[Congressional Record Volume 140, Number 7 (Wednesday, February 2, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 2, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
    SENATE CONCURRENT RESOLUTION 59--RELATIVE TO HEALTH CARE REFORM

  Mr. BURNS (for himself, Mr. Pressler, Mr. Lott, Mr. Craig, Mr. 
Nickles, Mr. Murkowski, Mr. Faircloth, Mr. Brown, Mr. Wallop, Mr. 
McCain, Mr. Gramm, and Mr. Lugar) submitted the following concurrent 
resolution; which was referred jointly, pursuant to the order of August 
4, 1977, to the Committee on the Budget, and to the Committee on 
Governmental Affairs:

                            S. Con. Res. 59

       Expressing the sense of the Congress that any Federal 
     Government mandated health care reform should be on-budget.
       Whereas the Administration's proposed health care reform 
     plan would constitute the largest expansion of Federal 
     entitlements in history;
       Whereas the proposed health care premiums would be 
     mandatory taxes;
       Whereas the Administration's proposed health care reform 
     plan would constitute a massive tax increase;
       Whereas the costs of any health care reform plan that is 
     kept off-budget would be difficult to control and account 
     for;
       Whereas placing health care reform off-budget means that it 
     would be exempt from annual budget reviews and would have no 
     meaningful restraints on growth;
       Whereas the Office of Management and Budget's own risk 
     tables, and past and present entitlement growth trends show 
     that the Administration's proposed health care reform plan 
     could increase Federal budget deficits by up to 
     $800,000,000,000 by the year 2000;
       Whereas the Federal Government has already run up massive 
     unfunded liabilities outside the budget process; and
       Whereas the attempt to place the health care reform plan 
     off-budget is a move to hide the true cost of the plan from 
     the American public: Now, therefore, be it
       Resolved by the Senate (the House of Representatives 
     concurring), That it is the sense of the Congress that any 
     Federal Government mandated health care reform should be on-
     budget.

  Mr. BURNS. Mr. President, I rise today to submit a resolution stating 
that it is the sense of the Congress that any Federal Government 
mandated health care reform should be on-budget. Notice I said ``any''; 
this is not a resolution to single out the Clinton plan or any other 
plan. This, by the way, is the same resolution that my friends in the 
House, Representative Wayne Allard and Representative Tim Penny, will 
be introducing today.
  It is my strong feeling that we need to take responsibility for the 
health care plans that we ask our folks to implement and to live with. 
If we are to increase taxes, especially mandated taxes, we need to be 
responsible for the costs. Leaving any program off-budget, especially 
when the reform is as massive as this reform will potentially be, will 
mean costs will be difficult to control and account for. We need to 
make certain that we have some way to restrain growth or I can just see 
it now. Instead of a health care crisis, we'll be looking at a budget 
crisis of incredible proportions.
  As you know, Mr. President, our States are buckling under the weight 
of unfunded mandates already. I cannot, in good conscience, support any 
plan which will add more liability to my State without Federal 
responsibility. And keeping health care reform off-budget will hide the 
true cost of the plan from the American public. I think they have the 
right to know the true costs and I think it's in our best interest to 
make those costs known. And it is imperative that whatever health care 
reform proposal we enact should be subject to annual budget reviews or 
we will never get a handle on what is driving these costs skyward.
  We all want the same thing--and that has come through in all of our 
many debates on this issue. we are aiming for increased access and 
lower costs. Let's be fiscally responsible in the process. We are 
talking here about one-seventh of our economy. That's a huge chunk to 
have no control over. I don't think we can afford to leave this off-
budget.
  CBO will shortly be making their decision as to whether or not this 
will be on-budget. Let me remind them that some precedence has been 
set. The Coal Industry Retiree Health Benefit Act, enacted in 1992 by 
Congress, requires coal companies to pay health premiums to a privately 
managed fund for its retired coal miners. The premiums do not go into 
the Treasury and yet it is considered on-budget. And the Federal 
Unemployment Trust Fund is also treated in this fashion. States act as 
agents of the Federal Government, raising and paying out unemployment 
benefits, and this is counted on-budget.
  Let's do something that the people have been asking us to do for 
years. Let's act responsibly. Let's tell the folks at home that any 
Federal Government mandated health care reform will be on-budget and 
reviewed annually to make sure cost containment is a priority.
  I am joined by a number of colleagues in introducing this resolution 
and would ask they be listed as original cosponsors: Senator Larry 
Pressler, Senator Trent Lott, Senator Larry Craig, Senator Frank 
Murkowski, Senator Don Nickles, Senator Lauch Faircloth, and Senator 
Richard Lugar.
  I would also ask that remarks from Senator Pressler and a letter he 
wrote to Mr. Reischauer be entered into the Record immediately 
following.
  I yield the floor.
  Mr. PRESSLER. Mr. President, I'm pleased to join with Senator Conrad 
Burns in offering this concurrent resolution. To my amazement, this 
common-sense approach to health care reform is opposed by some. We 
believe that all costs associated with health care reform should be 
considered on-budget.
  The American public concurs that too many are without health 
insurance and that medical costs are increasing at alarming rates. We 
may not all agree upon the best method of addressing these problems. 
However, we share the same goals--reduced cost and increased access, 
which is a good starting point.
  President Clinton, in his Health Security Act, envisions an expanded 
role for the Federal Government. I, for one, do not agree with this 
approach to reform. Rather, I support market, insurance, and 
malpractice reforms as means of reducing costs. We can best help the 
uninsured by reducing costs and providing vouchers to help those who 
need it to purchase private insurance.
  I'm not here to debate the merits of the various health care plans. 
Instead, I'm here to express my belief that the cost of any health 
plan, whether advanced by a Republican, Democrat, or independent, must 
be considered on-budget. This is an important first step in the health 
care debate. We must show that we are serious about reforming the 
health care system and serious about being fiscally responsible in the 
process.
  The Clinton administration and others have argued that certain 
sections of the President's health plan should be considered off-
budget. If this were done, the true cost of the President's health plan 
would be hidden from the taxpayer.
  The President's health plan would redistribute one-seventh of our 
Nation's economy. Some economists estimate that the health alliances 
proposed in the President's plan will collect and distribute more money 
than the governments of the States in which they operate. This awesome 
reallocation of resources would be directed by the Federal Government. 
If the Government is going to engage in economic control on this scale, 
these activities should be accurately reported and monitored.
  The premium payments made by employers under the Clinton plan are 
mandated, thus they are payroll taxes. These premiums represent a new 
cost for many small businesses and individuals. Some predict the 
employers' costs will represent about half of the nearly $700 billion 
in new spending over the next 5 years. Their contribution is a payroll 
tax and as such, it should be considered on-budget.

  The expense of health care reform is a great unknown. Many models and 
estimates have been offered. The fact is that we cannot accurately 
project the course of the economy. And as the runaway costs of Medicare 
and Medicaid show, we cannot accurately predict the course of 
Government spending. One study estimates the Clinton health care plan 
will add $1 trillion to our national debt. To prevent health care from 
breaking the Nation's bank, we must keep reform on the budget, where it 
can be monitored and controlled in years to come.
  On December 8, 1993, I wrote to Robert Reischauer, Director, 
Congressional Budget Office urging that all costs associated with 
health spending be considered on-budget. Mr. President I wish to submit 
a copy of that letter for the Record.
  The intent of this concurrent resolution is simple. All costs 
associated with health care reform must be considered on-budget. I urge 
my colleagues to support this proposal.
  Mr. President, I ask unanimous consent that additional material be 
printed in the Record.
  There being no objection, the additional material was ordered to be 
printed in the Record, as follows:

                                                      U.S. Senate,


                                  Committee on Small Business,

                                 Washington, DC, December 8, 1993.
     Mr. Robert D. Reischauer,
     Director, Congressional Budget Office, Ford House Office 
         Building, Washington, DC.
       Dear Robert: President Clinton's health care plan 
     represents unprecedented federal spending, price controls and 
     bureaucracy. I am deeply troubled by recent news reports that 
     the Congressional Budget Office is considering scoring the 
     health care plan ``off budget.'' I urge you to truthfully 
     label this plan and include it in the federal budget. U.S. 
     taxpayers deserve to know the full cost of any health plan 
     adopted by the Congress.
       As you are well aware, the President's plan would 
     redistribute one-seventh of our Nation's economy. Some 
     economists estimate that the health alliances will collect 
     and distribute more money than the governments of the states 
     they operate in. This awesome reallocation of resources would 
     be directed by the Federal government. If the government is 
     going to engage in economic control on this scale, these 
     activities should be accurately reported and monitored.
       The premium payments made by employers under the Clinton 
     plan are mandated, thus they are payroll taxes. The premiums 
     represent a new cost for many small businesses and 
     individuals. Even with the proposed subsidies, the employer 
     mandate would cost small firms an additional $32 billion each 
     year. Because these new expenses are not voluntary, they must 
     be labeled as taxes.
       Scoring premium payments and health care services ``off 
     budget'' is a dangerous move. This would hide the true 
     expense of the plan. Costs undoubtedly will be harder to 
     monitor and control. This plan should not be afforded a 
     special exemption from our system of checks and balances. In 
     looking at the runaway costs of other broad based government 
     programs, we cannot afford to let another entitlement venture 
     go unchecked.
       Taxpayers deserve to know the true cost of the Clinton 
     health care plan. I urge you to call a spade a spade, and 
     include these new taxes and federal outlays in the national 
     budget.
           Sincerely,
                                                   Larry Pressler,
     Ranking Member.

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