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 the Medicare and Medicaid programs.

   WHEREAS, the Medicare and Medicaid programs were originally created to provide health security and financial protection to older Americans, persons with disabilities, and the poor; and
   WHEREAS, the United States House of Representatives has recently adopted House Concurrent Resolution 34 encompassing the budget proposal of Budget Chairman Paul Ryan which would make fundamental changes to the Medicare and Medicaid programs, profoundly impacting individuals and states in contravention of this original intent; and
   WHEREAS, under the proposal the traditional guaranteed benefit Medicare program would be replaced with a system of premium support payments; and
   WHEREAS, the system proposed would provide a fixed subsidy amount for each Medicare beneficiary to use toward acquiring their own health care coverage in the private health insurance market; and
   WHEREAS, the Congressional Budget Office estimates that not only would the cost of coverage in the private marketplace be considerably higher than under traditional Medicare, as evidenced by the experience with Medicare Advantage plans, but the percentage of out-of-pocket costs required to be paid by a typical Medicare beneficiary would increase to 68 percent by 2030, compared with 25 percent under the traditional Medicare program; and
   WHEREAS, the cost of buying health care coverage in the private marketplace would double the amount of out-of-pocket expenses for a typical Medicare beneficiary in 2022 from an estimated $6,150 under the traditional Medicare program to an estimated $12,510; and
   WHEREAS, the amount of the cost shifted to Medicare beneficiaries would be exacerbated by linking the increase in the amount of the subsidy over time to the consumer price index for all urban consumers rather than to health care inflation, which historically has increased at a faster rate; and
   WHEREAS, the shifting of increased costs to Medicare beneficiaries, whose median annual income is $21,000, would effectively price Medicare beneficiaries out of the private health care market, relegating them to the ranks of the uninsured and denying them critical health care services, thereby undermining the promise of health security and financial protection made by Congress in 1965; and
   WHEREAS, the budget proposal does nothing to rein in health care costs, but merely shifts payment of increasing costs from the federal budget to current Medicare beneficiaries and portends the elimination of the Medicare program for future generations; and
   WHEREAS, the budget proposal would also reopen the gap, known as the “doughnut hole”, in Medicare Part D prescription drug coverage, resulting in additional costs to Medicare beneficiaries; and
   WHEREAS, with regard to the Medicaid program, the budget proposal replaces federal matching payments to states with fixed-sum block grants; and
   WHEREAS, the Congressional Budget Office projects that even with additional state flexibility, such block grants would result in reduction of payments to states, requiring states to decrease reimbursements to Medicaid providers, reduce Medicaid eligibility, and reduce the scope of available benefits, or, in the alternative, force states to increase state expenditures; and
   WHEREAS, the Kaiser Commission on Medicaid and the Uninsured notes that the use of the block grant and the cap on federal Medicaid spending would substantially reduce states’ ability to provide coverage to low-income Americans and, combining this with the budget proposal’s repeal of specified provisions of the Affordable Care Act, would add millions more to the number of uninsured Americans and compromise the role of Medicaid as the health safety net especially during economic downturns; and
   WHEREAS, since the Medicaid program covers approximately 62 percent of all long-term care spending in the United States, a reduction in Medicaid funding would disproportionately endanger necessary services for low-income seniors and persons with disabilities; NOW THEREFORE,

   BE IT RESOLVED BY THE SENATE, That the Senate respectfully expresses its opposition to the budget proposal encompassed in House Concurrent Resolution 34 and any proposals to change the Medicare or Medicaid programs that are projected to lead to fewer Americans, especially those most vulnerable due to age, disability, or poverty, being able to obtain or retain health care coverage; and

   BE IT FURTHER RESOLVED, That the Secretary of the Senate is directed to distribute copies of this resolution to the Iowa congressional delegation.