Consumer-First Energy Act of 2008 - Motion to Proceed

Floor Speech

CONSUMER-FIRST ENERGY ACT OF 2008--MOTION TO PROCEED -- (Senate - June 11, 2008)

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Mr. WYDEN. Mr. President, before he leaves the floor, let me thank my good friend from Colorado, Senator Salazar, for his kind and gracious comments about the Healthy Americans Act. He has been a wonderful addition to the Senate Finance Committee. I know we are going to be spending a lot of time trying to deal with these important challenges in the days ahead. I thank him for all his thoughtfulness, both today and on a regular basis.

Every day from coast to coast, millions of our seniors look at Medicare as a lifeline. These are the seniors who walk on an economic tightrope, balancing their fuel bills against their food costs and their food costs against their prescription costs. They are just trying not to fall off the economic tightrope. As the distinguished Senator from Missouri has pointed out, when you look at these skyrocketing gas and fuel prices over the last few months, that is enough to send seniors trembling about the prospect of being able to pay for necessities every month.

This legislation is a substantial step in the right direction of major health reform. It is not everything that needs to be done. As Senator Salazar has noted, I and others are working with seven Democrats and seven Republicans on what we think is a comprehensive overhaul of American health care system.

But, clearly, this legislation moves in the right direction. I want to touch on three areas--the question of physician reimbursement; protections for low-income people; and then, finally, marketing practices--to highlight the fact that this legislation, which I hope the Senate is going to vote to move along tomorrow, clearly makes changes that will be helpful for older people today, but also will pay dividends for the broader course of health reform in the future.

First, with respect to this question of trying to ensure a step forward with respect to physician reimbursement--all over this country, we have physicians in small practices who are literally having trouble keeping the doors open. They can have a couple of people in their office and spend virtually the whole day trying to pry out of insurance companies information from their insurance matrix about what they are going to pay for various services. Literally, these physicians are not going to be able to keep their doors open if Medicare physician payments are cut by more than 10 percent.

So this is not an issue of somehow protecting fat-cat doctors or those who are affluent in our society. This is a question of protecting primary care and primary care for the most vulnerable people in our society. I am of the view that if this cut were allowed to go forward on July 1, it would be a body blow to the older people of this country, those millions who are walking on an economic tightrope.

I commend Chairman Baucus and Senator Snowe and the whole group on the Finance Committee who are trying to move this forward. I hope we will do that tomorrow.

Second, I believe the protections for the low-income older people are another step in the right direction. This legislation increases the amount of resources that Medicare beneficiaries can have and still qualify for the Medicare Savings Program. So what that does is it helps older people fill in the gaps in their coverage. The provision, also with respect to low-income people, adds money to boost the State Health Insurance Assistance Programs and the Area Agencies on Aging that are enrolling low-income older people in assistance programs.

So those are the first two provisions that I think make a real difference for older people: the expansion with respect to services they would get from doctors if the reimbursement goes up, particularly in terms of primary care services for older people; and, second, the additional protections for the low-income Medicare beneficiaries.

But what I wish to highlight this afternoon is the additional protection in the Baucus-Snowe legislation against abusive marketing practices.

I will tell the Presiding Officer and colleagues, when I came to the Congress many years ago, in the days when I had a full head of hair and rugged good looks, it was pretty common for an older person to have a shoe box full of health insurance policies, and a lot of them were not worth the paper they were written on. They would be wasting money on these health insurance policies that they ought to be using on food and fuel and essentials.

So in the early 1990s, we got a law passed; and we changed that. It was a law to reform what was known as the Medigap market--the market for policies sold to supplement Medicare. It has worked. It has standardized the market. It has been good for old people. It has been good for responsible insurance companies. It worked.

But what happened? After the Medicare prescription drug program went in, we saw once again some people in the private insurance sector--certainly not a majority, but some--say: Boy, here is another wonderful opportunity to make some fast money. We have seen some horrendously abusive practices in this area, particularly through a product that is known as Medicare private fee-for-service. That has been the area where, in effect, you do not even have the protections you would have in Arkansas, say, if an older person had an HMO, a health maintenance organization, plan or another.

These programs exist outside the oversight and the scrutiny we ought to have for the protection of older people. And sitting next to the distinguished Senator from Arkansas on the Finance Committee, Mrs. Lincoln, we have heard in our committee about these abuses on a regular basis.

I also point out that Chairman Kohl, the distinguished chairman of the Aging Committee, had some superb hearings which pointed out exactly the same practices: how you saw older people being victimized by cold calling arrangements and door-to-door sales activities. These agents would be swooping in to apartment buildings and senior living facilities, basically trying to get people into events where there would be a free meal, or calling it an educational program, and all of a sudden they would be selling these products that were not worth a whole lot more than the paper they were written on.

So, in effect, what we saw in the last few years--it is a different product--but Medicare Advantage was going the same way we saw some of those Medigap programs going in the 1980s, which we eventually fixed.

It is important for Senators to note when they vote tomorrow on moving this Medicare legislation ahead that Chairman Baucus and Senator Snowe, with the excellent work done by Chairman Kohl in the Aging Committee, are taking a real step in the right direction to protecting seniors from these marketing abuses.

This bill would require the agents and brokers to set the scope of any sales appointment when they are setting it up. It would require inclusion of the plan type in the particular program. What happens now is it is hard for people to even figure out what type of plan is being discussed because there has not been the kind of openness and disclosure of those particular provisions.

There also would have to be training for those agents and brokers who are selling Medicare Advantage in what has come to be known as Part D so they would be out in the marketplace in a position to answer the questions of older people.

Also--and I thought this was a particularly important benefit in the Baucus-Snowe legislation--agents and brokers would have to be licensed and appointed as required by State law. We saw this in both the Baucus hearings and the Kohl hearings, that the lack of that requirement was a serious deficiency in terms of consumer protection.

I hope tomorrow the Senate will move forward on this Medicare legislation. I think without the additional assistance, particularly for doctors in the primary care field, it will reduce access to older people. We need the protections, the low-income protections I have outlined. And, finally, we need the protections for older people in terms of ensuring we do not have these flagrant, outrageous cases of marketing abuses that take us back to the 1980s, when a lot of us thought we had gotten rid of that kind of fly-by-night flimflam rip-off of older people.

The last point I want to mention--I know the distinguished Presiding Officer has been kind to talk to me about this in the past--is I think we need to pass this legislation as a foundation for the broader health reform effort that is going to take place next year. In other words, it is going to be pretty hard to go on to broader health care reform if we see physicians clobbered this year and that cutback in reimbursement goes into effect.

If you have physicians cut 10 percent, and we lose a lot of physicians in primary care, it is going to be pretty hard next year when we have a new President and bipartisan interest in the Senate to go on to broader health reform.

I think we have an opportunity with respect to comprehensive health reform that we have never had here in the Senate. For the first time in the history of the Senate, we have 14 Senators--7 Democrats and 7 Republicans--willing to work in a bipartisan way. For the first time, the people who keep the budget numbers, the Congressional Budget Office and the Joint Committee on Taxation, say that the numbers add up for comprehensive reform, that we can do it in a budget-neutral fashion. In fact, they say in the third year of an effort it would actually start generating some surpluses for the Federal Government.

So there is a lot to work with, particularly when we get Senator Kennedy back here, and he is going to be the champion of our effort. I think we can move forward with comprehensive reform, and do it in a bipartisan way. But to move forward next year with comprehensive health reform, we cannot make mistakes in this session of the Senate.

It would be a huge mistake, for example, to let this physician cutback go through that is going to harm primary care. It would be a huge mistake not to have the protections for marketing abuses, not to protect the low-income older people.

We can pass this legislation. I hope we will do it in a resounding fashion in the Senate, starting tomorrow with the important procedural vote.

I close by saying, we ought to do it now. We ought to do it at this time because it will help seniors for the future but also because I think it will lay an important foundation for bipartisan health reform in the next year of the Senate.

Mr. President, I yield the floor.

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