WASHINGTON – First District Congressman Paul Ryan joined 100 other concerned Members of the House of Representatives today in signing a letter to President Clinton urging him to sign legislation that would provide crucial Medicare relief to Wisconsin health care providers and the seniors they serve. The House passed this legislation on Thursday as part of a larger package that included $240 billion in tax relief over ten years and a minimum wage increase. Despite the fact that many of the bill's provisions enjoy broad bipartisan support, the President last week threatened to veto this legislation.

In their letter to President Clinton, Ryan and fellow Members of Congress cautioned that "…without this legislation many of our rural health care providers may be unable to provide essential medical services to our constituents." Among its specific health care provisions, this legislative package:

• Provides additional funds for Medicare + Choice to stabilize the program and increase reimbursement rates in areas such as southeastern Wisconsin, by raising the "floor" – the lowest reimbursement level for Medicare + Choice providers. The bill sets the minimum floor payment at $475 per person per month for rural areas; currently, the floor is approximately $400 in rural areas of Southern Wisconsin, which is below the break-even point for area Medicare + Choice providers;

• Increases funding available to disproportionate share hospitals (DSHs), which care for large numbers of low-income Medicare and Medicaid beneficiaries;

• Delays for two years the implementation of a proposed Clinton Administration regulation that would change the way Wisconsin claims losses in operating costs by nursing homes and (if implemented this year) would have resulted in serious funding shortfalls for county nursing homes;

• Protects funding for home health services;

• Accelerates the reduction of high co-payments Medicare beneficiaries pay for outpatient hospital visits. (Currently, many beneficiaries pay as much as 70 percent on certain co-pays for outpatient hospital care.)

• Reduces out-of-pocket costs for beneficiaries getting clinical lab tests done in critical access hospitals (CAHs) and expands access to ambulance services furnished by CAHs.

Today's letter to the President echoes some of the same concerns voiced by Speaker of the House Dennis Hastert in a letter he sent to the White House on Friday, October 27. Both appeal to President Clinton to sign this significant legislation.

Copies of both Speaker Hastert's letter and the letter from Ryan and other Members of Congress are attached, as is a list of groups that support the Medicare refinement bill.