Act One: Merkley Cuts Medicare

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Dr. Monica Wehby for U.S. Senate

Sen. Merkley Champions Medicare, Cuts It, Champions It, Then Attacks Wehby

Portland – Hypocrisy is the scarlet letter of modern day politics, and Jeff Merkley is wearing it. From Main Street to Wall Street, Senator Merkley’s actions rarely match his rhetoric. Saying one thing, and doing another is the recipe by which Merkley and his political cohorts hold on to power, proving his allegiance lies not with the people of Oregon, but rather D.C. special interests.

The first act of hypocrisy we’ve caught Senator Merkley in is his outspoken support for Medicare and outlandish attacks on Monica Wehby, despite his own votes to cut the program and the benefits seniors rely on.

Like so many politicians before him, Jeff Merkley took winning a seat in Congress to mean he could do whatever he so pleased, and that included breaking his promise to protect Medicare for our seniors. While protecting Medicare on the campaign trail may be beneficial to a candidate, Jeff Merkley saw that cutting it could also be a means to an end, once elected.

Since taking office, Jeff Merkley’s record protecting Medicare has been less than stellar, voting on three separate occasions against preventing cuts to Medicare Advantage and once for one of the biggest cuts in Medicare history. His justification? Passing Obamacare…

Obamacare isn’t feasible without massive cuts  ^[2]to the Medicare program, and so Merkley did what he had to do to get legislation he called “historic” passed.

Despite Oregon having one of the highest ^[3] percentages of Medicare Advantage enrollees in the nation, Jeff Merkley voted against efforts to prevent Medicare Advantage cuts or allow Medicare Advantage enrollees to keep their existing coverage under Obamacare:

• In December 2009, Merkley Voted AGAINST A Motion That Would Have Prevented Medicare Cuts In The Bill, Including Cuts To Medicare Advantage (H.R. 3590, Vote #358: Motion rejected 42-58: R 40-0; D 2-56; I 0-2, 12/3/09, Merkley Voted Nay) 
• In December 2009, Merkley Voted AGAINST A Motion That Would Have Allowed Medicare Advantage Enrollees To Retain Their Existing Benefits (H.R. 3590, Vote #370: Rejected 42-57: R 40-0; D 2-55; I 0-2, 12/8/09, Merkley Voted Nay) 
• In March 2010, Merkley Voted To KILL An Amendment That Would Have Prevented Cuts To Medicare Advantage (H.R. 4872, Vote #72: Motion agreed to 56-42: R 0-40; D 54-2; I 2-0, 3/24/10, Merkley Voted Yea)

Furthermore, Merkley’s vote for Obamacare was a thumbs up to raiding Medicare ^[4] to pay for new programs created by the ACA:

• In March 2010, Mr. Merkley voted for Obamacare, which cut $716 billion from Medicare to pay for Obamacare (H.R. 4872, Vote #105: Passed 56-43: D 54-3; R 0-40; I 2-0, 3/25/10, Merkley voted Yea; Congressional Budget Office, Letter To Speaker John Boehner, 7/24/12)

Jeff Merkley’s support of these cuts could have serious consequences:

• According to the CBO ^[5], the payment cuts in Medicare include:

• A $260 billion payment cut for hospital services.
• A $39 billion payment cut for skilled nursing services.
• A $17 billion payment cut for hospice services.
• A $66 billion payment cut for home health services.
• A $33 billion payment cut for all other services.
• A $156 billion cut in payment rates in Medicare Advantage (MA); $156 billion is before considering interactions with other provisions. The House Ways and Means Committee was able to include interactions with other provisions, estimating the cuts to MA to be even higher, coming in at $308 billion.
• $56 billion in cuts for disproportionate share hospital (DSH) payments.* DSH payments go to hospitals that serve a large number of low-income patients.
• $114 billion in other provisions pertaining to Medicare, Medicaid, and CHIP* (does not include coverage-related provisions). ( 8/1/12 ^[6], Daily Signal)

• Less Access to Services “…If Obamacare’s major reductions are implemented by Congress over the coming decade, seniors’ ability to access Medicare services will surely diminish. In fact, the Medicare Trustees project that the lower Medicare payment rates would cause 15 percent of hospitals, skilled nursing facilities, and home health agencies to become unprofitable by 2019, and this percentage would reach roughly 25 percent in 2030 and 40 percent by 2050.” ( 8/20/13, ^[7]Heritage)
• Less Access to Physicians “ Obamacare gives new powers to make additional cuts in Medicare through the Independent Payment Advisory Board (IPAB)…. One of the only significant tools available to IPAB to reduce Medicare spending is to cut physician reimbursement rates…The Centers for Medicare and Medicaid Services released information that 9,539 physicians who had accepted Medicare opted out of the program in 2012, which is significantly more than the 3,700 who dropped out in 2009. With the ominous power of an unelected new board hanging over them, it is likely that more physicians will choose to leave the Medicare program in coming years.” (8/20/13, ^[8] Heritage)
• Increased Costs and Loss of Current Plan “…the Medicare Actuary projected that the impact of Obamacare’s cuts would be significant. …This means that these enrollees [Medicare Advantage] would have to enroll in the less generous traditional Medicare program, causing them to lose their current health plan and likely face increased out-of-pocket costs.” (8/20/13 ^[9], Heritage)
• Reduction of Benefits Oregon is estimated to see reductions in Medicare Advantage benefits between $50 and $60 per member. ( 3/1/13 ^[10], America’s Health Insurance Plans)
• Higher Premiums “According to CBO’s preliminary estimate, enacting those changes would lead to an average increase in premiums for Part D beneficiaries of about 4 percent in 2011, rising to about 9 percent in 2019.” ( 3/19/10 ^[11], CBO Comparison of Projected Medicare Part D Premiums Under Current Law)

Now, fast forward to this year – an election year. Jeff Merkley again campaigns as a champion of the program, and calls for a stop ^[12] to the cuts he voted for in the first place:

• Merkley joined other vulnerable Senators in writing a letter to CMS warning of the dire consequences their cuts would make:“We write to raise serious concerns about the Medicare Advantage (MA) 2015 rate notice and the impact further cuts may have on the millions of individuals enrolled in the program,” the senators write. “We are strongly committed to preserving the high quality health plan choices and benefits that our constituents receive through the MA program. Given the impact that payment policies could have on our constituents, we ask that you prioritize beneficiaries’ experience and minimize disruption in maintaining payment levels for 2015.” (2/20/13, Letter to CMS)

Then, he attacks Monica Wehby by playing on the fears of Oregon’s seniors, lashing out at Wehby for conjectural cuts, despite his very real cuts to the Medicare program. Merkley subsequently launched a tour  ^[13]aimed at pitting seniors against Dr. Wehby for the very sin he committed, and so Merkley’s circle of hypocrisy is complete.

Jeff Merkley saying one thing and doing another on Medicare is emblematic of his career politician and Washington insider status. These actions serve as a sore reminder why Oregon can’t trust Jeff Merkley.

***Bonus Act of Hypocrisy***

Merkley calls himself “A Senator for all of us”, but requires seniors be on a list in order to speak with him… go figure.

Dr. Monica Wehby is currently the Director of Pediatric Neurosurgery at Randall Children’s Hospital in Portland, Oregon. Monica has nearly 30 years of experience formulating medical policy and is a mother of four.