USA FREEDOM Act

Floor Speech

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Mr. KAINE. Madam President, I rise in honor of a birthday.

Forty-nine years ago, Medicare was signed into law. Every year, the trustees prepare a report about the fiscal health of Medicare and Social Security, and that report was issued earlier this week. On this 49th birthday of Medicare, I wish to talk about Medicare's health because there is some good news.

The 2014 trustees' report released earlier this week looks at the trust fund financing for Medicare hospital coverage and indicates that trust fund, under current projections, will remain solvent until 2030. Last year the 2013 report indicated that solvency period would go to 2026. So in 1 year the fiscal projections for Medicare and Medicaid improved by 4 years--solvency until 2030.

In addition, the projected Part B premiums, the Part B portion of Medicare, which is the prescription drug premium program for seniors, for the second year in a row the premiums will not increase one penny.

This improved health of Medicare is significant. The health of it has improved dramatically, even in the last year. But where the improvement truly looks significant is if we compare the 2014 report with the 2009 report, the report that was done on Medicare's 44th birthday 5 years ago. The 2009 report said the hospital insurance trust fund was not adequately financed for the next 10 years, and it would be exhausted in 2017.

Again, just to compare, 2009 Medicare trustees' report, the trust fund will be exhausted by 2017; 2014 Medicare trustees' report, the trust fund will be solvent all the way through 2030. There is a difference of 13 years of additional solvency in Medicare, according to the projections and the change just from 2009 to 2014.

I think we know where I am going with this subject. What explains the improving solvency of the Medicare trust fund? Why would it have changed so dramatically from the 2009 to the 2014 projection and added 13 years of solvency to the trust fund?

The Congressional Budget Office and others have indicated it was not the 2009 recession that was the primary driver for Medicare spending reduction. Instead, the CBO and others are indicating that a large part of the improved solvency of Medicare is because of the reforms that were included by Congress when Congress passed the Affordable Care Act in 2010. When it comes to reducing costs, bending the cost curve, the Affordable Care Act is working.

That is not the only reason Congress passed the Affordable Care Act. Coverage is expanding. Certain health care indicators are improving. More people have access because they are not denied insurance because of preexisting conditions. Kids can stay on family policies. Businesses can get tax credits if they are small.

But one of the areas--and that was why the first day the ACA was affordable. It was to try to do things that would control health care costs.

This Medicare trustees' report on Medicare's 49th birthday shows on cost reforms the ACA is working. The innovative systems of changing the payment model from pay-for-procedure to pay for quality, paying for value over volume, for

reducing costs and improving health care delivery systems are extending the solvency of Medicare.

Not only is this cost containment good for the Federal Government, for the Federal Treasury, it is also good for Medicare recipients: 8.2 million Medicare recipients saved more than $11.5 billion on prescription drugs thanks to closing the Medicare Part D doughnut hole.

In Virginia, people with Medicare saved $254 million on prescription drugs because the Medicare Part D doughnut hole was closed just since the ACA was enacted--$254 million since the 2010 enactment. In 2013 alone, 37.2 million Medicare recipients received free preventive benefits, including more than 900,000 in Virginia, because of the Affordable Care Act.

The work obviously needs to continue to bend the cost curve the right way, but the trustees' report from Monday is not the only evidence of the improving health of our fiscal expenditures.

Just this month CBO again revised downward its 10-year estimate for spending on Medicare and our Nation's major health care programs. Since 2010 CBO has lowered its estimates for Medicare and Medicaid and other health care programs by $1.23 trillion--lowered projections of health care spending since the Affordable Care Act was passed.

The CBO said in a recently issued long-term budget outlook that the government will spend 1.6 percent of GDP less on health care programs than estimated in 2010 before the ACA was passed. A report released this week by the Office of the Assistant Secretary for Planning and Evaluation at HHS reported essentially no growth in Medicare expenditures on a per capita basis last year.

That report also said Medicare spending between 2009 and 2012--for beneficiaries in the traditional program--was approximately $116 billion lower than it would have been if the average growth rates from years 2004 to 2008 had been projected forward.

So there are many reasons we should be thankful the Affordable Care Act passed, that we should be absolutely committed to maintaining it, and that we should also be committed to maintaining it wherever we can. But as we celebrate the 49th anniversary of Medicare today, one of the reasons we should be thankful is it is clear that the ACA is helping us make health care more affordable.

To conclude, the report that was issued this week was not all good news because it also had challenges with respect to Social Security. The Social Security trust fund will be exhausted in 2033, and that represents no change from last year. The solvency of the trust fund was not changed at all in the interim year.

But in the area of Social Security disability income, that insurance program--at current projections--will be completed by 2016.

Secretary Lew indicated this week that measures need to be taken to make sure that program--which is of critical importance to millions of Americans who are on disabilities--requires that we take action to fix that program so they can count on it.

So what we see is when Congress in the Affordable Care Act acted in a smart way to deal with Medicare, we have improved the area of Medicare costs and we are saving money. Congress has not acted with respect to Social Security and the Social Security disability insurance program, which is critical to folks with disabilities. It is going to need some quick fix.

I conclude and just say it is good for Congress to act. We can filibuster. We can debate. We can consider nominations. We can do a bill in one House and send it over and wait--as with immigration reform for 1-year-plus--for the other House to do something about it. None of that is action. None of that will fix any of the challenges that face us.

But when we do act and we are willing to tackle tough problems such as Medicare cost growth, we do it in both Houses and take the risk, we will find we will be better off than if we don't act. Social Security needs to have the same kind of focused and careful attention to it, especially the disability insurance program, as we paid to Medicare in 2010.

Medicare is one of the best programs this Nation has ever embraced. I wish it a happy 49th birthday today and congratulate those who were in the Senate in 2010 for being willing to risk action and thereby found a way to save costs and make Medicare work better.

I yield the floor.

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