PRESERVING HEALTH CARE CHOICES FOR SENIORS -- HON. MICHAEL BILIRAKIS (Extensions of Remarks - July 01, 1999)

[Page: E1469]
---

HON. MICHAEL BILIRAKIS OF FLORIDA IN THE HOUSE OF REPRESENTATIVES THURSDAY, JULY 1, 1999

Mr. BILIRAKIS. Mr. Speaker, today, I am proud to introduce legislation that will help millions of Medicare beneficiaries whose health coverage is in jeopardy. My Florida colleague, PETER DEUTSCH, has joined me in sponsoring this bipartisan measure. Our bill--the ``Medicare+Choice Risk Adjustment Amendments of 1999''--will help to preserve and expand health care choices for seniors who participate in Medicare managed care plans.

The Medicare+Choice program was created as part of the 1997 Balanced Budget Act to increase health care options for Medicare beneficiaries. While the majority of beneficiaries remain in traditional fee-for-service Medicare, enrollment in managed care plans has grown rapidly in recent years. Many seniors now depend on the additional benefits (such as prescription drug coverage) available through plans under the Medicare+Choice program. However, a serious crisis threatens this vital program.

Last year, nearly 100 Medicare managed care plans did not renew their Medicare contracts or reduced their geographic areas of
```
[Page: E1470]
```
service. This year, many more plans have announced their intent to leave the Medicare+Choice program, raising serious concerns about its continued availability as an option for Medicare beneficiaries. Many plans cite inadequate reimbursement as a major factor in their decision.

Unless Congress takes action to correct this problem, the consequences will be devastating for Medicare beneficiaries, especially low-income seniors. Many will lose the option of participating in a Medicare managed care plan altogether. Others will face increased out-of-pocket costs or a reduction in benefits.

This situation is largely due to a decision by the Health Care Financing Administration (HCFA) to disregard the intent of Congress in establishing the Medicare+Choice program. The 1997 Balanced Budget Act required HCFA to establish a process for ``adjusting'' Medicare+Choice payments based on the likelihood or the ``risk'' that enrollees will use health care services.

Congress anticipated that this new ``risk adjustment'' process would provide Medicare+Choice plans with higher payments for patients who are chronically ill and lower payments for those who are generally healthy. We did not intend to decrease overall Medicare+Choice spending through this process. Instead, we were simply trying to make sure that Medicare+Choice funds would be distributed based on the health status of Medicare+Choice enrollees.

However, HCFA has completely disregarded the intent of Congress on this critical issue. The agency is using its authority to establish a ``risk adjustment'' process as an excuse to try to impose deep spending cuts in the Medicare+Choice program. HCFA's ill-advised decision threatens to seriously underfund the Medicare+Choice program. Estimates indicate as much as $11 billion may be drained from Medicare+Choice over the next five years, if HCFA is allowed to go forward with its plan.

At the time the 1997 Balanced Budget Act was considered, the Congressional Budget Office (CBO) estimated no savings from the risk adjuster. CBO's analysis assumed that the risk adjuster would simply shift funds within Medicare+Choice. By contrast, HCFA's approach would drain billions of dollars from the program.

The ``Medicare+Choice Risk Adjustment Amendments of 1999'' would address this problem in two ways. First, it would require HCFA to implement its risk adjustment process on a budget neutral basis--as Congress intended. Second, the bill would repeal a provision of current law that automatically requires the annual increase in Medicare fee-for-service payments.

Millions of seniors rely on Medicare+Choice for greater flexibility in meeting their health care needs. My legislation will help to stabilize this vital program and guarantee continued health care choices for Medicare beneficiaries. I urge my colleagues to join me in protecting seniors' health care choices by cosponsoring the ``Medicare+Choice Risk Adjustment Amendments of 1999.''
END