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  • House Gop Doctors Caucus

    by Representative Gus M. Bilirakis

    Posted on 2013-03-05

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    BILIRAKIS. Thank you, I appreciate it, Dr. Gingrey. Thank you, Dr. Roe, I appreciate it. Thanks for bringing up and sponsoring this Special Order that is so very important to our constituents. Thank you for informing them.



    This is a very, very serious issue. We must repeal this SGR and replace it. Again, since coming to Congress more than 6 years ago, doctors in my district have consistently stressed the unsustainability of the SGR and how it impedes them from developing long-term business models.

    Each year, Congress has implemented, of course, a temporary stopgap measure to avert the payment cliff, but the doctors have to have certainty. Again, we have a shortage of doctors in the State of Florida, and it's only going to get worse. We must repeal this SGR and replace it. It has led to uncertainty for medical providers, again, as I said, which threatens patient care. Again, access to care is what it's all about. I'm glad that the chairman of [[Page H971]] the Energy and Commerce Committee, of course, Chairman Upton, has made this a top priority in fixing, again, the SGR.

    Again, not only is the uncertainty associated with reimbursement rates impacting physician practices; it also impacts how the Centers for Medicare and Medicaid Services plans to update Medicare Advantage rates for 2014. That's a huge issue. I know that the seniors in my district love their Medicare Advantage. Even though, year after year, Congress has not only allowed the devastating SGR cuts to take effect, CMS is assuming these cuts will take place as it determines the Medicare Advantage adjustment. So in other words, we always fix it at the end of the year, but they're assuming that the cuts will take place. I worry this will result in reduced benefits and increased premiums for the many seniors who like--really love--their Medicare Advantage.

    Mr. GINGREY of Georgia. If the gentleman would yield, I want to thank the gentleman from Florida because what he is addressing right now goes back to the creation of this law, the Affordable Care Act, PPACA-- sometimes referred to as ObamaCare--where money was taken out of the Medicare program, the existing Medicare program, which is already strained almost to the bursting point, and the Medicare Advantage program. Probably 20 percent of Medicare recipients select that model because it gives them more bang for the buck. It gives them more coverage, and it includes things--and the gentleman from Florida knows this, and this is what he is referencing--it includes more than just an annual physical when you turn 65. It includes more than being able to go to see a doctor and have it reimbursed under Medicare when you have an episode of illness.

    There is a strong emphasis on Medicare Advantage to wellness. Let's say you do go and see the doctor because of an episode of illness, and maybe several prescriptions were written. It's very important that the patient take the medication on a regular basis and not run out of medication. So under Medicare Advantage, there would be a nurse maybe in the doctor's office who within just a few days of that encounter would call the patient to make sure that he or she could afford to get those prescriptions filled and they were taking them in the right way. That's what the word ``Advantage'' was all about, Medicare Advantage, rather than just a traditional fee-for-service Medicare.

    But this new law created 2 years ago, and will go into full effect in January, 2014, literately gutted that Medicare Advantage part, did it not, Representative Bilirakis? It cut that program 12 to 14 percent. I mean, it's just literally gutted. I'm talking about $130 billion was taken out of that one program.

    {time} 1510 So now seniors that were on Medicare Advantage are having to look for new doctors, look for new programs, try to again go through those Yellow Pages and find somebody that will see their momma who's been going to this other group for years and is totally satisfied.

    When the President said to the American public, If you like the health insurance plan you have, don't worry, you can keep it; you will not lose it, that just wasn't true. I don't think he deliberately told an untruth, but it clearly is not true. And as I said at the outset of this hour, some 7 million people have already lost insurance provided by their employer, and many more of these people that were getting their Medicare through the Advantage program, they have lost that through no choice, Madam Speaker, of their own. They have been forced out of those programs.

    I yield back to my colleague, and we will continue this colloquy.

    Mr. BILIRAKIS. I couldn't have said it better myself, Dr. Gingrey.

    Again, I have constituents in Florida, and it's above 20 percent in my district and closer to 40 percent, who have chosen Medicare Advantage.

    It's all about choices, as far as I'm concerned. If I want to get hearing aids, if I want to get a gym membership or eyeglasses, I should have the choice to choose my plan. It works so very well in our area, and we want to continue to give seniors that choice.

    I want to thank you guys.

    My father, as you referenced, worked so many years to fix this SGR, and I'm very proud now to serve on the Health Committee to contribute.

    But I appreciate the two doctors here and all the doctors who have really sacrificed to run for Congress and do what's good for our people, patients. Treating patients is what it's all about. So thank you very much for allowing me to participate.

    Mr. GINGREY of Georgia. I thank the gentleman from Florida and I thank his dad, Representative Mike Bilirakis, Madam Speaker, who served in this body for so many years with distinction. I hope that he is enjoying a happy and healthy retirement in the Sunshine State. And I hope he's able to find care, but I bet you it's not under Medicare Advantage, as his son just told us.

    At this point, I would like to yield back to the gentleman from Tennessee (Mr. Roe).

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