DeLauro Testifies on Medicare for America at Energy & Commerce Health Subcommittee Hearing on Universal Coverage
WASHINGTON, D.C. — (December 10, 2019) Today, Congresswoman Rosa DeLauro (CT-03) testified at the House Energy and Commerce Subcommittee on Health’s hearing on "Proposals to Achieve Universal Health Care Coverage" to promote Medicare for America, legislation introduced by herself and Congresswoman Jan Schakowsky (IL-09) to ensure universal, affordable, high-quality healthcare coverage. A full video of her testimony can be found here, and below are her remarks as delivered:
Thank you so much, and to Congressman Pallone, to Congresswoman Eshoo, Ranking Members Walden and Burgess. I am delighted to be here this morning. It’s an honor for me to join with the members of this committee and also to be with all of my colleagues here this morning on what is a critical, critical discussion on what are the pathways that we can move forward to universal care.
I am here this morning to advocate for Medicare for America, which I first introduced with my dear friend and my colleague, Congresswoman Jan Schakowsky. We did this in December 2018, and we reintroduced it this May.
Medicare for America achieves universal, affordable, high-quality health coverage by creating a program based on Medicare and Medicaid. It covers all Americans through auto-enrollment starting at birth, while maintaining high-quality, affordable, employer coverage. Medicare for America moves every individual currently enrolled on the individual exchanges and Medicare beneficiaries onto the program. Individuals and children enrolled in Medicaid and CHIP are transitioned onto Medicare for America over time to ensure that their care is not disrupted as we transform our health care system. We made this deliberate choice after working with members of the disabilities community who know all to well about disruptions in the face of budget cuts and other complications.
For those with employer-sponsored coverage, two things can be true and are true. Employers have shifted many Americans to high-deductible plans with less generous coverage; and, many are very satisfied including those union members that negotiated very good coverage in lieu of wages in lean budget years. So, Medicare for America allows high-quality, affordable private employer-sponsored coverage to remain or employers can enroll their employees in Medicare for America and continue to pay a contribution. Or those employees who work for these employers that continue to offer private coverage can choose Medicare for America, and their employer contributes toward the premium. This way no one is locked into employer sponsored coverage.
Let me touch on something that I hear from most of my constituents, and that is cost.
For individuals, seniors, families living below 200% of the Federal Poverty level, they will have no premiums and no cost-sharing.
There are never any out of pocket costs for children under 21 and for maternity services, for preventive and chronic disease services, for Long Term Services and Supports, and for prescription drugs. There are also zero deductibles. Zero.
Annual out of pocket costs are no more than $3,500 for individuals, $5,000 for families on a sliding scale.
And premiums are capped: no more than 8% of income for enrollees, and are determined on a sliding scale.
And additionally, on the topic of cost of the program, our bill includes pay-fors. I ask you to read it. I won’t enumerate all of them, but the pay-fors are there.
Let me discuss what is innovative about Medicare for America.
Today, health care benefits are too dependent on your zip code. Universal coverage must be universal. So, Medicare for America is explicit in the benefits covered especially with respect to long-term services and support.
We are in a crisis. Families spend themselves into poverty to get the care their aging loved ones need. Hundreds of thousands of individuals with developmental and intellectual disabilities that wait years for services that may never come.
So, Medicare for America establishes the gold standard for Long Term Services and Supports. We partnered with members of the disabilities community on the entire bill in order to ensure their needs. The resulting coverage: home health aides, personal attendant care services, hospice, care coordination, respite services. To name a few. We prioritized those supports and services for workforce development. Raising the reimbursement rates for direct care workers and ensuring a career pipeline, credentialing, and worker rights. Then, in the interim, the bill recognizes the central role that family caregivers play by compensating them for their work. Because it is work.
Beyond the LTSS workforce, Medicare for America preemptively raises reimbursement rates for primary care and mental and behavioral health and cognitive services. Far too many individuals face roadblocks because reimbursement rates are too low. Far too many providers are weighed down or scared off because of mounting debt and choose only private insurance. So, Medicare for America establishes all-payer rate setting. Private insurance pays the Medicare for America rate.
It all comes back to getting patients the care they need. That is why we ban private contracting. Current law allows providers to cover individuals, and private coverage, they also talk about paying out of pocket for care, even if their insurance covers the benefit. It’s a two-tiered system that must not continue. Patients deserve to be treated fairly to get the care they need. We acknowledge the crippling of the student loan debt so that in many [sic] health care workers face that often leads to private contracting. So, we say to providers: pay our rates, see our patients, and we forgive 10% of your student loan. By making smart investments up front, the American people save a great deal of money in the long-run.
At its core, Medicare for America is about ensuring that every American has health care. And as we debate into the future on universal healthcare coverage, my view that Medicare for America is the best way forward in providing historic change.