Transcripts For CSPAN2 Health 20240703 : vimarsana.com

CSPAN2 Health July 3, 2024

Just under three hours. [background noises] [background noises] quick to subcommittee will come to order the chair will recognize for five minutes for Opening Statement. Also a lot of things happening in the whole house today between both sides. And so we are going to have to try to manage this hearing and thank you everyone who is testifying first and second for your patience and willingness to work with everyone. We appreciate that. The chart recognize mckay will recognize myself an Opening Statement. Today we are considering legislation to rewrite greater access to care for seniors with lower cost Prescription Drugs reducing unnecessary red tape for Healthcare Providers. We are also considering proposals design to make updates to our physician reimbursement bottles distract the critical balance between driving Higher Quality care while ensuring Medicare Programs remain solid for future generations. According to september 2023 report the centers for Medicare Medicaid Services Healthcare is expected gdp over the next decade. This is simply unsustainable especially for our Medicare Program for the data shows proportionate healthcare spending of those over 65 costs on average almost 2. 5 times more than the average working person spends with picking up much of the higher share of the spending. Their support only further underscores the need for hearing examiner policies and sustain and strengthen the Medicare Program. This is the first time in several years weve thoughtfully examine our reimbursement for physicians many of whom are providing specialized care for seniors with chronic conditions for these conditions also require coordinated care that spans across multiple providers and clinical staff requiring every targeted reimbursement incentivizing Higher Quality standards for these patients. These are complicated problems they require Serious Solutions and our goal is figure how to best access seniors in sustainable responsible manner with this boat require constructive work between stakeholders, regulators, and the subcommittee. Any changes we ultimate pursue will be fully offset and promote the highest quality of care for our seniors i want to thank our witnesses for being here today in the first panel i will yield my repainting to the vice committee. Correct think it mr. Chairmans hearing means a lot to me. As a provider myself many issues on todays agenda are pretties of mine. Ensuring patients have access to quality providers is the most fundamental reason why i came to congress in the first place. I want to talk for a moment about why this hearing is so important. Providers choose to work in healthcare because they care about people. They invest years often decades of their lives to treating then they work grueling hours many of them. They sacrificed time from themselves and their families to take care of patients. While they are working had the lives of others in their hands which can be incredibly stressful. We owe it to these providers and their patients to allow them to focus on patient care not worry about the massive amounts of paperwork waiting for them at the end of the day or about longterm ability to operate their practice. We note medicare is a single largest payer for Healthcare Services in this country and often shapes private plans approach coverage. It is critical we ensure medicare operates in a way that supports providers thereby ensuring the millions of seniors who rely on medicare continue to have access to the doctors. My passion for this issue is why i worked for many years to get the approving seniors timely access to care bill across the finish line to remove certain prior authorization restrictions from Medicare Advantage. That is why fears have led the charge in bipartisan efforts to ensure physicians are reimbursed appropriately including hr 2474 to provide them with inflationary updates to reimbursement levels. That it is why i believe strongly we must pass legislation to promote value based care as was intended when Congress Passed the medicare chip reauthorization act in 2015. I hope my colleagues will join me today and recognizing the importance of these issues and commit to working with me and others on this committee to ensure provider access for medicare patients. Mr. Chairman i yield back. A gentleman yields back. The chair will now recognize her gentle lady from california representative for five minutes for an Opening Statement. Thank you, mr. Chairman. I think i speak for all of us its good to be back in our hearing room doing our work. It is good to be with all of you. Last year my constituents in the present of the California Medical Association wrote a letter to me saying that quote within our Healthcare System a crisis of grave proportion is taking shape unquote. It was november 2022 while coving cases at ease healthcare workers were still struggling to keep up. For us in the patients we serve doctor hernadez wrote the crisis is far from over. California medical association surveyed its members about how medicare payments are impacting access to care. The response is really striking and i think highly instructive. 87 of physician said low medicare rates negatively impact their ability to recruit and retain physicians and 76 of physicians said medicare payments did not cover the cost of providing care. A few bills we are considering today attempt to stabilize doctor etiquette reimbursement although we are notably not considering doctor bruce on to provide a physician payment as it ties to inflation. That is a must on a bipartisan basis. I often hear from physicians in my district about Administrative Burdens for medicare and commercial health insurers. For example seven years ago Congress Passed macro the medicare access cheap reauthorization act the doctor said to finally end the annual need to pass to save doctors from cost of medicare reimbursement. That legislation created the meritbased incentive Payment System which the gao found added more administrative verdict while doing little to improve quality of care. I think our subcommittee should seriously consider recommendation to eliminate the meritbased incentive Payment System. While traditional medicare increased its paperwork Medicare Advantage plans also started burning doctors by overusing prior authorization. Prior authorization has morphed into a costly inefficient mechanism that prevents patients from receiving care and unnecessary burdens onto providers. It is why i support the improving seniors timely access to care act to reduce the overuse of prior authorization Medicare Advantage plan. While this hearing is focused on improving Patient Access to care and reducing burdens of physicians i am concerned my republican colleagues once again are not considered legislation to fund state Health Insurance programs in the area agencies on aging. These are two programs whose funding expired on september 30. As i said, not that you would remember it at our last hearing california state Health Insurance program is called hightail. This is a program that works and it works very, very well. Provide Stellar Services every day for seniors in my district to have medicare problems. We should not allow this to expire im also concerned our subcommittee is once again considering a huge slate of bills, 23 in total with nearly half either in discussion draft form or only formally introduced a week ago. I look forward to hearing from our witnesses today. Hunt how we can enhance a beneficiary access to care and reduce burdens on physicians. Without jeopardizing the Financial Sustainability of the Medicare Program. 10,000 americans age into medicare every single day. So if that is not reason enough to find a solution to these issues, i dont know what is. Thank you, mr. Chairman and i yield back. Her gentle lady yields back i will not recognize the chair full committee for five minutes for an Opening Statement for. Thank you chair guthrie good morning everyone. Our focus today it is to explore solutions to improve medicare payments to providers and ultimately help patients. Everyone has been hurt by inflation driven by President Biden the democrats record spending spree. Just last week we got two more pieces of bad news on inflation. First Medicare Part b premium are increasing by almost 6 next year. In fact since President Biden took over medicare premiums are up nearly 18 . Next we found out core inflation metrics show prices continuing to increase by 4 over last year. Inflation remains a huge problem everyone from patients to providers is feeling the pain of higher prices and higher interest rates. Patients have less money to spend on basic needs food, housing, healthcare and providers the cost of renting independent practice is growing as well this committee has heard testimony the whole Healthcare System becomes more expensive when providers cannot afford to stay independent. Todays hearing will focus on how we can eliminate unnecessary red tape and most importantly sustain access to care and lower costs for Medicare Beneficiaries. Regardless of where they live in and my doctor collects is that its important to let doctors do what they do best, spend time seeing patients and less time filling out paperwork. The balance the need to ensure patients and medicare are accurately paying for that care. While recognizing paperwork even if wellintentioned can limit time spent on providing healthcare increases costs. As we look to modernize our medicare Payment System wheat must be thoughtful and striking the best and right balance. Today we will consider a wide range of discussion drafts inflation aims to support medicare providers as they deal with raising paperwork, rising inflation and rising labor costs. For example if you discussion drafts address expired payment initiatives. If congress does not act before the end of the year doctors in certain rural areas and laboratories will see a pay cut for medicare starting january 1. In the short Term Congress should act to avert these cuts. We should consider why we are having the conversation every single year. If we did further proof government should not intervene in the economy look no further than the physician fee schedule and her efforts to create a more perfect price control congress is increase medicare payments to doctors seemingly every single year since 2003. Im not saying these are not worthy endeavors. I believe in supporting our doctors in 2015 this committee in Congress Passed to get us out of the cycle of the annual fixes. Yet here we are. With a system that again has underperformed those who rely on the Medicare Program. And still some of my colleagues across the aisle would expand such a system to cover every patient in the country. The fact is politicians and bureaucrats will always do a worse job than the market at determining the most efficient prices for an item or a service. Congress should spent its efforts on longterm reform to the program we have now so we are not back at this every one, two, or three years but its also important to recognize the greater context of this discussion. Parts of medicare are on pace to be insolvent or 2031. Solutions like the bipartisan lower cost more Transparency Act will save medicare money in the long run. But our resources are finite we must make sure we are examining every dollar medicare spends in andmaking sure its going to the right places before assuming Additional Resources are necessary. If Additional Resources are necessary we should Work Together to find ways to save medicare money and other areas. Again our goal today is to strengthen the Medicare Program and increasing access to care improving the way we reimburse providers and i think our witnesses for being here today and i look forward to the conversation. I yield back mr. Chairman progressive templating yields back. It is now date 17 of house being paralyzed without a speaker. We are 29 days away from another potential shutdown. This hearing comes at a time when House Republicans dysfunction is hurting the American People weakening our economy and undermining our national security. House republicans have caved to the extreme elements of his a party who has no interest in governing. They for severe cuts to critical programs in spite of the fighting agreements between the former speaker and President Biden they came dangerously close to a Government Shutdown that would have closer National Economy upwards of 13 billion a week and forced our troops to work without pay. I just think the American People deserve better democrats have repeatedly stopped the chaos and dysfunction from hurting every day americans but it is long past time for House Republicans to reject the extremists in their party. We should be working together to lower costs for American Family and grow our economy and the middleclass is time for the chaos to end. Now, turning to the topic of todays hearing medicare is played a Critical Role in the lives of our nation senior and disabled americans since its enactment. Medicare is the main source of healthcare for most of our nation seniors and disabled individuals. We must ensure it remains sustainable longterm delivers the highest quality care. I have Major Concerns about the process leading up to todays hearing. My republican colleagues the vast majority of the discussion will be discussing less than a week before the hearing. Many drafts are still halfbaked and given the broad array of topics and bills i am disappointed we do not have adequate time to fully event some of these policies and provide democratic input from the beginning. Republican majorities also put forward a long list of expensive republicanled bills that could collectively cost billions of dollars without any proposed way of paying for them. This is especially ironic given just yesterday his speech on the house for nominating jim jordan as a candidate for speaker republicans expressed concern with medicares finances and cited their support for jordan because of his desire to make devastating cuts to our nations social safety net healthcare program. It is unfortunately a pattern we see over and over again from republicans pushing forward policy changes and then demanding devastating spending cuts to medicare that white andd cruise costs for seniors the truth is medicare is not broke it does not need major changes and it certainly does not need terrible republican ideas to cut benefits, raise the retirement age are increasing your cost contribution. What we need is for republicans to stop their infighting so congress can come together to find Bipartisan Solutions for the American People. Nelson these policies before so they may have merit and dress addresscritical need above medie patients and providers of forcing my republican colleagues have thus far refused to engage with us constructively or proposed a path forward to move these bills on a bipartisan basis. Even the republicans unproductive track record on the house floor of this congress, i remain concerned were not going to bill to successfully move a bipartisan legislative package out of committee under the house floor and into the president s desk. Aerobic and codex also rejected Committee Democrats will request to include legislation in todays hearing that would directly expand access to care reduce healthcare costs for seniors. The majority refused to include hr 5630 the health low income seniors Affordable Care act led by representative craig for the bill would directly extend coverage for senior lower their outofpocket costs by extending coverage for outreach and Enrollment Programs. These programs help low income Medicare Beneficiaries enroll in medicare and access benefits at lower their outofpocket costs. Thanks to these programs about 3. 5 million Medicare Beneficiaries have received assistance and the number of seniors enrolled in the low Income Subsidy program increase of 11. 8 million in 2014 to 14point to million in 2020. Now let me just say i am concerned the totality of these proposals would result in significant funding cuts the Medicare Program raise healthcare costs for seniors to increase premiums. This will place

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