The continuing debate over health care reform has resulted in new initiatives that could drastically change the services we receive. With his membership on the powerful House Commerce Committee, Rep. Engel has assumed a prominent role in the health care reform debate, continually striving to protect the rights of New Yorkers and all Americans to receive quality medical services. Reforming Medicare remains a critical issue before Congress, and Rep. Engel has been a leader in the effort to enhance the current system. He has also staunchly opposed efforts by the Republican-controlled Congress that would have drastically cut Medicaid funding. While the need for reform is apparent, the proposals set forth in recent years by the Republican majority have been unacceptable. Rep. Engel has continually asserted the need to provide assistance to the elderly, poor, and disabled, and will continue to do so.

In an effort to reform the current health care system and provide optimal care at minimal cost, Rep. Engel has developed an aggressive Health Care 2000 agenda outlined below.

Medicare Coverage of Outpatient Prescription Drugs

Rep. Engel is committed to providing senior citizens with affordable health care. As a Member of the House Democratic Medicare Task Force, Rep. Engel has heard testimony time again of how the increasing cost of critical modern medicines have cut deeply into seniors’ savings. Many seniors in New York and across the country are forced to make life and death choices on a daily basis. Some seniors must decide whether to use their money to purchase prescription drugs or food. One out of three Americans on Medicare have no coverage at all and what coverage does exist is purchased at extra costs.

When Medicare started in 1965, drugs amounted to only about 5% of health care costs. Today, drugs consume up to 14% of medical expenses. To address this important issue, Rep. Engel introduced H.R. 1109, the Medicare Outpatient Prescription Drug Coverage Act. This legislation adds a cost-sharing Medicare prescription drug benefit for seniors by covering up to 80% of the actual cost for multiple source drugs and 90% for sole source drugs, while setting a $250 deductible per individual per calendar year. Rep Engel has stressed to Congress and the President that the time has come to expand Medicare to include prescription drugs. Stating “our seniors deserve it.”

Long-Term Care

Rep. Engel is working to ensure that seniors have the ability to obtain quality long-term care. In fact, over 7.3 million Medicare beneficiaries in the United States need long-term care services. However, with the average cost of nursing home care exceeding $40,000 per year, many seniors are left without coverage. Individuals without long-term coverage are more likely to need emergency and other medical services. To address this issue, Rep. Engel has authored HR 131, "The Comprehensive Long-Term Care Act," which will provide the long-term coverage that our seniors desperately need.

Medicare only covers limited amounts of community-based long-term care services but most chronically impaired seniors need much more. Rep. Engel’s legislation will provide chronically impaired individuals with non-medical supportive care and assistance plus basic self-care functions for active daily living. Rep. Engel has stressed to Congress that the care provided will become a preventive tool which will increase overall health and actually lower medical costs.

Home Health

Rep. Engel has realized the dire need for home health care for senior citizens in New York and across the country. Thousands of New Yorkers receive their medical care at home rather than in more expensive hospitals or other medical facilities. To encourage less costly care at home, Medicare beneficiaries do not currently make co-payments for these vital services. The plain truth is that Medicare home care patients tend to be among the oldest, poorest, and sickest Medicare beneficiaries.

In the ongoing debate in Congress over health care reform, Rep. Engel has stressed to his colleagues that home care enables seniors to stay out of nursing homes and hospitals, which reduces overall medical costs. Unfortunately, changes in the Medicare program instituted by the Balanced Budget Act of 1997 will change how home health clinicians bill for their time. The result will be a drastic increase in the cost of home health care, which will eventually force many home health care providers out of business and leave nursing homes the only option for seniors. However, in his continuing effort to provide seniors with the best possible care, Rep. Engel has authored HR 2924, the Medicare Home Health Payment Improvement Act, which would preserve home health care services, allowing seniors to remain living at home and receiving the care they need. In the coming months Rep. Engel will be fighting in Congress to ensure that senior citizens have access to affordable home care services.

Providing Health Benefits for Dependent Parents

The need for access to quality health care coverage continues to be of paramount priority to Rep. Engel. In an attempt to assist federal employees with their health care responsibilities, he has introduced H.R. 2096, the Federal Family Health Coverage Act. This bill will assist federal employees who provide at least half of their parents yearly support by amending the Federal Employees Health Benefit Plan (FEHBP) to cover dependent parents who are not eligible for Medicare or have adequate health benefits under another health plan.

This legislation is not expected to represent a substantial addition to the federal budget. Just as federal employees today pay an additional sum for the option of family coverage under FEHBP, the Federal Family Health Coverage Act envisions an additional employee premium to cover dependent parents' health care.

The Federal Family Health Coverage Act is supported by New York Chapter 23 of the National Association of Retired Federal Employees (NARFE) and the National Treasury Employees Union (NTEU). These organizations recognize the importance of assisting federal employees with their family health care responsibilities.

Fighting for New York Hospitals

Rep. Engel marched to the defense of New York hospitals once again in 1999 as Graduate Medical Schools were threatened with drastic cuts in funding. Several New York Hospitals, including the Bronx's Montefiore Medical Center, have large Graduate Medical Education programs for residency training which faced a staggering $250 million in funding cuts. Montefiore, alone, would have lost over $50 million.

Rep. Engel moved swiftly to prevent the cuts from taking affect. Through negotiations with members of the House of Representatives and the Senate, an agreement was reached that reduced the cuts by 80%, saving the hospitals tens of millions of dollars. In the future, Rep. Engel will stand ready to fight for the interest of New York hospitals in his continuing effort to enhance the quality of life for all New Yorkers.

Rep. Engel also worked to obtain $1.5 million in funding for the new Children’s Hospital at Montefiore Medical Center, as well as an additional $12 million for medical research and programs in hospitals throughout the district. To see other federal funding that Rep. Engel secured for the 17th Congressional district of New York, click here.

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