Jan Schakowsky

Ms. SCHAKOWSKY

Ms. SCHAKOWSKY. Which is part of our bill.

Ms. SCHAKOWSKY. First of all, it's no wonder that the insurance industry is fighting us tooth and nail and with millions upon millions of dollars in TV advertising because they are making so much money and they do that by raising their rates. And it's really astonishing to me that in this period when the Congress is discussing how we're going to change and make the health care system affordable for people that they have the utter audacity to show their true colors by raising their rates. Let's look again at your chart. Anthem Blue Cross customers. That's in California, right?

Ms. SCHAKOWSKY. Ninety-four percent rate increases in the last 2 years. Something clearly needs to be done to get them under control. This bill does that. It says that they will have to justify, they'll have to open their books, they'll have to explain, and if they can't, that those rates can be modified, consumers can get a rebate. Enough of their taking such tremendous advantage of American consumers.

Ms. SCHAKOWSKY. That's right. And let me say I think truly this is one of the dividing lines between the Democratic majority that's about to pass this bill that stands with the American people versus the Republicans who persistently have stood on the side of the insurance companies that have raised our rates for decades, have cut people off, have canceled policies, have put in preexisting conditions. We want to stop those kinds of abusive practices. That's what they are. It's really abuse. And the Democrats are standing with the American people. It's a really, Which side are you on?

Ms. SCHAKOWSKY. That is a better Republican program, because that's if we do nothing, that's what would happen. But actually, the proposal that was laid out by Representative Paul Ryan, the top Republican on the House Budget Committee, he laid out what he called the roadmap that would actually end Medicare for you as an individual.

Ms. SCHAKOWSKY. Are you?

Ms. SCHAKOWSKY. So let's say you're 54. Let's pretend. Are you? Okay. I believed you. I thought you were 54. Okay. So let's pretend you're 54 years old.

Ms. SCHAKOWSKY. And what it means is, when you would get to 65 years old, rather than getting Medicare, you would get a voucher and be told, Go out and buy insurance. There is no more guaranteed Medicare for you. There is no more guaranteed package of benefits. You go out and buy insurance. And that is really privatizing Medicare and destroying it for every American that is currently under 55 years old. When they get to 65, they wouldn't have it.

Ms. SCHAKOWSKY. That is exactly what I'm saying. And that it would also hurt Medicaid.

Ms. SCHAKOWSKY. The do nothing deal is better than the plan that they say is good for Americans.

Ms. SCHAKOWSKY. Those are the tragic stories that result from our health care system. But there are also enormous lost opportunities. One of the things that we know about our health care system is people get locked in jobs. They may dream about creating something, a really innovative product, or starting a new business or becoming a great artist, thinking of a new invention that will transform medicine or energy, but they are stuck in their job. A Canadian was telling me about the incredible freedom that people in Canada have to innovate, to experiment, to create, to do all the things that so many Americans, because of our health care system, are unable to do. If America, the United States of America, wants to be number one in innovation, we want to release that creative spirit and that spirit of innovation which is trapped in a job because of health care.

Ms. SCHAKOWSKY

Ms. SCHAKOWSKY. Tell them your background, too.

Ms. SCHAKOWSKY. One of the great things that you pointed out is that Medicare was passed in 1965, but we continue to work to improve it, to make it better, to even expand the coverage so that it is more affordable for the elderly. This is a work in progress. It's really been a job that has been the life's work of the Democratic Party for generations to make sure that Medicare really does do what it needs. When Medicare first came into being in 1965, prescription drugs were actually a very small part of the whole health care cost. Now they are at the center--front and center, often--of extending life, of making life more livable, of preventing death, and so we work to find all the ways that we can perfect what has been a very successful program. I want to once again just make sure that people see the advantages to older Americans, how health care reform means security and stability for America's seniors, extends the life--that's what solvency means-- extends the life of Medicare, lower seniors' cost for prescription drugs, improves the quality of seniors' care with better coordination among doctors, trains more primary care doctors so there will be access when we add more people to health care. Some seniors are worried. Okay, add 30 million people to health care coverage, are there going to be enough doctors? We say we've got to do that. That's what is in this bill, to make sure that we train and create incentives for more primary care doctors, and nurses, too, so that we have the professionals that we need. Covering the cost of preventive care for Medicare patients, you described that. That's for things like mammograms and colonoscopies. No out-of-pocket costs. Expand home- and community-based services to keep seniors in their homes. So the question really is: What is the Republican plan if they say our plan is bad? Well, Paul Ryan, one of the up-and-coming Republicans, proposed the plan. He's the top Republican on the House Budget Committee, and he put forth what they call the roadmap. The Republican roadmap wouldn't improve Medicare. It actually ends it. Now you're thinking, Oh, this is all partisan. That can't be true. But, actually, it is true. It would end Medicare, when they get to be 65, for everyone who is now under the age of 55. Once those people who are under 55 get to be 65, instead of Medicare, they get a voucher. Go out and find health care for yourself. And the Congressional Budget Office, the nonpartisan Congressional Budget Office, reports that that voucher over time would be worth about a quarter of what Medicare is valued right now. The roadmap wouldn't require that private insurers actually accept those vouchers or charge affordable premiums or provide necessary benefits, making those vouchers pretty darn worthless. Let me tell you what one of the expert groups said. This is the nonpartisan Center on Budget and Policy Priorities: The Ryan plan imposes no requirement that private insurers actually offer health coverage to Medicare beneficiaries at an affordable price or at all. Did you want to speak to that?

Ms. SCHAKOWSKY. Good. And I hope that what you have said has now convinced many others. But it is really wrong, I think, to put out information that really causes older Americans who are so dependent on Medicare, and that is most of the people on Medicare that really rely on it for most of their health care even if they have a supplemental, to tell them things that just aren't true, that benefits in some way are going to be cut. I want to introduce now someone who also has been a great advocate for the constituents in her district and for older Americans, a great friend of senior citizens, from Nevada, and that is Congresswoman Dina Titus.

Ms. SCHAKOWSKY. You've got that right. You would get a voucher.

Ms. SCHAKOWSKY. I have to say that it is not necessarily just a little bit. At the beginning of September, the Department of Health and Human Services and the Department of Justice announced the largest health care fraud settlement in history. Pfizer, the drug company, agreed to pay $2.3 billion for illegal marketing practices. That is going to return about $1 billion to Medicare and Medicaid. So that is not chump change.

Ms. SCHAKOWSKY. Thank you very much for reminding everybody, first of all, that Medicare is the government program of health care for older Americans. It is not just a made-up story that sometimes people come up to us and say, Keep government hands off my Medicare. Well, we have to remind people that this is a 100 percent government program. And thank God for Medicare, because so many people, that is the only insurance they have. And I have to tell you, a lot of people come into my office every week and saying, I can't wait. I can't wait for my 65th birthday so that I can finally get the insurance and the care that I need. I am also, as I said, going to talk about how this bill even helps people age 50 to 65 with their health care problems. But right now, I want to introduce somebody who knows a bit about insurance, who knows a bit about health care, and knows a bit about what seniors in this country, what Americans in this country need when it comes to health care. He is a new Member, but he is not new to this issue, and he is not new to advocacy for all good things for consumers and for the seniors, and that is John Garamendi, my colleague from California.

Ms. SCHAKOWSKY. Great. I thank you so much. I wanted to talk in very specific terms. Again, you talked a little bit about some of the issues, how this bill actually, in a concrete way, on a day-to-day basis, is going to help older Americans. I think it's so important that we explain the details of this bill because there have been a lot of myths out there particularly aimed at older Americans. And it really makes me mad. There has been a lot of fear about how somehow this bill is going to cut Medicare. And I'm going to talk about how that is exactly the opposite, how this bill is actually going to extend the life of Medicare, not cut any benefits. So let's look at some of these things, how health care reform means security and stability for America's seniors, extends the solvency of Medicare. What does that even mean? Extend the solvency of Medicare. What that means is that currently if you look at the Medicare funds, by 2017, that fund is going to be in some trouble. Aha. But we pass this bill, and the solvency, the health of the Medicare Trust Fund is going to be extended another 9 years. So we are now up to 2026. We want to figure out ways to even go beyond that, but that's a pretty good start, to extend it to 2026. Lower costs for prescription drugs. You talked a bit about the doughnut hole. And, again, you're right, you talk about the doughnut hole. Not only does it sound benign, a lot of people don't know what we're talking about when we say that. But there is this gap in coverage. And so I'm going to tell you about one of the seniors who actually had this pretty horrible experience when she went to the drugstore and found out that she was not covered. Here she is. My constituent had a Humana part D Medicare, that is a prescription drug plan, and had trouble paying the monthly premium. Humana originally told her that she would never pay more than a few dollars for her medications. Sounds pretty good. One day she went to CVS, she went to the drugstore, and was told that one medication out of the eight that she is taking was going to cost $130, whereas the previous month the cost was $20. From $20 to $130. At that point, the pharmacist told her about the doughnut hole. She found out that from then on she was going to have to pay out of pocket until she paid $3,600 out of pocket. She would continue to pay her premiums every month, but her drug costs were going to be out of pocket until she had paid $3,600 more. Well, what she told us was that she stood at the pharmacy counter and cried because she just couldn't afford to get her medicine. So she walked out of the pharmacy. She called our office, and she was concerned that she wouldn't be able to take her lifesaving medicine because she didn't have the money. And fortunately, there was an Illinois program in existence at the time called Illinois Cares Rx, and she is able to get her medication through that program. But fortunately, she fit the eligibility requirements. Plenty of people don't. And then her physician gave her some free samples. And you know that doesn't last forever. So we are going to permanently close that doughnut hole, and we are going to begin to do it on day one, lowering the cost of prescription drugs. We are going to improve the quality of seniors' care with better coordination among the doctors. And that is going to be cost savings, too, because we are going to have coordinated care so that they get this continuum of care. We are going to train more primary care doctors. That's what we need to do. We are going to provide incentives to make sure that we have more primary care doctors. We're going to cover the cost, as you mentioned, Representative Holt, of preventive care for Medicare patients. No more out-of-pocket costs. You have your Medicare card--that's all you're going to need for those preventive services. And we're going to expand home and community-based services to keep seniors in their homes, which, we should add, is exactly where they want to be. People don't want to be forced into nursing homes. They want to be able to stay at home. If we expand those home- and community-based services, someone being able to come into the home at a price they could afford, adult day care centers where people can go during the day and be safe and active, then they are going to be able to stay in their homes. That's just the beginning of what we do for seniors. Let me turn it back to Representative Holt for just a minute because we were talking earlier about how frustrating it is that there is a question about Democrats, the majority, wanting to somehow cut Medicare.

Ms. SCHAKOWSKY. Thank you so much, Representative Matsui, for being such a strong advocate for older Americans, really for all Americans, that are going to be helped by this legislation. And we are going to be talking much more about that. I wanted to just let everyone know that for 5 years I had the pleasure of being the executive director of the Illinois State Council of Senior Citizens. It was between 1985 and 1990, and those were among the most fun years and learning years my life. I was a lot younger then, not a senior citizen as I have reached today, and what I learned is that our older Americans, while facing many, many challenges, are the people who really helped build our middle class, who helped build our society, and now in their older years, especially in this time of economic downturn, are facing incredible difficulties in getting their health care. Thank goodness for Medicare. We will talk more about that program that was passed in 1965. There is a reason why every advocacy group for older Americans is supporting this legislation. If you look at the list, and I'm going to read it, you will see that the people who know best, because they either are made up of older Americans or their job is to advocate for older Americans, are supporting this legislation. That would include the AARP, which represents tens of millions of older Americans, people from 50 and upward, and we will talk about how this legislation not only helps people 65 and older, but 50 and older, the National Committee to Preserve Social Security and Medicare, the Alliance for Retired Americans, the Center for Medicare Advocacy, Families USA, the Retirees of AFSCME, B'nai B'rith International, National Senior Corps Association, National Academy of Elder Law Attorneys, National Council on Aging, Service Employees International Union, National Association of Professional Geriatric Care Managers, Easter Seals, Medicare Rights Center, American Federation of Teachers Program on Retirement and Retirees, Volunteers of America, the American Society on Aging, and National Senior Citizens Law Center. I'm sure there are more that aren't on my list. I have some other data from some of these organizations. These are the people who know what seniors want. That is their business. They are made up of seniors and certainly of their advocates. And one of the advocates for the elderly is a great colleague mine. Rush Holt from the great State of New Jersey is here tonight to talk about how people in his State and around the country, older Americans, are going to benefit from this legislation.

Ms. SCHAKOWSKY. Madam Speaker, I'm so happy to be here tonight, particularly after I have heard what my colleagues had to say. One of them said, Our people need to hear the truth about the health care legislation. That's exactly what we're going to talk about tonight. Tonight we're going to talk about how this legislation helps our older Americans, our senior citizens. We're going to talk about how this bill protects Medicare for the next 10 years. It's solvent for an extra 10 years so we keep our promise for an aging population and take care of our citizens when they get older. We're going to talk about closing the doughnut hole, about protecting seniors from elder abuse, about making visits to the hospital safe. I have the pleasure of being the cochair of the Democratic Task Force on Senior Citizens, on seniors, and my cochair is the gentlelady from California, Doris Matsui. And Doris, I'm going to turn it over to you to get us started tonight.

Ms. SCHAKOWSKY. You know, a lot of us have been barraged with phone calls like your mother said to you. She believed you, didn't she?

Ms. SCHAKOWSKY. Nine years.

Ms. SCHAKOWSKY. And then eliminates it over 10 years.

Ms. SCHAKOWSKY. That's right.

Ms. SCHAKOWSKY. I think it's really important at this point to just mention some of the things that do happen as soon as the bill passes. A lot of people, one of the things that the Republicans have been saying about this legislation is that, Well, you have to wait until the bill takes effect for another 4 years. Well, that's true that a number of the elements of the full rollout of the bill take 4 years, but a number of things happen right away, and among those is the beginning to close the gap in coverage, or the doughnut hole. A lot of seniors out there are worried about their grandchildren. This legislation, on the day that it's enacted, says that children with preexisting conditions will not be excluded from health care. Imagine if you have a grandchild with asthma or a grandchild with autism and suddenly they're trying to get health insurance for the family. This child will be covered. Imagine the relief it will take off of the parents and the grandparents' shoulders if we're able to do that. Lifetime caps. Many people have chronic illness and right away they find that they have reached the limit of how much their insurance company is going to pay.