Senate Resolution 15 - Introduced SENATE RESOLUTION NO. 15 BY McCOY , BEALL , BLACK , BOLKCOM , BOWMAN , COURTNEY , DANDEKAR , DANIELSON , DEARDEN , DOTZLER , DVORSKY , FRAISE , GRONSTAL , HANCOCK , HATCH , HOGG , HORN , JOCHUM , KIBBIE , QUIRMBACH , RAGAN , RIELLY , SCHOENJAHN , SENG , SODDERS , and WILHELM A Resolution opposing proposed Congressional changes to 1 the Medicare and Medicaid programs. 2 WHEREAS, the Medicare and Medicaid programs were 3 originally created to provide health security and 4 financial protection to older Americans, persons with 5 disabilities, and the poor; and 6 WHEREAS, the United States House of Representatives 7 has recently adopted House Concurrent Resolution 34 8 encompassing the budget proposal of Budget Chairman 9 Paul Ryan which would make fundamental changes to the 10 Medicare and Medicaid programs, profoundly impacting 11 individuals and states in contravention of this 12 original intent; and 13 WHEREAS, under the proposal the traditional 14 guaranteed benefit Medicare program would be replaced 15 with a system of premium support payments; and 16 WHEREAS, the system proposed would provide a fixed 17 subsidy amount for each Medicare beneficiary to use 18 toward acquiring their own health care coverage in the 19 private health insurance market; and 20 WHEREAS, the Congressional Budget Office estimates 21 that not only would the cost of coverage in the 22 private marketplace be considerably higher than under 23 traditional Medicare, as evidenced by the experience 24 -1- LSB 2813XS (7) 84 pf/nh 1/ 4

S.R. 15 with Medicare Advantage plans, but the percentage of 1 out-of-pocket costs required to be paid by a typical 2 Medicare beneficiary would increase to 68 percent by 3 2030, compared with 25 percent under the traditional 4 Medicare program; and 5 WHEREAS, the cost of buying health care coverage 6 in the private marketplace would double the amount 7 of out-of-pocket expenses for a typical Medicare 8 beneficiary in 2022 from an estimated $6,150 under 9 the traditional Medicare program to an estimated 10 $12,510; and 11 WHEREAS, the amount of the cost shifted to Medicare 12 beneficiaries would be exacerbated by linking the 13 increase in the amount of the subsidy over time to the 14 consumer price index for all urban consumers rather 15 than to health care inflation, which historically has 16 increased at a faster rate; and 17 WHEREAS, the shifting of increased costs to Medicare 18 beneficiaries, whose median annual income is $21,000, 19 would effectively price Medicare beneficiaries out of 20 the private health care market, relegating them to 21 the ranks of the uninsured and denying them critical 22 health care services, thereby undermining the promise 23 of health security and financial protection made by 24 Congress in 1965; and 25 WHEREAS, the budget proposal does nothing to rein 26 in health care costs, but merely shifts payment of 27 increasing costs from the federal budget to current 28 Medicare beneficiaries and portends the elimination of 29 the Medicare program for future generations; and 30 -2- LSB 2813XS (7) 84 pf/nh 2/ 4

S.R. 15 WHEREAS, the budget proposal would also reopen the 1 gap, known as the “doughnut hole”, in Medicare Part 2 D prescription drug coverage, resulting in additional 3 costs to Medicare beneficiaries; and 4 WHEREAS, with regard to the Medicaid program, the 5 budget proposal replaces federal matching payments to 6 states with fixed-sum block grants; and 7 WHEREAS, the Congressional Budget Office projects 8 that even with additional state flexibility, such block 9 grants would result in reduction of payments to states, 10 requiring states to decrease reimbursements to Medicaid 11 providers, reduce Medicaid eligibility, and reduce the 12 scope of available benefits, or, in the alternative, 13 force states to increase state expenditures; and 14 WHEREAS, the Kaiser Commission on Medicaid and the 15 Uninsured notes that the use of the block grant and the 16 cap on federal Medicaid spending would substantially 17 reduce states’ ability to provide coverage to 18 low-income Americans and, combining this with the 19 budget proposal’s repeal of specified provisions of the 20 Affordable Care Act, would add millions more to the 21 number of uninsured Americans and compromise the role 22 of Medicaid as the health safety net especially during 23 economic downturns; and 24 WHEREAS, since the Medicaid program covers 25 approximately 62 percent of all long-term care 26 spending in the United States, a reduction in Medicaid 27 funding would disproportionately endanger necessary 28 services for low-income seniors and persons with 29 disabilities; NOW THEREFORE, 30 -3- LSB 2813XS (7) 84 pf/nh 3/ 4

S.R. 15 BE IT RESOLVED BY THE SENATE, That the Senate 1 respectfully expresses its opposition to the budget 2 proposal encompassed in House Concurrent Resolution 3 34 and any proposals to change the Medicare or 4 Medicaid programs that are projected to lead to fewer 5 Americans, especially those most vulnerable due to age, 6 disability, or poverty, being able to obtain or retain 7 health care coverage; and 8 BE IT FURTHER RESOLVED, That the Secretary of 9 the Senate is directed to distribute copies of this 10 resolution to the Iowa congressional delegation. 11 -4- LSB 2813XS (7) 84 pf/nh 4/ 4