I rise today to introduce legislation to prohibit the comparative cost adjustment program, which is commonly known as premium support, from operating in Hawaii.

The Medicare Prescription Drug Improvement and Modernization Act of 2003 included the creation of premium support demonstration programs in select metropolitan statistical areas starting in 2010. In these demonstration programs, seniors would be provided with a defined contribution payment for Medicare Part B rather than a defined benefit. Seniors would receive a set minimum payment to be used towards enrolling in either traditional fee-for-service Medicare or a managed care plan. Seniors that choose options that are more expensive than the defined premium would have to pay the difference themselves.

Many of the older and less healthier seniors stay in the traditional fee-for-service Medicare rather than enrolling in Medicare managed care programs. The defined contribution premium will likely not be able to cover the entire cost of their fee-for-service premium. So, they may not be able to afford to stay in the traditional Medicare program and will be forced to enroll in lowest-cost health maintenance organization (HMO) or preferred provider organization (PPO) in their community. Seniors deserve to have their right to choose whether to remain in traditional Medicare or enroll in a managed care program based on their health care needs and not be forced into managed care programs because they are not able to pay the increased premium required for traditional Medicare.

Now, seniors across the country pay the same premium for Medicare Part B services. After the implementation of the premium support demonstration programs, this will not be the case. Not only are there likely to be wide variations in Medicare Part B premium rates for beneficiaries across the country, but there will even be differences among seniors within the same state. This is unjust. Seniors that receive the same benefits should be paying the same premium in an entitlement program such as Medicare.

Proponents of the premium support plan believe that this will help control Medicare costs and save money. However, this proposal will only work if more of the costs are shifted to seniors who will have to pay higher premiums or have their benefits reduced.

Mr. President, it is my hope that these demonstration projects are never implemented in any state. My legislation would ensure that the residents of Hawaii are protected from having this demonstration program impair their Medicare Part B choices. I am pleased that several of my colleagues have also introduced legislation to protect seniors in their states from the premium support demonstration projects.

I request that the text of my bill be printed in the Record following my remarks. Thank you Mr. President.