In both categories, the consequences have been far different from what we in this body intended or expected. The effect of this difference on the accessibility and quality of care for our seniors transcends budget numbers, however. This bill, the Balanced Budget Refinement Act, makes important restorations in several key areas that will help our seniors secure the medical care they need. But two years after BBA's passage, seniors' options have diminished rather than increased as many rural areas have lost their Medicare HMOs and even in higher cost urban areas, plans are reducing benefits and raising premium charges. In some states, there has never been a managed care option for seniors.
Most health plans cite low payment rates as the reason for their lack of participation.
This bill offers bonus payments to plans that are willing to enter markets where there is no Medicare HMO option today. There are additional areas that still must be addressed. My proposal for GME replaces the current outdated payment structure for residents with a fair national standard based on actual resident wages. As the dire financial situation of academic medical centers worsens, I hope we can recognize the need to stabilize their financial condition. We can act to shore up these institutions and ensure the continuation of the high-quality medical workforce we enjoy today.