Roger Wicker

Mr. WICKER

Mr. WICKER. The reason he cannot make this guarantee--

Mr. WICKER. This segment of debate will end at the bottom of the hour, so it is almost over. I appreciate my friends yielding. This debate will continue for days, weeks. I say to my friends, there are Members on their side of the aisle who have come before this body and said these Medicare Advantage cuts are unacceptable. I think they are going to have to have a lot of convincing too. Democratic Members of the House have also come forward. I am not convinced. I don't think they are convinced.

Mr. WICKER. It is clear the Senator does not like Medicare Advantage. It is also clear no guarantee can be made that Medicare Advantage benefits will not be cut under this legislation. It is also clear there are tens and tens of millions of American senior citizens who like their Medicare Advantage, notwithstanding the Senator from Montana, and they stand to lose those benefits under this legislation.

Mr. WICKER. The chairman, when he is calling HHS to change the handbook, also needs to tell them to change their Web site, where it says Medicare Advantage is part of Medicare. Can the Senator from Connecticut guarantee that under this legislation, the benefits to Medicare Advantage recipients will not be cut? Can he make this guarantee?

Mr. WICKER. Will the Senator yield?

Mr. WICKER. One other question. Is it a semantic question to ask: Are the American seniors who are currently enjoying Medicare Advantage going to be disallowed from this program? The answer is yes, under this bill.

Mr. WICKER. I realize my friends have a difference of opinion. The authorities for Medicare who put this publication out year after year say Medicare Advantage is part of Medicare. It is Part C. I think it is disingenuous for my friends to say it is not.

Mr. WICKER. The question I had was: Is this a part of Medicare?

Mr. WICKER. I know this. It is in the handbook. I want my two friends of the majority party to get it out of there. We thought all along it is part of Medicare and the millions of senior citizens who rely on this and who were told in the campaign, if you are satisfied with your coverage, you don't have a thing to worry about, they are going to be able to keep their coverage. Under the Democratic legislation, they would not be allowed to keep their coverage under this bill.

Mr. WICKER. Isn't it in part of the Medicare legislation?

Mr. WICKER. Even though Medicare put it in their handbook, has had it for several years, it is wrong?

Mr. WICKER. I realize we do not have much time. I have a quick question. I was listening to the debate on television. I understood the Senator to say Medicare Advantage is not part of Medicare. My question is: I have here the Medicare handbook for 2010, ``Medicare and You.'' It says right on page 50: Medicare Advantage Plans (Part C). A Medicare Advantage plan . . . is another health coverage choice you may have as part of Medicare. My question to the Senator is--to my friends on the other side of the aisle: Is the Medicare handbook inaccurate and, if so, will you be calling CMS, Medicare, and be asking them to change what they say explicitly on page 50 of the Medicare handbook?

Mr. WICKER. Madam President, will my friend yield for a question?

Mr. WICKER. Mr. President, if I could just maybe take 1 minute of that time and then y colleagues can wrap it up. I wish to emphasize what a devastating effect these Medicare cuts are going to have on rural America. Once again, I wish to quote some of my colleagues from the other end of the building because it shows the bipartisan opposition we have against these cuts from rural America. Mike Ross, a Democrat from Arkansas, said: With more than $400 billion in cuts to Medicare, it could force many of our rural hospitals to close, providing less access and care for our senior citizens. Representative Larry Kissell of North Carolina: From the day I announced my candidacy for this office, I promised to protect Medicare. So he voted no on the bill in the House of Representatives. Ike Skelton said: The proposed reductions to Medicare could further squeeze the budgets of our rural health care providers. Finally, Representative Boucher, a senior Democrat from Virginia, said: The plan could place at risk the survival of our regions' hospitals. Unless these Medicare changes are taken out of the bill, this bill devastates health care for senior citizens in rural America. I thank my colleague for yielding me the time.

Mr. WICKER. We have three Republicans standing now saying this, and we have had quoted some official independent sources. Let me quote a Democrat, Representative Michael McMahon of New York: Medicare Advantage, which serves approximately 40 percent of my seniors on Medicare, would be cut dramatically. That is why that Democrat from the State of New York voted no on the plan when it was before the House of Representatives. So you don't have to take our word for it, from a partisan standpoint. Democrats are saying no because of the Medicare cuts and the cuts to Medicare Advantage--drastic cuts.

Mr. WICKER. If the Senator would yield on that point.

Mr. WICKER. Mr. President, I appreciate the Senator yielding to me. I think it is important for us all to understand where we are now. We have had a debate about the Medicare issue. The Senate had an opportunity, with the McCain amendment, to protect Medicare from the almost one-half trillion dollars in cuts the Reid bill proposes to do to Medicare. We said no to that opportunity and instead passed the amendment offered by Senator Bennet of Colorado which in sum total does absolutely nothing. What we have done now with the Bennet amendment is say that along with apple pie and motherhood, we also love Medicare, and we want everybody to know that. But the substantive effect of what we have now done is nothing. I have this challenge to the managers of the bill on the other side and to the Democratic leadership: Now that Bennet has passed and McCain has been defeated, I challenge them to take this bill, send it back to CBO and CMS and have the independent analysts there look at it again. They will be duty bound to come back with the facts. The facts will be that the almost one-half trillion dollars cut in Medicare is still there. Now that the McCain motion to commit has been defeated, and the sham of the Bennet amendment has been passed, there are still the same cuts to hospitals, there are still the same cuts to Medicare Advantage and to all the senior citizens who depend on that and who were told during the campaign their coverage would not be taken away from them if they liked it. The cuts to nursing homes are there. The cuts to home health are there. And the cuts to hospice are still there. Send the bill back to CBO. We can continue debating it. We will not have to miss out on one bit of rhetoric that we have already had. But ask the independent analysts: Are the Medicare cuts still there? They will be duty bound to come back to us and say: Yes, the same cuts that were there before are current in the bill now. We have accomplished absolutely nothing today to protect Medicare. I thank the Senator for yielding.

Mr. WICKER

Mr. WICKER. I think this constituent of mine, from Brandon, MS, said it very well in a recent e-mail I received. Obviously she is dependent upon home health care. I support the goal of health care for all. However, that goal should not come at the expense of frail, elderly and disabled homebound Medicare beneficiaries receiving care in their homes and communities. . . She points out what this legislation would do to home health care. Truly, this bill before us and the one from the House and the one from the two committees takes money from America's seniors to the tune of $\1/2\ trillion, and instead of shoring up the system that needs to be enhanced and protected, it puts that money in the new government entitlement program we have exhibited here. I certainly believe we can do better.

Mr. WICKER. Mr. President, before the Senator leaves that subject matter, I wonder if I could interject. My friend from Idaho also has listed specific cuts under this legislation: hospitals, Medicare Advantage, cuts to nursing homes, cuts to home health, and hospice. But also I think Senators and Americans need to understand that the Reid bill also establishes a permanent board of unelected members appointed by the administration which, in this case, initially at least would be the Obama administration, and they would dictate further savings under Medicare. This gets to the question of my friend from Arizona about rationing. It would dictate annual Medicare cuts geared toward reducing Medicare spending. These people are not going to be like us--accountable. They will not have to go back to their district every 2 years or their States every 6 years. But they will have the unbelievable power under this legislation to dictate additional cuts that we know not. The Wall Street Journal called this a rationing commission. This ties right in with the concerns that Americans have had over the last 2 or 3 days about these recommendations with regard to mammograms. I realize I am intruding on the Senator's time, but I have a letter from a physician in Mississippi who is fearful that this sort of rationing board is going to impose the requirement that mammograms not be given until after age 50. He says: My wife and I have two daughters who had breast cancer in their 40s. One daughter was age 42 and it was picked up on a routine yearly mammogram. The other daughter was age 49 and she found an abnormality by self breast exam and it was confirmed by a mammogram. . . . Now we have a group of unelected people coming forth and saying you are not supposed to get a mammogram, you are not entitled to a mammogram, and we learned that some insurance companies have already decided to follow that dictate. This gentleman, a physician, says my two daughters would be dead from breast cancer if that were imposed. I am afraid that in addition to these very definite cuts, this permanent board of unelected members would impose the very type of requirement that we are fearful might come forward on mammograms.

Mr. WICKER. Will my colleague yield? This Reid substitute that will be substituted for the shell bill contains taxpayer funding of abortions and it contains a government-run company to compete with the private sector. So Senators who vote to proceed on that bill, in my opinion, are playing with fire and very much risking that type of legislation might come out of the closed room that will be the House- Senate conference.

Mr. WICKER. I appreciate the Senator asking that question. The answer is there is no reason for us to go down that path. Early in our hour, the Republican whip pointed out that there are many proposals the Republicans have that do not require the huge expenditure, the huge expansion of Federal power and actually are relatively simple and relatively inexpensive. For example, we have a proposal: To reduce junk lawsuits against doctors, by Senator Ensign, the Medical Care Access Protection Act. It is only 28 pages, compared to these huge pieces of legislation in front of us. That would not cost anything. It certainly would not require any reduction in Medicare. To combat waste, fraud, and abuse, by my friend from Florida, and I congratulate him for that. It is only 21 pages, something Republicans have been begging for and arguing for for years and have been stymied on. To allow small businesses to pool resources to purchase health insurance for employees. Small business people in restaurants and realty companies, small motels, ought to be able to pool together and have the same purchasing power the huge corporations have. But that would only take 8 pages, it would not involve a cost to the Federal Government, and certainly not involve these draconian cuts of $\1/2\ trillion to Medicare and Medicare Advantage. Further, we could purchase health insurance across State lines. We certainly agree there is not enough competition in health care purchasing. I would love to see a commercial someday with someone coming in saying, ``I have great news, I just saved a ton of money on my health insurance by switching to XYZ Company.'' We see that in car insurance and life insurance. There is vibrant competition. But if we opened competition across State lines to the 50 States and if I could buy insurance from Idaho, I might find a company that gives me better service, that provides better care or reduced premiums. Or if I could look at a Florida insurance company, the Senator from Florida might look at a Mississippi company. We would use good old American competition that has worked in our market society for years but has not been allowed to work in the area of health insurance. Then, of course, health savings accounts--a one-page bill by my friend from Arizona and our colleague Senator DeMint. And then wellness and prevention, again only a simple 14 pages. None of these would require cuts to Medicare. None of these would involve the $2.5 trillion that this spends per decade, once it is fully implemented. So the answer to the question of why we are doing it is, it is not necessary. I guess the reason people might be doing it is that they believe that big government works well. I have a different view on that. I see, as the Senator pointed out, all of these Federal programs that are not exactly working as efficiently as they were projected to be. My dad is on Medicare. We are going to protect Medicare. Republican and Democrat, we are going to do that. But as the Senator pointed out, it goes broke in the year 2017. We certainly do not need to be taking from Medicare to pay for a new entitlement. Medicaid, as has been pointed out--many doctors will not take Medicaid payments anymore because it is broke and it doesn't reimburse at a market rate. So we see in my home State of Mississippi, 60 percent of the doctors will not take Medicaid. Yet there are some people in this building, there are some people in this country within the sound of my voice, who believe that somehow a huge $2.5 trillion takeover of one-sixth of our economy can work and will not be like the Census and Fannie and Freddy, like the post office and the highway trust fund, and will not be broke. It comes down to a difference in philosophy. But certainly we ought to all agree that savings we find in Medicare ought to be used to shore up Medicare, to make sure it is there for people such as my dad and people who are going to rely on that program for years to come.

Mr. WICKER. Mr. President, I wonder, before the Senator closes, if he would yield.

Mr. WICKER. Mr. President, I think it is important for us to understand that there are some differences between the bills--the HELP bill, the Finance Committee bill, and the bill that has come out of the House of Representatives--but in each and every case the proposals put forward by the Democrats do have this $\1/2\ trillion cut in Medicare. Indeed, as the Senator pointed out, these involve cuts to hospitals, to Medicare Advantage, Medicare cuts to nursing homes, to home health, and to hospice. There is no question about that. I appreciate the Senator bringing some information to the public and to the Senate about the concerns of his constituents. In the previous hour, I heard a Senator from the other side of the aisle talk about scare tactics Republicans will be putting forward during the coming weeks of this debate. Of course, you have read letters from your constituents outlining why the people of Arizona are legitimately fearful for the coverage they have enjoyed. I would tell my colleagues that the opposition to these Medicare cuts has come in a bipartisan way. We heard a great deal about that from our friends at the other end of the building when the House of Representatives was talking about this. The president of the Blue Dog Democrats, Mike Ross, a senior Democrat from Arkansas who has worked to try to make this palatable to people in his constituency, had this to say about these Medicare cuts: With more than $400 billion in cuts to Medicare, it would force many of our rural hospitals to close, providing less access to care for our seniors. Less than 12 days ago, Representative Ross from Arkansas said this. His constituency in Mississippi is very much like mine, and I can assure my colleagues that a great number of our hospitals in Mississippi and throughout the country are rural and no doubt they are in Arizona too. So there is a very real concern. The gentleman from Arkansas flatly says it can force many of these hospitals to close. Representative Larry Kissell from North Carolina said this: From the day I announced my candidacy for this office, I promised to protect Medicare. I gave my word I wouldn't cut it and I intend to keep that promise. Representative Kissell from North Carolina concluded that in his judgment, the only way he could keep that promise was to vote no on this legislation. Representative Michael McMahon of New York said: Medicare Advantage, which serves approximately 40 percent of my seniors on Medicare, would be cut dramatically. This is not a Republican scare tactic; this is a flat statement by an elected Democrat from the State of New York in the Northeastern part of our country, one of the larger States. But he said flatly that Medicare Advantage would be cut for 40 percent of his seniors and he voted no on that basis. Representative Ike Skelton, the chairman of the Armed Services Committee, said: The proposed reductions to Medicare reimbursement could further squeeze the budgets of rural health care providers. Chairman Skelton goes on to say: I also oppose the creation of a new government-run public option and continue to have serious concerns about its potential unintended consequences for Missourians who have private insurance plans they like and, of course, we know that this Reid bill also has the government-run option. Finally, to quote Representative Rick Boucher, another senior Democrat from Virginia, he said: I also intend to oppose the bill because of my concern that a government-operated health insurance plan could place at risk the survival of our region's hospitals. I am concerned, and I am determined to protect the rural health care we have in the State of Mississippi and that we have in these districts that are represented by these comments. So I wanted to jump in now, before the Senator from Arizona concludes his portion of the initial remarks, and say that the concerns are not only coming from Republicans, they are coming from actuaries, they are coming from people who have analyzed this bill, and they are coming from Democrats who have read the bill, who understand its meaning and who understand that these cuts to Medicare are real and they are hurtful. I yield back to the Senator.

Mr. WICKER. Will the Senator yield?

Mr. WICKER. I notice that in Florida that reduction, according to the CBO map, would be 81 percent. That is an unthinkable, drastic change in Medicare Advantage. In my area of the country, over in Arkansas, for example, it has a 40-percent reduction. My State, Mississippi, has a 41-percent reduction. Our neighboring State of Louisiana--these are some examples--has an 81-percent reduction, the same as the proposed reduction this legislation would cause for the State of Florida. I think it is important for our constituents to understand the magnitude of these Medicare Advantage reductions.