[Extensions of Remarks]
[Pages E74-E75]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

1972: SENATE PASSES EARLY BUY-INTO MEDICARE

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HON. FORTNEY PETE STARK

of california

in the house of representatives

Tuesday, February 3, 1998

Mr. STARK. Mr. Speaker, Members of Congress will soon be introducing
a bill to provide affordable health insurance for people in the age 62-
65 bracket and for displaced workers over age 55. The bill will let
Americans buy-into Medicare at full cost--that is, without any cost to
the existing Medicare system.
Five Senators have already voted for this proposal: Senators Roth,
Stevens, Thurmond, Byrd, and Inouye all voted for it in 1972, when the
Senate version of H.R. 1 included a proposal from the Senate Finance
Committee to let spouses of Medicare eligible individuals and early
Social Security retirees buy into Medicare.
Senator Dole also voted for the proposal.
The Senate floor statements by Republican Senator Gurney of Florida
and Democratic Senator Cranston of California are still an eloquent
testimony to why this year's proposal makes great sense. I would like
to include this legislative history in the Record at this point. The
numbers cited in speeches have to be updated, of course, but the
reasons why we should give people the option of spending their own
money to buy into Medicare are still accurate:

Social Security and Welfare Reform--Summary of the Principal Provisions
of H.R. 1 as Determined by the Committee on Finance, Committee on
Finance, United States Senate, Russell B. Long, Chairman, June 13, 1972

Medicare Coverage for Spouses and Social Security Beneficiaries Under
Age 65

Present Law
Under present law, persons aged 65 and over who are insured
or are deemed to be insured for cash benefits under the
social security or railroad retirement programs are entitled
to hospital insurance (part A). Essentially all persons aged
65 and over are eligible to enroll for medicare insurance
(part B) without regard to insured status. The House bill
includes a provision that would permit persons aged 65 and
over who are not insured or deemed insured for cash benefits
to enroll in part A, at a premium rate equal to the full cost
of their hospital insurance protection ($31 a month through
June 1973).
Problem
Many additional social security cash beneficiaries find it
difficult to obtain adequate private health insurance at a
rate which they can afford. This is particularly true if they
are of an advanced age, say, age 60-64. Frequently, these
older beneficiaries--retired workers, widows, mothers,
dependents, parents for example--have been dependent upon
their own group coverage or that of a related worker who is
now deceased for health insurance protection. It is a
difficult task for such older persons to find comparable
protection when they no longer are connected to the labor
force.
Finance Committee Amendment
The provision makes Medicare protection available at cost
to spouses aged 60-64 of Medicare beneficiaries and to other
persons age 60-64 (such as a beneficiary who elects early
retirement at age 62) entitled to benefits under the Social
Security Act.

[[Page E75]]

Social Security Amendments of 1972--Amendment

amendment no. 989

(Ordered to be printed and referred to the Committee on
Finance.)
Mr. GURNEY. Mr. President, I am today introducing an
amendment to H.R. 1 that would apply to that part of the bill
dealing with medicare.
My amendment is directed toward the 3 million or so people
between 60 and 65 whose husbands or wives receive medicare
benefits but who are not eligible for it themselves. By and
large these people live on limited retirement incomes and, as
retirees, are more vulnerable to economic hardship resulting
from serious illness. The most reasonable solution would be
to bring them under the umbrella of medicare, while adding as
little as possible to the cost of that program.
This amendment would do just that. It provides that one
spouse must be over 65 and already enrolled in the medicare
program for the other spouse, who must be at least 60, to
enroll in the program and receive equivalent benefits at
cost.
The cost of these benefits to the newly eligible spouse
should be reasonable enough to attract enrollees yet
comprehensive enough to provide the necessary medical
coverage. For an estimated $30 to $35 a month, spouses will
get the same hospital insurance and insurance to cover
physician's charges that anyone else enrolled in medicare
gets.
To discourage people from waiting until they are sick to
enroll, this amendment provides for a 10-percent increase in
premiums for each year they delay. Thus, the potential
enrollee has an incentive to sign up when he or she is 60.
Such a proviso will put the program on a sounder financial
basis.
In summary, this proposal will provide the spouse of a
retiree on medicare with adequate medical insurance at
reasonable rates during a 5-year period when getting a policy
from a private company would be either impossible or
prohibitively expensive. Once the person reached age 65,
regular medicare would take over, dropping the $30 to $35 a
month charge to an estimated $5.80 per month.
Since the financial burden of this proposal would be
underwritten by the subscribers and since its implementation
would utilize the administrative services of a program
already in existence--medicare--this seems to be the most
efficient and most economical way to reduce some of the
trails and tribulations faced by our senior citizens. They
have worked hard for their retirement and they deserve a
chance to live it in peace and contentment. This amendment
would help give them that chance without depriving them of
their dignity or overburdening the already hard-pressed
American taxpayer.
____

Extension of Medicare Coverage to Early Retirees and Their Dependents

Mr. CRANSTON. Mr. President, I submit for printing today
for myself and the Senator from Florida (Mr. Gurney) an
amendment to H.R. 1, which would enable certain individuals
who have not yet reached age 65--those who are entitled to
old-age, wife's, husband's, widow's, widower's, or parent's
Social Security benefits--to ``buy-into'' Parts A and B of
Medicare by the payment of equal-to-cost-premiums.
The need for this legislation stems from the fact that
medicare eligibility does not begin until age 65, yet many
older persons lose their group health coverage when they
retire before the age of 65. They are then forced to enroll
in high-cost individual health policies--usually not even
available to them--or to forego any coverage whatsoever,
gambling that they will stay healthy at least until they
reach age 65 when they become eligible for medicare. This is
an intolerable situation, Mr. President, and I believe that
we can effectively counteract it through the enactment of the
measure we propose today.
Senator Gurney submitted on March 3 an amendment (No. 989)
to H.R. 1. The amendment provides that if one spouse is over
65 and enrolled in medicare, the other spouse, if at least 60
years old, may enroll in the program and receive equivalent
benefits at cost. As Senator Gurney stated when he introduced
this measure:
``Since the financial burden of this proposal would be
underwritten by the subscribers, and since its implementation
would utilize the administrative services of a program
already in existence--Medicare--this seems to be the most
efficient and most economical way to reduce some of the
trials and tribulations faced by our senior citizens.''
I believe that Senator Gurney has submitted an excellent
amendment, and I have requested to be added as a cosponsor.
In discussing the benefits afforded by amendment No. 989,
which the Finance Committee has already tentatively adopted
in its markup of H.R. 1 in executive session, Senator Gurney
and I agreed that, at still no cost to the American taxpayer,
these benefits could be made available to an even broader
range of older Americans--those already on the social
security rolls. It is these individuals that the amendment we
are submitting today would cover. They include in addition to
the social security spouse covered by the Gurney amendment:
First, social security old age beneficiaries 62 years old and
over; second, a wife or widow, regardless of her age, if she
is caring for a child under 18 or disabled and the child
received payments based on the worker's record; third, a wife
62 or older or widow 60 or older; fourth, a dependent husband
62 or over, or a dependent widower 60 or over; or a disabled
widower who has attained age 60; or fifth, dependent parents
of a deceased worker.
The ``buy-in'' procedure we propose today is similar to
that allowing States to buy into medicare on behalf of their
retired public employees 65 years old or older--a provision
contained in section 202 of H.R. 1 as passed by the House.
And H.R. 1 as passed by the House also extends medicare
coverage to recipients of social security disability
benefits. The Senate Finance Committee has tentatively
agreed to this extension of coverage which I have long
advocated. In light of this expansion of the medicare
program, I believe it is only fitting that we concern
ourselves, too, with the health care needs of the
individuals who would be covered by this amendment.
Our amendment would allow these individuals, at an
estimated cost of approximately $30 per month in the first
year of operation--and perhaps as law as $22 per month
thereafter--to enroll in part A of medicare--Hospital
Insurance Benefits--anytime they are or become eligible
during a 90-day period following receipt of notice of
eligiblity from the Social Security Commissioner.
Because the enrollment period is limited to a specific
number of days--a reasonable period of 90 days after the
recipient receives notice of eligibility--the opportunity for
adverse selection of coverage is very much reduced, thereby
promising to keep premium charges to the absolute minimum.
Our amendment would allow these same elegible individuals
to enroll in part B of medicare--Medical Insurance Benefits--
within the same 90 day period. The premium for part B
coverage would be 200 percent of the regular part B premium--
one-half of which the Government presently underwrites for
medicare beneficiaries. If a provision is enacted in H.R. 1
to eliminate completely or place a limitation upon, as the
Finance Committee proposes, the part B premium cost to
beneficiaries--it is presently $5.60 per month--I expect that
the cost to those covered by this amendment would be
appropriately adjusted.
Individuals may opt out of either part A or part B at
anytime, but automatically cease to be eligible for part B if
they drop or lose eligibility for part A. All of these
beneficiaries of course, would be eligible for the regular
medicare program when they reached the age of 65.
Mr. President, on March 3 and 4, as ranking majority member
of Senator Eagleton's Subcommittee on Aging of the Labor and
Public Welfare Committee, I was privileged to preside at
hearings in California on legislation affecting our Nation's
more than 20 million older Americans. I discussed with many
of the witnesses present the legislation that Senator Gurney
and I propose today, and all testified to the importance of
and vital need for such a measure.
Adequate health care coverage is a matter of the greatest
concern to Americans reaching retirement age. This amendment
addresses that concern and provides a mechanism for a
substantial number of particularly hard-pressed older
Americans to take full advantage of the benefits under the
medicare program.

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