With respect to the current amendment process, the National Right to Life Committee urges members of the Senate Finance Committee:
To SUPPORT Amendments 135 or 130 to require a Congressional vote in order to implement recommendations of the Medicare Commission.
The Medicare Commission is given almost unlimited powers to change Medicare in order to reduce Medicare payments to fit with the limits on growth it is designed to achieve. The only limits in the Chairman’s Mark not qualified by the term “if feasible” are that its proposals “not impact providers scheduled to receive a reduction to their inflationary payment updates in excess of a reduction due to productivity in a year in which the Commission’s proposals would take effect” and that they not “ration care, increase revenues, or otherwise change Medicare beneficiary cost-sharing, benefits, or eligibility standards.” (Page 156 of Chairman’s Mark as modified).
Consequently, the Commission, without a vote by the people’s representatives in Congress, could, for example, significantly curtail the Private-Fee-for-Service alternative in Medicare Advantage. Under current law, the private fee-for-service alternative is the only one that permits senior citizens, without being subject to limits that could be imposed by the Center for Medicare and Medicaid Services, to add their own money on top of the government contribution in order to get health insurance that is less likely to limit access to medical treatment through managed care techniques or other means. With the significant cuts in Medicare funding that this legislation imposes in order to finance extending subsidies to cover the uninsured, it is particularly important to preserve this option for older Americans to allow them to protect their own life and health with their own money.
While under the unamended Chairman’s Mark Congress could theoretically alter the Commission’s proposals so long as its legislative product resulted in the same reductions in Medicare, the burden of acting would be put on the Congress; an unelected group could eviscerate the right of senior citizens to get what they deem adequate care UNLESS majorities in the relevant committees and in both houses of Congress, with the agreement of the President, acted to preserve it. This is a risk too dangerous to take.
Therefore, the National Right to Life Committee urges support for Amendments 135 or 130, which would eliminate the automatic implementation of the Medicare Commission recommendations, requiring instead a vote by Congress to give them effect.
[The National Right to Life Committee has taken positions on other amendments – see http://powellcenterformedicalethics.blogspot.com/2009/09/position-on-certain-amendments.html and may shortly take positions on additional amendments.]