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Medicare

Sen. John B. Breaux

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Madam President, today is a very important day because it is the 37th anniversary of the passing of the Medicare legislation providing universal coverage of health care for all seniors. Everybody got it. No matter what your income was, there was no gap. Those with low income got Medicare, hospital, and doctor coverage. If you were of moderate income, you got it. If you were upper income, you got it. It was a concept 37 years ago that Medicare should be a universal health care plan for all seniors.

Today, we are at some point going to be debating a fundamental change in Medicare by saying that only a portion of seniors are going to get real prescription drug coverage--not all seniors, but we are going to means test it. According to the piece of paper provided by the supporters of that approach, individuals below 200 percent of poverty--which is $13,300 for an individual--are going to have a Cadillac-type of coverage plan. But if you make $13,301, tough luck. You are going to have to pay 95 percent of your drug coverage if you are not below 200 percent of poverty until you reach a figure of about $3,300 worth of out-of-pocket drug expenses, and then the Government will make up 90 percent.

It is really interesting to see whom are we talking about covering. It is also important to think about whom we are not covering under this scaled-down version.

The average number of people in the United States below 200 percent of poverty is 30 percent. That means 70 percent of the American elderly would not qualify by being under 200 percent of poverty. These are working people who have paid taxes when they were working, who are retired, and now, because they don't qualify as being 200 percent under poverty, all of a sudden we are going to leave them out of a Medicare Program that was supposed to provide universal health coverage for all Americans. This is a fundamental break with what Medicare was all about, which was a universal plan for all seniors, not just for seniors making under 200 percent of poverty.

Seventy percent of America's elderly would not qualify for the 200 percent poverty standard. That is not what we signed into law 37 years ago and celebrate today, the advent of a Medicare Program that was universal coverage for all citizens.

I understand why we are attempting to do that. That is because we are trying to spend less money. The tripartisan plan said we could spend $370 billion and reform Medicare by giving seniors new options and also provide a universal prescription drug plan that covered all seniors, not just those under 200 percent of poverty.

If I were a senior who had an income of $13,301, according to their chart, I would be very unhappy with what the Senate is considering now. Seventy percent of America's seniors would not qualify under 200 percent of poverty. We can do better than that. We can do far better than that. We can do more for less, if we do it correctly and we do it in the proper fashion.

We had a plan under the tripartisan plan that was a comprehensive plan. It was a $24-a-month premium for seniors who have to meet a $250 deductible, and then, after that, it was universal coverage for all seniors. They paid 50 percent coinsurance, but everybody participated. Every senior was treated equally, not just spending a substantial amount of money for a selective number of people.

Medicare is not an antipoverty program; Medicaid is. Medicare is universal coverage. It is not just saying to 70 percent of our seniors, you are not going to get any real help. Some will say we are helping those over 200 percent of poverty. You are not helping them very much when you tell them they have to pay 95 percent of the cost of their prescription drugs. Ninety-five percent, what kind of coverage is that? We are going to say: We will help you with 5 percent, but 95 percent is going to have to come out of their pocket after 200 percent of poverty. That doesn't seem to be a very good deal to me.

Then you say: When you get $3,300 worth of out-of-pocket drug costs, the Government will help you again. It is not really the best we can do. We can do far better than that. I think we ought to.

I don't know why we are actually voting. No. 1, everybody should realize the bill did not come out of the Finance Committee, where all of this type of work should have been done, where all the compromises should have been accomplished, instead of trying to go to the floor and having one bill one day without 60 votes, another bill without 60 votes, and yet today another bill that does not have 60 votes.

We are putting people on the spot unnecessarily. I suggest we put this off and begin the real work that is possible and get something that works.

The Senator's time has expired.

The Senator from Maine is recognized.

Sen. Olympia J. Snowe

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Madam President, I ask unanimous consent to add 3 additional minutes to my 12.

Is there objection?

Without objection, it is so ordered.

Sen. Olympia J. Snowe

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I would be glad to yield further to my colleague from Louisiana.

Sen. John B. Breaux

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No, thank you.