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| Wilson to President Clinton: “Seniors are waiting for action” |
December 12, 2000 |
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| The Honorable William J. Clinton
The White House
1600 Pennsylvania Avenue NW
Washington, D.C. 20500
Dear Mr. President,
One of the most important issues remaining to be resolved as we finish the work of the 106th Congress is adjustments to Medicare.
I know from published reports that you and your staff have concerns about Medicare Choice reimbursement rates. I have worked closely with the Congressional leadership on this issue and helped craft elements of the bill relating to Medicare Choice that passed the House in October. I want to share with you why these provisions are so important to New Mexicans, particularly low income New Mexicans.
Over 40,000 seniors in New Mexico have chosen a managed care plan through Medicare Choice. These plans offer good quality care and a lower cost than most "Medigap" policies. Most of them also include some prescription drug coverage, which is not currently available in basic Medicare.
As one of the national leaders in managed care, a large percentage of New Mexicans choose managed care, including my family and me. We are used to it and have found good health care through our many managed care providers. For these reasons, a large proportion of seniors, particularly those with lower incomes or no retiree health benefits, have chosen Medicare Choice in New Mexico.
Being one of the national leaders in managed care hurt us when the Medicare Choice formulas were established. These formulas inherently discriminate against states like New Mexico that controlled costs early and where utilization of health care was low. Our reimbursement rates are half of what the federal government pays in other parts of the country. As a result, the three Medicare Choice providers remaining in New Mexico lose money on every patient they enroll.
I know you are concerned that Medicare Choice providers might take profits and not increase access or provide better care. The provisions in the bill passed by the House sets a floor that disproportionately helps a handful of states like New Mexico that have reimbursement rates far below the national average. There are three Medicare Choice plans in New Mexico. Two are
non-profits: St. Joseph`s, run by the Catholic Hospitals of America and Presbyterian, run by the Presbyterian Foundation. The third is Lovelace, which was purchased by CIGNA some years back but has a long history and commitment to this community.
All three of these providers have told their patients and the federal government that they will have to scale back or end their Medicare Choice programs effective January 1 because they cannot cover the losses. I believe all three will stay if we can get the reimbursement rates to come close to the cost of providing care. That will be great news to the 15,000 New Mexico seniors who will have to go back to basic Medicare on January 1 without our help.
We don`t pay into Medicare based on where we live. New Mexicans should not be denied access to health care because of where we live.
I introduced bipartisan legislation (H.R. 5001) to address the Medicare Choice problem this fall. The companion bill in the Senate was introduced by Senators Domenici, Wyden, Grassley, Kerrey, Sessions, and Voinovich. Key portions of this bill were included in H.R. 5543 and I urge you to include them should legislation to amend the Balanced Budget Act of 1997 be finalized by this Congress. Specifically, the items include:
* Establishing a new Minimum Payment Floor of $525 a month per beneficiary in 2001 for all counties in Metropolitan Statistical Areas (MSA`s) with populations exceeding 250,000;
* Increasing the Payment Floor for Rural Areas by raising the minimum payment floor for all other counties from the current $415 to $475 in 2001;
* Increasing the rate at which Medicare Choice reimbursement rates are allowed to grow from year to year;
* Changing federal law to permit Medicare Choice plans that announced their withdrawal in July 2000 to return in 2001.
There are few things more important to New Mexico than getting some remedy to the Medicare Choice problem and strengthening Medicare more generally. I urge you not to stand in the way of letting seniors keep the health care coverage that has worked for them.
Thank you for your consideration.
Sincerely,
Heather Wilson |
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