CBO further found that the federal government will pay 92 percent of the $734 billion total cost for this coverage.  CBO has previously found that the entire cost of the legislation, including changes to Medicaid, is fully paid for and reduces the deficit by more than one trillion dollars over the next two decades.  [CBO, 2/18/2011]

III. Republican Accusations on State Medicaid Costs:

Republicans estimated that the expansion will cost state taxpayers an additional $118.4 billion through 2023.  The Republicans’ assertion is about twice the independent Congressional Budget Office estimate of $60 billion through 2021.  The Congressional Budget Office has long been the independent, official scorekeeper of the effects of Congressional legislation. [Republican Congressional Report, 3/1/2011]

What are outside groups saying about the Republicans Accusations?

• The report ignores independent, non-partisan analyses that account for the savings and increased revenues the Affordable Care Act will produce.  These savings could amount to more than $160 billion across all states. [Lewin Group, 12/1/2010]
• Republicans projections cherry-pick “worst-case scenarios from various studies that use different time frames and rely on flawed assumptions.” [CBPP, 3/1/2011]

IV. Rationale for Variation of State Medicaid Costs:

While Republicans highlight an inflated estimate regarding the Medicaid expansion cost to states, other independent, non-partisan analysis showsasavings of $106.8 billion. [Lewin Group, 12/1/2010] According to Kaiser, “There are a number of reasons why the estimates of the ACA on states varies so widely. Expanding Medicaid naturally costs more in states where there are more uninsured residents with Medicaid income levels, and the magnitude of the estimates tend to be larger in high-population states. Moreover, the estimates use different methodologies in projecting costs of new enrollment and in including or omitting other costs, savings, or revenues.” [Kaiser, 2/1/2011]

Republican Projections Exclude Health Reform Savings and Revenue to States

• Republicans projections fail to account for reductions in state support for uncompensated care,“ACA-driven increases in coverage will reduce uncompensated care, especially for public hospitals and clinics, along with private safety net institutions. States could share in the associated savings by making changes in the various ways that they support localities and safety net institutions. No state report estimates savings of this type, perhaps in part because of the complexity of funding flows, although two of our five recognize that they will occur… The national estimates from the Lewin Group and from Dorn and Buettgens projected very large savings of this type, up to $100 billion over ten years, enough to generate overall net savings to states under the ACA, although savings will vary by state.” [Kaiser, 2/1/2011]
• According toRep.  Henry Waxman (D-Ca.), ranking member of the Energy and Commerce Committee, “All of these estimates overstate state costs because they do not include savings from reductions in states’ payments for uncompensated care. For hospitals alone, the spending for uncompensated care in 2009 was estimated to be $40 billion.” [NJ, 3/1/2010]

• Republican estimates do not account for revenue to states from taxes on insurance premiums. According to Kaiser, “Such revenues will be higher because the extent of insurance coverage will rise under the ACA. Maryland’s revenue estimate found that this would generate over two-thirds of the net savings that the state projected.” [Kaiser, 2/1/2011]

• Republican projections do not account for savings tostate programs. According to Kaiser, “The expansion of coverage and benefits under the ACA will very likely mean that people will seek much less care from existing state and local programs, such as those now funded through public health or mental health departments. States that operate high-risk pools should also see reduced demands and therefore savings in these programs.” [Kaiser, 2/1/2011]

• Republicans fail to account for savings through increased efficiency or enhanced value through initiatives in care management, coordination, and payment methods.According to Kaiser, “For example, the ACA provides a new health home initiative to better coordinate care for individuals with chronic conditions with 90 percent match rate for these services. The ACA also allows states to integrate care for ‘dual eligibles,’ people jointly enrolled in Medicaid and Medicare, and thereby improve value or efficiency… Many different opportunities exist to obtain federal funding such as grants, incentive payments, or demonstration support.” [Kaiser, 2/1/2011]

Republicans Use Studies with Different Timeframes and Flawed Assumptions

• Republicans use worst-case scenarios from studies in order to project high costs to states.According to CBPP, the GOP report, “… doesn’t mention that the Urban analysis produced two sets of estimates for each state — one assuming that the Medicaid participation rate would remain at about its current level, and another assuming that it would rise significantly.  Most credible analysts use the lower estimate, but the GOP report references only the higher one.” [CBPP, 3/1/2011]

• Republicans use studies with flawed assumptions.“The report’s cost estimates for Indiana, Mississippi, and Nebraska come from misleading studies conducted by the consulting firm Milliman, Inc. that rely on flawed assumptions.  One estimate assumes that literally everyone who becomes eligible for Medicaid under health reform will sign up for it on Day 1 — something that has never happened in a means-tested public program.” [CBPP, 3/1/2011]

• Republicans extend the timeframe to manipulate the numbers. The report extends the time frame for the estimate by two years to make the numbers look larger.  This exaggeration misleads the reader by providing an apples to oranges comparison.  The standard time frame used by CBO is 10 years, from 2012 through 2021. This report uses a 12 year time frame, from 2012 through 2023, artificially raising the estimate.

• Republicans rely on studies which include costs not related to the Affordable Care Act.“For example, its Utah estimate comes from a state report that seems to assume enhanced federal funding will run out by 2014, forcing Utah to shoulder a larger portion of the expansion’s costs.  Its Florida estimate, also from a state report, not only assumes that 100 percent of newly eligible individuals will enroll but also includes the cost of raising Medicaid’s payment rates for primary care to Medicare levels after 2014 — a change the health reform law does not require.” [CBPP, 3/1/2011]

V. Other Estimates on State Medicaid Costs:

Republicans contend that the Medicaid expansion under the Affordable Care Act will bust state budgets.  They argue that this expansion will cost state taxpayers billions through 2023, with Texas ($27 billion between 2014-2023), Florida ($12.9 billion between 2014-2023), and California ($19.4 billion between 2018-2023) accounting for the majority of the costs.

The Kaiser Commission on Medicaid and the Uninsured recently conducted an analysis of these and other estimates. As demonstrated below, the estimates range from a multi-year total cost of $27 billion in Texas to savings of over $106 billion across all states. [Kaiser, 2/1/2011]

[Kaiser, 2/1/2011]

VI. Governors agree that expanded Medicaid eligibility and increased flexibility benefit states:

Testifying before the House Ways and Means Committee on the Medicaid expansion, Governor Deval Patrick stated “Federal reform is good for Massachusetts, it has given us an affordable way to extend the promise of coverage to Massachusetts residents.” [WP, 3/1/2011]

A number of states, including Connecticut, Minnesota, Washington, and the District of Columbia, have been approved to expand Medicaid eligibility ahead of the 2014 deadline.

• Minnesota Governor Mark Dayton explained the benefits of the changes, “As my first official act as Governor, I’m going to take two important steps. One is to sign an executive order, committing Minnesota to the so-called Early Option for Medicaid…This is a step that benefits all of the people of our state at no, and I repeat no, net cost to the state of Minnesota.”

VII. The Administration is working to ensure that States have the flexibility to secure savings and increase state revenue:

• Under the Affordable Care Act, States may structure their Medicaid programs to more closely resemble the private insurance coverage options available in the Exchanges. States can tailor the benefit packages based on private coverage options available in their States – such as the standard Blue Cross/Blue Shield plan, the State employee health plan, and the largest commercial HMO available in the State. States can go beyond these standards to provide additional benefits but are not required to do so.
  • Governor Martin O’Malley argues, “We in the State of Maryland greatly appreciate Secretary Sebelius’ understanding of the extraordinary budget pressures all governors now face, and her commitment to working with us collaboratively to reduce costs in our Medicaid programs… I welcome Secretary Sebelius’ offer to help us build on our existing efforts here in Maryland to improve quality of care while saving significant Medicaid dollars over the short and long term.”[Office of the Governor, 4/4/2011]

Please find additional resources below:

KFF, “State Budgets Under Health Reform”: http://www.kff.org/healthreform/upload/8149_ES.pdf

KFF, “5 Things to Know About Medicaid:” http://www.kff.org/medicaid/8162.cfm

KFF, “Medicaid Enrollment: June 2010:” http://www.kff.org/medicaid/enrollmentreports.cfm

Center for Budget and Policy Priorities: http://www.offthechartsblog.org/republican-report-inflates-state-medicaid-costs-under-health-reform/

WEST

Billings Gazette Editorial: Congress must fund Billings VA Clinic. “With well over 100,000 veterans here and 36,000 enrolled for VA services, the potential for more demand is tremendous. Most the Montana veterans enrolled with the VA have service-connected disabilities. Montana must be ready to serve those who have served our country. As reported previously by The Gazette, Tester noted recently that Republicans in the U.S. House were considering cutting $278 million from the overall VA construction budget. We call on Montana’s sole U.S. House member, Republican Denny Rehberg, to ensure that the proposed VA construction budget isn’t reduced in the House. We call on Tester and U.S. Sen. Max Baucus, D-Mont., to fight for the budget that includes the Billings VA expansion.” LINK

Vancouver Columbian: Budget cuts may cost ports $10M. “Fallout from the congressional budget showdown may cost the Port of Vancouver $10 million in federal funding for a rail improvement project intended to attract new industrial development. […] Larry Paulson, the port’s executive director, raised the issue in a letter sent last week to members of the state’s congressional delegation. ‘This action would likely result in significant loss of anticipated jobs, which are needed to help the Southwest Washington region to recover from our country’s long recession,’ Paulson wrote.” LINK

Tri-City Herald: House budget could mean lost jobs for PNNL. “Pacific Northwest National Laboratory employees have been warned that 100 to 600 jobs could be lost under the budget passed by the Republican-controlled House for the remainder of the fiscal year. […] The local impact to PNNL would hurt, [PNNL Director Mike] Kluse said. But the larger impact would be to the nation at a time it needs to make a full-court press on developing alternative fuels, methods of capturing and storing energy and cleaner ways to burn hydrocarbons, he said. ‘It’s a very unfortunate time not to sustain stable funding,’ he said.” LINK

Santa Rosa Press Democrat: Sonoma County health clinics fear federal cuts. “Community health centersin Sonoma County and across the state are bracing for federalfunding cuts, with millions at stake in congressional budget deliberations.  ‘Everybody’s very worried,’ said Naomi Fuchs, chief executive officer of Santa Rosa Community Health Centers, a network of eight clinics that serves 34,000 patients. ‘We hope the funding is restored.’ […] Statewide, the loss would deal a ‘crippling blow’ to efforts to boost clinic capacity incorporated in the health care overhaul, said Carmela Castellano-Garcia, president and CEO of California Primary Care Association. LINK

Las Vegas Sun: GOP fights funding for vital Nevada renewable projects. “Since it was officially announced in late 2009, the Crescent Dunes Solar Energy Project in Tonopah has been one of Nevada’s flagship commercial renewable energy projects. […] But the whole enterprise depends on federally backed loans that House Republicans marked for the chopping block in the budget they passed two Saturdays ago. […] ‘It’s U.S. technology and U.S. jobs — it would just be ridiculous for the U.S. government to clip its wings at the last minute,’ [said Kevin Smith, CEO of SolarReserve].” LINK

CENTRAL

Chicago Tribune Op-Ed: Science budget cuts threaten high tech jobs, future frontiers. “In these tight economic times, people of all political stripes agree that America needs more good jobs, especially in the economically vital areas of science and engineering. Yet thousands of high-tech jobs in the Chicago area would be lost if lawmakers enact science budget cuts now being considered in Washington. Losing these jobs would create a ripple effect in our local economy. Beyond that, the loss of innovative projects and young scientists to other countries could hamper America’s global competitiveness for decades to come.” LINK

Quad City Times: Jobs program faces shutdown, advocates say. “Chuck Stewart, director of the Partners in Job Training and Placement office, said Thursday the [House] cuts would shut his office down. ‘We wouldn’t be open six weeks after July 1,’ he said. ‘I doubt we’d last six weeks.’ Stewart’s office helps laid off workers get retraining and assists them, as well as young people, find jobs. The office also is preparing to help up to about 400 Rock Island Arsenal workers who are expected to stay in the Quad-Cities when the TACOM office on the island moves its operations to Detroit later this year. The move was required by the 2005 base closing process. ‘What concerns me is we’re cutting a jobs program during a recession,’ Stewart said Thursday.” LINK

Dayton Daily News: Federal budget cuts would close Ohio’s poison control centers. “One or more of the three poison centers in Ohio could be forced to close as part of a sweeping bill recently passed by the U.S. House of Representatives that aims to slash federal funding across the country. […]About 90 percent of people who call the Central Ohio Poison Center’s hot line in Columbus do not need medical treatment and are told to stay home, instead of making unnecessary emergency room visits and spending millions of dollars on medical costs, said David Baker, the center’s managing director. ‘If we can give someone that knowledge and make that assessment, we can basically save $7 for every $1 that is invested in poison control centers,’ Baker said.” LINK

EAST

The New London Day Editorial: Understand effects before making cuts. “There is a cautionary tale in the news that recent cuts in federal spending could derail a much ballyhooed supportive housing project for veterans in Jewett City. In the works for years, the endeavor would transform the LaFlamme-Kusek American Legion Post 15 building into housing units for homeless veterans. After fits and starts and twists and turns, the $6 million project is finally nearing realization. Or at least that’s what everyone thought until House Republicans OK’d $61 billion in budget cuts last week, including about $75 million used as rental assistance for homeless veterans and to help pay for their case management and clinical services. […] While Congress must slow the growth in federal spending, lawmakers must first do their homework before deciding how to go about it.” LINK

Frederick News-Post: Proposed Pell Grant cuts would slash 15 percent. “Nine hundred dollars. It doesn’t sound like a large sum of money, relatively speaking, but Vanessa Morris said it is all that stands between her being a college student or not. Morris, a business administration major at Frederick Community College, received $900 this semester through the federal Pell Grants program that provides financial assistance to college students. But if a spending resolution passed by the House of Representatives becomes law, the Pell Grant program is in for deep cuts.” LINK

Wheeling News-Register: Head Start cuts were ‘painful.’ “David Murphy said votes by Congressman David McKinley and fellow House Republicans to cut $61 billion from the federal budget may cost Murphy’s children a chance to go to Head Start. […] Murphy said he has been unemployed for more than a year now, noting that he and his wife, Irene Gonzalez, are back in school at West Virginia University and West Liberty University, respectively. Murphy and Gonzalez said the federal Head Start program provides affordable day care and educational opportunities for their young children, 4-year-old Jacob and 22-month-old Irenita. ‘I know there are things they need to cut, but cutting out Head Start is not the answer,’ Murphy said.” LINK

SOUTH

Birmingham News Editorial: Cut NIH, hurt UAB. “Federal funding, much of it from the NIH, fuels UAB as a top-tier academic research center. When there’s more of it, the grants create more jobs for research staff and support personnel, who put more money into the local economy. […] Obama has proposed increasing the NIH budget, which is a little more than $31 billion, as part of his effort to invest in research and technology. But House Republicans want to carve a $1 billion chunk out of the NIH budget. […] In a federal government that this year is spending $3.8 trillion, there are other places to find $1 billion to cut. Let’s hope Congress, for UAB’s and Birmingham’s sake, finds them.” LINK

Oklahoma City Journal Record: Community health centers face loss of federal money. “The prospect of Oklahoma’s community health centers losing $5.5 million in federalmoney has their leaders and supporters worried about the future of a program that has been making significant headway. U.S. House lawmakers approved a continuing resolution that proposes cutting $1.3 billion for community health centers from the president’s fiscal year 2011 request. […] ‘I’m all about accountability, but not elimination. These communitieshave worked so hard putting together projects that will address their unmet health needs, and they may not have the chance to see that through. Patient outcomes will continue to be poor as a result,’ [said Judy Grant, director of communitydevelopment for the Oklahoma Primary Care Association].” LINK

Atlanta Journal-Constitution: Job training in crossfire of deficit battles. “Carol Mullins is all for putting the nation’s fiscal house in order. But something else tops the Tyrone widow’s Washington wish list: A job. […] Mullins hopes her fortunes turn with the help of a federal job-training program that proponents say leads to full-time work for three of every four participants. She is wrapping up five months of computer training. IT is one of the state’s hottest growth industries. Congress, though, is considering killing the $3.6 billion job training and assistance program. […]President Barack Obama’s proposed fiscal 2012 budget cuts 5 percent from the U.S. Labor Department’s budget but maintains WIA funding. The House budget calls for zeroing-out all WIA money.” LINK

Dallas Morning News Blog: Conservative budget irony. “Reading about Republican plans to hack the federal budget to pieces, I was particularly struck by the suggestion that Congress cut $272 million in border security and immigration enforcement. Border issues were fresh on my mind since I recently listened to a federal-government-bashing Rick Perry give a dramatic, finger-wagging speech in Washington about how the federal government needs to be sending more border agents to Texas. Well, if the budget is slashed as planned, it would cut the number of agents patrolling the Mexican border from 21,370 to 20,500. Be careful what you wish for, Mr. Governor. Less Washington isn’t always a good thing.” LINK

• Improving Access to Care
• New, Draft Form W-2, and Another Assurance that Health Coverage is Not Taxable
• Helping 1,000 More Businesses Help Early Retirees
• Ensuring Access to Health Insurance for Children with Pre-Existing Conditions
• Putting Patients Back in Charge
• Improving Care and Preventing Abuse in Long-Term Care Facilities
• Legal Challenges to the Affordable Care Act
• Additional Information

Previous updates on health reform implementation and other information are available from the DPC. [DPC]

Improving Access to Care

Community Health Centers

The Affordable Care Act creates an expanded and sustained national investment in community health centers by providing $11 billion over five years to these critical health care providers. [P.L. 111-148; P.L. 111-152]  The country’s 1,250 community health centers provide quality health care to 20 million Americans without regard to a patient’s ability to pay or health insurance coverage. [National Association of Community Health Centers, accessed 8/23/10]  The Affordable Care Act’s investment in community health centers will allow them to nearly double the number of patients they serve.  By providing primary care and focusing on preventive services, health centers estimate they save our health care system $9.9 billion – $17.6 billion each year.

Recently, HHS announced awards of $727 million to 143 community health centers nationwide for construction and renovation projects that, when complete, will allow the health centers to provide care for an additional 745,000 patients. [HHS, 10/8/10]  Community health centers are a constant source of quality, affordable health care to millions of Americans, but especially during this economic downturn, health centers can be a critical source of care for those who have lost their health insurance, who are in between jobs, or who face other financial difficulties.

School-Based Health Centers

HHS and the Health Resources and Services Administrative (HRSA) also recently announced the availability of $100 million in funding for the construction and renovation of school-based health centers. [HRSA, 10/4/10]  The Affordable Care Act includes funding to assist school-based health centers in providing comprehensive and accessible preventive and primary health care services to medically-underserved children and families.  HRSA anticipates 200 grants will be awarded to construct, renovate, or purchase equipment in school-based health centers.  Grant applications are due December 1, 2010, and more information is available at Grants.gov. [Grants.gov, accessed 10/18/10]

New, Draft Form W-2, and Another Assurance that Health Coverage Is Not Taxable

To provide Americans with more information about the value of their health insurance, the Affordable Care Act requires employers to disclose the value of any employer-sponsored health insurance for each employee, on the employee’s annual Form W-2.  Despite an onslaught of rumors to the contrary, employer-sponsored health benefits are absolutelynottaxable, and the Affordable Care Act does not change the tax-free status of these benefits.  Reporting the cost of coverage will be optional in 2011, and, in 2012, all employers who offer health insurance will be required to report the value to each worker on their Form W-2.

Last week, the Internal Revenue Service (IRS) released a draft Form W-2 for 2011. [IRS, 10/12/10]  The new draft form looks a lot like the existing Form W-2, except that it includes a space for employers to report the cost of employer-sponsored health coverage. [IRS, undated]  And, the form itself clarifies that the cost is provided for information purposes only:

Cost of employer-sponsored health coverage (if provided by the employer).  The reporting in Box 12, using Code DD, of the cost of employer-sponsored health coverage is for information only.  The amount reported with Code DD is not taxable.

Helping 1,000 More Businesses Help Early Retirees

The Affordable Care Act creates a $5 billion Early Retiree Reinsurance Program to support employer health plans that provide coverage to retirees who are not yet eligible for Medicare, helping to protect access to coverage while reducing costs for employers and retirees. [P.L. 111-148; P.L. 111-152]  HHS recently announced that another 1,000 employers were accepted into the program, bringing the total number of participating employers to nearly 3,000. [HHS, 10/4/10]  Participating employers come from all 50 states and the District of Columbia, representing large and small businesses, state and local governments, educational institutions, non-profits, and unions.  A fact sheet explaining the program and a list of all participating employers in each state is available at HealthCare.gov and the list will be updated each week as new employers join the program.  Applications are still being accepted, and more information on the Early Retiree Reinsurance Programs is available at ERRP.gov.  This month, participating employers will begin to submit claims and receive reimbursement payments for qualifying expenses.

The Early Retiree Reinsurance Program is another bridge to the Health Insurance Exchanges and reformed health insurance markets effective in 2014, which will make it easier for earlier retirees to access affordable health insurance.  Skyrocketing health care costs have made it difficult for employers to continue to provide health benefits for employees and retirees, and this temporary program will provide financial assistance until 2014.  Earlier this year, a survey found that 76 percent of large employers that offer retiree benefits planned to pursue participation in the program, and that the average federal reimbursement for each early retiree will represent between 25 and 35 percent of each early retiree’s health care costs. [Hewitt Associates, 5/25/10]

Ensuring Access to Health Insurance for Children with Pre-Existing Conditions

On September 23, 2010, the six month anniversary of the enactment of the Affordable Care Act, the Patients’ Bill of Rights took effect.  One of the most critical protections included in the Patients’ Bill of Rights prohibits insurers from denying coverage to children who have pre-existing conditions, for all new plans and for existing plans in the group market.  Before enactment, insurers were free to deny health insurance to children who had a pre-existing condition, such as asthma, or could offer to cover the child but refuse to pay for any treatment related to the pre-existing condition.  The Affordable Care Act ended this practice, providing children and their parents the peace of mind that comes with knowing they can always access coverage.

Despite a March 29, 2010, letter in which AHIP expressed its commitment “to make pre-existing condition exclusions a thing of the past,” some health insurers are still choosing to deny coverage to children who need it by refusing to offer new “child-only” policies.  These types of policies are issued in the individual market and cover only children, not an entire family.  Last week, HHS Secretary Sebelius sent a letter to the National Association of Insurance Commissioners outlining efforts by HHS, working with states, to ensure that children with pre-existing conditions continue to have access to health insurance. [HHS, 10/13/10]  The letter clarifies a range of insurer practices related to child-only policies that are permissible under the Affordable Care Act and highlights answers to frequently asked questions, available online. [HHS, 10/13/10]  In addition, the letter outlines steps some states have taken and other states might consider, including the establishment of open enrollment periods, offering unsubsidized buy-in to a state’s Children’s Health Insurance Program (CHIP), and seeking coverage through existing state high-risk pools.  The Affordable Care Act also created the Pre-Existing Condition Insurance Plan (PCIP) which is available to eligible children and adults with pre-existing conditions who have been uninsured for at least six months.   Information is available at PCIP.gov.

Putting Patients Back in Charge

The Affordable Care Act protects consumers by ending some of the worst health insurance industry abuses.  One way the Affordable Care Act protects consumers and puts patients back in charge of their health care is by providing grants to states to establish or expand offices of health insurance consumer assistance or health insurance ombudsman programs. [P.L. 111-148; P.L. 111-152]  These independent offices will assist consumers with enrolling in coverage and with filing complaints and appeals, educate consumers on their rights and responsibilities, and collect, track, and quantify consumer problems and inquiries.

Earlier this year, HHS issued a grant notice, and on October 19, 2010, HHS announced awards of nearly $30 million for state consumer assistance programs. [HHS, 10/19/10]  Thirty-five states, four territories, and the District of Columbia applied for and received this funding.  More information about this grant program and summaries of how each grantee will use this new funding is available at HealthCare.gov. [HealthCare.gov, accessed 10/19/10; HealthCare.gov, accessed 10/19/10]

Improving Care and Preventing Abuse in Long-Term Care Facilities

In order to improve care and prevent abuse in long-term care facilities, the Affordable Care Act requires the Secretary of HHS to establish a nationwide program for national and state background checks on employees with direct access to patients at certain long-term supports and services facilities or providers. [P.L. 111-148; P.L. 111-152]  Earlier this month, HHS announced it had awarded $13 million to six states to design comprehensive applicant criminal background check programs for jobs involving direct patient care. [HHS, 10/6/10]  The Affordable Care Act provides a total of $160 million for the background check program, which should allow all states to participate.   Another round of grants is expected in the near future.

Legal Challenges to the Affordable Care Act

Since the Affordable Care Act became law, several state Attorneys General have filed lawsuits to challenge its constitutionality.  Opponents of health reform, having failed to prevent it from becoming law, are now taking their opposition to the courts.  But constitutional law scholars are confident these suits have no merit, and that, as President Reagan’s Solicitor General Charles Fried wrote, “the health care law’s enemies have no ally in the Constitution.” [DPC, 3/26/10; Boston Globe, 3/21/10]

On October 7, 2010, in the first substantive ruling on the individual responsibility policy, Judge George Caram Steeh of the U.S. District Court, Eastern District of Michigan, determined that the Affordable Care Act is constitutional.  In considering the Commerce Clause, Judge Steeh wrote:  “Far from ‘inactivity,’ by choosing to forgo insurance plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now through the purchase of insurance, collectively shifting billions of dollars, $43 billion in 2008, onto other market participants.” [Opinion available here]  In dismissing the lawsuit Judge Steeh concluded:  “The minimum coverage provision, which addresses economic decisions regarding health care services that everyone eventually, and inevitably, will need, is a reasonable means of effectuating Congress’s goal.”

On October 14, 2010, Judge Roger Vinson in Florida dismissed four of the six claims brought by several Republican Attorneys General and issued a procedural ruling allowing the two remaining claims to proceed. [Washington Post, 10/15/10]  The ruling does not address the merits of the constitutional claims raised by the suit, but allows the process to continue to a summary judgment hearing later this year.

Additional Information

The Democratic Policy Committee has released 13 previous updates on health reform implementation, available on the DPC website here.  In addition, DPC maintains a centralized listing of health reform implementation resources which is frequently updated and is available here.

Republican Repeal Costs $143 billion

Health Reform Reduces the Deficit

The nonpartisan Congressional Budget Office, the official scorekeeper of Congress, determined that the Affordable Care Act reduces the federal deficit by $143 billion over the first ten years of enactment. [CBO, 3/20/10]  The Affordable Care Act reduces the deficit while ensuring that 94 percent of Americans have health insurance and reducing the rate at which health care costs grow.

Republican Repeal Plan Increases the Deficit

Extrapolating from CBO’s estimate of the deficit savings resulting from the Affordable Care Act, repeal of health reform is likely to increase the deficit by $143 billion.

Republican Repeal Raises Drug Costs for Seniors

Health Reform Fills in the “Donut Hole”

More than 1.2 million Medicare beneficiaries who have entered the “donut hole” have received their $250 rebate checks, the first of the Affordable Care Act’s steps to completely fill in the “donut hole” by 2020. [HHS, 9/23/10]  Checks will continue to go out monthly for the rest of the year as beneficiaries enter the coverage gap. [White House, 6/8/10]  The $250 rebate check is tax-free and seniors do not need to do anything to receive it; Medicare automatically mails a check when the beneficiary reaches the “donut hole.” [Centers for Medicare & Medicaid Services, 5/10]  Seniors who do not receive Medicare Extra Help should expect their check in the mail within 45 days or less of hitting the coverage gap.  Information on the number of seniors in your state who may qualify for the rebate check is available from the DPC. [DPC, 6/22/10]

Beginning next year, Medicare beneficiaries who do not receive Medicare Extra Help will receive a 50 percent discount on brand-name drugs and biologics they purchase when they are in the coverage gap.  In addition to the discount, coverage in the “donut hole” will increase until 2020, when 75 percent coverage on all drugs purchased in the gap will completely fill in the “donut hole.”  More information on filling in the “donut hole” and other benefits of health reform for seniors is available from the DPC. [DPC, 6/10/10]

Republican Repeal Raises Drug Costs for Seniors

The Republican scheme to repeal health reform would deny seniors the $250 rebate check and rescind the 50 percent discount on brand-name drugs and biologics purchased in the “donut hole” next year to help them afford their medication.  The Republican plot to repeal reform would ensure the “donut hole” remains in place, rather than being closed by 2020 as under the health reform law.

Republican Repeal Revokes Tax Credits for Small Businesses

Health Reform Provides Small Business Health Insurance Tax Credits

The Affordable Care Act provides tax credits for up to 35 percent of premium costs for small businesses that offer coverage to their employees.  Effective this year, the full credit is available to firms with 10 or fewer employees and average annual wages of up to $25,000, while firms with up to 25 employees and average annual wages of up to $50,000 will also be eligible for a credit.  Beginning in 2014, tax credits are available for up to 50 percent of premium costs.  In April, the Internal Revenue Service began mailing postcards to more than four million small businesses and tax-exempt organizations that may be eligible for the credit, and provided answers to frequently asked questions about the credit. [IRS, 4/19/10; 5/5/10]  Information on the number of small businesses in your state who may qualify for the tax credit is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Revokes Tax Credits for Small Businesses

The Republican scheme to repeal health reform would deny small businesses this tax credit, putting small business owners right back where they were before health reform was enacted, struggling to find affordable coverage options to offer their employees, or simply not offering coverage because affordable plans are unavailable.

Republican Repeal Rescinds Coverage for Young Adults

Health Reform Expands Coverage for Young Adults

The Affordable Care Act allows young adults to stay on their parents’ health insurance plan until their 26^th birthday.  Before passage of the new law, many plans dropped young adults from their parents’ policies at age 19 or upon graduation from high school or college. [National Conference of State Legislatures, 4/10]  Thirty percent of young adults age 19 through 29 are uninsured, the highest rate of any age group.  This provision is effective for all policies issued or renewed after September 23, 2010, and more than 65 insurance companies voluntarily started providing this coverage to young adults earlier this year, before the deadline. [The White House, 5/10/10]  Information on the number of young adults in your state who may benefit from this coverage extension is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Rescinds Coverage Expansion for Young Adults

The Republican scheme to repeal health reform would revoke the new health insurance coverage options that health reform offers for young adults.  For young adults, especially new college graduates facing a challenging job market, the option to stay on a parent’s health insurance could be the only reasonably priced insurance option they have.  Without it, many will be forced to go uninsured.

Republican Repeal Revokes Coverage for Children with Pre-Existing Conditions

Health Reform Guarantees Coverage for Children with Pre-Existing Conditions

The Affordable Care Act prohibits health insurers from denying or excluding coverage of pre-existing conditions for children, effective for policies and plan years beginning on or after September 23, 2010, and applying to all group plans and all new plans in the individual market.  The Administration has worked with the health insurance industry, which has agreed to ensure that children with pre-existing conditions are not denied coverage. [HHS, 5/10/10]  This means that children, no matter their health status, and their parents will soon have the peace of mind that comes with knowing coverage of a child’s pre-existing condition cannot be denied.

Republican Repeal Plan Revokes Protections for Children

The Republican scheme to repeal health reform would revoke the protection children now have from having their health insurance coverage denied or limited due to a pre-existing condition.  The Republican effort to repeal reform gives insurance companies the freedom to deny coverage of a child’s pre-existing condition, including congenital conditions a child may have at birth.  No child should be denied health care for a condition they were born with, and every parent deserves the peace of mind that comes with knowing their child’s health care is covered.

Republican Repeal Revokes the Patients’ Bill of Rights

Health Reform Guarantees Patients’ Rights

The Affordable Care Act includes numerous consumer protections and a Patients’ Bill of Rights – provisions that Senate Democrats have been fighting to enact for nearly a decade.  These patient protections take effect for policy or plan years beginning on or after September 23, 2010, and apply to various types of health insurance plans, as noted.

·         No lifetime limits on coverage. Insurers will be prohibited from imposing lifetime limits on benefits.  This provision applies to all new and existing plans in all markets.

·         No coverage rescissions when Americans get sick. Insurers will be prohibited from rescinding health coverage when a beneficiary gets sick as a way of avoiding paying that person’s health care bills.  This provision applies to all new and existing plans in all markets.

·         Required coverage of preventive care with no cost-sharing. Insurers will be required to provide coverage of preventive health care services without cost-sharing.  This provision applies to all new plans in all markets.

·         Regulated annual limits on coverage. Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This provision applies to all new plans and existing employer plans, until 2014, when the Exchanges are operational and use of any type of annual limit will be banned for all new plans and existing employer plans.

·         Fair opportunity to appeal coverage and claims decisions. Health insurers will be required to develop an appeals process that, at a minimum, provides beneficiaries with a notice of internal and external appeals processes and allows beneficiaries to review their file and present evidence in their appeal.  This provision applies to all new plans in all markets.

·         Right to choose your doctor. Patients’ rights are protected by allowing health insurance plan members to choose any participating primary care provider, or in the case of children, any participating pediatrician, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.  This provision applies to all new plans in all markets.

Republican Repeal Plan Revokes Patients’ Rights

The Republican scheme to repeal health reform would deny all Americans the consumer protections and patients’ rights that will soon take effect as a result of the new health reform law.  The Affordable Care Act puts control over health care decisions in the hands of the American people, not insurance companies.  It seems Republicans advocating for repeal of the new law are on the side of insurance companies, not patients.

Republican Repeal Raises Costs for Early Retirees

Health Reform Lowers Costs for Early Retirees

The Affordable Care Act created a $5 billion re-insurance program for employer health plans that offer coverage to retirees who are not yet eligible for Medicare, to help protect access to coverage while reducing costs for employers and retirees.  This temporary program will provide financial assistance until 2014, when health insurance Exchanges will make it easier for early retirees to access affordable health insurance options.  Early retirees are at particular risk of becoming uninsured, or of being forced to pay exorbitant premium costs until they become eligible for Medicare, and the percentage of large firms offering retiree coverage has dropped precipitously, from 66 percent in 1988 to just 31 percent in 2008. [The White House, 5/4/10]  The program began on June 1, 2010, in advance of the June 22, 2010, effective date required by law. [Federal Register, 5/5/10; The White House, 5/4/10]  Information on the number of early retirees in your state who may benefit from this program is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Leaves Early Retirees Without Critical Protections

The Republican scheme to repeal health reform fails to protect early retirees, who will continue to be at a very high risk of becoming uninsured or of paying excessive premiums if they are lucky enough to maintain their health insurance coverage.  Employers are struggling to continue providing health benefits to retirees, and Republicans are working to repeal the assistance that the health reform law provides them to do the right thing.