Opening Statement of the Hon. Paul Ryan, M.C., Wisconsin

Hearing on the Medicare+Choice: Lessons for Reform

May 1, 2001

Two years ago, in the district I represent, the First District of Wisconsin, we had many seniors who were about to lose their Medicare + Choice benefits because two providers had to stop providing services. The reimbursement rates in Racine, WI, were simply too low for these providers to be able to continue to provide quality care.

I held a town hall meeting on the withdrawal of these providers. Over 2000 seniors showed up at this meeting to express their support for continuing a Medicare + Choice program. Seniors in my district told me they did not want to lose the choices and benefits that this program provides them.

Thanks to the efforts of one senior in attendance at that meeting a petition drive was started to improve the reimbursement rates for Medicare + Choice providers in Wisconsin. With the help of Congressman Bill Thomas, Members of this committee and the efforts of health care providers in the first district of Wisconsin, we were able to persuade a Medicare + Choice provider to stay in my district.

That experience taught me two things: 1) Seniors want and deserve to have choices in Medicare beyond those that the traditional Medicare system are able to offer; and 2) the current Medicare system is woefully inadequate to meet the needs of this population.

Medicare is plagued by inadequate reimbursements for managed care organizations all over the country but Wisconsin is one of the states that is hardest hit. The Medicare + Choice system developed under the Clinton administration does not adequately reflect the cost of care to providers.

Medicare HMOs in some areas of the country are able to provide prescription drug coverage through the Medicare + Choice program. 17% of all Medicare beneficiaries receive prescription drug benefits through this program. Currently, due to inadequate reimbursement rates, Wisconsin seniors and seniors in other parts of the country are not able to take advantage of prescription drug benefits in their Medicare + Choice HMOs.

The inadequate reimbursement rates for providers and the inability of Medicare to keep up with the changing needs of seniors, especially in states like Wisconsin, show the need for comprehensive Medicare Reform. I believe we need to allow seniors to have more choices in health care. I think Medicare + Choice has shown us that seniors want and need these choices.

The Medicare system needs reform because many current provisions are proving to be unworkable. The current system is overly complex and too many providers are not receiving adequate reimbursements-this situation threatens the benefits that seniors are receiving. Medicare should be reformed to allow seniors to have the same number of choices that Members of Congress receive in their health plan. Seniors have a right to choose the coverage that provides for their specific needs.