Health Care

Floor Speech

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Mr. THUNE. Mr. President, in July of 2009, President Obama said: ``If you like your doctor, you keep your doctor.

If you like your current insurance, you keep that insurance. Period, end of story.'' Then later, in September of 2009, the President said: ``Now these steps [ObamaCare] will ensure that you--America's seniors--get the benefits you've been promised.''

Well, Mr. President, last Friday we saw yet another group of Americans fall victim to the Democrats' broken ObamaCare promises, and this time it was America's seniors. ObamaCare cuts of over $300 billion to Medicare Advantage are already hurting seniors who rely on that popular program for their health care needs. More than 15 million seniors, close to about 30 percent of all Medicare recipients, are enrolled in Medicare Advantage plans.

The Wall Street Journal reports that approximately one out of every two new Medicare enrollees chooses Medicare Advantage. Seniors often choose Medicare Advantage because it is a more comprehensive and cohesive way to get health care services and it offers seniors the chance to pick a plan that is right for them instead of a one-size-fits-all approach picked for them by Washington, DC.

The administration's additional cuts to Medicare Advantage announced last week will make it even harder for America's seniors to keep their benefits, plan, and preferred doctor. The Kaiser Family Foundation estimates that more than one-half million seniors will lose their current plans in 2014, which is a direct violation of the President's promise.

This administration's cut to Medicare Advantage in order to try to pay for ObamaCare is having real-world impacts on people throughout the country.

A constituent of mine, Cheryl from Box Elder, SD, wrote to me this past week and said:

My husband and I both pay for a Medicare Advantage Plan. ..... We have already had our original policy cancelled because of ObamaCare. And our prescription costs have increased for the same reason. So I am practically begging you to do all you can to keep our Advantage Plan from being cut.

Every Senator who voted for this train wreck owes America's seniors such as Cheryl an explanation for these Medicare cuts, which are already resulting in canceled plans, higher costs, and reduced access to the doctors they had and liked.

When the ObamaCare legislation was being debated and these proposed cuts to Medicare were being advanced, many of us said this would be a big mistake because what they were essentially doing was cutting Medicare--particularly Medicare Advantage, which is especially helpful to a lot of seniors across this country and which is working out there--taking the savings and then using them to pay for a whole new entitlement program.

At the time we talked about this--and, of course, because of the weird conventions used in trust fund accounting here in Washington, the hundreds of billions of dollars that were cut from Medicare were not only then used to pay for this new entitlement program, ObamaCare, but were also credited to the Medicare trust fund. Their argument was that they were preserving and extending the lifespan of Medicare, and at the same time they were using these savings from the cuts coming in Medicare Advantage to pay for a whole new entitlement program. I think for most Americans this would be spending the same money twice. It would be double-counting revenue.

Essentially what they are saying is this: We are going to put an IOU into the Medicare trust fund which at some point in the future we are going to have to redeem to pay benefits, and this is going to require us to borrow more money.

It is intergovernmental debt. We talk about publicly held debt, which is debt held by the public, but there is also intergovernmental debt, which adds to the total debt burden we place on American citizens and which is debt that we are going to have to pay back in the future.

Essentially, all they have done is put a promissory note--an IOU--into the trust fund. At some point in the future when we need to be able to pay benefits to beneficiaries, we are going to have to borrow the money to redeem that IOU.

Essentially, they were able to argue that we were somehow extending the lifespan of Medicare at the very time these cuts were being made and also at the same time paying for a whole new entitlement program under ObamaCare. It was spending the same money twice. It was double-counting revenue--something which anywhere else in the country would probably land most Americans in jail.

That being said, these Medicare Advantage cuts are now having real-world impact--something we predicted all along.

The reason Medicare Advantage is a popular program and the reason one in two new beneficiaries is signing up is that it gives you options. It gives you choices. It provides competition, which is something we need to have more of, not less of, in health care today.

If you want to put downward pressure on prices, if you want to constrain utilization in health care, then create competition out there. Give people more ownership, more skin in the game. Give them some personal investment in their own health care decisions.

As it is, with the traditional Medicare Program we have a fee-for-service Medicare Program. Many seniors are enrolled in that. But Medicare Advantage gave them another option--an option that presented choices and opportunity to cover things they want to see covered in their health care plans. And it has worked. It has been an effective program, one that I think most people point to as a success.

So we are going to cut the very program that is working perhaps the best out there in terms of meeting the health care needs of America's seniors in order to fund a whole new entitlement program, ObamaCare, and in the meantime end up with these higher premiums, canceled coverages, and all the dislocations that are coming as a result of these Medicare Advantage cuts to seniors across this country. That is the wrong way to approach this issue.

There is a much better way, one that relies more on the very things on which Medicare Advantage is based--more competition, more choice, more options--and wouldn't lead to canceled coverages, higher premiums, higher deductibles, and fewer doctors and hospitals to choose from for America's seniors. But that is exactly where we are, and American seniors are now experiencing the very thing a lot of other Americans have already experienced. People who get their insurance on the individual marketplace have seen a lot of these canceled coverages already. They have seen these huge increases in premiums.

Many of us have been here on the floor reading constituent mail and emails from families and individuals who have been adversely impacted and harmed by ObamaCare because of canceled coverage, higher premiums, higher deductibles, and loss of doctors and hospitals. We have seen this in the individual marketplace. We are starting to see this--and we will see more--in the small business, employer-provided marketplace.

But now, as of last week, the real impacts are being felt as well by seniors across this country who in big numbers have been signing up for Medicare Advantage. Close to 30 percent of all Medicare recipients--15 million seniors--as a result are going to see higher premiums and reduced access to health care because of the cuts that will occur to Medicare Advantage in order to pay for a new entitlement program, ObamaCare, which, based on the number of delays the administration has made, has already demonstrated it is not working. And I, as have many of my colleagues here, have argued for a long time that it can't work because it is built upon a faulty foundation.

There is a much better way to do this. We should do away with this approach, go back to the drawing board, and use a step-by-step approach to reforming health care in this country, realizing the status quo doesn't work but realizing as well that the best way to get lower costs, more affordable health care, and more accessible health care for more American citizens is to create downward pressure on prices. That requires giving people choices and creating competition in the marketplace. Those are the things we ought to be advocating and advancing rather than this top-down, government-knows-best, one-size-fits-all solution coming out of Washington, DC, which is hurting more and more Americans and most recently American citizens who are now experiencing the adverse impacts of

ObamaCare because of the cuts to their Medicare Advantage plans.

Madam President, I yield the floor, and I suggest the absence of a quorum.

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