The controversial vote this week was about nothing less than the future of Medicare itself, a trusted program that has been cherished by America's seniors -- our mothers and fathers, our grandmothers and grandfathers -- for decades.  To vote for this prescription drug proposal would be to dismantle President Johnson's vision and to extinguish "the light of hope".

Let me be very clear – I strongly support adding a drug benefit to Medicare.  I have voted multiple times this year alone in support of a strong prescription drug program within Medicare.  However, I am not willing to destroy a program that seniors have trusted for nearly 40 years in exchange for a feeble prescription drug benefit.  Congress needs to deliver a real benefit that maintains Medicare's promise to the elderly and disabled.  It took the conferees almost five months to work out the differences between two very bad bills, H.R. 1 and S. 1, and come out with an even worse conference report.  The final product was a 681-page insult to America's seniors. 

• This bill is the first step in ending Medicare by privatizing it.  The plan claims to be "voluntary" – but forces millions of seniors to pay more for Medicare if they don't give up their doctor and join a private HMO.

• This bill is not just detrimental for Medicare beneficiaries, but it affects anyone who needs prescription drugs.  It actually prohibits Medicare from using the purchasing power of 40 million beneficiaries to negotiate better drug prices for all Americans.

• This plan penalizes the poor and the middle class.  It forces 6 million low-income seniors who get additional assistance from Medicaid to actually pay more for their prescriptions. It also imposes an unfair assets test that disqualifies seniors if they have modest savings. 

• This bill fails to control premiums and allows private plans to operate in underserved areas without competition.  In one area of the country, a beneficiary could pay $35, while their sister 200 miles away could be paying $175 per month.  Additionally, seniors have to continue to pay those premiums even during the $2,800 coverage gap-where they will also be responsible for 100% of their drug costs.  And, that is just the premiums—seniors also get stuck with 25% co-payments until they spend $3,600 out of their own pockets.

• Additionally, our community has 'access to care' issues that will be worsened by this bill.  Seniors in South Texas rely on community cancer clinics and local pharmacists to meet their medical needs.  The conference report will deprive America's cancer care system of $1 billion a year.  Many cancer centers will close, others will have to admit fewer patients, and still others will lay off oncology nurses and other critical support staff. Cancer patients could be forced to travel further and twice as often to get their treatment.  And, these treatments will often be delayed, increasing health risks to cancer patients. The conference report also favors mail order pharmacies, eliminating the close, trusting relationship many seniors enjoy with their pharmacist.  As it is now, if a patient does not understand the label instructions, or if their doctor prescribes something new, there is a familiar person they can speak with face-to-face who knows their medical history and needs.  This bill jeopardizes these important relationships and the health of South Texas seniors.

• The conferees included some long overdue, yet temporary, payment corrections for doctors and hospitals, particularly rural hospitals.  These provisions are a meager band-aid compared to the work that needs to be done on physician and hospital reimbursement.  I am dedicated to keeping hospitals open and doctors practicing in South Texas.  I am also confident that they do not want to be used in an attempt to alienate some of their neediest patients from the healthcare system. Whatever the outcome of this prescription drug bill, I will continue to support and fight for the passage of several pieces of separate legislation that offer permanent formula fixes for health care facilities and providers. 

Ultimately, the story of Medicare may come down to a tale of two Texans.  The first Texan was President Johnson, who took a 20 year-old fight for America's seniors and turned it into Medicare, a promise of security and access to care for the elderly.  The second Texan is President George W. Bush, who would like to turn the successes of Medicare into a plan worth less to seniors than a shredded AARP card.  This Texan proudly stands with LBJ and will continue to work to expand, not extinguish, his "light of hope".