Issues: Seniors’ Health

Expanding Access to Affordable Prescription Drugs

Senator Nelson supported the prescription drug bill which has dramatically improved seniors’ access affordable prescription drugs. The lack of prescription drug coverage was a glaring omission in the Medicare program. It prevented many seniors from getting the treatments they need and undermined the promise of the Medicare program – to make quality health care available to our seniors. Because of Senator Nelson’s support, over 80% of Nebraska’s 265,000 Medicare beneficiaries now have prescription drug coverage, and public surveys indicate that more than 80 percent of enrollees are satisfied with their benefit. In July of 2006, seniors reported paying an average monthly dollar amount of $64 for prescription drugs, which is 54% less than the reported $139 per month average seniors reported in 2003, before the Medicare prescription drug coverage was passed. And because Medicare is taking responsibility for low income seniors that have historically been paid for by the state, Nebraska will save $167 million over eight years.

Protecting Rural Hospitals

Many rural hospitals are too large to qualify for critical access hospital status, yet they are too small to benefit from the high volume of patients that larger hospitals enjoy. Senator Nelson worked with Senator Brownback (R-KS) to introduce legislation to create a new designation of “rural community hospital” for hospitals between 25 and 30 beds.  Because of their work, this proposal was included as a pilot program in the Medicare Modernization Act of 2003, and 15 rural community hospitals received cost-based Medicare reimbursements, allowing them to recoup their costs of providing care as well as to maintain their facilities by making necessary improvements.  Senator Nelson worked with Brownback again to introduce the Rural Community Hospital Assistance Act of 2005 to make this designation a routine part of how the Centers for Medicare and Medicaid Services deal with rural hospitals.

Fighting for Seniors

In 2003, budget shortfalls in many states, including Nebraska, threatened Medicaid services. Low-income seniors faced a very real threat that critical services and reimbursements to providers would be cut. Senator Nelson went to work to protect this important program. He fought to include $10 billion in additional Medicaid funding to states as part of the 2003 tax cut.

Access to high quality rehabilitative care is critical for seniors. In 2003, the government agency that oversees the Medicare program released a regulation that limited the types of patients that could be admitted to a rehabilitation hospital.  The rule denies thousands of patients access to inpatient rehabilitation and jeopardizes the ability of patients to lead independent lives to the greatest extent possible.  Senator Nelson led the effort in the Senate to reverse this regulation by introducing and passing the Tim Johnson Inpatient Rehabilitation Preservation Act of 2007 as part of the Medicare, Medicaid and SCHIP Extension Act of 2007, which permanently overturned the ill-advised rule. Now, patients with a variety of injuries can benefit from the inpatient rehabilitation care which will see them through their medical complications and restore their physical function and family routines.

Senator Nelson also supported legislation to restore Medicare funding for highly skilled nursing care by cosponsoring the Medicare Skilled Nursing Beneficiary Protection Act.

In addition to inpatient rehabilitation, outpatient rehabilitative services are also in jeopardy.  In 1997, an ill-advised cap was placed on the amount of outpatient therapy services Medicare would pay for a senior.  The cap was put in place to cut Medicare costs, but those in the most need of rehabilitation, such as stroke victims and those with brain injuries, suffer the most.  Senator Nelson has repeatedly cosponsored legislation to repeal this ill-advised cap.  His efforts have been successful, and each year the cap is lifted.  However, the latest moratorium will soon expire, and Senator Nelson has co-sponsored the Medicare Access to Rehabilitation Services Act of 2007 to fix this problem.

Updated: 1.29.08

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