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| Wilson Urges House to Ensure Affordable Health Care in New Mexico and other Rural States |
October 04, 2000 |
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| WASHINGTON, DC -Congresswoman Heather Wilson is leading a bipartisan coalition of 13 Members of Congress in urging the House Leadership of both parties to ensure affordable health care for New Mexico’s seniors and others like them across the country. Over the last two years, low Medicare reimbursement rates have resulted in the decision by plans in New Mexico to reduce benefits, increase premiums, or discontinue offering service to seniors entirely.
In a letter to Speaker of the House J. Dennis Hastert (R-IL) and Minority Leader Richard Gephardt (D-MO) Wilson and the other 13 Representatives stated, “As you know, the Medicare Choice program has suffered a number of setbacks with managed care organizations throughout the country choosing to discontinue service under the Medicare program. This leaves many of our seniors with no option other than fee-for-service coverage. Fee-for-service Medicare does not adequately address the needs of our seniors. We must continue to allow seniors a choice in Medicare coverage.”
They continued, “Reforms such as raising the minimum payments and providing bonuses to plans which reverse a prior decision to leave a county will help provide an incentive for Medicare Choice providers to continue to offer the high quality of health care services to which many seniors have become accustomed. We call your attention to HR 5001, introduced by Rep. Wilson/Luther/Ryan. Many of the Medicare Choice provisions in this bill would help meet our shared goal of retaining options for our seniors.
“We believe it should be a top priority for this Congress to increase reimbursement rates to ensure that our senior citizens and disabled Medicare beneficiaries have choices in the Medicare program. We believe that long term change is necessary to correct the problems within the Medicare program; however, we believe these immediate changes will provides a solution in the short run to preserve quality choices in health care for beneficiaries.
“We urge you to include provisions to encourage Medicare Choice providers to reverse decisions to reduce their offerings in any Medicare/Medicaid “Giveback” Bill that will be voted on by the House of Representatives,” they concluded.
On September 26, the House Commerce Committee, of which Rep. Wilson is a member, passed H.R. 5291, which included key provisions from Congresswoman Wilson’s Medicare legislation. Specifically, the Commerce Committee included Wilson’s provision to address the reimbursement inequities and instability in the Medicare Choice program by:
*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;
“New Mexico is being discriminated against by the federal Medicare program. We need some immediate relief. Reduced federal reimbursements for Medicare and Medicaid dependent citizens has significantly impacted these providers ability to provide quality healthcare to the state’s most needy,” said Wilson.
Additionally, the bill passed by the Commerce Committee includes the following provisions that were also part of Wilson’s legislation:
*Increase the rate at which Medicare Choice reimbursement rates are allowed to grow from year to year;
*Allow New Mexico to keep 60% of the State Children’s Health Insurance Program (SCHIP) federal funds ($34.68 million) that they have not yet spent until 2002; and
*Changes federal law to permit Medicare Choice plans that announced their withdrawal in July 2000 to return to New Mexico in 2001.
Attached: Copy of the coalition letter to the House leadership.
Dear Speaker Hastert and Minority Leader Gephardt:
We are requesting your support for provisions in a Medicare refinement bill which would help prevent Medicare Choice plans from reducing their service areas. We have seen the effect which low payment rates have had in the last two years, resulting in the decision by plans in many of our districts to reduce benefits, increase premiums, or discontinue offering the plan entirely.
As you know, the Medicare Choice program has suffered a number of setbacks with managed care organizations throughout the country choosing to discontinue service under the Medicare program. This leaves many of our seniors with no option other than fee-for-service coverage. Fee-for-service Medicare does not adequately address the needs of our seniors. We must continue to allow seniors a choice in Medicare coverage.
Many of these managed care organizations cite the low reimbursement rates provided by HCFA as the main obstacle to providing quality health service. Providers of Medicare Choice plans have been hit hard under the current payment system, which penalizes health care systems for their historic efficiency. The rising cost of providing health care makes it difficult for these providers to make ends meet. The payment structure for Medicare Choice pays providers based on calculations under three rules (blend, minimum increase, and floor), and then makes adjustments for budget neutrality.
Reforms such as raising the minimum payments and providing bonuses to plans which reverse a prior decision to leave a county will help provide an incentive for Medicare Choice providers to continue to offer the high quality of health care services to which many seniors have become accustomed. We call your attention to HR 5001, introduced by Rep. Wilson/Luther/Ryan. Many of the Medicare Choice provisions in this bill would help meet our shared goal of retaining options for our seniors.
We believe it should be a top priority for this Congress to increase reimbursement rates to ensure that our senior citizens and disabled Medicare beneficiaries have choices in the Medicare program. We believe that long term change is necessary to correct the problems within the Medicare program; however, we believe these immediate changes will provides a solution in the short run to preserve quality choices in health care for beneficiaries.
We urge you to include provisions to encourage Medicare Choice providers to reverse decisions to reduce their offerings in any Medicare/Medicaid “Giveback” Bill that will be voted on by the House of Representatives.
Sincerely,
Rep. Heather Wilson
Rep. Paul Ryan (R-WI)
Rep. Tom Barrett (D-WI)
Rep. Bill Luther (D-MN)
Rep. Ron Paul (R-TX)
Rep. James Barcia (D-MI)
Rep. Lee Terry (R-NE)
Rep. Martin Frost (D-TX)
Rep. Greg Walden (R-OR)
Rep. Earl Blumenauer (D-OR)
Rep. Richard Baker (R-LA)
Rep. James Sensenbrenner (R-WI)
Rep. James Oberstar (D-MN) |
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