[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.
____________________