Floor Statement of Sen. Chuck Grassley

Iowans' Sticker Shock Under the Affordable Care Act

Delivered Thursday, Dec. 19, 2013

Mr. President, I come to the floor again to share the voice of one many Iowans who have contacted me over the sticker shock they're experiencing under the Affordable Care Act.

A constituent in Sioux County writes:

QUOTE:  I am a pastor in rural Iowa and early this past summer, trusting naively in the integrity of our President's repeated promise that "If you like your health insurance you can keep it. Period[,]" I made a change to my policy, moving to a higher deductible to save the church money.

Now I have been informed that because of that change, my policy is no longer grandfathered and therefore I will be forced out of it in a year and compelled to purchase a MUCH MORE EXPENSIVE (Un)Affordable Care Act compliant policy.

I am young, male, healthy -- and will not qualify for any subsidy.

In effect, because of legislation Democrats supported -- my government is kicking me off from health coverage that I carefully researched, chose, and like a lot -- and forcing me to buy coverage that I do not need at a price I scarcely can afford.

And [the government] has the audacity to resort to Orwellian doublespeak and call such a draconian policy the "Affordable Care Act."

Please convey to your Democratic colleagues that I grew up on a dairy farm and now pastor a church of farmers.  I am the epitome of middle class America that they claim to champion.

This bill is unjust. It is based on lies to Americans like myself.  It hurts real people -- including the church I serve.  END OF QUOTE.

I have done my job, Mr. President. I have shared this constituent's message with my colleagues.  I hope they were listening.  I yield the floor.

The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) have released a new data book, "Beneficiaries Dually Eligible for Medicare and Medicaid."  The merging of data to help inform Congress on the critical issue of dually eligible beneficiaries is an important step that Sen. Chuck Grassley of Iowa has advocated.  Grassley has previously used information that was produced from jointly reconciled data by the two organizations that was the precursor to this report. Grassley made the following comment on this development.

"Providing better coordinated care and reducing costs for high-cost beneficiaries is critical for the future of Medicare and Medicaid.   All of us need to understand the needs and the costs of covering the dually eligible and other high-cost beneficiaries before we can find rational ways to control costs and preserve needed services.  I appreciate the work of these two expert commissions to inform the debate."

WASHINGTON - Sen. Chuck Grassley of Iowa, Sen. Jay Rockefeller of West Virginia and Sen. Tom Carper of Delaware said today they will look for opportunities to advance their bipartisan proposal to provide coverage of intensive behavioral therapy for obesity and the coordination of programs to prevent and treat obesity in Medicare and Medicaid.

"The costs to society caused by diabetes and obesity are tremendous," Grassley said.  "There are ways to reduce the incidence of both those conditions.  Working with the Finance Committee on a bipartisan basis and the Congressional Budget Office, I'm confident we can take steps to achieve better health for Americans battling these two conditions."

"I've long held that preventive measures are one of the best ways we can improve health outcomes and save money on health care," Rockefeller said.  "Chronic diseases like diabetes are expensive to manage and, if left unaddressed, lead to additional health problems down the road. Our effort works to prevent and manage obesity and diabetes through increased access to prevention programs for Medicare and Medicaid subscribers. This will lead to greater health care savings and has the potential to improve overall health outcomes which will boost the productivity and well being of our communities."

"We all know that obesity and diabetes are two of the main drivers of poor health and increasing health care costs in our country," Carper said. "If we do not rein in the growth of obesity and diabetes, this may be the first generation of Americans with a shorter life span than earlier generations.  Overweight and obese patients are at increased risk for cancer, cardiovascular disorders, and other adverse health outcomes. Spending on diabetes treatment alone is one of the fastest growing parts of Medicare. To get this epidemic under control, we need to ensure that Medicare covers the full range of therapies and treatments that might help lower our country's obesity rates and better prevent chronic diseases like diabetes."

Grassley, Rockefeller and Carper sponsored an amendment, which was offered and withdrawn, to the physician payments bill considered in the Finance Committee last week that would provide coverage of intensive behavioral therapy for obesity and the coordination of programs to prevent and treat obesity in Medicare and Medicaid.  The proposal would establish diabetes prevention program services for eligible diabetes prevention program participants.  It also would broaden coverage of prescription drugs for weight loss management under Medicaid and Medicare Part D.

The proposal is meant to take advantage of existing anti-diabetes efforts and a new spate of federally approved weight loss drugs to address both diabetes and obesity, conditions that often interact.

Grassley, Rockefeller and Carper said they will look for legislative opportunities to advance this proposal in the coming months while continuing to work with other sponsors of the legislation including Sens. Al Franken, Susan Collins and Lisa Murkowski.  The senators also recognized the work of several senators and House members in this issue area and said they hope for bipartisan advancement of proposals to combat obesity and diabetes.

Tuesday, Dec. 17, 2013

WASHINGTON -- Sen. Chuck Grassley of Iowa said today he will look for opportunities to advance his proposal to include pharmacists in Medicare's program encouraging providers to give coordinated, high quality care to their Medicare patients.

"Pharmacists can play a critical role in coordinated health care," Grassley said.  "As Medicare moves toward payment policies that reward integrated care, we should recognize the role pharmacists play in encouraging adherence with doctors' drug prescriptions."

Grassley filed an amendment to the physician payments bill considered in the Finance Committee last week that would include pharmacists in Medicare programs encouraging Accountable Care Organizations.  These are groups of doctors, hospitals, and other health care providers who come together voluntarily to give coordinated, high quality care to their Medicare patients.  The coordinated care is meant to achieve the right care, especially for chronically ill patients, while avoiding wasteful duplication and preventing medical errors.

The organizations share in the savings they achieve for the Medicare program when they succeed in delivering high-quality care while avoiding wasteful duplication and spending.  Medicare currently does not promote pharmacists' participation in Accountable Care Organizations, even though pharmacists play a significant role in overseeing patients' prescription adherence.

Grassley said he will look for legislative opportunities to advance this proposal in the coming months.  He also co-sponsored an amendment offered by Sen. Tom Carper of Delaware encouraging the development of quality metrics related to medication adherence.