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Fact Sheet 108-2-08
Last year, President Bush signed into law legislation that made the most sweeping structural changes in the 38-year history of the Medicare program. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 has major implications for America's retirees and disabled persons. This law requires the traditional Medicare program to compete with private for-profit health plans in 2010. Because the premiums for traditional Medicare will be higher, it would force the nation's 40 million Medicare beneficiaries into private plans, known as "premium support." This privatization scheme is an untried and untested system that could lead to weakening the health care system. This $539 billion Medicare reform law also provided a $12 billion "slush fund" in incentives to lure health plans (e.g., preferred provider organizations), to offer coverage. President Bush's fiscal year 2005 budget would provide another $46 billion in payments to HMOs. The law does nothing to help seniors pay for prescription drugs. Instead, it bars the Federal Government from negotiating low prices for drugs, although this is already done for the military. Allowing the Federal Government to seek the best prices from the drug industry can save taxpayers and consumers billions. Permitting open pharmaceutical markets could save American consumers at least $635 billion of their own money each year. The Medicare reform law did little to discourage employers from dropping retirees from their health care plans, leaving over 3 million retirees at risk of losing comprehensive coverage. In addition, for the first time, the legislation linked benefits to income - - a move away from the universal nature of Medicare. Equally disturbing, the law created Health Savings Accounts (HSAs) to allow for "tax-free" savings for health care costs. This would ultimately lure younger, healthier and wealthier workers away from employer-sponsored health care plans. HSAs would leave employer-sponsored plans holding the bag for paying the cost of care for sicker and more expensive patients. Workers in employer-sponsored plans will pay higher premiums for coverage as a result. Individuals with HSAs will end up paying higher deductibles and premiums for less generous insurance coverage. HSAs would cover 170 million individuals. To correct the problems in last year's law, CWA supports the Defense of Medicare and Real Medicare Prescription Drug Benefit Act, S. 1992, introduced by Senator Edward Kennedy (D-MA). Also known as the Health Security and Affordability Act, this legislation would: eliminate Medicare privatization by eliminating the Medicare Advantage (MA) Regional Plan Stabilization Fund, thus, getting rid of the excessive payments to PPOs. It would also eliminate the late fees seniors would have to pay for delayed enrollment. The bill would close the coverage gap (known as the "donut hole"); eliminate the assets test to enable all seniors and disabled persons to be equal partners in Medicare participation, and allow Medicaid "wrap-around" coverage for dual-eligibles (persons eligible for Medicare and full Medicaid benefits), including drugs; eliminate the inability for seniors to buy supplemental coverage, and allow certain Medi-gap Rx policies that provide wrap-around prescription drug coverage to be sold, issued, and renewed. It would also fix key costs issues, including: (1) the inability of government to negotiate lower drug prices, and (2) allow states to re-import drugs (as long as it is safe to do so). Most importantly, S.1992 would repeal the tax deduction for Health Savings Accounts, and eliminate discriminatory treatment of employer plans. The bill would eliminate the TROOP (True Out Of Pocket) definition in the law to prevent employers from dumping retirees from their health care plans onto the Medicare system. It would require government to pick up 40-60% of what is currently paid for by employers. To remedy the increasing lack of employer health care overage, this legislation would create a new National Health Benefits Program (NHBP) that would provide coverage for all families and individuals not eligible for employer-based coverage or coverage under a public plan such as Medicaid, State Child Health Insurance Program (SCHIP), and Medicare. Employers would be permitted to enroll employees in this program. The program would provide the same insurance plans provided to Members of Congress through the Federal Employees Health Benefits Program. Employers would be required to provide 75% of coverage. Small employers would have the option of making a sliding scale contribution for coverage of workers through the National Health Benefit Program based on ability to pay. The employer contribution would be capped at 12% of payroll. This bill would also help low-income workers pay their share of the premium with reduced cost-sharing. These workers would pay only nominal premiums, with the difference between the cost of coverage, the amount the employer pays, and the amount they pay made up by government. CWA also supports the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, H.R. 3672, introduced by Congressman Chet Edwards (D-TX) to provide for negotiation of fair prices for Medicare drugs. Safe Nurse Staffing for Patient SafetyNurse understaffing is driving down quality of care and contributing to the growing nurse shortage in our nation's hospitals. According to a report issued by the Joint Commission on Accreditation of Healthcare Organizations, understaffing is a contributing factor in 24 percent of all accidental patient deaths and injuries in hospitals. An Institute of Medicine report published in 2003, recommends raising staffing levels in all health care facilities in order to reduce medical errors in health care facilities. A similar study conducted by the University of Pennsylvania found that increasing a registered nurse's patient load from four patients to eight - - increases the risk that a surgical patient will die within 30 days by 31 percent. Last year, an American Federation of Teachers survey found that, on average, medical-surgical nurses care for eight patients during a shift. These low levels of staffing place patients in great danger and must be prevented. In its drive for increasing profits, the hospital industry has severely lessened the number of nurses available on units, creating deteriorating working conditions for many nurses. Nurses have left the profession in frustration. As a consequence, hospitals continue to face great difficulty recruiting new nurses. In an effort to create safe nurse-patient standards and to encourage nurses to return to this profession, CWA supports the Safe Nurse Staffing for Patient Safety and Quality Care Act of 2004, introduced by Congresswoman Jan Schakowsky (D-IL). This legislation would require safe levels of staffing in hospitals, ensuring federal minimum nurse-to-patient standards that all hospitals must follow. It would require that all hospitals develop and implement nurse staffing plans that must meet newly established minimum direct care registered nurse-to-patient requirements, adjust staffing levels based on acuity of patients and other factors, and ensure quality care and patient safety. Minimum Nurse Staffing Standards: This bill would: permit hospitals to staff higher but not lower than the established minimum requirements; enable the Federal Government to establish ratios in newly created units; and would not interfere with states that already have established requirements for nurse-to-patient ratios that further limit the number of patients that may be assigned to direct care registered nurses. It would also require a study to establish a licensed practical nurse (or licensed vocational nurse) nurse-to-patient minimal staffing requirement. Hospitals Developing the Staffing Plan: The bill would require hospitals developing the staffing plan to: involve direct care registered nurses in the development and the annual re-evaluation of their staffing plans; meet minimum ratios set forth in the bill; meet any additional staffing requirements as provided by other law or regulation; identify and employ an approved acuity system that will address fluctuations in actual patient acuity levels by providing for guidelines by which the hospital must increase staffing to meet nursing care requirements necessitated by patient need; factor in an appropriate skill mix of other health care workers to ensure that staffing levels account for patient care needs that do not require a direct care registered nurse; and begin developing their staffing plans six months prior to the enactment of the bill. The measure would also protect nurses who report staffing violations from retaliation and discrimination on the part of employers. CWA also supports the Safe Nursing Patient Care Act of 2003, S.373/H.R.745, introduced by Senator Kennedy (D-MA) and Congressman Pete Stark (D-CA), to provide patient protection by limiting the number of mandatory overtime hours nurses must work. Universal Health CareToday, increasing numbers of people are losing their health care benefits. Employers are shifting more of the cost of coverage to employees by reducing benefits and increasing premiums and co-pays. This trend will have serious effects on both patients and the communities in which they live. The situation is dire and is expected to worsen. While incremental state and federal reforms have made some improvements in accessibility of health care for the uninsured, the country remains in need of a national and coherent strategy aimed at covering the entire population. align=justifyTo this end, CWA supports House Concurrent Resolution 99, introduced by Congressman John Conyers (D-MI) and Senate Concurrent Resolution 41, introduced by Senator Edward Kennedy (D-MA) to provide for health care for all. This measure would direct Congress to enact legislation to guarantee that every person in the United States, regardless of income, age, or employment or health status, has access to health care that:
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