[Congressional Record Volume 157, Number 15 (Wednesday, February 2, 2011)]
[Senate]
[Pages S434-S475]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
FAA AIR TRANSPORTATION MODERNIZATION AND SAFETY IMPROVEMENT ACT
The ACTING PRESIDENT pro tempore. Under the previous order, the
Senate will resume consideration of S. 223, which the clerk will report
by title.
The legislative clerk read as follows:
A bill (S. 223) to modernize the air traffic control
system, improve the safety, reliability, and availability of
transportation by air in the United States, provide for
modernization of the air traffic control system, reauthorize
the Federal Aviation Administration, and for other purposes.
Pending:
Stabenow amendment No. 9, to repeal the expansion of
information reporting requirements for payments of $600 or
more to corporations.
McConnell amendment No. 13, to repeal the job-killing
health care law and health care-related provisions in the
Health Care and Education Reconciliation Act of 2010.
Mr. ROCKEFELLER. Madam President, this is, in fact, the aviation
bill. As everybody knows, that is what we are doing; we are doing the
aviation bill. We are talking about health care, but secretly we are
doing the aviation bill. So I thought it would be interesting to talk
about the aviation bill, to sort of bring people's minds back to that
very important subject. It is interesting, because we want
transparency, no filling up of the tree, everybody could offer all of
the amendments they want. We immediately got amendments to repeal
health care and other kinds of things but nothing about aviation. So as
manager of that bill, I am going to talk about aviation. I do not
guarantee it will be a scintillating speech, but it is going to be
about aviation, because that is the bill we are on.
I rise to speak about--which I did a little bit yesterday--the
modernization of the Nation's air traffic control system. It is kind of
important to New York and New Jersey.
I cannot emphasize enough to all of my colleagues the importance of
this issue to the United States. It is an issue I care deeply about,
one Senator Hutchison cares deeply about, one I am completely committed
to getting done. We have to. It is a sine qua non. It will make air
traffic safer, more efficient, provide numerous economic and
environmental benefits.
I touched on air traffic modernization in my opening statement
yesterday. But I want to spend a short time, knowing that my colleague
Senator Hutchison is here and wants to talk, on the air traffic
modernization. It just has to be discussed in a tiny bit greater detail
so people understand how important it is.
There will be some technical stuff in here, and I apologize for that,
but people have to understand this. I know this subject is very
technical. It is very confusing. It has lots of acronyms, unmemorable
acronyms, but the technology will change aviation in truly amazing
ways, and it is of overwhelming importance to the country.
Every time I get in my car, I find it implausible that so many
automobiles navigate using more sophisticated global positioning
systems than aircraft. Well, that is amusing, except it is horrifying,
actually. It is horrifying. We can do it in Detroit with automobiles
that sell for $15,000, $25,000, but we cannot do it on a multimillion-
dollar aircraft because we have not decided to do it aggressively in
our legislation. So we have to upgrade our system now or we are going
to face absolutely enormous consequences.
I continue to believe that the modernization of our Nation's
antiquated air traffic control system has to be one of the Nation's
highest priorities. We have fallen behind, as is now--it is actually
kind of interesting. It has become a mantra: We have fallen behind
Mongolia. People like to talk about that. I am the original author of
that startling fact--this tiny little nation ahead of us. But it does
not make any difference. Everybody should steal the line because it
makes the point: They have it. They are building it from scratch. We do
not. So if we recognize the benefits of using the most advanced
technology and if they do, perhaps it is something we might think
about.
The United States, of course, has a much larger and more complex
airspace system than Mongolia or any other country in the world, but
this is precisely the problem: that we are so big and we are so
complicated; there are 36,000 flights in a day. There are airplanes
during the day, all day long, all over the country, at different
altitudes, coming in, avoiding weather, avoiding each other, facing
delays or not. Our aviation system actually moves 30,000 flights a
day--I would say 36,000, but it says 30,000--and nearly 800 million
people per year--a lot tougher than Mongolia. But we face gridlock if
we do not make significant progress on modernization and make it very
soon. The FAA's most recent forecasts estimate demand for air travel
will be about 1 billion people within the next decade. That is a 40-
percent increase. That is horrific.
Senator Isakson has just come on the floor. His airport in Atlanta is
one of the most complicated and busy in the entire world. He needs, as
do we all, an air traffic control system which is digitalized, which
makes communication between air traffic controllers and pilots much
more accurate so they can see terrain, they can see mountains, they can
see weather, all in streamingly live exactitude.
The economic downturn of the past several years has actually, in a
quirky way, bought us some time to reform our system. We have declined
to use it, but this will quickly change as the economy rebounds. Our
present air traffic control system is stretched to its limits already.
Anyone who flies on a regular basis has experienced the system's
congestion and delay problems. We talked about that yesterday. We will
talk more. This system will not meet the projected growth of the next
decade.
So we have this choice. An industry that employs 11 million people
and several more in indirect jobs, that traffics 800 million people
around the country to all kinds of places large and small, very
complicated--runway problems, gateway problems, all kinds of problems--
if we do not have this up to speed, we are a nation in trouble and
people will start dying.
The Next Generation Air Transportation System, NextGen, will create
significantly more capacity by allowing aircraft to move more
efficiently and take more direct routes. I talked about that yesterday.
It is so important. Planes now, because of the sort of radar ground-
based system, wind their way to their destination, avoiding planes,
avoiding weather, and how quickly can they see it, how accurately can
they see it, are they aware of the altitude of other planes above them
and below them? Probably not very accurate. So they don't take direct
routes. So these improvements, if they do take direct routes, will save
our economy billions annually.
The technology will also allow the FAA to safely allow the closer
spacing of aircraft. More aircraft can land and do so more safely
because of the reality of the digitalization of everything is so clear
to the pilot and to the air traffic controller. They are in sync for
the first time with a highly sophisticated system. And the Northeast
corridor probably will be the greatest beneficiary of all of that. It
will be.
Greater operational efficiency will also create substantial
environmental benefits. Drastic reductions in fuel consumption--taking
more of a straight line from one place to another rather than going all
over the place--saves a
[[Page S435]]
lot of fuel, and that means less carbon emissions, and it also
significantly lowers noise emissions. Almost every community near an
airport will greatly benefit from this effort, and this will also save
airlines millions of dollars annually in fuel costs.
Airlines, you have to remember--people just assume they are always
there. Well, they are almost always in trouble financially. They merge.
Sometimes they merge not because they want to but because they have to
because one of them is declining financially. They have to be able to
meet payroll.
Most importantly, NextGen will dramatically improve the safety--the
safety--of our air transportation system. It will provide pilots and
air traffic controllers with better situational awareness. The military
uses that term--SA it is called. It is called SA, situational
awareness. Pilots and controllers will be able to see other aircraft
and detailed weather maps and other things such as mountains in real
time. If they are flying low, they need to have a very good sense of
what the terrain holds. So just as in battle, better SA--situational
awareness--will save lives.
Modernizing our air traffic control system will require sustained
focus and a lot of money. Our bill takes concrete steps to make sure
the implementation of this system begins now. And there is some of it
out there in a few airports, and where it is out there, it is working
very well, just as Senator Hutchison and I have described.
The bill directs the FAA to move forward on dedicated timelines to
implement key NextGen technologies. In particular, it requires clear
deadlines for the adoption of existing GPS navigation technology. All
of this has to be calibrated. Carriers have been very excited about
using this; it is just that we have not made it available to them. And
they are a part of it because as we build it they are going to have to
have corresponding avionics and systems within their own cockpits,
which they will pay for. They want to do that because they want to have
this safer system so they are not harassed so much and so they can save
fuel and just do better in general. Why do something out of the 19th
century when you can do it out of the modern era that will last for
years?
It also requires the FAA to move forward on developing air traffic
procedures to make certain airlines will reap the benefits of equipping
aircraft in their fleet.
These technologies are as follows. They are called area navigation
and required navigation performance, RNP. That will permit aircraft to
fly more precise routes in both the en route environment and enable
aircraft to land more efficiently and safely at airports. Our
legislation requires the FAA to develop the procedures that accompany
this technology at the Nation's 30 largest airports by 2014--Senator
Hutchison said that yesterday--and at all commercial airports across
this country by 2018, if we do our work here. Then the whole thing will
be done in the county by 2018 and all the biggest ones by 2014.
The bill accelerates the timeframe for the integration of automatic
dependent surveillance-broadcast--ADS-B--technology by requiring the
use of ADS-B Out on all aircraft by 2015 and the use of ADS-B In on all
aircraft by 2018. This technology will significantly improve the safety
of our system by providing pilots and air traffic controllers with more
precise information on their location. That is everything in air
traffic control--where people are, how high, how low, how close, how
far. The FAA has moved forward on the requirement for ADS-B Out for all
aircraft operating in our airspace, and we plan to work with them to
make sure this is a success.
The bill--coming to the end--takes further steps to make certain that
implementation of NextGen continues at the FAA, including the creation
of an air traffic control modernization oversight board. Oh, wonderful,
another board. Well, this is a really complicated system, and you need
to have an advisory group that oversees, gives oversight--as we in the
Commerce Committee will do--of FAA's modernization activities.
It establishes a Chief NextGen Officer position at FAA. Oh, another
person to oversee something at FAA. Well, we have not done this. We are
not doing it. And to have an officer dedicated to that I think is very
important.
It requires the development of processes to include representatives
of Federal employees in the planning of NextGen projects. Why is that
important? Because it means that people who are working the towers, who
are actually involved in the system as it is now--and if you go out to
other places--Herndon--you can see these enormous rooms of computers
with air traffic controllers and these sort of vague shapes. We want to
turn those into precise shapes. That is what our bill would do.
It establishes a new process to make certain labor disputes at the
FAA are adequately resolved through mediation and arbitration if
necessary.
So our future as the world's leader in aviation, our safety, our
economy--all depend on a successful modernization of our air traffic
control system. An FAA-funded study determined that our economy lost
$33 billion in 1 year as a result of delays attributed to the air
traffic control system. That is not smart and it is not safe. Of this
total, $8 billion was from the airlines themselves. They are not in the
position to lose $8 billion--an amount that would go a long way toward
giving them a healthier bottom line and making other improvements. The
other $25 billion in losses was borne by the traveling public--they had
to pay for it--and business.
So this overdue FAA reauthorization takes the necessary steps to make
certain we begin to implement this critical upgrade of our airspace
technology right now. We must follow through on these efforts or face
dramatic challenges. This is not a song and dance effort; this is life
and death for the future of our air system, in literal terms and
symbolic terms.
Madam President, I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Texas.
Mrs. HUTCHISON. Madam President, I commend the chairman of the
Commerce Committee. He and I have been working on this bill since 2007.
As we mentioned when we began consideration of the bill yesterday,
this is the 18th short-term extension we are on. I think any person in
America, any person who flies in America, any person who is subject to
FAA regulation, and certainly any businessperson in America knows you
cannot do long-term planning and ensure that your agency is doing its
work knowing what they can expect in support from Congress in short-
term extensions for over 4 years. That is not good business, it is not
good management, and it is certainly not the way government should
run. So I am in agreement with Senator Rockefeller, our chairman, that
we need to act on this bill. I hope it is going to be an effort that is
bipartisan, that we will address the issues that have held up the bill
in the past in a reasonable way so we can get on with, hopefully, a 3-
year authorization of the FAA, and especially so we can start next
year.
America is the premier user of air traffic control systems. Our
system is based on the 1960s technology of ground operations and use of
radar. We want to move to a satellite-based system that will increase
the capacity at our clogged airports--the bigger airports that have
more traffic than they can accommodate--and where the traveling public
is in the most need. We need the efficiency and we need the modern
technology. That is what this bill will set us on the path to do.
So I agree with the chairman in that respect, and I look forward to
working with my colleagues on their amendments that pertain to this
bill going forward.
I wish to take a few moments to speak to the amendment that is at
hand, which is not an amendment about the FAA authorization, but it is
a very important amendment. Basically, it is Senator McConnell's
amendment that would repeal the health care reform that was passed over
a year ago. He is trying to say: Let's stop right now. We have seen
every signal that the concerns we had when we spoke against this bill
in December of 2009 are coming home to roost. In fact, the concerns we
raised are now being shown to be a huge problem in this country.
The health care reform bill that was passed cost $2.6 trillion. Over
6,000 pages were added to the Federal Register to implement this law.
All of this
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indicates the bill does a whole lot more than my colleagues are
referencing right now in the floor debate because when I hear the floor
debate, the people who supported this bill are saying all we did was
fix a few problems with our health care system that we all agree on.
But in reality, this is a bill that costs $2.6 trillion, $500 billion
in new taxes on business and on individuals, and it cuts $500 billion
out of Medicare, a program that isn't working to the maximum extent
possible. It is certainly not considered the most efficient program.
Now we are putting $500 billion out for a new government entitlement
program that puts the Federal Government between patients and their
doctors.
Here are a few of the provisions that are in the 2,000 pages of the
health reform law. First, if you don't buy government-approved health
insurance for you and your family, the health reform bill says you must
pay a new tax. That is the individual tax.
If you own a business and don't buy government-approved health
insurance, which is going to have a formula and a requirement for how
much businesses have to pay and what has to be in it, then you must pay
a new tax. If business owners want to grow their employees over the 50
mark where it kicks in for businesses, then there will be costly new
Federal regulations with which they will have to comply.
So here we are in an era where unemployment is at all-time highs, and
we are putting a cap on employees for businesses that are going to
incur huge expenses if they go over 50. So if an employer is in the 40-
to-45 range, they are looking very carefully at not going above 50. Is
that really what our economy needs right now? I don't think so.
What we want is to encourage businesses to hire. That is what every
one of us in this body should want, and we should be passing laws that
would ensure that businesses have the freedom to hire, not a stifling
effect on that kind of effort. We need to get the government off the
backs of our job creators and not put up miles of redtape and more
bureaucracy and more regulations and more taxes and fees that would
curb the ability to hire and still make a profit.
Next, it was said during the health care reform debate that if you
like your current health plan, you will be able to keep it. But
everything that has happened since the bill passed says you can't keep
it because even the administration is now admitting that when it issued
the rules that employers now have to follow when deciding what health
care plan it will offer, that because of health reform, by 2013 as many
as 80 percent of small businesses will no longer offer the same health
care plans they offer today.
Families who rely on their health savings accounts or flexible
spending accounts, which have been a wonderful boon for families to be
able to put money aside before taxes to be able to use on the health
care expenses they have that are not covered by insurance, that is
being used by more and more people--in the millions. But in the health
care reform bill there is now a restriction, a cap, on how much you can
put aside, and you have to have a prescription drug to be able to pay
for it with your pretax dollars. You can no longer buy a bottle of
Tylenol or aspirin off the counter and have your health savings account
help you pay for that. So here we are.
The Presiding Officer and I have children. Are we going to stop and
call the doctor or run and get a prescription if we have a health
savings account to buy aspirin or Tylenol? That is not helpful.
Why would we put a restriction on what people can set aside for their
own health care costs? Why wouldn't we make it easier for them?
Instead, the health care reform bill makes it harder to use those
pretax dollars. There is no reason for it. I will have an amendment
that will try to take the caps off and take the restrictions off so
that people can provide for their health care out-of-pocket expenses
with pretax dollars. That is the kind of incentive we need, not the
opposite, which is in the health care reform bill.
If you are a woman under 50, whether you have access to routine
mammograms is going to depend on a task force that was granted new and
unchecked powers by the health care reform bill. The same task force
that is going to have that power has already given the indication that
mammograms under the age of 50 are not necessary to be covered. The
women of the Senate stood firm years ago when the Clinton
administration was trying to pass a health care reform bill to say we
are absolutely not going to stand in the way of a woman and her doctor,
knowing her history and her family, from having a mammogram whenever it
is needed. There is not one person in this body who doesn't have a
friend or a relative who has had breast cancer before the age of 50 and
probably before the age of 40. So that is in the health care reform
bill, and it needs to come out.
This week, another Federal court announced that the Federal
Government could not force individual Americans to purchase a private
product--even health care. The judge in the most recent case in Florida
said when Congress passed health reform it exceeded its constitutional
power and, therefore, the court voided the entire law. This is the
second court that has found the health reform bill unconstitutional.
Now, this lawsuit is going through the judicial process. Yet even
though it is being appealed by the Obama administration, it will most
likely go to the Supreme Court of America. We shouldn't have to wait
for the Supreme Court to rule that this law is unconstitutional. We
shouldn't have to wait for them to reassure the American people that
Congress most certainly shouldn't be regulating anything and everything
just because the Federal Government says so. We don't have to spend
millions more in taxpayer dollars implementing a bill that ultimately
could be struck down by the highest Court in the land.
The Senate has the opportunity, and I believe the responsibility, to
say: Moratorium. Let's wait until the Supreme Court has ruled on this
enormous bill and the enormous cost that is being incurred for
implementation right now. Let's wait. Let's repeal this bill now and
start all over so we do not have to spend taxpayer dollars that we know
are being borrowed to implement a bill that may be unconstitutional,
and we have now had two Federal courts that have said so. Why not
repeal and support this amendment? Some of what is in the bill could be
reenacted because it is good, but some of the things I have just talked
about should be repealed immediately.
Most certainly we could repeal items such as the 1099 which will be
another amendment we can vote on. That 1099 form is the biggest thing I
hear about from my small businesses in this country, and certainly
those in Texas have said: What are you all doing up there? Well, of
course, I am happy to say I didn't support this bill. But these are the
kinds of things we can repeal today and start all over. We can take the
good parts of the Obama health care. Let's do away with the bad parts
instead of spending millions of dollars to make a mom have to get a
prescription from a doctor to get Tylenol with her health savings
account.
The American people have made their opinion on this bill known loudly
and clearly. They spoke at the ballot box: Enough is enough. That is
what the voters said. Enough deficit spending; enough government
intrusion into our businesses, our families, our lives, and our health
care decisions. The people of America support the repeal of this bill,
and they will work with us to substitute responsible health care reform
that will allow them to have health savings accounts to provide for the
costs not covered, that will give them affordable coverage which we all
want to have, but not with the government prescription, not with a
government task force that can tell a woman that she doesn't need a
mammogram before the age of 50. We don't need a task force to tell us
that. We need the doctor who is looking at this patient and her family
history.
Those are the things that need to come out right now. Repeal and
replace. That is what this Senate could do, and we can move forward on
a bill that we can get a bipartisan consensus to pass that I think
would show the American people we heard what they said. We know we can
do better, and it is our responsibility to do so.
Thank you, Madam President, I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from West Virginia.
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Mr. ROCKEFELLER. Madam President, I ask if the Senator from the State
of Washington would grant me 30 seconds to say one thing.
Mrs. MURRAY. Of course, I will.
Mr. ROCKEFELLER. Madam President, yesterday Senator Hutchison raised
a very good point about slots. Slots are kind of the hidden problem in
the FAA bill. What I think I would like to put forward--and I wish she
were here to hear me--is that I recognize the majority of the
population growth in this country, and, therefore, the need for more
flights, is in the West. It is not in the East. That is extremely
important. We deny it, but a lot of people are east coast centric, and
we have to learn how to be equally west coast centric.
So one of the things that occurs to me is that maybe we are thinking
too much about airlines and not enough about the people who take those
airlines to go to various places in the West.
It cannot stand that Los Angeles has a flight a day to DC. It cannot
stand. They need at least four or five. They can bear that traffic.
I want to lay before the Congress--and the Senator from Texas made
this point yesterday and I totally agree with her--the growth of
population in this country and the need for air flights, yes, is in the
East but it is more now in the West. As we go through this bill and
come to the matter of slots, it is important we keep that in mind and
that we think about the public flying as individuals, not necessarily
is it United, is it USAir, is it American, is it whatever. It is the
question, Can we get them to where they want to go.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Texas.
Mrs. HUTCHISON. Madam President, will the Senator from Washington
allow me to make a couple minutes response to the Senator from West
Virginia?
Mrs. MURRAY. I will.
Mrs. HUTCHISON. Madam President, I appreciate so much what the
chairman has just said. That is a major statement because what he says
is true. There is one flight from Washington National to California.
That is all we have, one direct flight. That is not fair. It is not
fair to the people in the West, certainly in the largest State in
population in America--California.
I hope what he has said will lead us to a table to negotiate this
issue so we can be fair to the entire western half of the United
States, so that we are also taking into account the people who live in
and around the Washington metropolitan area, which is what I think the
Western Senators have tried to do. But let's talk about it, let's get
something on the floor, let's negotiate this because with that, this is
a bill that, with a few tweaks perhaps, ought to pass for the right
reasons for our country and for the traveling public.
I thank the chairman for his leadership, and I thank Senator Murray.
The ACTING PRESIDENT pro tempore. The Senator from Washington.
Mrs. MURRAY. Madam President, we are here today to debate the FAA
reauthorization bill, very important legislation. It will create
thousands of jobs and put in place the infrastructure for us to make
sure we are competitive in the future.
It is disheartening to me that this bill has now been hijacked by a
political debate, an amendment to repeal health care reform. Not every
bill has to become political. Unfortunately, that is what we have today
because we have an offer of an amendment to repeal health care reform.
Let me speak to that amendment.
Last year, I watched as President Obama signed health care reform
into law with a young man by the name of Marcelas Owens. He stood just
a few feet away from the President. I met Marcelas a few months earlier
at a rally in Seattle, and he told me a story that stayed with me
throughout the health care debate. I want to mention it again.
Marcelas, a little boy, came up to me at this health care rally. He
leaned in close to me and he said he wanted to tell me about his mom
named Tifanny. She was a single mom, working hard. She got sick and
lost her job. Because she lost her job, she lost her health care.
Because she lost her health care, she lost her life. Little Marcelas
looked up at me and said: Please don't let this happen to any other
little boy. Please pass health care.
I was proud when that health care reform law was passed and is now
working to make sure Marcelas and thousands of other little kids do not
get into that terrible situation through which he has lived.
He was not alone. I heard from thousands of people from my home State
of Washington who were demanding reform to the system we have. I heard
from small business owners who wanted to cover their employees but they
could not continue to do it because of the skyrocketing premiums. I
heard from moms and dads who wanted to cover their children but they
were getting rejected because their son or daughter had a preexisting
condition. I heard from seniors who were desperate because they had
fallen into the doughnut hole. They did not know how they were going to
afford the drugs they needed to take so that they could have dignity of
life in their senior years.
I heard from men and women in every part of my State, some barely
holding on to their health insurance and a lot with no coverage at all.
Each one of their stories had a common thread: The health care system
we have in this country did not work for them. It failed their families
one way or another, and they wanted it to change.
That is why I fought so hard with so many of my colleagues to reform
that broken health insurance system, to fight for our families who
needed help and were desperate and to level the playing field for
people who needed a little bit of support.
We got that done for our families, and we can never go back. We
cannot go back to a time when millions of Americans stayed up at night
worrying about what would happen to them and their families if they
lost their job and their health insurance; when insurance companies put
unreasonable and unfair lifetime caps on coverage for our families;
when women were not able to get equal access to coverage; when small
businesses could not afford health care; and when so many seniors who
could not afford it had to pay the full cost of expensive medications.
We cannot go back to that situation.
My question for Republicans today is, why would they want us to?
The changes we made require insurance companies to cover preventive
services with little or no cost sharing on the part of patients. It
gives families access to new streamlined assistance to help them appeal
services they have been denied or not covered adequately, something so
many families got lost in prior to passage of this legislation.
It helps anyone who has ever been buried under a blizzard of forms
from their insurance company and denials for coverage they need to
have. It helps our small businesses to afford care for themselves and
their employees who are now getting a tax deduction. As they fill out
their forms, they say: I did not know this was in the health care bill.
And we are going to vote to take that away?
I ask, why do Republicans want to take away the benefits as part of
the business of the Senate as we just get started to get our economy
back on track?
In my home State of Washington, the Republicans' plan would mean
nearly 900,000 seniors who have Medicare coverage will be forced now to
pay more for regular checkups and important preventive services. It
would mean they will lose out on the 50-percent discounts on some of
their prescription drugs. And it would mean that insurance companies
would no longer be required to allow young people to stay on their
policies until they are 26 and that, by the way, is going to be
especially harmful now when so many of those young people today are
having trouble finding a job.
Our families are depending on the changes we made within this health
care reform law. It is why I supported reforming our health care
system. It is why I fought so hard for so long to make sure it worked
for our families and small business owners. And it is why I am going to
keep fighting to make sure we do not go back to the way things were,
that we continue to make progress and do this right.
I am happy to work with anyone--Democrat or Republican--to improve
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this law, but I will do everything I can to fight a full repeal that
will devastate our families and small business owners across America. I
urge my colleagues to vote no against this full repeal of health care
reform.
One final point. We hear so many people talking about the deficit
today and how important it is that we get our hands around the budget
and our budget deficit. It is astonishing to me that this first
amendment brought by the Republicans will cost our Federal Government
$1.5 trillion and put us deeper into a deficit hole.
Progress is important. Getting our families back on track is
important. Making sure that our economy is moving within the FAA bill
we are talking about on the floor is important. And it is important
that we continue to make sure the health care reform insurance system
we put in place works for our families. That is what I will be voting
on later today.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Arizona.
Mr. KYL. Madam President, yesterday I spoke on one of the reasons for
the repeal of this legislation; that is to say, the support for the
amendment to repeal the health care legislation that is pending before
us. Today I wish to speak about a couple other reasons to support that
amendment.
One of the things that was said in the campaign to pass the health
care bill was that those who liked their current health care would be
able to keep it. But as we know now and as we pointed out prior to the
bill's passage, provisions in the law would cause many Americans and
will cause many Americans to lose their coverage. That is why the
administration is now giving out waivers for some of the bill's most
burdensome provisions.
I wish to speak for a moment about these waivers the administration
has granted and the problems that the waivers reveal with the bill as a
whole.
So far, the administration has granted 729 waivers. All of these are
temporary. They protect companies and labor unions from one of the
bill's most onerous mandates--the phasing out of annual caps on costs
paid by insurers. Another four waivers were granted to States applying
on behalf of insurers. According to the administration, waivers may be
granted if the applicant can show that a ``large increase in premiums''
or a ``significant decrease in access to coverage'' would occur absent
a waiver.
So far, the waivers cover 2,283,106 people. That is more than 2
million people whom the administration has had to protect from its own
bill.
All of these waivers were granted to limited benefit plans, or so-
called mini-med plans. About 1.4 million Americans have these mini-med
plans, including many part-time employees who work in the restaurant
and retail industries. These plans are low cost and usually have an
annual cap on costs the insurer would pay out.
Under the Obama plan, these plans would be outlawed. A phaseout on
annual caps begins this year. Starting this year, plans cannot impose
an annual limit of less than $750,000. That threshold gets
progressively higher, until 2014 when ObamaCare will prohibit annual
caps altogether.
What this does, of course, is create an incentive for employers who
currently offer mini-med plans below the $750,000 threshold to drop
their coverage completely until the employer mandate and penalties
become effective in 2014. They can either comply with the requirements
of the health care law or pay a fine for each employee.
The employees caught in this mess who currently have coverage through
mini-med plans will have to hope in the meantime that their employer
can get a waiver; otherwise, those employees will have to wait until
2014 and buy a government-approved policy from the new insurance
exchanges or hope that their employer is in compliance with the many
employer requirements in the bill.
McDonald's, for example, which offers mini-med plans to many of its
employees, received a 1-year waiver. The company warned that absent a
waiver, 30,000 employees could lose their current coverage and would be
left ``without an affordable, comparably designed alternative until
2014.''
It is not clear what will happen when the 1-year waiver expires. That
is another part of the problem. The waivers are often given on the
condition that the recipient brings itself into compliance during the
waiver period. Whether the waiver renewals are available is unclear. As
with many other provisions of ObamaCare, the uncertainty for businesses
surrounding annual cap waivers is immense.
While the waivers are welcomed by those who benefit, they represent a
poor way to run the government or health care. When the government
picks which entities will have to abide by the law and which ones will
not, it is literally picking winners and losers. That is not the recipe
for objective or wise policymaking. It is called discrimination.
I will note that a large number of these waivers were being given to
the administration's political allies. Unions, for example, many of
which praised the bill's passage, are a major beneficiary. Of the 733
waivers granted, 182 went to unions. That is a quarter of all the
waivers, even though unionized workers make up only 7 percent of the
private workforce.
Many of the unions applying for waivers are the very same that were
full of praise upon passage of ObamaCare. In its press release praising
passage of the bill, the Service Employees International Union gushed
that ``it is a new day.'' About 6 months later, Local 25 SEIU applied
for a waiver from the annual limits limitation for 31,000 of its
members. It was granted 2 weeks later. Apparently, it is a new day--
just not for 31,000 SEIU members.
Similarly, when the bill was enacted, the American Federation of
Teachers referred to it as an occasion where ``morality trumped
greed.''
Six months later, its New York City affiliate obtained a waiver
affecting 351,000 individuals.
In the recent column in Forbes magazine, law professor Richard
Epstein explains the dangers of administrative discretion related to
waivers and how the waiver process can undermine the rule of law:
Waivers are by definition an exercise of administrative
discretion that benefits the party who receives its special
dispensation. Nothing in Obamacare explains who should
receive these waivers or why. The dangers from this
uncertainty are enormous. . . . Without major steps to
overhaul or repeal Obamacare, government by waiver will
become standard operating procedure to the detriment of us
all.
This is a bill that was written behind closed doors, creates a huge
uncertainty and problems for job-creating businesses and their
employees, and now waivers are being dispensed by the administration to
protect almost 2.3 million people from the very law it fought so hard
to get passed.
These developments are yet more confirmation that the law is deeply
flawed and one more reason why it should be repealed in its entirety.
The second issue I would like to speak to is the fact that under this
law, there are substantial increased costs, but they are being masked
by the way the bill has been written, and the calculations, therefore,
some have suggested, would actually result in a savings of $230
billion. This is only plausible if you believe the way this bill was
written was an honest way of stating its costs. It is not that the CBO
has done anything wrong in its calculations, it is that it was told how
to calculate certain things. The bill's authors said: Never mind what
the reality or truth is, here is how you will calculate the cost of it.
The CBO, as a functionary, did exactly that to come up with a number.
But former CBO Director Douglas Holtz-Eakin recently cowrote an
article, along with Joseph Antos and James Capretta, explaining that
the bill's purported deficit reduction is based on ``budget gimmicks,
deceptive accounting, and implausible assumptions used to create the
false impression of fiscal discipline.'' The fact is, repeal will not
add to the deficit. The bill itself is the budget buster, not repeal.
I am in favor of full repeal of the so-called Affordable Care Act.
There are many problems with this bill and many reasons to support
repeal. Today, I want to talk about cost.
A central talking point from the bill's supporters has been that the
bill, intended to cover 32 million Americans, will reduce the deficit
by about $230 billion, according to the Congressional Budget Office.
Therefore, repeal
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will increase the deficit by the same amount.
Maybe this sounds plausible--but only until you study these numbers
more closely. Only in Washington could the ``cost'' of repealing a
massive entitlement program add to the deficit.
This is not because of anything the Congressional Budget Office did
wrong. Remember, when the Congressional Budget Office calculates these
estimates, it is required to accept every assumption it is given,
however unrealistic such assumptions are. That's how the authors of
ObamaCare got CBO to produce such a favorable number.
Indeed, former Congressional Budget Office director Douglas Holtz-
Eakin recently cowrote an article, along with Joseph Antos and James
Capretta, explaining that the bill's purported deficit reduction is
based on ``budget gimmicks, deceptive accounting, and implausible
assumptions used to create the false impression of fiscal discipline,''
and that repeal will not, in fact, add to the deficit. The bill itself
is the real budget buster. Not repeal.
Let me walk through the false assumptions and gimmicks Holtz-Eakin
and his co-authors describe.
First, as Republicans pointed out again and again before the bill's
passage, the bill's original $938 billion pricetag does not reflect the
true 10-year cost. That estimate was generated using 10 years of taxes
to pay for 6 years of subsidies. Remember, while the taxes begin this
year, the subsidies don't kick in until 2014. So, the 10-year cost of
the bill's full implementation is actually about $2.3 trillion.
Second, there is an additional entitlement program within this new
entitlement: the so-called CLASS Act, a new, government-run,
government-funded program for long-term care, intended to compete with
long-term care plans provided by private insurers.
Participants would pay into the system for 5 years before they start
collecting benefits. So, for at least the first 5 years, the program
would generate surplus receipts for the government. But eventually,
outflows would exceed receipts. This is why the chairman of the Senate
Budget Committee referred to the CLASS Act as ``a Ponzi scheme, the
kind of thing that Bernie Madoff would have been proud of.''
This is a bailout waiting to happen. As Holtz-Eakin, Antos, and
Capretta write, ``CLASS Act hitched a ride on the Affordable Care Act
for one reason only: Premiums are collected in the first 10 years, but
no benefits are provided. Voila, it creates the perception of a $70
billion deficit reduction. . . . Only in Washington could the creation
of a reckless entitlement program be used as an `offset' to grease the
way for another entitlement program.''
Third, is the illusory savings from cuts made to Medicare's health-
care providers, which would bring payments below those made to Medicaid
providers. We know that the network of doctors and hospitals willing to
see Medicaid patients is constrained in part because of low
reimbursement rates.
Accordingly, about 15 percent of America's hospitals and physicians
would have to stop seeing Medicare patients to help curtail their
losses, although the bill assumes that seniors would not see any change
in their care. Holtz-Eakin, Antos, and Capretta write, ``The idea that
Medicare could pay less than Medicaid is such sheer folly that Congress
will rapidly reverse course. The truth is these cuts cannot be relied
upon for anything.''
In addition, the bill double counts these so-called Medicare
``savings,'' claiming that they can both shore up Medicare's solvency
and help pay for ObamaCare.
Fourth, ``a central CBO assumption'' about how many Americans will
get federal health care subsidies ``could be disastrously off the
mark.''
Today, about 111 million Americans are eligible for subsidies through
the new insurance ``exchanges'' if they don't have an employer-based
plan. But the bill assumes that only 19 million would receive these
subsidies. This assumption fails to take into account the incentive the
bill creates for certain employees to find their way onto the
exchanges, rather than accept coverage from their employers, if
offered. As the authors note, ``the new subsidies are so generous that
low- and moderate-income workers come out way ahead if they get paid in
cash, not benefits, and move to the new entitlement.''
If only the 35 million lowest paid workers jump onto the new
entitlement, Federal spending will rise by another $1 trillion in the
first decade alone.
So, those are four reasons that the purported cost estimates for this
bill are simply wrong or misguided. It's clear that the claims that the
bill will reduce the deficit, or else increase it upon repeal, do not
hold up upon close inspection. Repeal is not a threat to the budget; to
the contrary. The real budgetary threat is ObamaCare itself.
For these reasons, and many others, I support full repeal of this
bill.
Again, there were four basic false assumptions that were built into
the legislation in the way it was drafted, which theoretically
demonstrate a savings of money through the adoption of the legislation,
as the authors point out, but which actually result in not a savings
but an increase in the Federal budget deficit.
One of these has to do with the fact that taxes are collected for 10
years, but costs only accrue over 6 years. Obviously, you are going to
get some money that way. But after that first 6 years, you have to
count the costs as well as the revenue taken in.
Another is the inclusion of the so-called CLASS Act, which has been
described by some as a Ponzi scheme--actually, by the chairman of the
Senate Budget Committee--because it collects all the money upfront and
doesn't pay out any benefits. Once you have to pay out benefits, there
will be a cost. That is a way to show that you are taking in money and
you are not spending it. But it is a dishonest way to write the bill.
Third, the way the cost of Medicare was calculated. The $500 billion
savings is not a savings at all but rather goes to pay for other parts
of the bill. It doesn't help Medicare at all. It only works if, as the
Congressional Budget Office said, Congress actually follows up with the
cuts to hospitals and physicians, which nobody believes Congress would
have the courage to do.
Finally, there are the subsidies and exchanges calculations, which,
as I pointed out in these comments, are woefully understated, as a
result of which it is likely we will have a significant budget deficit
rather than a savings as a result of this legislation.
In fact, repeal of the bill is going to save taxpayers money. The
legislation is what costs money. Think about this: How can you cover an
additional 30 million people--or however many will be covered by this--
without increasing costs? It can't be done. It would not be done under
this legislation. In addition to the reason I talked about yesterday--
the cost of Medicaid to the States--and the two points here today and
the fact that these waivers are being granted in a discriminatory way
only demonstrates that the underlying bill is not a good idea and that
the cost calculations are way off.
I hope my colleagues will take this opportunity to follow the advice
of the American people and vote to repeal ObamaCare.
The ACTING PRESIDENT pro tempore. The Senator from Montana is
recognized.
Mr. BAUCUS. Madam President, we, unfortunately, are in a period where
we are going to be redebating health care reform. We had long debates
on health care reform in the last couple years. I cannot think of
legislation that has occupied so much time in this body, as well as the
other body. But, regrettably, we are going to redebate health care
reform, even though legislation was passed last year, and even though
the legislation was signed by the President. The law is enacted.
Nevertheless, this body, regrettably, is going to spend, it looks like,
a lot of time redebating health care reform. Why? Basically, because
the other side of the aisle wants to do so--wants to not admit health
care reform is the law of the land. It wants to repeal it.
The other side knows there are not sufficient votes to repeal health
care reform. That is a well-known fact. The other side knows and those
who have covered health care debate reform know the votes are not
there. It is the law of the land, signed last year, and it will remain
the law of the land.
So then, you might ask, if it is the law of the land today and if
everybody knows Congress will not repeal health care reform, why in the
world are we going to debate this for another who
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knows how many weeks, months or maybe even years? To be honest, I think
it is because the other side thinks--and I will pick the charitable
explanation first. They don't like health care reform, for whatever
reason, even though I strongly disagree with their reasons. But in
addition to that, they think it is a political issue. They think they
can score political points by mentioning points which, in the main, are
not accurate but say them anyway, and they will say it over and over,
and unless those points are refuted or those myths are busted, many of
the American people will start to believe some of that stuff.
There is another reason, which is a bit regrettable, and that is
because there have been lawsuits filed in Federal district courts
around the country, alleging that the law is unconstitutional--the
health care law. It looks like those decisions will eventually make
their way up to the Supreme Court of the United States, and I expect
the Supreme Court will not rule for, I don't know, maybe 1 year, which
means we will further debate health care reform, waiting to see the
outcome of the U.S. Supreme Court.
I heard one that I think is a very ill-advised argument a few minutes
ago, which is that because the Supreme Court has not yet decided on the
constitutionality of health care reform, we should, in effect, pass a
moratorium. We should forget the provisions of the law because we don't
know how the Court will rule.
That is one of the most specious and inadvisable arguments I have
heard in a long time. That, in effect, means that whenever any law is
passed and there is a lawsuit filed, that law is invalid because the
suit is filed. If we are to follow that line of reasoning, then anytime
we enact a law, anybody who doesn't like it could rush off and file a
lawsuit, and that would mean we don't follow the law. I think the
better course, by far, is to assume the law is the law of the land,
until it is overturned on a statutory basis or a constitutional basis.
That is the way we should operate.
The Senator who suggested, about one-half hour ago, that we should
enact a moratorium, in effect, I think should rethink her position. If
she wants that to be the precedent, I think she would recognize that
pretty soon the country could not function because anybody could file a
lawsuit on maybe something passed 10 years ago. They could say: I don't
like that law, so I will file a lawsuit. Following the Senator's line
of reasoning, we can't enforce that law because somebody doesn't like
it. That makes no sense.
One of the myths that has been discussed many times, and as was said
by the previous speaker in his argument for repeal of health care
reform, is that repeal will save money. He thinks the health care bill
adds to the deficit.
You and I have been around here long enough, Madam President. We have
lived long enough to know that anybody can come up with any set of
figures or statistics that he or she wants. That is a fact of life. So
if somebody asserts this and that, I think it is wise to see what that
person's authority is. Who says that? Where does that come from? Who
verifies or validates that? We well know there is one organization that
has studied health care reform and has concluded that health care
reform saves, I think, about $240 billion; it reduces the deficit by
$240 billion in the first 10 years, and it reduces the deficit by north
of $1 trillion in the next 10 years. That is the Congressional Budget
Office.
The CBO, I remind my colleagues--and for anybody listening--is a
nonpartisan, professional organization that analyzes legislation for
both Republicans and Democrats for the House and the Senate. They are a
very professional outfit. They work very hard. No one has ever even
hinted that this outfit, the Congressional Budget Office, is
unprofessional or that it has a partisan bias. Nobody has suggested
that. Everybody knows they work very hard and do the best they can,
under difficult circumstances--I say ``difficult'' because it is
difficult to predict the future, to know exactly how any request they
are given will actually score. It is a complicated process. You have to
build models. It takes a long time to build a model and to know what
goes into the model.
I wish to make it very clear to anybody listening that repeal of the
health care law will actually increase the deficit by about $240
billion over 10 years and increase the deficit by over $1 trillion in
the next 10 years. That is what the CBO says. That is the organization
that all Members of Congress must live by. Different Members of
Congress might have different points of view. They may belong to some
different organization--very liberal or very conservative--that has an
ax to grind, and they can come up with some other figure. But they
usually have an ax to grind, a bias they want to perpetuate.
The one arbiter in the middle, which is professional, the one
organization nobody has ever accused of being partisan or
unprofessional is the CBO. They conclude, again--and they have written
letters to us in the Congress--that repeal would essentially add about
$\1/4\ billion to the deficit over 10 years. It would add; that is what
repeal would do. It will add to the deficit over $1 trillion in the
next 10 years.
That should end the argument right there because it is the one
neutral professional organization that has looked at this. Other
organizations can have their points of view, but the one that is
professional, the CBO, has ruled, and we have to go by those numbers
anyway in passing legislation here. That should be the end of the
argument. That has been settled. That is what the effect of repeal
would be. That is it, as anybody knows when he or she is spouting off
numbers that are not the CBO's but some other organization--I don't
know which--maybe Heritage or some other organization. First of all,
they are not neutral. They are not unbiased. Second, we can't go by
those numbers anyway under the rules of the Senate. So it is kind of
silly, frankly. They may be scare tactics. That is one of the scare
tactics used on this floor to try to score political points, but it is
inaccurate. It is just plain simply inaccurate.
Now, a couple of other points. What do we spend on health care in
America today all together? We spend about $2\1/2\ trillion a year on
health care, we Americans do. About half of that is public--that is
Medicare, Medicaid, children's health insurance--and about half of that
is private--the commercial insurance industry. That is the American
way. That was the division before health care reform was enacted.
What is the division after health care reform was enacted? It is
about the same. It is about 50-50. So this is no government takeover.
This is no government takeover. It is still about the same. Maybe it is
a percentage point or so different, I don't know, but it basically is
the same. There is no government takeover. Half of it is still private
commercial insurance, as it always has been.
Also, in America we spend much more per person on health care than
the next most expensive country. I don't know the exact number. I think
it is 50 percent, 60 percent more per person on health care than the
next most expensive country, but we are not 50 percent to 60 percent
more healthy per person than the next most expensive country.
In fact, all the international health care data ranked us pretty low.
We are not No. 1; we are not No. 2 in health care. We are way down
there. I have seen statistics--I haven't looked at it recently--that
show us being maybe 14th and 20th in terms of health. Our infant
mortality rate is much higher than many countries. Our death rate is
higher than many countries. I don't know about our diabetes rate, but I
expect that is high compared to other countries, and maybe cardiac and
other chronic care is high compared to other countries. But we are not
No. 1 in terms of health care. We are No. 1 in per capita cost of
health care.
So I would think we should begin to reduce the rate of growth of
health care expenditures in our country, and that is what this
legislation does. It starts to reduce the rate of growth of health care
costs in this country. That is probably why the Congressional Budget
Office reaches the conclusion that it actually reduces the deficit by
$\1/4\ trillion over 10. It is probably why the Congressional Budget
Office says it reduces the deficit over $1 trillion over the next 10
years. And it is probably also why the Congressional Budget Office says
that compared with prior law, I think it is 90 percent of Americans'
premiums will be lower--90 percent of people's premiums will be lower.
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Again, that is the Congressional Budget Office. That is a neutral
organization. They do the best they can. They are professionals. Some
Members of Congress criticize them because they do not come to the
conclusions they like. Other Members of Congress criticize the CBO
because the CBO doesn't come up with the conclusions they like. It is
tough what they do, but they have always been praised for doing the
best job they can, and they have never been criticized for any
partisanship or unprofessionalism. They are a very good outfit.
I have had my problems with the head of CBO, Mr. Elmendorf. I have
talked to him many times on the phone. Most of the time it is saying:
Can't you get your numbers to us more quickly? Why does it take so
long?
He does his best. He is very professional. He says: Senator, I am
just doing the best I can. And I know he is, but still I am a little
frustrated, but I know he is, and I think he does a pretty decent job.
Now, you might ask: Why are American health care costs so high? Why
is that? Why are American health care costs so high? Well, there are a
lot of reasons for that. Essentially, it is waste. It comes down to
waste. There is a lot of waste in the American system, and this
legislation, among other things, is designed to root out a lot of the
waste.
What is some of the waste? I am not going to go into great detail,
but I am struck with an article written by Dr. Guandi on June 1, 2009,
in the New Yorker magazine comparing El Paso, TX, with McCallum, TX.
What conclusion did he reach? This is an article that many in the
health care industry cite because most people think this fellow got the
nub of the issue right.
Health care costs in El Paso are about half per person as compared to
health care costs in McCallum, TX. They are both border towns so it has
been adjusted for immigration and so forth. The outcomes in El Paso are
higher. People do better in El Paso than they do in McCallum, TX.
Why, one might ask. The basic conclusion of this article is that it
is because of the way we in America reimburse doctors and hospitals and
providers. It is a way which allows a culture in a community to spend a
lot of dollars on health care, if it wants to, and it is a way it
allows a culture in a community to spend fewer dollars and focus more
on a patient, if it wants to. That is the culture of a community. That
is because we pay providers in America; that is, doctors, hospitals,
the pharmaceutical companies, medical equipment manufacturers, and so
forth, on the basis of quantity and volume, not on the basis of
quality.
So there is a bias in the system. Doctors want to do the right thing,
but there is a bias for a doctor to order an extra procedure. There is
a bias to order an extra drug for this or that. There is a bias to get
this new equipment, and I might say, too, though it is awfully
technical, but when we reimburse hospitals there is something called
DRGs, the DRG purp, and it is according to procedure in a hospital, but
it does not include the medical equipment. So there is no real fix on
what is the cost of that medical equipment. So the medical equipment
manufacturers can charge virtually what they want, and they charge a
lot.
We have read lots of stories about how you can go to Walmart and get
the same little small whatever it is for about one-tenth of the cost
that a hospital is going to charge, and it is because the providers are
purchasing through DRGs. That is an example of a lot of the waste that
occurs in the system.
Let me give another example. I think there are excessive procedures
in America. You can do a lot with anecdotes, but this is one that I
think gives some indication of one of the problems we face in America.
I know a doctor, he is a neurosurgeon, and a very reputable, very
good one. He said to me: Max, you know, there is another neurosurgeon
group that wanted me to join their practice. So I went to talk to them.
We talked a while. I have my own practice, and they have their
practice. After a while, the negotiations kind of cooled a little bit.
Why? It turned out the group who was seeking to have my friend join
them did an audit on my friend's neurosurgical practice, and it was
that audit which kind of cooled the ardor of the group having my friend
join them. Why? Well, the group said: Our hit rate is 2 to 1, and your
hit rate is only 20 to 1.
Those were the exact words they used--``hit rate.'' What does that
mean? That means in the practice of the several neurosurgeons, for
every two patients they see, they perform one procedure. They have a
hit rate of 2 to 1. My friend's hit rate is 20 to 1. For every 20
patients he sees, he performs 1 procedure. Those doctors in that group
love procedures. They want to do everything under the Sun. You have a
back pain, it is an operation, a procedure, and all that; whereas,
often you don't have to have the most expensive procedures.
But our system in America, because it compensates doctors and
hospitals on the basis of volume and quantity, has a bias toward
excessive procedures. That is one reason we have waste in America
today. Nobody disputes that. It is one reason we have waste in America
today.
Something else. There is something called the Atlas study by a guy
named Jack Wennberg. This is from a few years ago. He looked at health
care costs across the country, and what did he conclude? By the way,
this study has not been refuted in any significant way over the years.
He concluded basically--and I am exaggerating now--if a person lives,
say, in a Wheat Belt State, say Montana, the Dakotas, or the Northern
Plain States, that person's health care costs per person are roughly
one-half of what they would be if that person were in a Sun Belt
State--you know, Miami, Denver, Los Angeles, Phoenix, or Dallas. The
outcomes in the Wheat Belt States versus the Sun Belt States are
better. People have better outcomes; that is, they are cured better,
faster than are people in the Sun Belt States where the cost is twice
as much per person.
Well, you might ask, why is that? The reason is because, basically,
it is supply driven; that is, in the South there are a lot more doctors
per person. There are a lot more hospitals per person. People like to
live in the South. They like the sunshine weather. When you have more
doctors and more hospitals, that is supply driven, and that tends to
push up costs because those doctors and those hospitals want to do
things. They want to order procedures for their patients, to make them
worthwhile, and that is what happens.
Now, most doctors around the country, including the South, are good
doctors. They want to do the right thing. But I can tell you, I have
run into individuals--one cataract surgeon, an ophthalmologist, told
me--and I couldn't believe it because he was very upset--he was only
getting paid $2 million a year. Basically, he had people come in and
rotated people in his office to do more cataract procedures--more
cataract--and he was upset that he was only getting paid $2 million a
year.
So this health care bill is trying to address that basic problem, and
it is called health care delivery reform. We are going to move slowly
toward reimbursing doctors and hospitals a little more on the basis of
quality as opposed to quantity. It is hard to measure quality. How do
we measure quality? It is hard, very hard. But there are some
provisions in this legislation--which have been criticized by people
unfairly--designed to help both the doctor and the patient have a
better idea of what the right procedure is and how to get the highest
quality health care. That is what it is designed to do. There are lots
of names for it--bundling, ACOs, and all kinds of things--but that is
the whole purpose of it.
The key is this: It is not at all intended to tell the doctor or the
patient what to do, as has been claimed. It is not that at all. Rather,
it is just the opposite. It is to help the doctor and the hospital have
better, more information so the doctor and the patient can decide for
themselves what procedures should next be performed or not. It is more
information to the patient, it is more information to the doctor so the
patient and the doctor can make their own decision.
There are implications by some on the other side of the aisle that
this legislation destroys or significantly undermines the doctor-
patient relationship. There is not a whit of truth to that. It is just
the opposite. It helps with information to the doctors and information
to the patients so they are
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in a lot better position to know what they should and should not do.
I have talked to a lot of doctors. They want to learn more. Right
now, the drug rep comes into their office and pedals this drug, and the
doctor wonders: Gee, is this the right drug? We are trying to get a
little more objective source of information so that the doctor and the
hospital and the patient have better information.
Let me go back to the earlier point. I mentioned that health care
costs, according to the Dartmouth study, are much lower in the Northern
High Plains States than the Southern States. The Congressional Budget
Office--people don't like this because it is the Congressional Budget
Office. People on one side of the aisle may not like it because it is
the Congressional Budget Office. But they concluded that if the entire
country's health care system were applied, nationwide, in the way that
it is applied in Wheat Belt States; that is, Montana and other Northern
High Plains States, the cost of health care in America would be reduced
by 29 percent. Remember, the outcomes in the Wheat Belt States are
better than are the outcomes in the Sun Belt States.
I said earlier that we spend $2.5 trillion on health care. Thirty
percent of $2.5 trillion is a lot of money. What is that--north of $800
billion a year? I do not stand here to say we are going to save all
that money, but I am saying that is some indication of some of the
waste that occurs in the current system. Others will say there is waste
because too many doctors have to practice defensive medicine. I do not
deny that. I think too many docs do have to practice defensive
medicine, and that has to be addressed. But that is waste. That, by and
large, is waste. It must be addressed.
I know there are other Senators who wish to speak, but there are a
couple of points I want to make.
Preexisting conditions is really a big deal. In my State of Montana,
about 425,000 people have preexisting conditions. That is nearly half
the population. That means that without health care reform, most of
those 425,000 would not get quality health insurance. They would not
get health insurance--certainly not quality health insurance. They may
get it, but they will have to pay too much in premiums to get coverage.
This legislation moves us toward that day where a health insurance
company cannot deny coverage based on preexisting conditions. We have
already done it for kids. We have a pool for kids. In a couple of
years, all Americans will be able to get quality health insurance. They
will not be denied coverage based upon preexisting conditions.
What is the consequence today of denial based on preexisting
conditions? Part of it is people do not have health insurance, but also
it is this: In my State of Montana--this is true in all States--a lot
of people go to the emergency room. They go to the doctor--they get hit
by a truck or get cancer--and they don't have insurance. If you don't
have insurance, what do you do? You go to the ER, that is what you do.
You have a good ER doc, and he or she takes care of you, and you see
another doc.
If you can't pay the hospital bill because you don't have insurance,
what happens? You get the care. But the cost of the doc, the ER doc,
and the other physicians and the drugs in the hospital--somebody has to
pay for it. So who pays? All the rest of us who have health insurance,
we pay. It is all transferred to the rest of us who pay. Our health
care bills, our premiums, are higher today because of the people who do
not have health insurance. It is called uncompensated care. In Montana,
the bill is about $2,100 a year--the premium in Montana, $2,100, family
health care premium in Montana, due to uncompensated care. If people
had health insurance, if the whole country had health insurance, we
would not have that cost transfer to the rest of us who have to pay for
you.
Then you say: Gee, how do you get those other people to pay for
health insurance? That is one of the questions that comes up in this
bill. It is an honest question. This bill says two things. People must
have health insurance. They can do two things. If they are poor, they
can go to Medicaid. That is expanded a little bit. Then there are
issues such as, that costs too much, aren't States having to pay big
bills, and so forth. The answer is, there is no increase in bills to
the States for 3 years. Then the match is reduced from 100 percent down
a little bit--that is after several years--which is much higher in
Federal dollars than it is for other Medicaid. We can have that
discussion and figure out ways to help States legitimately needing
help. But still it is more insurance for people because if they need
health care, those bills are not passed on to the rest of us.
The other way is to give assistance to people who cannot afford
health insurance. It is through a rebate in the Tax Code. That is where
a lot of the money goes. But it is clear that some people who would
have too much money to qualify for Medicaid but not enough to buy
health insurance are going to need some assistance, so this legislation
is designed to help those people get assistance, and the wealthier they
are, the less assistance they get. Some say that is why this bill costs
so much.
I think it is important to remind people here that according to the
Congressional Budget Office--again, the neutral group that we trust.
Nobody questions their integrity. It says this bill does not cost a
thin dime. A lot of people like to say it is $1 trillion. It does cost
$1 trillion, but it raises $1 trillion, so on that basis it doesn't
cost anything. The dollars are raised because the rates we pay
providers are cut back a little bit. There are also some fees on some
of the providers. That is true. That is true. That is how this bill is
paid for.
But let's remember, almost all those providers, all those people who
are paying a little higher taxes, and all those groups whose
reimbursement rate is a little lower favored the bill. They are in
favor of it. You might ask, why in the world do they favor this bill?
The answer is, because more people have insurance. If more people have
insurance, their margins might drop a little, but their volume will
increase. They can make money. They figure they are going to make money
under health insurance reform. Hospitals, pharmaceutical, medical
equipment manufacturers, most of the insurance industry, you name it,
they think they can make some money.
I don't want to take too much of my colleagues' time here, although I
do have one other point, and that is Medicare. It is stated on this
floor: This hurts Medicare. It takes money out of Medicare. That is a
red herring--a red herring in the sense that somebody says something
that on the face of it is true, but it is irrelevant to the main point.
It is true that reimbursement rates to providers is a little lower, but
it is also true that this legislation extends the life of the Medicare
trust fund by about 120 years. The trust fund under this legislation is
extended. The life of the trust fund is extended by 12 years compared
to what it would be before this law was enacted. Some people want to
repeal that. They want to cut back the life of the Medicare trust fund.
What else do they want to cut back with repeal? Repeal gives many
seniors--4 million Americans I think is the number--a drug benefit in
the doughnut hole of $250 a year. In my State of Montana, it is 9,000
Montanans. After a period of time, that doughnut hole will be closed,
so seniors will not have to pay for excessive costs on prescription
drugs. Repeal would repeal that. Repeal would say: Oh, all you seniors,
4 million seniors, we are going to send you a $250 bill. We want you to
pay $250, in effect, for drugs. We don't want you to get any break.
That is what repeal does. I don't think Americans want health care
reform repealed--certainly those 4 million seniors do not want it
repealed.
I have a lot to say. I will finish up. All I ask is this. We are
going to have this debate, regrettably, for about a year until the
Supreme Court finally decides. I ask that we all stick with the facts.
Stick with the facts and don't indulge in histrionics, scare tactics,
and so forth. ``Just get the facts, ma'am,'' because facts generally
control. You can't change facts. The fact is, what does CBO say? There
are lots of facts here. I urge us to stick with the facts. We could
argue what they mean, but let's stick with the facts. Let's not
manufacture the facts. You can't manufacture facts and have a good-
faith debate. I assume this is going to be a
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good-faith debate, so let's stick with the facts.
I have one more small thing. A person once stood here years ago in
the Senate--it was Mike Mansfield from Montana. He was majority leader
in the Senate for 17 years. No other leader served for as many years as
Mike Mansfield. I ran across a statement by him which he gave in 1989
to a bunch of wide-eyed students. I can't remember exactly what he
said, but the main point of it is this--he was a very reasonable guy,
revered in Montana--in all efforts to be constructive, you have to
listen. Listen very well, very closely to the other person's point of
view. He went on to say: You are not always right. They are not always
wrong. The more you listen and the more they listen, you will see where
you are not right and you will see where they are not wrong. You also
see where you are right and they are wrong. But you have to listen to
try to find that common ground where somebody is right and somebody is
not right in an objective sense of the term and then use that
information constructively and with knowledge and with good faith.
I ask all of us to do just that.
The PRESIDING OFFICER (Mr. Franken). The Senator from South Carolina.
Mr. DeMINT. Mr. President, I ask unanimous consent that at the
conclusion of my remarks, Senator Johanns be allowed to speak.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. DeMINT. Mr. President, I think any American who heard the
explanation of what ObamaCare does for Americans will realize that the
complexity of the health care system, the importance of the patient-
physician relationship cannot be managed from the Federal level. I had
difficulty really determining exactly what was being said there.
I do want to talk about health care, but before I do, I need to make
a couple of comments about the FAA perimeter rule that is part of the
discussion to which the health care amendment will be attached.
The perimeter rule is an antiquated policy adopted in the 1960s that
prohibits aircraft flying in and out of Reagan National originating or
departing anywhere beyond an arbitrary 1,250-mile limit. Congress
imposed this limitation five decades ago in an attempt to help the
Dulles Airport in Virginia when it was first being opened. The
rationale was that the best way to ensure growth at Dulles was to limit
the growth at National Airport, and so, by federal fiat, a short-haul
airport was created at National and a long-haul airport created at
Dulles. At the time, Congress assumed government could create an
efficient aviation system and the government would best decide prices,
routes, and schedules.
The perimeter rule is outdated today. Americans out West want to fly
directly into downtown DC. Travelers from downtown DC do not want to go
to Dulles to fly to the west coast. The government needs to do away
with the perimeter rule, just as it did with the regulation of the
aviation system long ago.
Dulles is now an international airport and can easily compete with
National or any other airport in the country. The Federal
transportation policy should be based on competition and consumer need,
but the existing perimeter rule is denying consumers choice in air
travel and frustrating market forces that could accommodate these
consumers.
Consumer choices in the markets should govern the schedule and
flights out of Reagan National, not the Federal Government.
This week, President Obama gave a speech about health care--or
actually I guess it was last week now. The speech was at a fancy hotel
here in Washington. He told jokes to make everyone laugh and sad
stories to endear his audience further to his cause.
The President said, as he has many times before, his law will lower
the cost of health care. President Obama knows how to give a good
speech. He also knows how to tell it like it isn't. While President
Obama was busy selling his policies on the stump, others were busy
analyzing the real effects of his health care law. It is not limiting
cost.
We have heard some of the figures given by the Democrats here from
the Congressional Budget Office. But we have to expose that they are
playing with numbers. If you tell the Congressional Budget Office to
take $500 billion from Medicare, which is already bankrupt and cannot
pay doctors to see patients, you take $500 billion and call that
``savings'' that are created by ObamaCare, that is part of where they
get their money. The other part is to raise taxes on a lot of health
care products and services and call that new revenue creating by
ObamaCare.
Any thinking American knows you cannot create a trillion-dollar new
health care entitlement and it actually saves us money. When the
Congressional Budget Office looks at our whole health care spending at
the Federal level, it tells us, without all of those funny assumptions,
that the Federal spending on health care is going to double over the
next 10 years. That is not saving us money.
This is the same office that found, without these funny assumptions,
that ObamaCare would cause premiums to rise an average of $2,100 per
year for families in the individual market. That is telling it like it
is.
It was not that long ago that some of the country's largest insurance
carriers sent a letter to their enrollees warning them that ObamaCare
was going to drive up the cost of premiums. They told it like it is.
The Obama administration did not want this information to get out. So
the Department of Health and Human Services sent a letter back to the
insurance carriers saying their claims were not true, and HHS would
have zero tolerance for this type of misinformation. They want to keep
on telling it like it isn't.
Richard Foster, the Chief Actuary for Medicare, an independent
economic expert, recently testified before the House Budget Committee.
He was asked if it was true or false that Obama's health care bill
would lower cost. A true-or-false question. He said: I would say false
more than true. He told it like it is. False more than true is a very
polite way of saying no, it will not lower health care costs. That
claim is false.
President Obama also promised that if you would like to keep your
health care plan, you can keep it. Richard Foster was also asked if
those who liked their health care plans would be able to keep their
coverage. He said: Not true in all cases.
It certainly is not true if you live in one of the 34 States where
health insurance insurers stop selling child-only policies. It is not
true if you live in Colorado and have Aetna Insurance. Politico
reported Monday evening that the health insurance carrier was pulling
out of the individual markets. Many Americans will lose their health
plans with ObamaCare.
But you can keep your health care plan if your union or company got
one of the 733 ObamaCare waivers so far. The waivers cover almost 2.2
million people. You can get your health care or you can keep it if you
are a member of the six chapters of the Service Employees International
Union which got waivers, and whose political action committee spent
more than $27 million helping Barack Obama get elected, or if you are
one of the 8,000 members of the United Food and Commercial Workers
Union that got waivers. Their PAC has spent millions helping Barack
Obama and Democrats get elected.
These are the unions that supported cramming ObamaCare down the
throats of the rest of America. Even though labor unions represent less
than 7 percent of the private workforce, they have received 40 percent
of the waivers. They do not want the health care they want other
Americans to have to accept. Most Americans do not play these political
games. They do not have lobbyists and PACs. But I think they should all
get a waiver too.
I think we should name this repeal bill that we will vote on today
the Great American Waiver. Every Republican in the Senate is committed
to repealing this bill. Every American gets a waiver when we repeal
this bill. Soon, we will have a vote to repeal ObamaCare here in the
Senate. I strongly urge my colleagues to follow the House in repealing
it and returning it to the sender in the White House.
I am aware the President currently in the White House might want to
veto our repeal. There is, however, going to be a Presidential election
in 2012, and this health care bill, this health care
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law, is going to be a defining issue in that election. 2012 is 2 years
before the law will fully be implemented. We can get a supermajority to
overturn his veto in the next election or we can get a new President
who will support its repeal. I think both outcomes are possible. Let's
all go on record now showing where we stand. I suspect there are some
Democrats who might want to repeal this law before voters repeal them.
The question is, do they have the courage to break with their party?
For now, the President wants us to think his law can be fixed by
modifying it slightly. It cannot be fixed. Trying to fix it with a few
good ideas is like pouring a few glasses of fresh water into a polluted
river. ObamaCare cannot be fixed by tinkering with its provisions,
because the basic premise is flawed.
This law is actively creating a government-controlled system that
relies on high taxes, less choices, and bureaucrats making health care
decisions for Americans. This is exactly what we are opposed to and why
we insist on a full repeal. A recent analysis by the Center for Health
Transformation found it will give the Secretary of Health and Human
Services 1,968 new powers. Last year the Joint Economic Committee found
that ObamaCare created 159 new Federal programs and bureaucracies to
make decisions that should be made between patients and their doctors.
If the Democrats and Federal bureaucrats are permitted to control our
health care system, our Tax Code will look simple by comparison. Worst
of all, in the rush to pass this legislation, none of its proponents
cared if it was unconstitutional. They were not going to let the
Constitution get in the way of their health care takeover. Even now,
when asked about the constitutionality of the bill, the Secretary of
Health and Human Services has said: I am leaving those arguments to our
legal team from the Department of Justice.
So far their legal team is losing. Two judges have told it like it
is. ObamaCare has been ruled unconstitutional by judges in Virginia and
Florida. The Virginia court held that the individual mandate requiring
every American to purchase government-approved health insurance was
unconstitutional. The Florida court ruled the entire bill was
unconstitutional because of the individual mandate included in it. In
his decision handed down on Monday, Florida District Judge Roger Vinson
compared the law to a finely crafted watch in which one of the pieces
is defective and must be removed.
But what happens to ObamaCare when you remove that one piece, which
is clearly unconstitutional? The rest of the law falls to pieces--as
the judge might say: The watch will not work. Vinson wrote: ``I must
conclude that the individual mandate and the remaining provisions are
all inextricably bound together in purpose and must stand or fall as a
single unit.''
An unconstitutional law that touches the most important personal
decisions Americans ever make must not stand. We must repeal the bill
in its entirety. Because at the very heart of it, which makes all of
the other parts work, that very heart, that individual mandate,
violates the highest law of our land.
It is already failing Americans. Health care costs and premiums are
going up, despite the false assumptions we hear on the other side.
Choices and consumer control over the health care system are going
down. By continuing to follow a failing plan, the government is
planning to allow our health care system to fail.
Obama's broken promises are going to create a broken future for our
country. If we do not fully repeal this bill, it is going to add nearly
half a trillion dollars in new health care taxes and raise the Federal
budget deficit by more than $500 billion in the next 10 years, and
nearly $1.5 trillion in the next decade.
Yet the President says this is going to save us money. We know this
so-called Affordable Health Care Act for America does not live up to
its label. We must repeal this bill and implement commonsense solutions
that will lower the cost of health care for consumers and make health
insurance available to everyone, even with preexisting conditions.
We should allow Americans to choose affordable plans across State
lines, and we should end frivolous lawsuits that drive up costs, and
give equitable tax treatment to those who do not get insurance from
their employer. ObamaCare does none of this. The facts and figures tell
it like it is. President Obama tells it like it isn't. It is time for
Congress to tell it like it is and repeal ObamaCare.
I yield the floor.
The PRESIDING OFFICER. The Senator from Nebraska.
Mr. JOHANNS. Mr. President, I had an opportunity during the comments
of my colleague Senator DeMint to sit here and listen to those. I wish
to start my comments today by complimenting Senator DeMint. Those were
very thoughtful comments.
Many of my friends on the other side of the aisle are now
acknowledging the problems with the health care law. It was a
fascinating process, last September and October as we were leading up
to the November elections, to see Members running to be on the other
side of the aisle and saying, well, I would have done this differently,
and if I get there, I will do that differently.
One such provision designated for repair is my legislation to repeal
the 1099 reporting mandate that is in the legislation. To be clear, I
have never argued that that was the start of the unraveling of the
health care bill. I do not believe that for a moment. What I would say
is this: That provision should have never been in the health care law.
I am very pleased to report today that that legislation, after two
attempts to try to get it repealed, now has the support, bipartisan
support, of 61 Senators. The President mentioned repealing this
provision in the State of the Union Address.
While there is bipartisan agreement on this provision that it needs
to be taken out and repealed, the rest of the 2,700-page bill is still
bursting at the seams with flawed provision after flawed provision.
Months and months ago, as this bill was making its way forward, each
one of us individual Senators had an opportunity to decide: Can this
bill be changed enough to be saved? The conclusion I reached is there
were no amendments that could change this bill enough that I could ever
support it. It is fatally flawed and you cannot repair the problems.
The catch phrase these days--the catchy slogan--is that we will
repair this bill. Well, this bill is beyond repair. We cannot tinker
around the edges. We cannot just kick the tires and put some air in
them. A good detailing job on this bill will not save it. Even a major
overhaul cannot get this bill back on the road. It needs to go back to
the factory. This bill is a lemon. It is simply beyond repair. That is
why it is important for all of us to support Senator McConnell's
amendment to repeal the health care bill in its entirety.
Let me start out and say what courts are now acknowledging: This is
an unconstitutional piece of legislation. The underlying foundation of
the health care law is predicated on a false premise: that the
Constitution somehow allows us--us, here in Congress--to demand of
every private citizen that they buy a government-approved product or
face a penalty.
Let me repeat that. The premise of this legislation--the false
premise, the unconstitutional premise--is that somehow we, as elected
representatives, possess the constitutional power to force every
individual in America to buy a government-mandated and approved product
or face a fine. That is an unconstitutional premise.
Recently, this fundamental flaw was exposed by court rulings in
Virginia and Florida. As a lawyer, I have read both of them, first word
to last word. I just finished reading the Florida decision yesterday.
These courts, in thoughtful opinions, found that this so-called
individual mandate was simply unconstitutional.
Judge Vinson, in his Florida ruling, said:
If Congress can penalize a passive individual for failing
to engage in commerce, the enumeration of powers in the
Constitution would have been in vain for it would be
``difficult to perceive any limitation on federal power'' and
we would have a Constitution in name only.
You see, according to Judge Vinson's ruling, the entire health care
law is unconstitutional because it is predicated upon the individual
mandate. President Obama has argued that. Members have argued that on
the floor. Now there is
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this attempt to extricate from that argument, and it will not work.
The law will continue to be debated in other courtrooms, but I
believe we are looking forward to a day when the Supreme Court of the
United States says to Congress: You went too far. You went beyond the
Constitution of this great Nation.
However, the health care law is flawed, even beyond this
congressional overreach, this unprecedented congressional overreach.
The health care law double counts dollars, threatens the health care
infrastructure of this great Nation, and adds more individuals to a
system I am very familiar with as a former Governor: the broken
Medicaid system.
There is not a Governor in America who would come before any hearing
of Congress and argue that the Medicaid system is anything but broken.
This bill is also paid for by over $500 billion in tax increases and
over $500 billion in real cuts to Medicare.
Regardless of the claims to the contrary, Medicare cuts simply cannot
be counted twice. They cannot simultaneously reduce the deficit, extend
the solvency of Medicare, and then pay for this open-ended entitlement.
Well, I am sure any American out there would see the fallacy of
trying to say to them: Well, you can spend the same dollar twice. You
can, on one hand, pay for your mortgage and, on the other hand, use the
same dollar to make the car payment. No American would believe that.
You see, only in Washington could you get away with such Enron-type
accounting. It is simply budget hocus-pocus.
Even the administration's own CMS concludes that the law's Medicare
cuts ``cannot be simultaneously used to finance other federal outlays .
. . and to extend the trust fund.''
I have long made the assertion that if Congress makes reductions in
the Medicare Program, then those dollars need to stay in the Medicare
Program, to shore up a program that is running out of money, not to pay
for a new health care entitlement. Instead, here is what we end up
with. These cuts to Medicare are going to have long-term consequences
to seniors' access to physician and health care services.
Let me focus on my own State for a moment. Nebraska home health
agencies. Under this bill, in just 5 short years, two-thirds of our
home health agencies will be operating in the red.
Nebraska nursing facilities, already stretched to the limit, will
have to endure $93 million in cuts. Does anyone want to argue that is
not going to force the closing of nursing homes in Nebraska? Of course
it will.
Hospitals and hospice--major reductions in funding. Mr. President,
35,000 Nebraskans who like and receive the advantages of Medicare
Advantage are going to see reductions in their benefits.
If Nebraskans are going to endure these cuts, and others across the
country do the same, they should at least have the security of knowing
that the sacrifice they are being asked to endure is going to improve
the Medicare Program.
If all the tax increases and all the Medicare cuts were not enough,
the law's projected cost completely ignores the $115 billion it will
cost to implement the legislation.
Around here, billions of dollars are thrown around. We, all of a
sudden in the last 2 years, added new words to our vocabulary,
``trillions.'' A program is not big enough unless it has a trillion-
dollar pricetag anymore. Well, let us remind ourselves that those are
hard-earned dollars to somebody out there trying to make a living.
This is not about funding trillion-dollar programs. This is about
poor individuals in this Nation who are struggling to get by, nearly 20
percent of whom are underemployed or completely unemployed.
All these hidden costs will drive up the pricetag even more for this
ill-advised statute. However, one of the most troubling aspects of this
so-called reform is its massive expansion of Medicaid. It simply heaps
more unfunded mandates onto State budgets. As a former Governor, I do
not know how Governors are doing it these days. They are in a financial
meltdown, with few exceptions, and here we are simply heaping more
unfunded mandates onto State budgets that are already crumbling.
It puts--get this--16 million more people into the most broken part
of the health care system: Medicaid. I can attest to the challenge of
trying to provide quality health services for those on Medicaid today,
not even addressing the millions to be added. Even now, our offices are
flooded with frustrated individuals completely unable to find someone
to provide health care services to them due to the lack of
participation in the Medicaid Program.
You see, the story is this: 40 percent of doctors do not take
Medicaid patients. Why? They cannot afford to. Ask any doctor, any
hospital administrator in America: Could you keep your office or your
hospital open on Medicaid reimbursement, and they would laugh at you.
They would say: Absolutely not. We would go broke.
So what is the government's solution to that problem? Put 16 million
more people into a broken system. It is not because they do not want to
treat these patients, you see. They do. But the Medicaid reimbursement
rates would drive them into bankruptcy.
So instead of dealing with that problem--a very serious problem in
terms of access for poor people--what do we do? We burden our States
with additional costs with this legislation. We saddle them with little
flexibility through maintenance of effort mandates and totally
disregard the big question of how all these new eligible individuals
ever have a chance of finding care.
According to a recent study, the Medicaid expansion is going to cost
Nebraska between $458 million and $691 million over 10 years, depending
upon participation rates.
More shocking is that almost one in five Nebraskans will now be
forced on Medicaid--a system where we cannot find them care. We are not
unique. This is the true story in every State in the United States.
The impact on this Medicaid expansion could be profound to many
hospitals because Medicaid-eligible individuals who are unable to find
primary care--and there will be millions of them--will turn to the
emergency ward for their care.
Recently, the Centers for Disease Control reported detailed
statistics on nationwide emergency room usage. While only 14.1 percent
of all households in the United States had Medicaid coverage, Medicaid
patients comprised more than one-quarter--25.2 percent--of all ER
visits nationwide.
This preliminary May CDC report confirmed that the uninsured do not
visit the ER the most often, which is contrary to the arguments made on
the very floor I am standing. This preliminary May CDC report confirmed
that the uninsured do not visit the ER the most often; patients with
Medicaid do. Specifically, more than 30 percent of Medicaid patients
under 65 visited the ER at least once, compared to fewer than 20
percent of uninsured patients and those with private insurance.
An ER physician put it best:
High utilization (of the ER) is no surprise; many patients
have difficulty finding primary care providers who take
Medicaid, so the ER is the only alternative.
So what does this new law do to solve this problem? Nothing. It
exacerbates and exaggerates and compounds the problem. I could go on
and on because the flaws in the law are so abundant and so severe that
it cannot operate.
Let me wrap up with this thought: The people of America deserve
better than this effort. The people of America deserve something better
than an unconstitutional attempt to say the Federal Government knows
better than you. No mechanic could get this jalopy running again. They
would just scratch their head and say: Haul it to the junkyard.
This health care bill is so fatally flawed, it cannot be fixed. The
only option, contrary to what happened 1 year ago, is to go back and,
in a bipartisan way, work to build solutions to the health care
challenges, a step at a time, for once and for all; instead of
compounding problems, solve them.
I yield the floor.
The PRESIDING OFFICER. The Senator from New Jersey.
Mr. LAUTENBERG. Mr. President, I hear the requests of people on the
other side of the political aisle to repeal a health reform bill that
has been put in place, received majority support in the House and in
the Senate when developed. Now what we are witness to
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is that within a bill that is planned for the continued support for the
FAA, which takes care of the conditions under which our aviation
structure works, there is an amendment put in here that says: We want
to repeal, recall the health care bill, the health reform bill that was
signed into law by the President of the United States.
We have heard that there are challenges in court, but we hear also
that there are verifications in the courts that say this bill, this
act, does appear to be constitutionally sound. I am listening, and my
vantage point is that I grew up in a very poor working-class family
with all of the ills that follow poverty. I see America through that
kind of a prism.
I see an America whose intention is to be fair, to take care of our
citizens, to provide them with services, to make sure we have military
forces to protect us from enemies, to make sure we have labor standards
that try to make conditions healthy for working people so their health
is protected as they perform their tasks. There is an implicit promise
that says we are going to educate those in the early years for sure
with a reasonable education. In other words, there is a distribution of
the assets this country of ours holds to which almost everyone is
entitled to.
We are not talking about differences in income or differences in
personal material wealth--housing, et cetera--that somehow others don't
have. I am not talking about that. I am a capitalist. I came up the
capitalist ladder, working hard, and I will talk about that in a
minute.
So when I listen to the rhetoric that is delivered here on a
continuing basis about government interference in keeping people alive,
keeping people healthy--why should the government interfere with
people's chances to be overcome by illness or injury? I consider it an
outrage that some of our colleagues want to repeal a law that is
designed to improve the lives of millions of Americans.
I think the push to repeal health care reform is the worst kind of
hypocrisy coming from this place and the other end of the Capitol--here
with 100 people and the other side with 435 people. There are those who
have voted not to have this health care reform in the first place, and
now they are jumping on the opportunity to repeal a law that is
designed to help people's health, to help kids grow healthily, to help
families be able to maintain a degree of functioning when illness
strikes their family, to provide services that increase longevity to
our people. I, for one, speak well for that effort.
It is so hypocritical to me because the Senators who are advocating
repeal have access to the best health plan in our country. They get to
walk down the hall to a clinic with a half dozen doctors, competent and
skilled people. There are health care aides who work there,
professionals, and all they have to do is go in there and say: Doc, I
feel something here or I feel something here or I have this swelling
here, and they get care. We pay for it; not a lot but we pay for it.
But it is available. It is available. It is the kind of perk, I will
call it, that people across this country would be astonished to see how
well we treat those who make the laws in this country, those who have
the responsibility of taking care of our people, our constituents. They
would be astonished to see how easy it is to go into the clinic, and--
yes, we will take you. You need some surgery and we will get you over
to the hospital in short form and we are going to take care of this
before your disease gets the better of you.
When people here--Senators, Congressmen--get sick, they just have to
walk down the hall to the Senate Physician's Office. They don't have to
get in the car or anything like that. They don't know the worry or
understand the worry that comes if medical bills overtake the
opportunity to buy food or housing or even force people into
bankruptcy.
Again, let me say this isn't simple rhetoric for me. I lived through
these conditions. Yet these people who are up for repeal are fighting
to take away the lifeline the health care reform law has given to
families in need. I know firsthand what it is like when your family
doesn't have access to basic health care. I grew up in a family of
modest means in Paterson, NJ. It is a mill town. It was typically a
city that received immigrants on a regular basis. My father spent his
short life working in local silk mills, and he died of cancer at 43
years of age when I was still a teenager. My mother was 37 when she
became a widow.
I joined the Army. I enlisted in the Army. I attended college under
the GI bill. I was a soldier. I served in Europe during World War II.
As a consequence of the opportunity I had to get an education, I was
able to join a couple of friends and start a company that is known
across the globe. The company is called ADP. We have more than 40,000
people working around the world in more than 20 countries, three of us,
from poor families. Two of them are brothers, and their father was a
mill worker also. Because of the success I had in business, all my
family had to do was worry about their good health and not back-
breaking medical bills. But I never forgot what it was like to see my
mother working so hard behind the counter of the store to pay the
doctors, the pharmacies, the hospitals, to keep my father comfortable
for the 13 months he was in bed with cancer, robbing him of his life on
a daily basis.
That is why I was proud to vote for the historic health care reform
law which is holding insurers more accountable and making our system
more sustainable.
I looked at the history of the health insurers because we see the
health care bills constantly taking more of the GDP. But you wonder
where the health care cost increases take place. I have looked at some
of the companies. For instance, I took the year 2009. It was a tough
year for lots of people. Lots of bankruptcies, lots of foreclosures,
lots of jobs lost in 2009.
CIGNA had profits of $1.4 billion 5 years earlier and about the same
in 2009. The company's CEO got $18 million worth of salary, providing a
commodity service. Humana, in 5 years, went from $270 million worth of
revenues to $1.3 billion. The CEO got $6.5 million. United Health had a
heck-of-a 5-year period. They started off with $2.4 billion worth of
revenues in 2004, and in 2009 it went to $3.8 billion. From $2.4
billion to $3.8 billion, and the CEO got $9 million in salary, he got
big kickers at the end of the year. A company called WellPoint, in 2004
they did $960 million worth of sales revenues. Five years later they
did $4.7 billion. The CEO got $13 million.
I look at that as we ponder where the money has gone to pay for
health care in this country. So I see one place that a lot of it goes,
and that is to the insurance companies.
Some of our colleagues want to recall this bill and remove the health
care protection from 30 million Americans--30 million people across
this country. Almost 10 percent of our population will lose health care
if we repeal the bill that is now in place and is law. The fact is,
repealing the health care reform law would be an enormous step backward
for our country. It would hurt seniors, children, and small businesses,
and our deficit would balloon, grow larger.
Repealing this law would raise drug costs for seniors by removing
from them a 50-percent discount on drugs they purchase when they are in
the period of the doughnut hole. By the way, repeal of this law would
serve to prevent us from totally closing that doughnut hole. Seniors
across the country, listen to the truth about what is being said: The
doughnut hole is going to be closed. It is roughly a $4,500 element in
people's income--or cost, rather.
This repeal would also give the biggest insurance companies more
power over their patients to charge outrageous fees than ever before.
This means the insurers could once again reduce benefits, stop
coverage during a person's illness, and refuse to care for individuals
and children stricken with preexisting conditions.
Repealing health care reform would also hurt young adults, who would
no longer be able to stay on their parents' health plans until age 26.
For young adults--especially new college graduates facing a tough job
market--staying on a parent's health insurance is the only reasonably
priced insurance option available.
If health reform is repealed, small businesses will lose tax credits
for up to 35 percent of health insurance premium costs. It would
jeopardize the recent growth in the number of small
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businesses offering health insurance coverage to their employees.
This repeal effort is fiscally irresponsible because ending health
reform would increase the deficit by at least $1 trillion when we are
all looking at the deficit here and wondering what we can do to bring
it under control. We cannot do it with the costs we have scheduled for
health care.
Mr. McCAIN. Mr. President, will the Senator yield for a question?
Mr. LAUTENBERG. Yes.
Mr. McCAIN. How much longer will he be?
Mr. LAUTENBERG. About 3 minutes.
Mr. McCAIN. I thank the Senator.
Mr. LAUTENBERG. As a country, how could we repeal this law and then
look our children and grandchildren in the eye? We should be focused on
getting this critical jobs bill signed into law, not refighting last
year's partisan battles.
Make no mistake, Democrats are willing and eager to fix the parts of
the health care reform law that might need adjustment. I, for one,
would salute that kind of a review. But to repeal the entire law is an
example of outrageous overreach. Instead of meeting us halfway, our
colleagues on the Republican side are engaging in misguided political
battles. It is wrong, and we can't allow repeal of this law which is
improving the lives of millions of Americans.
I thank my colleague from Arizona for permitting me a courteous
extension of time.
I yield the floor.
The PRESIDING OFFICER. The Senator from Arizona.
Mr. McCAIN. Mr. President, I ask unanimous consent to engage in a
colloquy with the Senator from Wyoming, Mr. Barrasso.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. McCAIN. Mr. President, obviously we rise in support of the
amendment put forward by the Republican leader for repeal of the health
care bill. As we know, the House of Representatives has already acted
in an overwhelming fashion. Neither the Senator from Wyoming nor I
intend to go through all of the arguments we went through for nearly a
year here on the floor of the Senate. In the years I have been here, I
have never spent more time on any single issue, by far, than on the
health care issue on the floor of the Senate.
One of the most important parts of this debate has been the overall
cost--either savings or loss--if this legislation is repealed. Of
course, the highly regarded Congressional Budget Office has determined
that there would be an overall increase in the cost of health care in
America if the bill were repealed. I think it is very important for us
to recognize the valuable work the Congressional Budget Office does.
They are really one of the most important parts of the decisions we
make on legislation. But I think it is also very important to point out
that the Congressional Budget Office makes decisions directly related
to the input and the parameters and the details of legislation they are
sent. The Congressional Budget Office, most appropriately, does not
decide on policy; they are simply there as a budget office. So what I
am saying is, garbage in, garbage out. If you are given a certain
database on which to make judgments of costs, then of course you are
going to come out with basically predetermined results and analysis.
One of the numerous aspects or parts of the legislation that was not
taken into consideration by the CBO because of the way the legislation
was written is the so-called doc fix. The doc fix, as we all know, is
in compliance with a reduction in Medicare payments to doctors that was
mandated several years ago. Then we found out that doctors would stop
treating Medicare patients if they were deprived of the Medicare
payments they needed in order to make up for the costs of the treatment
they provided to Medicare enrollees. We know that every single year we
have had to do the doc fix, which has not allowed the previously
legislated reductions in Medicare payments to physicians. So that is an
additional $208 billion over 10 years--that alone is $208 billion.
Nowhere is that put into the equation.
Then we have, of course, the so-called CLASS Act, which is a poorly
designed Federal long-term care program. It was inserted at a point in
the debate that was never in the original bill passed through the HELP
Committee.
I ask my colleague, it is a program for long-term care where people
pay into the system in order to be eligible for long-term care
benefits, but over time that money comes back out--not in the timeframe
that was given to the CBO. There are a number of other provisions.
I ask my colleague from Wyoming what his assessment of the costs were
taking into consideration the doc fix, the CLASS Act, the envisioned
Medicare cuts by $500 billion, and others, which are simply not going
to happen. I would be interested in the Senator's total of the costs
that actually would be saved by repeal of this legislation.
Mr. BARRASSO. What we are trying to do is actually provide people
with the care they need, the doctors they want, at a cost they can
afford. Yet, when we look at this health care law that--remember, it
was written behind closed doors in spite of the promises. That is why
people were so offended and are still opposed to this. We had votes in
the middle of the night, and there were all those special deals cut for
Senators to get that 60th vote.
What I hear most about as I travel my State are the proposed cuts to
Medicare. As the Senator mentioned, it was $500 billion. You talked
about the President having a commission to look at the debt. What that
commission said is that if you are going to take money from Medicare,
which this law does--$500 billion--it doesn't do it to help strengthen
Medicare or lengthen the life or the vitality of Medicare; it does it
to start a whole new government program. It takes $155 billion from
hospitals, $202 billion from the 11 million seniors on Medicare
Advantage, $15 billion from nursing homes, $40 billion from home health
agencies, and $7 billion from hospices.
As my colleague from Arizona said--he mentioned the CLASS Act, which
has been called a Ponzi scheme that Bernie Madoff would be proud of.
The President's own debt commission says repeal that because, with the
way that is set up in terms of taking the money in first so they can
count that as coming in, the obligations 10 years and beyond will
bankrupt this country. Everyone on both sides of the aisle realizes
that. The bipartisan President's debt commission realized it to the
point that they put it in one of their recommendations. To hear our
colleagues and the last speaker talk about the fact that this may
actually help with the deficit and with the debt, anybody who looks at
this over the long term and the nature of our country knows this will
bankrupt the country.
I worry about the jobs in this country. We are at 9.4 percent
unemployment. I know both of us as Senators are working to try to find
ways to make it easier and cheaper to create private sector jobs in
America. This health care law makes it more expensive and harder to
create private sector jobs.
Mr. McCAIN. Nowhere during the debate, I ask my friend, did I
understand that there would be a very large use of ``waivers'' for
different companies, including unions, businesses, et cetera, and
already we have had well over 700 waivers granted to unions and others
who have sought relief from this legislation.
I am told that only entails about 1 percent of America's economy, but
isn't that quite a remarkable repudiation of this legislation? I would
have liked to have heard during the debate: By the way, the Secretary
of Health and Human Services is going to have to give well over 700
waivers for people so they won't have to comply with this law. And the
only reason you give a waiver, obviously, is because the implementation
of the law would be harmful to them. I am very interested in hearing my
colleague's comments about this so-called waiver business.
Along with that, the Governor of my State has written to the
Secretary of Health and Human Services to give the State of Arizona a
waiver. I hope that, since the Secretary of Health and Human Services
is in that business, she will grant that to my home State.
Mr. BARRASSO. I would like to see every citizen in this country get a
waiver. I would like every State to have an opportunity to get waivers
because last week the Secretary of Health and Human Services gave
another 500 new waivers. The total now is
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729 waivers. You can find them on the HHS Web site. It covers 2.2
million people.
It is interesting because before this bill was passed through in the
middle of the night, labor unions publicly supported this health care
law. Now there are 166 union benefit funds that are exempt and have
gotten the waivers. They got the waivers. Unions now have 860,000 out
of the 2.2 million waivers. Unions now have 40 percent of all the
waivers even though they are only 7 percent of the private sector
workforce in this country.
My question to my colleague is, if this law is so good, why do so
many people who supported it in the first place now say they don't want
it to apply to them? Is it, as Nancy Pelosi said when she was Speaker
of the House before the election--before the election that repudiated
this health care law and the way it was crammed down the throats of the
American public--didn't Speaker Pelosi say that first you have to pass
it before you get to find out what is in it?
It seems to me, and I ask my colleague from Arizona, that as people
know more about what is in this law, it is less popular on a daily
basis. Yesterday, 58 percent of Americans, in a Rasmussen poll, said
they would like to have it repealed, and the numbers of people who
thought all of us ought to be able to get waivers was even higher than
that.
Mr. McCAIN. I thank my colleague for his enormous contribution to
this debate and his knowledge and background in the medical profession.
There is one other issue I want to mention. Of course, I was pleased
to hear the President, in the State of the Union Message, say that we
ought to look at the issue of medical malpractice reform. I can't tell
the number of times we have tried on this floor to have at least the
beginning of some kind of meaningful medical malpractice reform. I said
to the Secretary of Health and Human Services at a hearing the other
day that I hoped she would be making some proposals to us, to the
Congress, so that we could obtain some kind of medical malpractice
reform.
As we all know, sometimes as much as 20 to 30 percent of the cost of
health care is accrued because of the physician's prescription for
unneeded and unwanted and unnecessary tests for fear of the physician
finding himself or herself in court trying to defend the treatment of a
patient. That, of course, is a huge portion of the additional costs in
health care in America today.
I was pleased to hear the President of the United States say he
wanted to examine and visit the issue of medical malpractice reform. I
know my colleague stands ready to work with him on that issue.
Mr. BARRASSO. The President said the same thing in June of 2009 when
he visited and spoke to the American Medical Association. So when that
issue didn't really come to the floor, as a number of us would have
liked, in this health care law that was written, as I say, behind
closed doors, they asked Howard Dean, then-chairman of the Democratic
National Committee, why they don't include it, and he said: We can't
stand up to the trial lawyers--who have such a remarkable influence on
the party on the other side of the aisle.
I am hoping that the President, in his statement in his State of the
Union Address, was sincere because it clearly did not follow through
what he said in June of 2009 when he met with doctors from all across
the country.
Mr. McCAIN. I thank my colleague. I thank the Senator from Maryland
for her patience.
I yield the floor.
The PRESIDING OFFICER (Mr. Udall of New Mexico). The Senator from
Maryland is recognized.
Ms. MIKULSKI. Mr. President, I rise today in very strong opposition
to any attempt to repeal the health care reform bill. The Republican
leadership has offered an amendment to repeal the Affordable Health
Care Act. They are only keeping half of their promise. They went out
there and campaigned--and the tea party had a teapot boiling over--and
they said: We are going to offer a bill to repeal and to replace. Guess
what they are doing today. One more hollow, symbolic, pander-to-the-
masses amendment. Their amendment offers a repeal, but it does not
offer a plan or strategy to replace. Do you know why? They have no
ideas. They just want to pander to the crowd.
I want my colleagues to know that I am emphatically and unabashedly
against the repeal of health care reform. But I want to say to my
colleagues, as I listened to this colloquy, every Senator has the right
to rewrite legislation, but they do not have the right to rewrite
history or to rewrite the facts.
I heard CBO criticized and being dismissed. But yet it was the
Republican Party who said we could not move anything, bring up
anything, even get a Kleenex without getting a CBO score. Now they do
not want a CBO score. You cannot say I want a CBO score one day and
then make fun of it the next. Garbage in, garbage out.
Then second: Oh, they rewrote the bill in the middle of the night,
sweetheart deals, whatever. I was on the HELP Committee. I chaired the
task force on quality. I went to several hearings in an open, public
forum to get the best ideas to produce the best bill. In many of those
instances, very few of the other party even bothered to show up. So I
am not real excited about their criticism.
Then we went into a markup of the bill, 4 weeks in the HELP
Committee, open, public markups in full view and on C-SPAN. Over 300
amendments were dealt with--300 amendments. How is that secret? How is
that behind closed doors? How is that in the middle of the night? We
worked in the middle of the night because there were so many
amendments. Fine, that is democracy. That is the way the legislative
process works. But don't try to rewrite history. Don't try to rewrite
facts. And if you want to rewrite the bill, keep your promise,
Republican Party. If you want to repeal, then let's go to replace.
I want to hear their ideas for replacement. I challenge them right
here, right now, today on this amendment. Come in with other amendments
on your ideas for replacement. I want to know what it is they want to
do. I want to know which parts of the health care reform they want to
repeal and replace. What is it they want to repeal and replace?
How about this? No longer can big insurance deny coverage to a child
with a preexisting condition. Do they want to repeal that? And with
what are they going to replace it? Do they want to repeal the part
where we allow young people to stay on their parents' plans until they
are 26? Do they want to repeal that? And with what do they want to
replace it?
We eliminated the cap on what an insurance company could pay out. Do
they want to repeal that cap--if you have cancer, if you need heart
surgery? And with what are they going to replace it?
I am proud of what we did in health care. It is an excellent bill. We
accomplished four goals. First of all, we save and strengthen Medicare.
We end those punitive practices of insurance companies. We expanded
universal access. And, guess what. We came up with quality and
prevention measures that save lives and save money. This is what people
wanted in health care reform. I heard it all over Maryland and heard it
at hearings. I had roundtables, hearings, I was in diners, I held
online townhall meetings, phone calls, letters. Once they got the
straight information about what we did, they liked it.
Let's go to Medicare. We extended the solvency for a decade. We
closed the doughnut hole that has been so hard to swallow. Last year,
more than 32,000 Maryland seniors received a $250 rebate check to help
pay for prescription drugs. That is in the health care reform bill. If
we repeal it, do I have to call up 32,000 Marylanders and say give it
back? Give it back; we repealed. Wow, I bet that is going to go over.
These same seniors will now get 50 percent off their brand-name drugs
when they hit the prescription drug coverage cap. Are we going to
repeal that? And with what are we going to replace it?
Also, one of my favorite parts of this bill is ending the punitive
practices of insurance companies, such as seeing a child denied
coverage because of chronic conditions because of asthma or juvenile
diabetes.
I also fought very long and hard, as everyone knows, for women. Did
you know, Mr. President, when we began our hearings on the bill, we
found out
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that in many instances insurance companies charged women 25 to 40
percent more in their premiums simply because they were a woman, more
than guys with the same age and same health status? Are we going to
repeal that and bring back gender discrimination?
Also, we ended the despicable practice of just being a woman being
treated as a preexisting condition. Another point my hearing disclosed
is that in seven States and the District of Columbia, women were denied
coverage for simply being a victim of domestic violence. They were
abused by their partner, and they were then abused by the insurance
company. Are we going to abuse them once again by repealing that
provision? Not if I can help it.
Then there were other issues also related to the whole issue of
prevention. We offered a prevention amendment. When they tried to take
our mammograms away from us, the Democratic women took to the floor--
and good guys supported this bill and we passed it: preventive measures
at no cost and no deductible in order to make sure we not only had our
mammograms but that there were other preventive services.
Provision after provision--are we going to go back to that? I hope
not. If they are going to repeal, that is what they are repealing. They
are really repealing the way we ended the punitive practices of
insurance companies. They are really repealing our attempt to make sure
Medicare is solvent and close the doughnut hole for prescription drugs
for seniors and also get them better health evaluations. We also did
other things.
I am so proud of this. We said to the insurance companies, 80 percent
of what you collect has to go into health care. It cannot go into
administrative costs. It cannot buy you another Armani suit or a pair
of Gucci shoes or a third or fourth home or $1,000 bottles of wine when
you have those conferences where you think about price fixing; you have
to put it back into health care. I do not want to repeal that
provision. I want that 80 percent collected to go back into health
care. I think that is a good idea.
In our bill, one of the things I am proud of is that we stop big
insurance from putting lifetime dollar caps on benefits. I heard from a
woman in Columbia who told me her husband had reached his lifetime
limit. So when he needed an EKG to deal with a long-time cardiac
problem, they had to pay for it out of pocket. Even with health
insurance, their health care costs still topped $17,000 a year with
their annual income at $60,000. By lifting that cap, the man can get
his EKG and prevent other kinds of problems.
I could go case example after case example.
Let's go to something called quality and prevention. I know that is
often ridiculed. That is goosh; that is not like real medicine. I want
to tell the story of a brilliant and talented physician at Johns
Hopkins, Dr. Pronovost. He developed a checklist that, if followed,
lowers infections that are caught in hospitals which takes lives, takes
money, and extends stays.
In health care reform, we improve patient safety and help prevent
medical errors. The Pronovost checklist, which we allow to occur in the
bill, has now, we found out, reduced in Michigan patient deaths by 10
percent, and it has nearly had over an 85-percent effective rate at
eliminating bloodstream infections.
The cost savings to both public and private insurance in Michigan has
been stunning. Do we really want to repeal these measures that are
saving lives and saving money?
I do not want to repeal this bill. We did a lot of good things in it.
If the Republicans have ideas, then I do not think they should vote to
repeal unless they have a better idea to replace what I outlined today.
I challenge them: If you want to repeal, keep the other half of your
campaign promise--replace. Let's put those replacement ideas out into
the light of day. Let's put them out for debate and discussion and then
vote. I am up to the task. I wonder if they are.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Georgia is recognized.
Mr. CHAMBLISS. Mr. President, I rise today to urge my colleagues to
repeal this highly unpopular health care law. Here is what repealing
this health care bill will mean to Georgians.
First of all, the Federal Government will not be required to spend
$8,470 on health care for every single Georgian every year; 176,000
Georgia seniors who are today enrolled in Medicare Advantage will not
have their benefits reduced; and the $500 billion in Medicare cuts will
not be used to pay for new programs under this law; around 2.1 million
Georgia households making less than $200,000 will not have to pay
higher taxes to fund this monstrous bill; 70 percent of small employer
purchasers will not face higher premiums; small businesses employing 50
or more people and 8,000 Georgia construction companies with five or
more employees will not have to pay higher health care costs or be
subjected to new penalties due to government mandates.
Under this law, hundreds of thousands of additional low-income
Georgians will become eligible for Medicaid in 2014. That is going to
result in an estimated $1 billion in new expenses for my State to fund
that program. How are we going to fund that $1 billion? We are a State
that has to have a balanced budget every year, and we are struggling
right now. Our Governor and the legislature are making tough and hard
decisions cutting expenses to balance the budget this year.
Under this bill, they are going to have to come up with another $1
billion. They are going to have to raise taxes, raise tuition costs at
our universities. Where are we going to get it? We do not know the
answer to that, but that is what this bill would require.
While States work to prepare balanced budgets in anticipation of
Medicaid expansion, they will not be given the flexibility to make
prudent market-based decisions to improve their fiscal outlook. The
Governor of Georgia has put forward proposals such as ending Medicaid
coverage of dental, vision, and podiatry treatment for adults. These
are painful decisions that States are being forced to make, but the
health care law requires States to maintain eligibility levels for
beneficiaries in order to keep their Federal Medicaid dollars.
Reimbursement from Medicaid is already so low that a majority of
doctors will not see Medicaid patients. States are left with little
options other than further reducing payments to providers or raising
copayments for beneficiaries.
The Federal Government should not be hindering States' flexibility in
dealing with their individual budget issues. This is not an area where
the Federal Government should be impeding on the sovereignty of our
States.
America's deficit is the single biggest issue facing our country
today. Repealing the health care bill means that our deficit will not
increase by an estimated $2.6 trillion when this bill is fully
implemented over a 10-year period, and it would also prevent that same
$500 million in cuts coming from Medicare to pay for entitlements that
would do nothing but exacerbate our budgetary woes.
My constituents in Georgia, and citizens all across this country,
have made it clear that they want Congress to repeal this legislation
and work to lower health care costs and insure Americans through
commonsense solutions that are not negotiated behind closed doors. We
need a law that replaces this law and that actually reduces health care
costs and enacts insurance reforms immediately.
Americans should be allowed to buy insurance policies across State
lines; small businesses should be allowed to pool resources and offer
more affordable insurance to workers; we need to limit baseless
lawsuits against doctors; and we should expand health savings accounts.
Furthermore, in light of recent judicial decisions in Virginia and
Florida, it appears the law may not be upheld in the courts. I applaud
the decisions reached by Judge Hudson and Judge Vinson that Congress
does not have the authority to force Americans to either purchase
health insurance or pay a penalty for not doing so. That provision of
law, obviously, is ultimately going to be decided by the Supreme Court.
I plan to vote on repealing this law and working with my colleagues
on both sides of the aisle to start the process over, to make sure the
next time we do it in the open and not behind closed doors and that we
get it right.
[[Page S450]]
Mr. President, I yield the floor, and I suggest the absence of a
quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. PRYOR. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. PRYOR. Mr. President, I thank my colleague from Oklahoma. I know
he has been gracious enough to allow me to speak in front of him. My
speech today, hopefully, will be fairly short, but I do want to raise
something that I think is of critical importance to the country.
(The remarks of Mr. Pryor pertaining to the introduction of S. 256
are printed in today's Record under ``Statements on Introduced Bills
and Joint Resolutions.'')
Mr. PRYOR. I yield the floor.
The PRESIDING OFFICER. The Senator from Oklahoma is recognized.
Mr. INHOFE. Mr. President, there has been some confusion, moving
around the time. While I was supposed to be here earlier, let me ask
unanimous consent that I be allowed to speak in morning business for
such time as I will consume.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. INHOFE. I say to my friend from Arkansas who just spoke, I know a
little bit about the program you have. In fact, the Senator is fully
aware my daughter Molly is a marketing professor at the University of
Arkansas, who has talked about this very concept. I do not know why all
the successes have gravitated to northwest Arkansas, but it seems that
they have. Maybe this has something to do with it. I look forward to
following through with the Senator on this program.
I wish to mention a couple things I have been wanting to talk about,
but I am here actually to describe two amendments I have to the FAA
bill.
First, I would like to say publicly how proud I am of the new
attorney general, Scott Pruitt, that we have in the State of Oklahoma.
He is taking the leadership in suing to determine the constitutionality
of the government-run health care. We are doing that currently in the
State of Oklahoma. I am looking for some great results from that.
As I look at this, sometimes you have to ask the very basic
questions. If you are talking about a government-run system, something
that doesn't work in Sweden or Denmark or the UK or Canada, why would
it work here, when we have all these members of Parliament coming over
saying: Why are you insisting on going to something that is a dismal
failure at the same time we are moving toward a much more successful
health delivery system, the model for the whole world, and that is what
we have in the United States.
I have to say also, when I look and listen to people talking about
the debt and the deficit and the problems we have, I think it is
ludicrous that we can go back and try to act like Bush had these great
deficits. If you take the deficits during the 8 Bush years, add them
all up and divide by 8, it came out to $247 billion each year. Now we
have a President who has in just 2 years accumulated almost $3
trillion--six times the deficit that was there under the Bush
administration. When people keep saying something over and over that is
not true, they assume people will eventually believe it. In this case,
I believe the American people are so concerned about the spending, the
unprecedented spending, the unsustainable spending of this
administration, this President and his majority in both Houses, they
are up on this issue.
Before I get to my two amendments, I wish to mention one other aspect
I was going to have as an amendment to the FAA bill. Unfortunately,
there was not time to put it together, so I will be doing some sometime
this summer, but I wish to serve notice. I have the distinction, I
guess you would say, since the retirement of Senator John Glenn, I am
now, I believe, the last remaining active commercial pilot in the
Senate. When I look at the FAA bill, I have a lot of interest in it.
I had an incident that occurred to me on October 20 of this year when
I was flying my twin-engine airplane into a field in south Texas. It
was called Cameron County Airport, a noncontrolled field. I experienced
something that is going to make me go back and revisit to see if
perhaps what happened to me, if it happens to someone else, people in
the FAA would be just as generous as they were with me.
Before I tell you what happened, I have to say the FAA could not have
been better. They could not have been more cooperative. I sat down and
talked with them about the incident. I will tell you what happened. I
was flying some passengers in one of my planes, a twin-engine airplane,
into Cameron County Airport. This happened to be a nice day. It was a
VFR--visual flight rules is what that means--so I didn't have to have
control with the controllers on the way down. However, as a
precautionary measure, what I always do, I talk to them anyway. So when
you go down straight south from Tulsa, OK, to Cameron County Airport,
you fly right over Corpus Christi. That is about 120 miles north of the
Cameron County Airport.
Because they have a lot of training down there--they have the Navy
guys, the training that takes place--it is always safer, when you are
flying around down there with a lot of kids who may only have 30 or 40
hours, to get on control so they are watching you. When you get on a
control, in this case it is an approach control, they give you a squawk
so you know--they know who you are, where you are, how fast you are
going, how you relate to the other traffic in the area. So I got on
Corpus Christi approach and I said: This is Twin Cessna 115 echo alpha.
I will be coming south on VFR, descending through 15,500 to go to the
Cameron County Airport.
Halfway down they handed me off--this is the terminology that is
used--to the FAA controller down there in the valley. This is way down
South. A lot of the people back East here do not understand that Texas,
when you get down to the southern tip, that is farther south than
Miami, FL. It is way down there.
We went down and they handed me off to what they call valley
approach. Valley approach took me all the way down to Cameron County
Airport, turned me loose--and I am trying to get the recording so I
know exactly when it was--to land at the Cameron County Airport. This
is the FAA.
The problem is, when I went ahead and landed--by the time I got
everything in landing configuration, it was too late to go around. We
are going below the blue line, as the saying is, so I had to land when
there were workers on the runway.
I say to my friend from Iowa, the way they normally preclude
something from happening, as he well knows, is they have you on their
radar. They know you are there. But they publish NOTAMs, that is Notice
to Airmen. Before you fly into any place, you check the NOTAMs to see
if there is construction on the runway, if there is any kind of
problem. Of course, we checked and there were no NOTAMs that day for
Cameron County Airport, but there were people working on the runway.
I wish to offer legislation, and I will include in the legislation a
requirement that NOTAMs are published where they can be found by the
pilot. In this case, the NOTAM that came out that there is someone
working on the airport did not come out until November 2 and this was
October 20, so I had no control over it. I am not blaming anyone. I am
saying they need to be in a conspicuous place where that will happen.
The second problem I see that affects general aviation is everything
we do when we talk to a controller is recorded, and the public should
have access to these recordings. I know it is a difficult thing. I have
requested this, now, since way back in October and have not yet
received it. I am going to try to set up a system where that is
available to everyone.
Then, last, because even though no action was taken--I didn't violate
anything and everything turned out fine; I did study procedures and all
that--but the bottom line is, all during that process, someone, a
bureaucrat, could have taken away my license. Here I have more hours
than most American airline pilots. I fly, on average, probably 4 hours
a week still to this day. That would be taking away a major part of my
life and that is how serious it is.
[[Page S451]]
Many years ago, about 10 years ago, the greatest pilot in America,
named Bob Hoover--he is a tremendous pilot, up in years, actually
considerably older than I am--and they actually took away his license.
This is called an emergency revocation. I authored a law to require a
type of an appeal, appellate process. We passed it. I think a similar
thing should be afforded to all members.
Again, I wish to say the FAA could not have been more cooperative and
more thorough, but I think we need to change the rules. We will
probably have to do it legislatively. I plan to do that during the
summer.
My two amendments. The first is one I think most people, when they
understand it, will appreciate; that is, they are attempting, it is my
understanding--right now there is a rule that is pending. It is not
part of this legislation directly but in a way it is because, with my
amendment, we would be able to preclude this from happening. The air
carriers are scheduled airlines and unscheduled. The unscheduleds--they
are called charter airlines and other types of airlines--they are under
a different FAR, the Federal Aviation Regulation, part 21, but it is a
subpart S. Subpart S says, if you are an unscheduled airline, you are
not restricted to the same crew restrictions they have for a scheduled
airline. There is a reason for this.
The reason is this. A scheduled airline, they are out there every
day, and they adjust their schedules for crew rest time. A charter does
not have that opportunity. So they may go maybe three or four times
what the crew's rest would be and then have to take a longer flight.
This does affect the military. Right now, if you are flying blood into
Afghanistan, it is flown in by charter airlines. These airlines will
take it down to Qatar and then go in probably on a C-17.
To go from Ramstein down to Qatar and back is longer than they can
take without crew rest or, if they take it into Afghanistan, that
charter flight would have to do crew rest actually in Afghanistan--
maybe in Kabul. Obviously, they cannot leave a civilian plane there
under some of those conditions. So the only choice, then, is we would
have to use some of our lift capacity of the C-17s to do that.
The problem we are having right now, our C-17s are so overworked, our
crews are overworked, so I believe that exemption should continue to be
in place and we will be trying to pass this amendment. I am going to
try to get in the queue. This is actually our amendment No. 7.
The other amendment I have I am very sensitive to because I have
participated in these programs. There are a lot of voluntary
organizations, volunteer pilots--I have done it at my own expense,
helping heart patients get around different places, flying in to help
people out. A lot of pilots are very generous with their equipment and
time and money and they do this. What I want to do is get them a
release from some of the liability to which they would otherwise be
exposed. In other words, these people are doing this at their own
expense, on their own time, but they are also exposing themselves to
major lawsuits.
These are the two amendments. That happens to be amendment No. 6. I
will be trying to get that in the queue after tonight's vote, so
perhaps we will be voting on it sometime between now and Tuesday.
With that, I appreciate the patience of my friend from Iowa and I
yield the floor.
Mr. HARKIN. Mr. President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. HARKIN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER (Mr. Cardin.) Without objection, it is so
ordered.
Mr. HARKIN. Mr. President, if there is one clear message that voters
sent in the last election, it is that they want Democrats and
Republicans in Congress to cut out the bickering and the partisanship
and to focus like a laser beam on boosting the economy, creating jobs,
and reducing the deficit. So I find it absolutely astonishing that the
Republicans' No. 1 priority, indeed their obsession in these opening
weeks of the new Congress, is to launch bitter new partisan attacks on
the new health reform law, in an attempt to repeal it in its entirety,
something that would cost hundreds of thousands of jobs, and add $240
billion to the deficit in the next 10 years.
It would be sufficient to oppose this reckless amendment strictly on
budgetary grounds. As I said, it would add $240 billion to the deficit
in the first decade. Nearly $1 trillion would be added to the deficit
in the second decade, if we repeal the Affordable Care Act.
The sponsors of the repeal amendment have proposed no offsets
whatsoever. So for all of the Republicans' crocodile tears over big
budget deficits, their first action in the new Congress is to propose
adding nearly $\1/4\ trillion to the deficit over the next 10 years,
and over $1 trillion in the second 10 years.
The Congressional Budget Office is our only objective nonpartisan
referee when it comes to budget projections. CBO has told us in no
uncertain terms that the McConnell amendment, the repeal amendment,
will add $240 billion to the deficit this decade. The Republicans'
response is to attack the credibility of CBO, the Congressional Budget
Office, and to claim that the hundreds of billions in budget savings,
thanks to new health reform law, are based on ``gimmicks.'' That is
complete nonsense. The budget savings in this new law are real. If
anything, CBO has underestimated the savings that will come about,
especially as a result of the robust wellness and prevention provisions
in the new law, provisions that will keep Americans healthy and out of
the hospital in the first place.
I would simply add that if the savings in the new law were based on
gimmicks, then those gimmicks would surely show up by the second decade
of the law's implementation. That is the nature of gimmicks; they
eventually get exposed. But the savings in the new law actually
skyrocket in the second decade to nearly $1 trillion. So to wildly
assert that the savings in the new health reform law are based on
gimmicks is flat wrong. It is irresponsible.
Let's be clear. The Republicans' obsession with repealing the new
health reform law is not based on budgetary considerations, it is based
strictly on ideology. They oppose the law's crackdown on abuse by
health insurance companies, and they oppose any serious effort by the
Federal Government to secure health insurance coverage for tens of
millions of Americans who currently have none.
We all remember William Buckley's conservative motto, sort of the
father of the, I would say, modern American conservative movement.
William Buckley said once that: The role of conservatives is ``to
thwart history, yelling `stop.' ''
In 1935 Franklin Roosevelt and the Congress passed Social Security,
providing a basic retirement security for every American. Republicans
fought it bitterly, and 75 years later they are still trying to undo it
and privatize it. In 1965, President Johnson and the Congress passed
Medicare, ensuring seniors access to decent health care. Republicans
fought it bitterly, and 45 years later they are still trying to undo it
and privatize it. To quote another famous Republican President: Here
they go again.
By the way, notice that the Republicans are no longer even pretending
to offer a realistic comprehensive alternative. They used to talk about
``repeal and replace.'' Now they are just talking about ``repeal.'' As
always, the Republican approach to health reform can be summed up in
five words: Pray you don't get sick.
So make no mistake, the fight to provide access to quality affordable
health care for all Americans has only just begun, it looks like. The
same ideologue who came up with the big lies about the death panels and
pulling the plug on grandma are rolling out their latest campaign of
misinformation.
The good news is that this time around the dynamics of the debate
have shifted. Just as I long predicted, as people learn more about the
great things in the Affordable Care Act, the benefits and protections
that are now guaranteed by law, support for health care reform is
growing steadily as time goes by and people learn more about what is in
it.
[[Page S452]]
A year ago, we were bogged down in the messy, frustrating politics of
passing a bill. This time around the law is the law, and what is at
stake is crystal clear: Are we going to put the health insurance
companies back in the driver's seat, once again free to discriminate
based on preexisting conditions, free to cancel your policy if you get
sick, free to cut off payments? Are we going to revoke access to health
insurance for more than 30 million Americans? Are we going to add
hundreds of billions of dollars to the deficit by wiping out all of the
savings of the Affordable Care Act? Are we going to impose higher taxes
on up to 4 million small businesses that are eligible for health care
tax credits thanks to this new health reform law?
I also want to rebut the extreme ideological attacks on the
individual mandate in the new law. Republicans claim that this is
somehow an assault on freedom. Let's look at it another way. It is
certainly an assault on an individual American's freedoms when someone
goes without insurance and they show up in the emergency room and they
stick other Americans with their emergency room bill. How about that
freedom? Shouldn't I be free, shouldn't you be free, from having to pay
for someone because they did not have insurance and they show up at the
emergency room, which is the most expensive form of health care, and
now we have got to pay the bill? What about that freedom?
The individual mandate is just common sense, and that is why so many
Republicans supported it in the past. Senator John Chafee's reform bill
in the early 1990s included an individual mandate. It was supported by
a number of Republicans, some of whom are still here. Republican
Senator Grassley, my colleague from Iowa, Senator Hatch, Senator Lugar,
all supported that individual mandate. More recently, the original
Wyden-Bennett bill--that is Senator Bennett, a Republican from Utah--
included an individual mandate. It was supported by Senators Alexander,
Crapo, Corker, and Grassley.
As we all know, the individual mandate was a critical piece of
Republican Governor Mitch Romney's health reform in Massachusetts. As I
said, it is just common sense. By eliminating free riders and putting
everyone in the risk pool, we keep rates down for everyone, and it is
the only way that people with preexisting conditions are not left out
in the cold.
So it comes down to this, as we learned--I was watching in the last
few weeks the HBO series, now on DVD--about John Adams. What the early
colonists finally realized is that they could enhance their freedom,
they would have more freedom, if they stuck together, if they worked
together, if they joined together.
The same is true here in health reform. When everyone is covered and
no one is left out, we enhance an individual's liberty. So health
reform is all about freedom, freedom from the fear that if you get
sick, you will not be able to afford a doctor; freedom from the fear
that a major illness will lead to financial ruin. These are the
practical freedoms that matter to Americans.
I cannot tell you how many people have come up to thank me and other
sponsors for passing the Affordable Care Act. They tell me how it has
personally affected their families in profoundly positive ways. Let me
first tell you about Sarah Posekany of Cedar Falls, IA.
She was diagnosed with Crohn's disease when she was 15 years old.
During her first year of college, she ran into complications from
Crohn's, which forced her to drop classes in order to heal from
multiple surgeries. Because she was no longer a full-time student, her
parents' private insurance company terminated her coverage, and 4 years
later, she found herself--are you ready for this--$180,000 in debt, and
was forced to declare bankruptcy. Sarah was able to complete one
semester at Hawkeye Community College but could not afford to continue.
Because of her earlier bankruptcy, every bank she applied to for
student loans turned her down.
With the new health law, people like Sarah will be able to stay on
their parents' health insurance until they are age 26. This is a real
person. This is a real story. These are real people. So they want to
repeal this? They want to tell Sarah: Sorry, we cannot help you any,
and we cannot help other young people like you stay on their parent's
policies until they are age 26.
We can consider the case of Eleanor Pierce, also of Cedar Falls, IA.
When her job with a local company was eliminated, she lost her health
insurance. She had the option of purchasing COBRA insurance, but it was
completely unaffordable. So she searched for coverage on the private
individual market and was almost universally denied access because of a
preexisting condition of high blood pressure. The plans that would
cover her came with premiums that she could not hope to afford without
an income. So Eleanor, at age 26, suffering from high blood pressure,
had no choice but to go without insurance and hope for the best. ``Hope
for the best'' is no substitute for regular medical care. One year
later, Eleanor suffered a massive heart attack. When all was said and
done, she had racked up $60,000 in medical debts. So real people, real
problems, and real solutions.
We need to get beyond the ideological obsession and listen to
ordinary Americans, victims of the old broken sick care system.
Americans have a clear message: The new law has important new benefits
and protections; do not take those protections away. Nearly half of
nonelderly Americans have some type of preexisting condition such as
high blood pressure, arthritis, heart disease. The new law outlaws the
denial of coverage based on preexisting conditions. The McConnell
amendment on repeal takes that away. The largest health insurer in
California used technicalities to cancel the policies of women who got
breast cancer. The new law outlaws the practice of cancelling policies
when people get sick. The McConnell amendment takes away that
protection and restores the right of health insurers to return to that
despicable practice. The new law prohibits insurers from imposing
lifetime limits on benefits. The McConnell amendment sweeps that away.
The law allows parents to keep adult children on their policies until
age 26, as I spoke about with Sarah. The McConnell amendment takes that
away.
I want to briefly mention the destructive impacts the McConnell
amendment would have on my State of Iowa. One, it would raise taxes on
more than 260,000 Iowans by taking away tax credits to help them
purchase health care coverage. More than 8,300 young adults would lose
their insurance coverage on their parents' health plans. Tens of
thousands of Iowa seniors would face higher prescription drug prices
and once again have to pay a copay for preventive services, such as
colonoscopies and mammograms, which now they can get without a copay.
And, of course, the 1.9 million Iowans with private coverage would once
again be vulnerable to a whole range of abuses and discriminatory
practices by the health insurance industry, like cutting you off if you
get breast cancer or putting a lifetime cap on it or an annual cap.
In addition, I want to mention that the new health care reform law
dramatically remedies the discrimination against Iowa, my State, and a
number of other States in terms of Medicare reimbursement.
A little background. Under a very complicated Medicare formula,
doctors in Iowa and a number of States were paid less for their
services than their colleagues elsewhere for the same service. Under
the formula, for example, Iowa physicians are reimbursed less than
doctors in Louisiana for the same procedure.
As part of the new health care reform bill, I joined with Congressman
Bruce Braley, Congressman Leonard Boswell, and Congressman Dave
Loebsack on the House side to negotiate a compromise that provides an
immediate $800 million to address geographic disparities for both
doctors and hospitals, as well as written guarantees from Health and
Human Services Secretary Sebelius for further action to reform Medicare
reimbursement rates. This great achievement is wiped out if the
McConnell amendment passes.
In addition, thanks to the new law, midsized hospitals in Iowa--we
call them the so-called tweeners. They are not big enough to have
economies of scale. They are not small enough to be put into the small-
hospital category.
[[Page S453]]
They are sort of in between, but they are important providers of health
care to so many communities in Iowa and other States around the Nation.
Well, thanks to the new law, we will see greater Medicare reimbursement
to these midsized hospitals in Iowa and other States. The 2-year fix
will cover fiscal years 2011 and 2012. It will aid these low-volume
hospitals, some of which have struggled to keep their doors open. The
fix was included in the new health care reform law, the Affordable Care
Act.
At the heart of the reform mission was an effort to decrease the
number of uninsured and increase access--access--to affordable care.
The law does just that and will ensure every Iowan access to quality
health care, which these midsized community hospitals provide. Again,
that goes away if the McConnell amendment prevails. We fought very hard
to get that compromise to protect these tweener hospitals--wiped out by
the McConnell amendment.
Finally, I want to mention the many millions of Americans who will be
denied health coverage if the McConnell amendment passes. The
Republicans apparently reckon that middle-class Americans who already
have health insurance do not care about those who are not so fortunate.
I could not disagree more strongly. I believe Americans do care about
the uninsured, and they are well aware of the devastating human costs
of repeal. Nearly 45,000 Americans die each year in part because they
do not have health insurance.
With the landmark law, we are ensuring at long last that every member
of our American family has access to quality, affordable health care as
a right and not a privilege--as a right and not a privilege. I believe
the American people, even those who have good private coverage
understand--understand deep down--that it is not right in our society
for 30 million Americans to go without health insurance coverage and
the devastating effects it has on those individuals and their families
when they do not have that health insurance coverage. So the American
people are not going to allow the Republicans to take away this great
humanitarian achievement.
I urge my colleagues to oppose the McConnell amendment. It blows a
huge hole in the budget deficit. It destroys hundreds of thousands of
jobs. It repeals the Patients' Bill of Rights, allowing health insurers
to return to the same old abusive and discriminatory practices. It
revokes health insurance coverage for tens of millions of Americans.
Instead, let's listen to those voices of the American people who have
cried out for so long--for so long--for health reform. Let's get rid of
the ideological obsessions.
If there are things that need to be fixed, we can fix them. I have
said many times that the health reform law is not the Ten Commandments,
written in stone for all eternity. It is a law. We pass laws. No laws
are perfect, and sometimes you have to make changes. We make changes in
laws all the time. We are about to make a change in part of the health
care reform law now dealing with small businesses. Fine. These things
need to be adjusted and worked on as we go ahead. They should be done
in a nonideological and hopefully bipartisan fashion. But to propose
that we repeal everything--everything; repeal it--makes no sense.
Let's move forward to build a reformed health care system that works
not only for the healthy and the wealthy but for all Americans.
Mr. President, I mentioned in my remarks about how we had changed the
law for Medicare reimbursement to benefit certain Iowa hospitals, and
because of that, many of the hospitals in Iowa were going to get a bump
up in their payments this year. I have a chart here. I did not have
time to get it put on a poster. For example, St. Luke's Hospital in
Cedar Rapids will get an additional payment this year of $794,841--this
year. That will be taken away by the McConnell amendment, by the way.
Trinity Regional Medical Center, in Webster County, will get $434,913
additional this year, taken away by the McConnell amendment. Mercy
Medical Center will get $584,883, in Iowa City, taken away by the
McConnell amendment. We worked hard to get these payments to help these
hospitals that are under duress and not able to serve people who are in
their communities. We are able to get this additional money to help
them survive. Yet the McConnell amendment would take it all away.
Mr. President, I ask unanimous consent to have an article by James Q.
Lynch that was in the Cedar Rapids Gazette and also a chart showing the
reimbursement to Iowa hospitals under our new Medicare rules for 2011
printed in the Record at the end of my remarks.
The PRESIDING OFFICER. Without objection, it is so ordered.
(See exhibit 1.)
Mr. HARKIN. Finally, I just say, for those of us in Iowa, in a small,
rural State, with a lot of midsized hospitals, with a lot of people
uninsured--and quite frankly, we are not in the upper echelons of
income in the United States--for us this health care law provides
immediate protections, immediate benefits, and promises even more
benefits as we get to 2014 and beyond. It would be a devastating blow
to my constituents in Iowa to have this health care reform bill
repealed. That is why I so strenuously urge all my colleagues to oppose
the McConnell amendment.
Mr. President, I yield the floor.
Exhibit 1
Medicare Reimbursement Changes Will Benefit Iowa Hospitals, Doctors
(By James Q. Lynch, July 1, 2010)
A proposed change in Medicare reimbursement could increase
payments to Corridor hospitals by more than $4 million next
year.
Under changes expected to be finalized later this month,
reimbursement for Medicare services would increase payments
to St. Luke's Hospital by $794,841 and to Mercy Medical
Center by $584,883. In Iowa City, the University of Iowa
Hospitals and Clinics could see an increase of $2.3 million
in 2011 and Mercy Hospital could get a $509,898 boost.
At the same time, a rule change on reimbursement to doctors
could boost their Medicare payments by 5 percent beginning
next year.
``This will mean a great deal to Iowa hospitals that have
been struggling for many years,'' according to 1st District
Rep. Bruce Braley, a Waterloo Democrat. He is part of a group
of U.S. House members who have sought to move Medicare away
from payment plans that resulted in geographic disparities
that ``punished health care providers in Iowa that provide
high-quality care and get low reimbursement rates.''
REIMBURSEMENT TO IOWA HOSPITALS UNDER PROPOSED MEDICARE RULES
------------------------------------------------------------------------
Hospital County 2011 Payment
------------------------------------------------------------------------
Marshalltown Medical & Surgical Marshall........... 164,967
Center.
St. Anthony Regional Hospital... Carroll............ 104,979
Unity Hospital.................. Muscatine.......... 74,985
Trinity Regional Medical Center. Webster............ 434,913
Iowa Lutheran Hospital.......... Polk............... 479,904
Mercy Hospital.................. Johnson............ 509,898
Mary Greeley Medical Center..... Story.............. 479,904
Skiff Medical Center............ Jasper............. 104,979
St. Lukes Hospital.............. Linn............... 794,841
University of Iowa Hospital & Johnson............ 2,399,520
Clinics.
Mercy Medical Center--North Iowa Cerrogordo......... 1,004,799
Mercy Medical Center--Cedar Linn............... 584,883
Rapids.
Iowa Methodist Medical Center... Polk............... 1,709,658
Mercy Medical Center--Des Moines Polk............... 2,129,574
Broadlawns Medical Center....... Polk............... 44,991
Spencer Municipal Hospital...... Clay............... 164,967
Lakes Regional Healthcare....... Dickinson.......... 74,985
St. Lukes Regional Medical Woodbury........... 374,925
Center.
Grinnell Regional Medical Center Poweshiek.......... 89,982
Mercy Medical Center-Sioux City. Woodbury........... 779,844
Continuing Care Hospital at St. Iowa............... Less than .0001%
Luke's.
---------------------------------------
Total....................... ................. 12,507,499
------------------------------------------------------------------------
The PRESIDING OFFICER. The Senator from Kentucky.
Mr. PAUL. Mr. President, I ask unanimous consent that Senator Isakson
be recognized to speak following my remarks.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. PAUL. Mr. President, today we will vote on repealing President
Obama's Federal takeover of health care. This vote will be not only to
repeal the specifics of this legislation but to reassert that we
operate under constitutional restraint.
When this bill first came up, many on the other side sniffed and were
incredulous that we would mention the Constitution. Many on the other
side said the Constitution--they really had not even comprehended that
the question would be asked, ``Where do you get the authority under the
Constitution to do this?'' Well, interestingly, we do still operate in
a society with constitutional restraint, and the courts have now
decided that the commerce clause does not mean you can do anything.
[[Page S454]]
The commerce clause, though, for the last 70 years has gotten larger
and larger. I used to joke that you can drive a truck through it now,
it is so big. I also used to joke that if my shoes were made in
Tennessee, they could regulate my walking in Kentucky.
The commerce clause--the expansive definition and understanding of
it--has been supplying no restraint to this body. But I think this
court case and I think this bill is about so much more than health
care. It is about whether we live and operate with constitutional
restraint of government.
This has been going on for a long time. It started with Wickard v.
Filburn back in the 1940s, where they told a farmer he could not grow
as much wheat as he wanted to.
He wanted to grow 20 acres of wheat, and the government said: You can
only grow 10 acres of wheat.
He said: Why?
They said: Well, because of the interstate commerce clause, we can
tell you how much you are going to grow.
He said: Well, I am not going to sell it to anybody. How am I engaged
in commerce? I am just going to feed it to my livestock.
They told him that by not selling it, he could indirectly affect the
price of wheat between the States. It was a ludicrous argument then,
and it is a ludicrous argument now.
My hope is that out of this case, as it moves forward to the Supreme
Court, maybe we will see a Court that takes a step toward overturning
Wickard v. Filburn. I think that would be the most important case in
the last 70 years in the Supreme Court, if we do it. Will we get there?
I do not know. But listen to what the Founding Fathers said about this.
Many people say: Oh, the general welfare clause says we can do this or
the commerce clause says we can do this. Madison wrote that we would
not have enumerated these specific powers and given them to the Federal
Government if we intended for there to be no restraint.
Recently, in the two Federal court decisions, the judges made a point
of saying that if you can regulate inactivity--basically, the nonact of
not buying insurance--then there is no aspect to our lives that would
be left free from government regulation and intrusion.
So I think this court case is incredibly important, more important
even than the specifics of the health care bill. There are many reasons
we should have opposed the health care bill and still should, but
really No. 1 among them is that we need to have a government that
operates under the Constitution and operates under a commerce clause
that was intended to promote free trade between the States and was
never intended to allow a government to grow so large and so invasive
that it could intrude into every nook and cranny of our economic lives.
With regard to the specifics of the health care bill, there were some
problems in health care. As a physician, I have seen some of the
problems. But do you know what the No. 1 complaint I got was? It was
the expense of health insurance, the rising expenses. The Federal
takeover of health care did nothing to that. In fact, it has already
increased the expenses to those. You see premiums rising.
But when you see problems, there are two directions to go. We had
problems in health care, but you could say: Do we need more government
or less government? From my perspective as a physician, I saw we
already had too much government involvement in health care. I saw that
what we had going on limited competition. You need more competition in
health care if you want to drive prices down. So you need to allow
insurance to be sold across State lines. You need to allow competition
in prices.
One of the surgeries I did was LASIK surgery, where you correct
someone's eyes so they do not have to wear glasses anymore. No
insurance covers it, and you would think: Well, gosh, maybe this body
will get together and force people to buy insurance for LASIK surgery.
It is good. It is a great thing. Well, do you know what. Without
government getting involved, competition drove the prices down on
LASIK. So the prices were driven down because the consumer was
involved. The same way with contact lenses; you can buy a contact lens
for 4 bucks, maybe 3 bucks. It used to be $20 or $30 a contact.
Competition works.
So what we should have asked ourselves when we looked at this health
care debate is--yes, there are problems. Yes, we can agree portability
was a problem. Yes, we can agree preexisting conditions were a problem.
But we should have said: Do these problems exist because there is too
much capitalism or too little capitalism? I would argue there is very
little capitalism at all.
I do cataract surgery also. Do you know what. I charge the exact same
price as every other doctor in my town, every other doctor in the
State, and every other doctor in the country because the prices are set
in Washington by a central committee. That is not capitalism, and that
is why health care is broken.
We need to get back to the fundamentals, and we need to say: Why does
capitalism work in nine-tenths of the economy but doesn't work in
health care? Well, maybe it is because we are not allowing capitalism
to operate in health care.
Today's vote on repeal is very important. There is great symbolism to
this because we have to say: Yes, we operate as a body under the
restraint of the Constitution, but there is also a message about
economic systems. The American economic system is capitalism, and we
should be proud of it. We should try to inject capitalism into more
enterprises and not less capitalism. We should not have such great
faith in government that government has all the answers because
government is notoriously inept and inefficient at most of the things
it does.
I rise today to support the repeal of the President's takeover of
health care. I hope the Democrats will reconsider. I understand some of
them are reconsidering.
I yield back the remainder of my time.
The PRESIDING OFFICER. The Senator from Georgia.
Mr. ISAKSON. Mr. President, first of all, I commend the Senator from
Kentucky, Mr. Paul, for his remarks and particularly his reference to
the Constitution. When I read the decision of Judge Vinson in Florida,
it read a lot like the Congressional Record of December 23 of last year
when we were on the floor right before Christmas Eve debating whether
to pass the Affordable Care Act. Judge Vinson was clear and precise
both on his ruling on the commerce clause as well as recognizing the
necessary and proper clause nor the general welfare clause can
substantiate requiring people to make the decisions that the health
care bill requires.
I am going to vote for the amendment by Senator McConnell to repeal
the Affordable Care Act. I wish to repeat the reasons I stated a year
and a half ago on the floor of the Senate as to why I believe that.
First of all, it has little or nothing to do with affordable care, in
my judgment, and we have seen in the 13 months since its passage and
the 9 months since its signing increase after increase in costs, both
in terms of insurance premiums as well as the application of the law to
the practice of medicine. So it is not about affordable care; it is
about care going up in its costs.
Secondly, if you look at the way in which the bill ostensibly claimed
it paid for itself, it shot big holes in America's health care future,
taking $500 billion out of Medicare to begin with, reducing the
reimbursement almost in its entirety for home health care which, in a
State such as Georgia with many rural people, is the primary way in
which health care is delivered to them, and the assessment of taxes,
whether it be on hearing aids and medical devices or the 3.8-percent
surtax placed on earned income for those people making more than
$200,000 or families making $250,000.
It is appropriate to start over, but by starting over it doesn't mean
we delay dealing with the problems Americans face with their health
care. It may mean we, in fact, accelerate it beyond what this bill
would have done if it is carried out to its entirety.
When we had the meeting at the Blair House a year and a half ago in
the middle of the health care debate, when the President and the
Democratic leadership sat down across the table from the Republican
leadership and for 4 hours engaged in a discourse over the differences
in the two ideas, it became quite clear what the majority wanted
[[Page S455]]
to do. They wanted to change the paradigm and put the government in
charge of health care in America.
That is why every provision in the bill, from the fines for not
buying insurance to the provisions of reimbursement, drives government
to be the decisionmaker and the controller, just as the distinguished
Senator from Kentucky talked about the price of health care today. The
price of health care begins and ends with the assessment of
reimbursement made in Washington, DC.
So, No. 1, we do need to change the paradigm and get back to a
capitalistic-type system and a competitive system. For example,
repealing the barrier on interstate sales of health insurance and
having a national marketplace. Allow affiliated groups or similar
groups to join together and compete across State lines as a larger risk
pool like independent contractors, like the profession I came from,
real estate agents, who are not employees, who don't have the benefits
of ERISA coverage but bound together could compete with IBM or any
other company in buying insurance as a group with a large enough risk
pool to reduce the cost of their premiums and raise their coverage.
It is very important to realize that the real solution to health
care, both in terms of its costs as well as a healthy America in the
future, is the way we practice wellness and disease management. Those
are the types of programs we can then begin to incentivize now to raise
them in their practice and lowering in the outyears the cost of health
care and begin to get our arms around what is right now a spiraling
contributor to the deficit and to the debt.
But most importantly of all, the fact that over 70 waivers have been
issued by Health and Human Services already is proof the bill is
flawed, and it is proof its continuation up until its beginning in 2014
is going to be nothing more than making other exceptions for other
groups for trying to make a bill that is designed to fail work. It
won't happen. It should be repealed.
I commend the leader on his amendment, and I will vote for it this
afternoon.
I yield the remainder of my time.
The PRESIDING OFFICER. The Senator from Indiana.
Mr. COATS. Mr. President, it was my understanding that another member
of the Democratic Party was going to speak at this time, but not seeing
him, I think I will just go ahead and deliver my presentation.
As a candidate for the Senate during this past year, I met with many
Hoosier families and small business owners, as well as health care
providers, patients, doctors, and all those involved with concerns
about where this health care process was going to go. Everywhere I
went, from Lake County to Fort Wayne to Indianapolis, Muncie, and down
to Evansville--all across the State I heard a resounding plea to
overturn the costly and intrusive health care law that was passed by
this last Congress and signed into law by the President.
The issue for these people was not whether we needed to address
issues of health care, whether it was quality, cost-effectiveness, or
access; the issues for them were two things: One, they resented the
process where a massive bill, which many did not fully understand or
grasp the implications of, was forced through these Chambers and passed
hours before Christmas. The rules were bent to try to move the bill
through the process, and it became a policy which was not supported on
a bipartisan basis but yet a policy that affected virtually every
American.
If experience tells us anything, it is that massive changes in policy
need bipartisan support to be acceptable if they are going to be
effective. The majority of people I spoke to about the health care plan
that is now in place believe it is fatally flawed and needs to be
repealed so we can start over with a much more cost-effective,
efficient, affordable health care plan.
Those who have listened to the people express their views on this
particular issue have come to the conclusion that their voices were not
heard, as they expressed throughout the deliberation of this; that
Congress wasn't hearing what they were saying. The results of
November--I think with this issue being central to the election--
ratified that. So I urge my colleagues in the Senate to listen to the
American people and repeal the law that is before us, a health care law
that raises taxes, penalizes businesses, straps States with costly
mandates, and increases premiums for American families.
Recent polls show a significant majority of Americans want the
President's health care law to be repealed, and they want Congress to
start over and put together a plan which does not cost the taxpayers a
lot of money and will not provide the access and the care and the
quality Americans are looking for.
We know more than half the States, including my State of Indiana,
have joined in lawsuits challenging provisions of the constitutionality
of the law that will be settled by the Supreme Court in due time. But I
believe we must take this opportunity now to overturn the law and start
over.
Let me address some of the consequences to my State of Indiana and to
Hoosiers if we do not repeal the current health care law. Hoosier
families will clearly face higher premiums. Nonpartisan budget experts
from the Congressional Budget Office reported that individual health
insurance premiums will increase by $2,100 per family as a result of
this new law. If we do not repeal the health care law, 50,000 low-
income Hoosiers will be dropped from the Healthy Indiana Plan. This was
the plan implemented by our Governor and our State representatives and
senators, an innovative plan that addressed the real problem of low-
income Hoosiers not qualifying for other support. This plan put in
place a proposal for health savings accounts. The program has been so
popular that it now includes more than 50,000 participants.
Unfortunately, as a result of the health care law, the State may need
to terminate the Healthy Indiana Plan and place its participants into
Medicaid. This is just one example of a provision of law enacted at a
Federal level that denies units of government--States, localities, and
others--from innovating and bringing about sensible, market-based
solutions to problems they face.
The one-size-fits-all Federal health care law basically says to those
States and those innovators: No, we know better. We will tell you what
to do regardless of what the cost is or regardless of how effective
your program is. Our Governor had negotiated savings for prescription
drugs for low-income recipients, but this law prevents that type of
innovation and progress made on the state level.
If we do not repeal the health care law, Hoosier taxpayers will bear
a heavy burden. The law will force Indiana to expand Medicaid,
enrolling approximately one of every four citizens in the program.
According to an actuarial analysis by the Indianapolis-based Milliman,
Inc., Indiana will have to absorb an estimated $3.6 billion in new
costs over the next decade if the 1.5 million eligible Hoosiers enroll
in Medicaid, which they may under this plan. That burden is passed on
to Hoosier taxpayers, and our State, frankly, cannot afford to do that.
The report also predicts that Indiana would have to spend more than
$300 million on new administrative costs alone. So with States already
facing budget cuts, there is no doubt these costs will either be passed
on to taxpayers or the State will opt out of the plan and turn people
over to the exchanges and to the control of the Federal Government.
If we don't repeal the health care law, Hoosiers will see a decrease
in the quality of service of care. I met with physicians, health care
providers, and hospital administrators at sites all across the State. I
heard a very common concern: The new law will jeopardize the quality of
care for patients.
The health care plan cuts reimbursement dollars for hospitals and
providers at a time when they can least afford it. These cuts simply
exacerbate the dire shortage of doctors and nurses and will result in
less advanced care for people in need, less personal attention from
providers, and fewer choices for patients.
If we do not repeal the health care law, Hoosier businesses will
suffer. The President's health care overhaul hits our job creators with
harmful mandates and regulations, mountains of paperwork, and countless
taxes. The new
[[Page S456]]
law requires businesses with 50 or more people on staff to pay a $2,000
tax per worker if the employer does not offer an acceptable health
insurance plan for its employees.
If I heard one thing more than any other thing from business owners,
it was that this law will drive them to make employment decisions that
are adverse to the benefit of those seeking employment. Companies that
were in the 45-to-50 range of employees, or even less, have basically
said if the choice comes down to whether to hire new employees or
whether to outsource or whether to use technology to replace those
employees, they will do so to prevent going over 50 employees and being
forced to offer insurance or pay a penalty.
An arbitrary line drawn at 50 basically puts the job creators of this
country--the small- and medium-sized businesses--in the position of
having to decide whether to take on the mandated tax burden of the
Federal Government or simply not go forward and hire over that
particular limit, forcing them to find other ways to produce their
product without added employment.
At a time when we are facing 9-plus--nearly 10 percent in many
areas--unemployment, putting a law into place on a nationwide basis
that discourages businesses from hiring is simply the wrong thing to
do.
Other businesses may find it more cost effective--and many have told
me they would drop workers from their health insurance plan and pay the
fine instead. Turtle Top, a shuttle bus maker located in New Paris, IN,
found that dropping health care coverage for employees and paying the
Federal penalty would generate a savings in the six-figure range for
the company. That is a story repeated over and over. The law dictates
that it financially benefits some companies to drop their insurance
plans and shift coverage for employees over to the Federal taxpayer.
In fact, the administration's own estimates revealed that more than
6,000 pages of regulations mandated by the law could force half of all
employers--as many as 80 percent of small businesses--to give up their
current health care coverage within the next 2 years.
One burdensome regulation is the 1099 provision. I believe we are
going to vote on that amendment, and I hope it passes. This is one of
the many egregious, unexpected consequences of pushing a law through
without fully understanding the law or the implications of the law.
Rather than beginning a piecemeal approach to de-construct this
approximately 2,100-page bill, I believe it is expeditious for us to
repeal and start over.
The medical device tax particularly impacts my State. It adds a 2.3-
percent sales tax on medical devices. This is an industry in the State
of Indiana that probably is one of our top manufacturers, is making a
profit, and is hiring people. Yet it will be arbitrarily taxed as a way
of helping to pay for the cost of the health care bill. Cook Medical, a
medical device company in Bloomington, IN, expects that the new health
care law will cost the company $15 million to $20 million per year.
This is a company, along with Biomet, Zimmer, and other medical device
companies, that had the deep pockets because they were producing
products that the world wanted to buy. They were one of our export
leaders, and because they were making profits at a time when the
Federal Government was looking for money to pay for other aspects of
the health care plan, they simply added a 2.3-percent sales tax on the
devices, to a total of about $20 billion.
The health care law devastates Indiana businesses. At a time when
nearly 1 out of every 10 individuals today in Indiana is looking for a
job, Congress should be focused on a way to encourage private sector
growth and job creation, not stifle it.
Our health care system in America has problems, but restructuring it
with a one-size-fits-all, government-run plan that increases taxes,
raises premiums, and hits businesses with penalties is not the right
thing to do.
Congress needs to repeal the current law and start over with a step-
by-step approach that reduces the skyrocketing costs of care.
Listening to Hoosiers over this past year, I created a list of 10
priorities that Congress, I believe, should focus on when we start over
on health care:
One, allow competition to cross State lines. We need to improve
access and the quality of care by increasing competition and allowing
consumers to purchase health insurance across State lines.
Encourage innovation. I talked about the innovation taken away from
our State through this law.
Eliminate frivolous lawsuits and include liability reform. Passing a
health care bill without liability reform part of it--when all of us
know defensive medicine is forced upon doctors and providers at
hospitals through frivolous lawsuits and without a sensible process of
providing for those who clearly are victims of malpractice--undermined
the credibility of what Congress was trying to do and what the American
people and the health care providers were looking for.
Improving Medicaid and the SCHIP program.
Allowing for the immediate creation of association health plans for
small businesses.
Incentivizing and rewarding healthy lifestyles.
Expanding health savings accounts, not reducing them.
Advancing the use of electronic medical records, while retaining
privacy.
Increasing cost transparency.
Retaining our promises to our military personnel veterans and their
eligible family members.
Those are all components of the more detailed plan I outlined this
past year in Indiana.
Most important, I believe the underlying principles to ensure that
our health care system is one that preserves personal freedoms and puts
individuals in control of their own health care decisions is critical
to addressing the next bill we take up.
Let's take this opportunity now and listen to the patients, listen to
the health care providers, the physicians and listen to the job
creators and small business owners and then let's listen to the
American people who sent us here to represent them. Let's repeal this
law and let's start over.
I yield the floor.
The PRESIDING OFFICER. The Senator from Florida is recognized.
Mr. NELSON of Florida. Mr. President, it seems to me that what we
ought to be doing with regard to this law is fixing it instead of
repealing it. We ought to be focusing on fixing it instead of focusing
on repeal. Already, unanimously, it seems, people have embraced
different parts of this law as certainly necessary. You could go down
the list. Twenty-six-year-olds can now stay on their parents' health
insurance policies. Health insurance companies can't go off spending
all kinds of money on all kinds of jet airplanes and vacations. They
have to deliver, on large group insurance policies, 85 cents of health
care out of the $1 of premium paid--85 percent.
Then, of course, you can't have a health insurance company cancel you
in the middle of your coverage. Who in the world would not embrace this
in the law; that is, you can't have some silly kind of reason that you
are not going to give health insurance to a patient because they had a
preexisting condition when, in fact, they had a skin rash, and that is
an excuse.
There is a lot in this law that is good, not the least of which is
that there are 35 million people out of the 45 million who are
uninsured in this country who, come 2014, will have private insurance,
private exchanges, called health insurance exchanges, in each State, to
which they can go and shop for health insurance. If they can't afford
it because they are somewhere between that and the rate at which they
are eligible for Medicaid or they are up to 400 percent of the poverty
level for a family of four, they will have some assistance from the
Federal Government so they can purchase that private enterprise
exchange insurance. If you can bring 35 million people into the health
insurance system, what happens to it? If they have health insurance,
they start getting preventive care. That means you avoid what happens
now, which is they don't have health insurance, they avoid going to the
doctor because they can't afford it, and they wait until the health
problem turns into an emergency. Where do they end up? They end up in
the emergency room, which is the most expensive place now, with a full-
blown emergency, and the laws of the 50 States require the emergency
rooms to treat
[[Page S457]]
those people. Guess what. Who pays? All the rest of us pay.
So if you can bring 35 million people out of the 40-some million
uninsured Americans into the health insurance system, you bring down
the per-unit cost that all the rest of us pay, which is tacked onto the
health insurance premiums we pay. Because when the hospital picks up
the tab, who do you think pays? It is distributed right out to the
health insurance system, and the rest of us end up paying. So there is
a lot of good in here. What we ought to do is fix it. We should not
repeal it.
There is another issue that has arisen in this great debate we are
having, which is of historic proportions, on what is going to happen to
this law that was passed in this body by a 60-vote margin. What has
happened is there have been a lot of lawsuits filed. In two cases,
Federal district judges have ruled the law is constitutional. In two
other cases, Federal district judges--this is the lower court of the
Federal court system--have ruled it is not constitutional. Of course,
we have had action by the legislative branch, the other House, the
House of Representatives, which has voted to repeal the law. Now here
we are with the issue in front of us on which we will vote later today.
Well, doesn't anybody conclude that this matter is going to the
Supreme Court to decide if this law is constitutional? When the Supreme
Court decides, regardless of what we have done or what we haven't done,
the Supreme Court decision is going to discard political and partisan
interests. So isn't it in our commonsense interest if we would come
here and join together in a resolution to petition the Supreme Court to
have an expedited review of this case?
Typically, what happens with these two for and two against, that will
work its way up through the court of appeals, and that will take
another year, year and a half, and then it will get to the Supreme
Court. That will take another year, year and a half. Why don't we
expedite the matter? Why don't we express our intent to have an
expedited review by the Supreme Court?
I have filed such a sense of the Congress--a resolution--and its
passage might prevent people from arguing back and forth over this law
for the next several years. Everybody in this country that will be
affected would have an answer, and they deserve an answer. Therefore, I
urge the Senate to consider adopting the resolution asking the Supreme
Court to step in and decide quickly whether the current law meets the
constitutional test.
My preference is that we fix the law, that we not throw it out. I
don't want to go back to the days of the insurance companies dropping
people because they get sick or depriving seniors of help getting their
prescription drugs. But because the matter ultimately is going to be
resolved by the Nation's highest Court, I think we ought to take a
commonsense approach on this resolution. I urge my colleagues to adopt
it.
Mr. President, I see no one else is on the floor seeking recognition.
I will just add that another commonsense component in this law that
certainly means don't repeal it is the assistance that is given to
senior citizens.
That assistance is in the form of help with the cost of their
prescription drugs. The Congress passed, and it was signed into law
years ago, a prescription drug benefit, but that benefit was only
partially assisted by the Federal Government, and senior citizens had
to pick up a big part of the tab. This law closes a lot of that gap,
what is commonly referred to as the doughnut hole. We do not want to
take that away from senior citizens. I certainly think that is going to
stand the constitutional muster.
There is another part of this law that is so beneficial as well, and
that is, are we not concerned about the deficit, are we not concerned
about how we are going to get our country back on a road toward balance
of our deficit so that we have a balanced budget? What this law does,
which seems to me common sense that you do not want to repeal it, it
saves the Federal Government, according to the Congressional Budget
Office, a nonpartisan, highly technical economic team, $250 billion
over the next 10 years and in the second 10-year period would save up
to $1.2 trillion to the Federal Government.
There are plenty of reasons that we ought to fix it instead of
repealing it. I urge my colleagues--and I see my dear friend from the
State of Nevada came in. Before he came in, I had urged us to consider
a sense-of-the-Congress resolution to have an expedited appeal to the
U.S. Supreme Court.
Mr. President, I yield the floor.
Mr. ENSIGN. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. ENSIGN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
The Senator is recognized.
Mr. ENSIGN. Mr. President, I rise today in support of the amendment
offered by the Republican leader to repeal what I believe is an
unconstitutional government takeover of our health care system. Make no
mistake, we all want to improve access to affordable health insurance
for all Americans, including those individuals with preexisting
conditions. Unfortunately, this health reform law is not the right
prescription.
Over the past year, I have spoken with tens of thousands of Nevadans
about this bill. They were very clear when they said that this law is
not the cure for our broken health care system.
This law imposes new burdens on most Nevadans and most Americans. It
requires that every American citizen purchase health insurance
coverage. Those who fail to buy health insurance that meets the minimum
requirements are subject to financial penalties.
Two weeks ago, I received an e-mail message from Tommy Felt, a Boy
Scout in Las Vegas. This is a picture of Tommy. He is 12 years old. He
attends Molasky Junior High School, and he is working to earn his
Citizenship in the Nation Merit Badge.
Tommy's e-mail stated:
I'm really concerned that the bill will damage our country.
I think it is unconstitutional for the government to force
citizens to buy health coverage. Also, I believe that the
hidden costs in this bill will drive our country much deeper
into debt. My dad says that this bill will lead to the
elimination of Senior Dimensions and Medicare Advantage plans
for our seniors.
I wish that more than half of my colleagues would heed the words of
this young 12-year-old.
I could not agree with Tommy more. I, too, am also concerned that
this health reform law will destroy our health system in our country. I
am also concerned about the unprecedented overreach of the government's
demand that every American purchase health insurance just because they
live in America.
A judge in Florida, as we have all heard, ruled that the entire
health care law is unconstitutional. Let's ask the question, Is it
really Constitutional for the government to tell all Americans they
must buy health insurance coverage? What is next? What personal liberty
or property will the Congress seek to take away from Americans next?
Will the government mandate what cars we are allowed to drive or what
food we feed our children? Where do we draw the line? Or will we even
draw one at all?
After all, the Constitution is about enumerated powers, the specific
powers given to the Congress. This bill blows the lid off those
enumerated powers.
I have spoken at length about the unconstitutional provision and even
raised a Constitutional Point of Order before the Senate voted to pass
this reform bill.
As I previously mentioned, earlier this week, a Florida judge ruled
the individual mandate unconstitutional and even went so far as to say
that the whole bill is unconstitutional because the mandate cannot be
separated out. In December 2010, a Federal judge in Virginia also
struck down the individual mandate as unconstitutional.
We know it could take several years for this case to reach the
Supreme Court of the United States. My good friend from Florida,
Senator Nelson, talked about expediting that procedure--which makes a
lot of sense--so that we do not have to wait several years for the
Supreme Court to reach its decision. The administration should ask for
that. The administration has the right to bypass the Court of Appeals
and go directly to the Supreme Court. In the meantime, because it
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may take several years, we should act to repeal this law before we
begin to suffer under its tyranny.
Now, going back to Tommy. His e-mail addresses the significant costs
associated with this health reform bill. Tommy has every right to be
concerned. In fact, every American should be concerned. Spending in
this country has continued to spiral out-of-control. The health reform
law is only adding to our financial demise. Unless we repeal it, the
law will further exacerbate the cost of health care, explode our
deficit and debt, and forever alter the relationship between the
government and the American people.
We hear from the other side that this bill is going to reduce the
deficit because there are $500 billion in cuts to Medicare as well as
tax increases. By the way, the Congress could repeal those cuts in
Medicare and often does. The other side also used fuzzy math when this
bill was being debated. A lot of the savings in Medicare were counted
twice. That is why a study by the Republican side of the Senate Budget
Committee said that this bill would actually increase the deficit in
the first 10 years by $700 billion.
Let's have some common sense. Do you think you can increase the
Medicaid rolls by 16 million people in America and actually cut costs?
Does that make sense to anyone? Increase the Medicaid rolls, which are
paid by the Federal Government and the States, and then say we are
actually going to decrease the deficit? That defies common sense.
Many small business owners in my State have already seen a dramatic
increase in their health insurance premiums. This bill was supposed to
bring down costs. It is doing exactly the opposite.
I have met with many companies across our State. At least three large
companies I've met with tell me they are considering, because of the
costs, dropping their health insurance and paying the $2,000 fine per
employee. It makes sense to them. They can pay their employees a little
stipend, they can put their employees on the government system, and
they are money ahead.
With businesses struggling just to make it today, this decision could
be the difference between staying in business or not. They are looking
at huge increases in their premiums, or paying the fine and putting
people on the government system. That is one of the reasons I think
this bill is going to massively increase the Federal debt.
This law does not help the typical Nevada family who purchases
insurance in the individual market either. In fact, in traveling the
State, I met with Nevadans who are already seeing increases in their
premiums. Those who purchase insurance plans in the individual market
could see a 10- to 13-percent increase in their premiums because of
this bill. But some of the small businesses that I have talked with are
already seeing increases this year around 15 to 30 percent. A few of
the small businesses are seeing increases around 8 or 9 percent, but
most of them are in the 15- to 30-percent range.
In my State, unfortunately, about 70 percent of all the health plans
provided by businesses will not meet the minimum requirements that will
be mandated by the government starting in 2014.
In Tommy's e-mail to me, he also mentioned Medicare Advantage. There
are more than 100,000 Nevada seniors who choose a Medicare Advantage
plan. These Nevadans are not better off because of this reform. Their
extra benefits actually will be reduced by more than half.
This bill does not help middle-income workers in Nevada either. Our
hard-working hotel housekeepers, casino restaurant workers, airline
workers, teachers, and police officers now look forward to collectively
sharing the burden of the $200 billion tax on health insurance holders.
Many American workers will pay for new taxes and penalties with
reduced wages and lost jobs. Oh, and by the way, there are also new
taxes on prescription drugs, clinical lab work, and medical devices
that will also get passed on to the American people.
Simply put, I believe this health care bill is a job killer. My State
cannot afford to lose more jobs. We have 14.5 percent unemployment in
my State, and 9.4 or 9.6 percent across the Nation. We cannot afford to
lose more jobs.
I am sure many of us have heard the phrase that the devil is in the
details. Truer words could not be spoken when talking about this health
care reform bill.
We know when Democrats passed this legislation that they gave
enormous discretion to the Secretary of Health and Human Services. But
I do not think any of us could have fathomed that the 2,000-page bill
would generate potentially up to 20,000 new pages and regulations.
I have printed off many of the rules and regulations as well as the
bill itself. Look at the size of this stack, and they are not even
close to being done writing all the regulations. I challenge any
company or any American to try to understand this bill and its
regulations. It is virtually impossible. It takes a team of lawyers and
health care experts to even come close to understanding all the
implications of this bill.
According to my staff's calculations, so far there are about 6,200
pages of regulations. As I mentioned before, this could go to at least
20,000 pages. It is safe to say that the devil is in the details with
this health bill.
The American people are going to learn more about the unintended
consequences of this legislation as more and more of these regulations
roll out. Remember last year when Nancy Pelosi said, We have to pass
the bill so we can find out what is in it. We may be able to find out
what is in the bill if you are able to understand it when you get
through reading it all. I wonder how many people in this body have read
not only the legislation but the rules regulations. It is absolutely
daunting.
This health care reform bill is an over 2,700-page bill full of new
taxes on Americans, funding cuts for programs they rely on, and raised
premiums, which is why we should be repealing this bill. Instead of
doing so, however, this administration is granting special waivers to
various provisions in this law. These waivers are basically exceptions
to the rules, and they allow organizations to circumvent the standards
required in this health reform law. If waivers are needed, isn't that
proof the health care reform bill is problematic? Isn't it proof this
health care reform bill isn't working, or are special interest waivers
a greater priority than the plight of the American people? It is
interesting to me that some of the biggest supporters of this law have
been working behind the scenes so they can obtain special waivers to
get out of complying with this law so that they will not be held to the
same standards as businesses in Nevada.
Nevadans are not behind this bill. The American people are not behind
this bill. But there is no doubt that we need to improve health care in
the United States. What is the primary problem with health care in the
United States? The new Senator from Kentucky said it best: It is too
expensive to buy health insurance in the United States. This bill does
nothing but make that problem worse.
The people of this country did not sign up for the kind of change
that brings with it billions of dollars in new taxes and a potential
loss of their current insurance coverage or the choice to decide which
coverage they have. The American people don't want a bureaucrat coming
between them and their doctor.
Now, turning my attention back to taxes just for a moment, this bill
alone ensures that hard-working Americans hand over even more of their
paychecks each month to the government. It is funny how reforming
health care means more money for Uncle Sam.
There is a new surtax on investment income--which, yes, does include
a gain on home sales--which has many Nevadans infuriated.
There are new limits on the use of flexible spending accounts, which
concerns many Nevadans who use these accounts to fund exceptional
medical costs, even though President Obama promised that people could
keep their current health care plans.
There is also a new tax on certain employer-provided health care--the
so-called Cadillac plans. There are taxes on drug companies, medical
devices, indoor tanning services, and the onerous 1099 reporting
requirements for small businesses that, apparently, even President
Obama opposes now.
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President Obama said in his State of the Union Address that we need
to fix parts of the bill that need fixing and move forward. Well, I
believe this whole bill needs fixing. So let's repeal it and replace it
with real health care reform that actually attacks cost, the No. 1
problem in health care in the United States. We can go back to the
drawing board, take the best ideas from both sides of the aisle, and
put together a health reform bill that will take us into the future.
Republicans have come up with many ideas on ways to fix the Nation's
broken health care system. The answer is not unbearable taxes,
unsustainable growth of the government, or paying for a brandnew
entitlement program.
Those aren't the qualities of comprehensive health reform. They are
the qualities of a terrible policy that will lead to devastating
results for Americans and our health care system, which is the best in
the world. There is a better way. It will take time, but if we can
change the way Americans think about health care, then we can create a
better system.
Imagine a system where Americans get to keep their choices in health
care and where they are allowed to buy insurance across State lines.
Imagine a system where there is transparency, where you know how much
your doctor's visit will cost and how much your surgery will be. Ask
yourself: When was the last time you went to a doctor's office and got
a written estimate? In this third-party payer system we have, where
someone else is paying the bill and you are receiving the service, the
doctors don't care what you think of the cost. So there is no
transparency in today's system. We need to have a system that is
transparent, where you can shop around for the best value for your
money.
Imagine a system that rewards individuals for engaging in healthy
behaviors. Imagine a system where you are not punished for having a
preexisting condition. Imagine a system that allows small businesses to
pool their purchasing power together to provide health insurance to
their employees through small business health plans.
Imagine a system where doctors can practice medicine to heal patients
instead of practicing medicine with the goal of not being sued. And
imagine a patient-centered health care system instead of an insurance-
centered system or a government-centered system, which is what we have
today.
These are all standards we should work toward. We cannot afford to
settle for this bill.
I believe this bill will bankrupt our country, our families, and our
neighbors.
We simply cannot survive with this agenda of taxing and spending away
our future. We can't survive it; we can't afford it.
Mr. President, I believe we should repeal this bill: all of its
pages, all of its regulations, all of the regulations to come. I
believe we should work together--not as Republicans, not as Democrats--
as Americans to address the primary problem in health care in this
country: the cost. It is critical for the future competitiveness of
American business, and it is incredibly important for the quality of
health care and for the future of our citizens as well.
Mr. President, I yield the floor.
The PRESIDING OFFICER (Mr. Begich). The Senator from New York.
Mr. SCHUMER. Mr. President, I rise in strong, vehement opposition to
the amendment offered by the minority leader, Senator McConnell, to
repeal the health care reform law.
First, I would say to my good friend from Nevada, yes, we would like
to work together to further reduce costs, but this bill does reduce
costs significantly. The CBO has said in no uncertain terms that repeal
would balloon the deficit by $230 billion in the first decade and more
than $1 trillion in the second decade. That is because the law smokes
out a good deal of the waste, the inefficiency, and the duplication
that we all know is part of our system.
That is the place where we have to continue to work together. Our
country delivers the best health care in the world, but it is also the
most inefficient. We spend 17 percent of our GDP on health care. The
next highest spending country is only 10 percent. Under the reformed
law, we will begin the first large step in keeping quality care but
getting costs under control.
If my colleagues on the other side of the aisle said: You know, you
are right; we have to reduce costs, we have a better way and they
offered a bill on the floor, well, then, maybe we would take a look at
it. But they are silent. It is very easy to sit there and say repeal,
but what would they put in its place?
The reason this amendment will be so easily defeated today is because
a budget point of order says if you are going to raise the deficit $230
billion in the first decade and $1 trillion in the second, you better
find out where that money is coming from. The other side is silent, not
a peep about where that money would come from. So that makes one feel
this is sort of for show. Let's wave the flag for some of our hard-core
supporters who definitely want repeal, but there is nothing in its
place.
The old mantra the other side seemed to have--some of them--of repeal
and replace is gone. It is now repeal and we have nothing to replace it
with. That does not meet with the favor of the American people. In
fact, the number who are against repeal is growing. Only about one-
fifth of those who say they want to see the law changed want full
repeal. Only 20 percent of the public wants full repeal. If those
numbers are correct, and I believe they are, that means almost
certainly that a majority of Republican voters don't want full repeal.
The bottom line, Mr. President, and particularly in this area of
health care, is that talking about deficit reduction is a lot easier
than doing it. That fact is evidenced by the amendment my friend, the
leader from Kentucky, will offer. That is why a budget point of order
is the appropriate response, and that is why this will be defeated
rather handily.
In later days maybe my colleagues will come up with parts of the bill
they wish to change. We will be open to it. Today Senator Stabenow is
offering an amendment to change the 1099 section of the law. She has
worked with people on both sides of the aisle. I know Senator Johanns
has been a leader, the Republican from Nebraska. We are going to pass
that today. So the idea that we are unwilling to change any part of
this law is belied by what we are doing on the Senate floor.
We want to work together. But somehow, when we get a repeal
amendment--repeal the whole thing, no substitute, no answer to how to
deal with the debt--one wonders what this repeal is all about.
Furthermore, why is the American public becoming more favorable to
this law as we go through this debate? That is what the polling data
has shown. Well, I would give two reasons. First, many of the horrors
that were bandied about as the law was being put together are proving
not to be true.
I will never forget that last summer someone came to me, a gentleman
from Long Island, and he said: Senator Schumer, I am a Democrat. I have
voted for you in every election, but I am not going to vote for you
again.
I said: Why?
He said: I hate the health care law.
I said: What do you hate about it?
He said: I am going to lose my health care benefits on Labor Day.
I said: What is your profession?
He said: I am a New York City firefighter. He lived on Long Island,
but he was a New York City firefighter.
Well, anyone who knows even a little about the health care bill knows
that a New York City firefighter will not lose their benefits on Labor
Day or any other time under this provision. But this poor man had
listened to some talk radio and they had convinced him he was going to
lose his benefits.
But that is all fading. I haven't spoken to the gentleman since. I
don't know his name. I just met him at a summer street fair. But he has
found his benefits are just as good today as they were on the day
before Labor Day, so it is pretty logical to suppose he would have said
repeal the law a year ago but wouldn't say so today.
But there is another reason, and probably an even more important
reason, this law is gaining support as people learn about it, and we
owe some thanks to our Republican colleagues because they have given us
a second chance to make a first impression. Most who looked last year
said the messaging--rightly or wrongly, falsely or truly--was done
better by the opponents than by the proponents of the
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law. But now, as people look at the law, they are learning about the
many good things in the bill.
I daresay that most of my colleagues on the other side of the aisle
want to keep those good things. I would be quite certain that the vast
majority of Americans would want to keep those things, and the polling
data backs that up.
So when you say repeal, when you just use a hatchet and not a
scalpel, you lose all the good things, many of which are in effect
today. So I would ask my colleagues on the other side of the aisle who
support repeal: Do you support increasing prescription drug costs for
our Nation's seniors? Thanks to this law, the so-called doughnut hole--
which was created in the prescription drug plan of 2003 under George
Bush--will be fixed. Seniors who fall into this doughnut hole--which
says when they pay about $2,500 for drugs, the government will help
them no longer--will now get a 50-percent discount on their
medications. This first year that will amount to a savings of $550 for
the average senior.
When you are a senior on a fixed income, $550 is a nice amount of
change, and that will help a whole lot of people. The discount keeps
increasing every year until the last crumb of the doughnut hole is
gone.
I will admit that is a mixed metaphor because a doughnut hole, by
definition, has no crumbs. But good try, staff. Excellent work, in any
case. It sounded very good to me too.
But in these times, these savings aren't exactly chicken feed. They
will make a huge difference for seniors. The average senior, when the
doughnut hole is fully eliminated--crumbs and all--will save more than
$2,000 a year.
How about the provision that helps young people? Every one of us
knows of instances where young men and women get out of college or get
out of high school and they go into the job market. Oftentimes those
new jobs they are seeking do not provide health care. That happens
quite often. It is a new job, it is a low-paying job, they are just
starting out. I know--I have spoken to many young people like this, and
their parents--there is a lot of anguish. Does that young person who
maybe has a job that pays $25,000 or $30,000 a year pay $1,000 a month
for health care for himself or herself? They cannot afford that.
On the other hand, to go without health care insurance--yes, they are
young and healthy but God forbid they have an accident, go to the
hospital, come up with some unusual and rare and expensive disease.
What are they going to do? This keeps lots of young people and their
parents up at night. This new bill solves that problem because you can
stay on your parents' health care insurance, should they have it, until
you are 26. By then you are in the labor force a little bit longer and
the likelihood of your employer giving you health care is somewhat
greater. Do my colleagues on the other side of the aisle want to take
that away? If so, what are you going to put in its place? What are you
going to tell the young people, 22 and 23 and 24 and 25 and 26, to do?
Then there is another provision that I think is worth keeping--
preventive medicine. We all know one of the big problems with our
health care system as opposed to some of the others in some of the
other western countries is we do not do enough prevention. So instead
of a disease being nipped in the bud, making the patient healthier and
costing the system a whole lot less, it waits and waits. Those of us
who put this health care bill together realized that and said early
detection saves not only lives but billions of dollars. In this health
care bill Medicare will provide a free wellness checkup once a year for
every senior citizen. If there is a little bit of illness, they can nip
it in the bud.
We all know the earlier you detect cancer or heart disease or
diabetes or emphysema, the better chance of curing it and the less
expensive to cure it. This is going to save billions of dollars. Just
giving certain tests at these wellness checkups will save people
themselves money but, more importantly, save the Medicare system money,
a lot of money. It is important for the people to save their money too,
of course. This makes a great deal of sense.
A mammography can find breast cancer before it metastasizes. A simple
blood test can find prostate cancer before it spreads. What are my
colleagues on the other side of the aisle going to say to seniors? What
are they going to say to the Medicare system, which is trying to get
more effective by getting involved in early detection and prevention?
Forget it? That is what you are doing when you vote for repeal. You
have nothing in its place.
How about the small business tax credit? My dad was a small
businessman. He had a little exterminating business. I know how small
businessmen struggle. My father truly never became happy until he left
the business. Now, praise God, he is 87 and he is a much happier guy
than he was, even at 60, struggling in that business. One of the
dilemmas that small business people face is the high cost of medical
care for their employees. They want to provide it, A, because they want
their employees to be healthy, B, because they like most of their
employees, and C, because they want to keep the employees from going
somewhere else if they are good--but it costs so darned much. Here is
what is in the bill. If you are a small business that makes less than
$1.2 million and you have 25 or fewer employees, you get a 35-percent
credit, going up to 50 percent in 2014. That is a huge help to small
businesses that are already providing health care for their workers,
and a great incentive for small businesses that are not already to do
so. Hundreds of thousands of small businesses in my State alone will
benefit from this. What, my friends on the other side of the aisle, are
you saying to those small businesses? What are you saying to their
workers? Go at it alone? Because you want to repeal it but you have
nothing--nothing--to replace it.
There is one more provision I want to speak of. There are so many
good things in this bill. No matter how much you don't like some of the
bad provisions--and I know that is genuinely held by some of my
colleagues--to just repeal it and get rid of the good stuff makes no
sense, in my judgment. We have all heard the horror stories of
insurance companies--when you go to them after you, your spouse, your
kid has an illness and you say: Thank God, I have insurance--the
insurance company deliberately, or maybe not but anyway they say: Mr.
Smith, you did not check off that little box on page 17. You did not
dot that I or cross that t. You are not covered.
We all know the intent was to cover it. We all know the insurance
company was happy to take the premiums even without that dotted I or
crossed t or checked box when the family was healthy and money was
coming in. But now all of a sudden they say bye-bye. This bill does not
allow that to happen.
The kinds of rescission I talked about are banned. What are we
saying, not just to the families who have experienced this but to every
American family with insurance who worries about this? What are we
saying to them? Again, you have nothing in its place because you are
repealing, not replacing, even though people said early on that is not
what they are doing.
I have one more point before I conclude. We are willing to work with
you. The Stabenow amendment on the floor of the Senate shows that. I
would have drafted it a different way and there will be a Levin
amendment that I would prefer. But either way we are going to address
the 1099 issue. Many people on your side of the aisle, many people on
our side recognize that was a mistake. Not every bill is perfect. We
are not digging in and saying we have to have the bill exactly as
written and exactly as drafted. But you are doing the inverse--you are
saying we have to have no part of this bill because if you wanted to
retain parts of it you would have had an amendment on the floor saying
take these parts out and keep these parts in. But you are not. Why?
Your guess is as good as mine. But it is a lot easier to tear down than
create, as we learned when we did the health care bill. But you have an
obligation, unless you believe there should not be a health care system
or we ought to go back to the system without any changes in the law
that we have, which nobody liked. It is not fair.
In conclusion, No. 1, this bill reduces the deficit. The repeal
increases the deficit and there is no money there to make up for those
funds that the bill would bring in by cost cutting and by
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fees. No. 2, there are lots of good things in the bill that probably my
colleagues would support but they get rid of them with no replacement--
nothing. Nothing for the seniors, nothing for the 21- to 26-year-olds,
nothing for the people who are treated poorly by their insurance
companies. And, No. 3, we want to work with you. There are some changes
we could work together on in the bill, not only 1099 but walking
farther down the road of reducing the inefficiencies in the system, the
high cost, the waste, by still preserving good care for the people who
get it. That is something that would lend itself, particularly in these
times of high deficits, to bipartisan support and working together.
Today, simple repeal, again, it may feed some red meat to the
minority in this country. It is a small minority, if you believe the
polling, who say repeal it. But the responsible job of a legislator,
whether you agree with this bill or disagree with this bill, is not to
repeal but to improve. That is not happening today.
I yield the floor.
The PRESIDING OFFICER. The Senator from Alabama.
Mr. SESSIONS. Mr. President, I rise in strong and vehement support of
the amendment of Senator McConnell to repeal the health care reform law
as now constituted, and I will support replacing it with reforms that
truly provide Americans with access to quality, affordable health care,
reduce skyrocketing health care costs, and put our Nation on a more
sustainable fiscal path. These good goals can be achieved. But this
current bill does not do it.
I am pleased to see my colleague say he would accept some amendments,
but the Johanns amendment he referenced was voted on twice last year.
When the Democrats held a significant majority in this body they voted
it down. After seven new Members have been added, many of them elected
on a promise to repeal this bill--virtually everyone on the promise to
repeal this bill--we now have agreement to change the 1099 reporting
requirements, which is about one-thousandth of 1 percent of what is
significant about this legislation. Indeed, if Senator Scott Brown had
been elected a month or so sooner, the bill would not have been passed
on December 24, the day before Christmas.
The truth is, the American people have never supported this bill.
Polling numbers show they still do not support this bill. The
Democratic health care legislation was sold as a package that would
reduce insurance premiums by $2,500 dollars per family. We were told
that repeatedly. It was also supposed to reduce the Federal deficit,
and immediately create 400,000 new jobs.
Sadly, none of these promises were met. They were all false. The
claims were attacked on this floor by sophisticated people who pointed
out how these matters were not going to be achieved, and they have not
been. They were false then, and they are false now.
Instead, the new health care law will cause health care spending to
rise over the next decade. Americans will see dramatic increases in
their premiums. That is a fact. The Federal deficit will increase by an
additional $700 billion. This bill does not reduce the deficit, and the
law's expensive mandates, penalties, and tax hikes will lead to job
losses and layoffs that will damage our economy. The last thing we need
to do now is to have employers lay off people because of surging health
care costs, as is happening. Talk to small businesses in your community
to confirm this.
As our Nation's reckless fiscal policy and surging debt bring us ever
closer to a tipping point--a debt crisis that could substantially
damage our country, as it has others around the world--respected
economists have stressed the need for Congress to reduce Federal
spending and contain mounting health care cost. But rather than tackle
these problems that threaten the long-term stability of our Nation, the
new health care law exacerbates our fiscal crisis by creating a new,
open-ended entitlement, a monumental new entitlement program and by
introducing $2.6 trillion in new spending. Tell me how we can spend
$2.6 trillion and not increase our country's debt.
Entitlements today are hammering our budget. They are surging our
deficit. Entitlements are dangerous things. The last thing we need to
do is create a new entitlement program that is not going to have
restrained spending. According to the Congressional Budget Office, our
official analysts appointed by the Democratic majority, says that the
health care law will cause insurance premiums in the individual market
to soar by 10 percent to 13 percent; for American families, translating
into a $2,100 increase in their costs for purchasing health care
coverage by 2016. That is huge.
Another $2,100? That is a stunning development, and it is the exact
opposite of the promises for the bill. CBO determined that. Total
health care spending in the United States consumes already 17.3 percent
of GDP, and we have felt that was too high. It is the largest of any
industrialized nation in the world. But under this new law, the
national health care spending will approach 20 percent of GDP by the
end of this decade.
Sadly, many supporters of the health care law continue to perpetuate
the myth that repealing this law would increase the deficit. My friend,
Senator Schumer, said: Repeal the law, and the deficit will go up. A
thorough examination of the law pulls back the curtains and exposes the
deceptive budget gimmicks to reveal its true cost.
First, our Democratic colleagues double counted $398 billion in
Medicare costs and taxes, $29 billion in Social Security taxes, $70
billion in new long-term health care premiums to pay for the new health
care spending--all double counted money. It is the largest false
accounting scheme, I suppose, in the history of the world.
Think I am exaggerating? December 23--the night before this health
care bill was finally passed 60 to 40, 60 Democrats, 40 Republicans--I
called the Congressional Budget Office and Dr. Elmendorf, selected by
our Democratic colleagues to be the Budget Director. This is what he
said: The key point is, savings to the HI trust fund--that is the
hospital insurance trust fund of Medicare--under the health care bill
would be received by the government only once, so they cannot be set
aside to pay for future Medicare spending and, at the same time, pay
for current spending on the other parts of the legislation or on other
programs.
This bill was cutting Medicare benefits and raising Medicare taxes.
They did not use the money to strengthen Medicare, which is heading to
insolvency. They took the money and spent it on a new program.
Actually, they borrowed the money from Medicare. But it was not the
Treasury's money to spend on new programs.
The way it was written, the CBO score double counted the money. It is
this money that they are counting to say this bill actually creates a
surplus. Without this money, there is no surplus.
Since Medicare is going into deficit, they are going to call their
debt instruments, their bonds from the Treasury as they go into
deficit. By the way, the U.S. Treasury pays Medicare interest on the
money they borrowed from them to start this new program. Soon that
money is going to be gone. We are going to have to borrow money on the
open market to fund this new entitlement, and the new entitlement is
going to cost far more than is currently estimated.
Over the 10-year budget window, the Congressional Budget Office
reports point out how the law was doctored to start certain revenue
enhancements, taxes, and so forth now, but only starting the
expenditure programs in 2014. Why is that important? Well, they got a
score from CBO of what it would cost over 10 years. So you get income
for 10 years and you get expenditures for 6. This plus the double
counting of the money and several other gimmicks might look pretty
good, which is how they say this is creating a surplus. But it is not a
surplus.
As the ranking member on the Budget Committee, I am stunned by how
difficult and how challenging our current financial situation is. We
have to do something about it. We need the President to help us and
lead, but he is not, so it looks like Congress may have to tackle it.
The former Director of the CBO, Douglas Holtz-Eakin, an economist who
understands budget gimmicks and has seen them for many years, cowrote
an article in the Wall Street Journal in January that eliminates any
confusion about the law's impact. I am disappointed that Members of our
Senate are still coming down here to suggest that repeal of this law is
going to adversely impact our deficit. I am stunned to see this
continue to be repeated.
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This is what Dr. Holtz-Eakin, a highly respected individual, said in
the Wall Street Journal in January. The article is entitled, ``Health
Care Repeal Won't Add to the Deficit.''
He said this:
Repeal is a logical first step towards restoring fiscal
sanity.
Fiscal sanity. He goes on:
How then does the Affordable Care Act magically convert $1
trillion in new spending into painless deficit reduction? It
is all about budget gimmicks, deceptive accounting, and
implausible assumptions used to create the false impression
of fiscal discipline. Repeal is not a budget buster, keeping
the Affordable Care Act is.
This Dr. Douglas Holtz-Eakin, former Director of the Congressional
Budget Office. There is no question about it. That is a stunning thing.
A poll by the Kaiser Foundation and Harvard University released last
week revealed that the American people are seeing through these ploys.
They have heard these talks before, and they are not buying it. Sixty
percent of the country believes the health care law will increase the
deficit over the next 10 years, while only 11 percent think it will
lower the deficit.
So, colleagues, give us a break, would you? The American people are
not going to buy this argument. I wish it would not be repeated. But
the President continues to say it himself. Clearly, the American
people, once again, show they are wiser than their government leaders
in many instances.
The final point I would like to make about the health care law is its
debilitating impact on jobs. The expensive mandates and penalties
included in the health care law, coupled with rising costs of insurance
facing families and businesses, are costing us jobs right now, and it
will continue to do so in the future.
I will just add, I had meetings with small business groups in Phenix
City, AL, and Jasper, AL, with 10 or 15 individuals. Every one of them
told me, without question, this health care law would cause them to
reduce their employment. We do not need to be reducing employment; we
need to be increasing employment.
This bill is a job killer. It is indisputable. Over 6,000 pages of
regulations have been written. Economic estimates indicate that
repealing the law that threatens our economic recovery would save
700,000 jobs. It is imperative that Congress repeals this law. Yes, we
need to start and continue to work on things we already agreed on, such
as preexisting conditions, interstate competition, and other things
that we all agreed on and could agree on to make health care better.
That is not the massive Federal entitlement program that funded by
dubious gimmicks imposed on the American people against their will and
damaging to the American economy.
We cannot allow this. It will be repealed, in my view. I know my time
is up. I will just conclude by saying, we had a new election. A lot of
people took that issue to the American people. I think their voice was
clear. The American people are not happy with Congress, which did not
listen to them and passed the bill against the public's wishes. They
expect Congress to reconsider it, eliminate it and start over with new
legislation.
Their message is clear, and that is what we need to do. I urge my
colleagues to support Senator McConnell's amendment.
I yield the floor.
The PRESIDING OFFICER. The Senator from Vermont.
Mr. SANDERS. Mr. President, it is very hard for me to understand how
anyone could be voting to repeal the entire health care bill. Because
when you do that, among other things, what you are saying is that we
will continue the odious practice by insurance companies of denying
health care to people who have preexisting conditions.
For 8 years under President Bush, more and more people lost their
health insurance, the cost of health care soared, and our Republican
friends had virtually nothing to say on health care.
Now that a bill has been passed, which I am the first to agree is not
the best bill we could have passed--and I will tell you why. It has its
share of problems which should be remedied. But to say right now, when
50 million Americans have no health insurance, when States all over
this country are wrestling with huge budget deficits, which no doubt
will result in millions more being thrown off health insurance, to say
we should retreat to where we were is beyond comprehension.
Second of all, for my Republican friends to say let's repeal health
care, there are millions of families who now are beginning to be able
to include within their own health care plans their sons and daughters,
up to the age of 26. Goodbye to that. Furthermore, in a nation which
ends up spending more on health care, almost double per person,
compared to any other nation on Earth, we have put in the health care
reform bill billions of dollars for disease prevention.
We are, as a nation, very weak in terms of trying to keep people
healthy, trying to keep them out of the hospital. We spend a fortune on
people after they are sick. In this bill, we have made some significant
steps forward in terms of disease prevention, wellness, which is very
cost effective in terms of health care dollars, not to mention human
pain and suffering.
In that regard, I am proud to have worked with a number of other
Senators in doubling, in that bill, the number of community health
centers in America, which are providing the most cost-effective primary
health care that is provided in this country, keeping people out of
emergency rooms, keeping people out of hospitals, giving them access to
primary health care, dental care, low-cost prescription drugs, and
mental health counseling.
In the midst of an extraordinary crisis in terms of primary health
care, where everybody recognizes we do not have enough primary health
care doctors or nurses or technicians, we tripled funding for the
National Health Service Corps, and it is already working effectively in
getting doctors and dentists and nurses and other practitioners into
underserved areas. All that would be undone. I think that makes no
sense whatsoever.
Now, to my mind, what we have to do is not to repeal this bill but to
make it a better bill. I will give you one very specific suggestion
that I have worked on now for over 1 year. Senator Wyden has worked on
this, others have worked on it. That is to say, that if a State in this
country, the State of Vermont, the State of Alaska, any other State,
can maintain the high standards for quality health care and coverage
that the national health care bill did, then that State should be given
significant flexibility to perhaps do it in their own way and do it
more cost effectively.
I should tell you that in the State of Vermont, our new Governor is a
supporter of a Medicare-for-all single-payer program. There are other
States that want to move in a different direction, maintaining high
standards but doing it perhaps in a different way than has been
proposed by the national legislation.
In my view, they should have that right. And if Vermont is effective
in doing what I believe we could--providing quality health care to all
of our people in a cost-effective way--I suspect other States around
the country can learn from Vermont's experience. I think that is a
positive step forward.
The beauty of our Federalist system: 50 States--every State has a
good idea. I think if we maintain standards that are high and give
States flexibility, this can improve the health care reform bill we
passed last year. But killing this whole bill makes no sense to me at
all.
Social Security
Mr. President, I also want to say a word on an issue which is getting
more and more attention; that is, Social Security.
In my view, Social Security has proven itself to be the most
successful social program in American history. Over a 75-year period--
and this is really extraordinary; we take it for granted, but it is an
extraordinary success story--in good times and in bad times, Social
Security has paid out every nickel owed to every eligible American. And
it does that with a minimal administrative cost.
Despite its strong record of success over the last 75 years, Social
Security now faces unprecedented attacks from Wall Street, from many of
my Republican friends, and from some Democrats. I have to be very
clear: If the American people are not prepared to stand up and fight
back, we could begin to see the dismantling of Social Security this
very year.
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Let me cite the facts with regard to Social Security. I know when we
watch TV tonight there will be some guy up there saying: Social
Security has gone bankrupt. Social Security is collapsing. That is
absolutely untrue. There has been a significant number of misstatements
regarding Social Security. Here are the facts that nobody denies.
No. 1, according to the latest report of the Social Security
Administration, Social Security will be able to pay out 100 percent of
all benefits owed to every eligible American for the next 26 years.
Now, you tell me how a system is going bankrupt--we have a lot of
problems in this government, and our country faces enormous problems,
but when you can pay out every benefit owed to every eligible American
for the next 26 years, do not tell me this is a program in crisis or
going bankrupt. After 2037, Social Security will be able to pay out 78
percent of promised benefits. Do we have to deal with that over the
next 26 years? Yes, we do. But it is not a crisis, and this Senator
will do everything he can to oppose any effort toward privatization,
any effort to raise the retirement age, any effort to lower benefits.
Second point. Everybody is concerned about the deficit crisis we
face--a $14 trillion national debt. How much has Social Security
contributed to the deficit and the national debt? How much? Well, not
one penny. Not one-half a penny. Social Security is funded by the
payroll tax. Social Security has a $2.6 trillion surplus. That surplus
will go up. To attack Social Security because of the deficit crisis is
grossly unfair.
Do you want to know why the deficit went up? We are in the middle of
a recession. We fought two wars in Afghanistan and Iraq and forgot to
pay for those wars. We gave hundreds of billions of dollars in tax
breaks to the wealthy; bailed out Wall Street; Medicare Part D
prescription drug program, written by the insurance companies--all
unfunded. Those are the reasons you have a deficit. Social Security has
nothing to do with it.
So I would suggest that in the midst of all of this financial
instability that is out there, with the middle class shrinking and
poverty increasing and people really worried about their retirement
years, one of the most significant things we as a Congress can do is
stand up and say: We are there. We are going to protect Social
Security. We are not going to cut it. And we are going to make it
stronger so that, while it has done a great job for the last 75 years,
it will continue to do a good job for the next 75 years.
With that, Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Louisiana.
Mr. VITTER. Mr. President, I rise today in strong support of the
McConnell amendment No. 13 that would completely repeal President
Obama's, in my view, unconstitutional health care bill. Of course, I
was an active participant in the debate last Congress about ObamaCare
and fought that tooth and nail. The day after it passed into law, I
introduced a freestanding measure to repeal it completely. The first
day of this new Congress that I could file bills, I reintroduced that
measure. Of course, for all those reasons, I certainly support this
amendment that accomplishes that important goal.
Let me begin by responding to the suggestions of my distinguished
colleague from Vermont. Everybody who wants to repeal this law,
including me--we do not want to do away with the idea that you should
not be shoved off insurance because of preexisting conditions, that you
should not have portability, you should not be able to meet those
obligations. We do not think that at all. We are, however, for complete
repeal for a very simple reason.
What is wrong with this bill, what is wrong with ObamaCare is not one
detail here and one comma there, it is not at the periphery of the
plan; it is at the heart of the plan, it is the essentials, it is the
core of the plan. We can and should and must pass significant reforms
such as protection for individuals with preexisting conditions. That is
why we have introduced those measures. We have advocated those measures
in a targeted way. That does not mean we can or should or must preserve
the whole of ObamaCare, which has significant problems at the core of
that gargantuan bill.
Let me mention four of those core problems from my point of view.
The first is--maybe most fundamental, most basic--there are important
elements at the core of ObamaCare that are flatout unconstitutional.
Even if they were not unconstitutional, they would be unwise because
they are a dramatic expansion of the power and role and authority of
the Federal Government.
The most obvious is an absolute mandate in the bill, a mandate from
your Federal Government that every man, woman, and child in the United
States must buy health insurance.
This is unprecedented. There has never been a mandate like that from
the Federal Government or any level of government. There has never been
this forced purchasing of a product in the private marketplace.
Some people bring up the comparison with car insurance, but that is
not a close comparison at all because at the State level that is not a
forced mandate; that is simply saying: If you want the right, the
privilege of driving a car, which is not some constitutionally
guaranteed right, then part of the deal is you have to cover the
damages from any accident. So that is not a good comparison.
So this absolute mandate that every man, woman, and child in the
United States go out and purchase health insurance, purchase a product
in the private marketplace, is unprecedented, and for that reason it is
unconstitutional. It is an unprecedented expansion of the power and
role and authority of the Federal Government.
In the last few days, there have been hearings--quite late to the
hour, but there have been hearings in the Senate in the committees
about the constitutionality or unconstitutionality of ObamaCare. Of
course, this central question came up. I found the response of some of
the witnesses at the hearings who favored ObamaCare or advocate for
ObamaCare pretty startling on this point. One Senator in the committee
asked them: Well, if we can mandate constitutionally that every
American man, woman, and child buy health insurance, why can't we pass
a law that says obesity is a real problem in this country--which it
is--and therefore we are going to mandate that every man, woman, and
child in America eat certain vegetables and certain healthy foods every
day? Do you know what the response was from this advocate of ObamaCare?
Well, I don't think you can mandate that they eat the food; you can
only mandate that they buy the food. Great. Very reassuring. To me,
that is not an argument for the constitutionality of ObamaCare; that is
a clear argument for the unconstitutionality and danger of the
ObamaCare Federal power overreach.
There are many other aspects of ObamaCare which also pose serious
constitutional problems. My point is, these are big problems, and they
are not minor details which we can tweak with amendments. They go to
the heart of this gargantuan bill.
Similarly is the dramatic expansion of government and the cost of
that expansion. Instead of controlling and lowering health care costs,
ObamaCare is expanding government and expanding health care costs. In
fact, the Senate Budget Committee estimates that the bill will cost
$2.6 trillion for the first 10 years of full implementation. All of
that new spending does not lower health care costs, and there are
multiple sources affirming that. Yet President Obama continues to claim
that the act will ``slow these rising costs.'' Maybe he did not see
that CMS's Chief Actuary, Richard Foster, said that overall national
health expenditures will increase by a total of $311 billion over the
next 10 years under the law. Now, when the CMS Actuary was asked
directly if President Obama's health care bill would hold down
unsustainable medical costs just last week, that Actuary replied: ``I
would say false.''
Last year, CBO also confirmed our concerns about the bill's inability
to contain costs, stating, ``In CBO's judgment, the health legislation
enacted earlier this year does not substantially diminish that
pressure.''
In addition to increased costs for the government and present and
future taxpayers, health insurance premiums will increase for Americans
and their
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families. In fact, the CBO estimated that premiums will increase by
$2,100 even though at least candidate Obama promised to lower premiums
by $2,500 per family.
So that big expansion of government and cost and health care costs,
including taxes and health care premiums, is another big problem.
Again, this is not a minor detail which we can fix with a perfecting
amendment, with a few tweaks to the bill. This goes to the core of the
entire plan.
Another fundamental issue which goes to the core of the entire plan
is the fact--and I think it is a well-established fact--that the
ObamaCare plan will cost us not just money, not just increased taxes,
not just increased health insurance premiums, it will cost us jobs.
That should always be worrisome, but it should be particularly
worrisome as we stand here today and debate this in a horrible economy,
as we are trying to come out of the worst recession since the Great
Depression of the 1930s. Again, this is not just any period of time;
this is a time of prolonged historic unemployment.
This bill costs us jobs, and this bill absolutely decimates job
creation. The bill taxes jobs and places more burdens on job creators.
For instance, the National Federation of Independent Business,
representing thousands of American small businesses, including many in
Louisiana, my home State, said:
If new taxes, new mandates and new government programs in
PPACA--
That is the ObamaCare bill--
remain intact the law will stifle the ability to hire, grow
and invest. . . .
In addition to the often-discussed 1099 paperwork nightmare for small
businesses, the bill also includes a pay-or-play mandate on job
creators. This complicated new tax penalty imposes a tax on businesses
with more than 50 workers if they do not offer coverage or do offer
coverage but workers elect to decline that benefit. Yet again, this is
a fundamental problem with the bill that goes to the heart of the bill,
not the periphery. This aspect of the bill will have many dire
consequences. First, because the $2,000 penalty for not offering
insurance is less than the $6,100 average employer benefit
contribution, businesses are actually given an incentive to drop
coverage. So there is a concrete money incentive, a major money
incentive for businesses to drop coverage and actually push workers off
good coverage many have right now.
Second, businesses that are able to grow and hire more workers may
choose not to create jobs and to stay under the 50-employee threshold
to avoid all of these disincentives and difficulties.
Because of all this, the nonpartisan Congressional Budget Office
concluded that the bill ``will encourage some people to work fewer
hours or to withdraw from the labor market.'' It also said: On net, it
will reduce the amount of labor used in the economy. Is that what we
want to encourage in any economy but particularly in a horribly down
economy? We are trying to come out of the worst recession since the
Great Depression. Do we want to reduce labor opportunity in our
economy?
These are stunning conclusions that so many of us warned against
during the debate--conclusions the majority of Americans feared. Taxing
American job creators and sticking businesses with more government
compliance requirements and costs is absolutely the wrong approach,
particularly in a down economy.
Finally, there is another core concern which I share with so many
others in this body that again goes to the heart of the bill. It is not
a minor debate. It is not something we can solve with a perfecting
amendment. It is not at the periphery. It is not changing a comma,
changing a sentence. It is at the heart of the bill; that is, the bill
contains at its heart over $500 billion in Medicare cuts--yes, over
$\1/2\ trillion in cuts to Medicare. These cuts aren't invested back
into Medicare. They don't help Medicare stay solvent. They don't help
Medicare survive or stay solvent longer. They don't help fix the
looming Medicare challenge. They are stolen from Medicare to pay for
brandnew stuff for other people in ObamaCare.
These Medicare cuts directly impact seniors, and one study shows that
the massive cuts to Medicare Advantage will hit Louisiana seniors
particularly hard. A study by the Heritage Foundation shows that
Louisiana seniors enrolled in Medicare Advantage plans lose more than
any other State in the Nation because of the Obama health bill. The
report says that projected enrollment in Medicare Advantage will drop
by over 125,000 Louisianians--62 percent--and benefits will be cut by
$5,000 per beneficiary.
So this bill takes away benefits and choices for seniors not to fix
Medicare, not to preserve Medicare, not to preserve its solvency for
longer, but steals it from Medicare, steals it from seniors for
brandnew purposes for other folks. This directly contradicts the
President's promise that ``if you like what you have, you can keep
it.'' No, you can't, Mr. President. Thousands of Louisiana seniors
can't. In fact, CMS's Chief Actuary also verified that the promise will
be broken, confirming that Americans may lose their current health care
coverage regardless of whether or not they want to keep it.
So I respond directly to my friend and colleague from Vermont by
saying that we want full repeal of ObamaCare for a very simple reason:
The big problems with the bill, the big problems with the plan aren't
at the margin, they are at the core, and the big problems can't be
fixed with a perfecting amendment, with changing a comma, changing
punctuation, revising 1 or 2 or 5 or 10 sentences. The big problems are
at the core of the plan, starting with a mandate from the Federal
Government--unprecedented--that every man, woman, and child in America
needs to go into the market and buy a particular product.
That is why we demand repeal, that is why we will continue to pursue
repeal until it happens, and that is why we will replace this huge
burdensome bill with targeted reforms such as protecting folks with
preexisting conditions, such as reimportation, such as generics reform
and other measures to reduce prescription drug prices, such as allowing
American citizens to shop for health insurance across State lines and
to pool together through their small businesses, through other means,
through association health plans.
Thank you, Madam President. With that, I urge all of my colleagues to
come together. Let's repeal this very problematic plan, and let's start
anew with focused, targeted reforms that the American people have been
asking for.
Madam President, I yield the floor, and I note the absence of a
quorum.
The PRESIDING OFFICER (Mrs. Hagan). The clerk will call the roll.
The bill clerk proceeded to call the roll.
The PRESIDING OFFICER. The Senator from Mississippi.
Mr. WICKER. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WICKER. Madam President, I rise today in support of the McConnell
amendment to the FAA reauthorization bill.
What we have this afternoon actually is an opportunity to show the
American people that we are listening to them. The American people want
the ObamaCare law--the affordable health care law, as it is known--to
be repealed and replaced with something less expensive, with something
workable. Polls show this, the individuals with whom we speak when we
go home tell us this, and this vote will be an opportunity for us to
show them we are listening.
I have heard some of my colleagues come to the floor this week and
suggest that this massive, 2,000-page, tax-increasing, job-killing bill
is, in fact, just what we need. I would suggest there are a number of
facts that indicate otherwise. The other side would have us believe
that without this health care law, this country is going to fall off
the tracks and the world will virtually come to an end. They try to
cite one or two popular proposals that are in this law, which, of
course, could be enacted after repeal practically by unanimous consent,
and ignore the fatal flaws in the law.
The former Speaker of the House, Nancy Pelosi, during the
consideration of this act in the House and Senate, famously told a
grassroots group that had come to Washington, DC: We need to hurry up
and pass the bill so you can find out what is in it. Well, indeed,
since the passage and signing of
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the law of ObamaCare, every day the American people are finding out
something new that is in the bill that they don't like. As a matter of
fact, it turns out that Members of the House and Senate who voted for
ObamaCare also did not know precisely what was in the bill and
certainly did not anticipate the ramifications of this massive, ill-
advised law.
Under the new law, it is absolutely a fact, and we know this, that
Medicare will face over $500 billion in cuts, and senior citizens have
a right to be concerned. Future senior citizens have a right to be
concerned about these cuts. They include $155 billion from hospitals,
$202 billion from Medicare Advantage, $15 billion from nursing homes,
$40 billion from home health agencies, and $7 billion from hospice.
Cuts from these Federal expenditures in Medicare are to pay for the
new ObamaCare legislation.
Everyone agrees that Medicare needs to be made more solvent, and we
need to work on Medicare. But these reckless cuts will only make
Medicare's problems worse.
Another thing Americans have found out about this affordable health
care law which is being implemented even as we speak is that the law
falls short of the President's goal of controlling runaway costs. In
fact, it raises projected spending.
Last week, in his State of the Union Address, President Obama said
the health insurance law we passed last year will slow these rising
costs. This is simply not true. To support my assertion it is not true,
I cite the President's own Actuary. CMS reports that, in fact, spending
will be increased by about 1 percent over what it would have been over
10 years. That increase could get bigger, of course, the report points
out, since the Medicare cuts I have pointed out may be unrealistic and
politically unsustainable, according to the report. CMS said, overall,
national health expenditures under the health reform act would increase
by a total of $311 billion and that health expenditures will be 21
percent of the gross domestic product by 2019.
But it is not just the government bean counters who are worried. Here
is what the National Federation of Independent Business said:
Small businessowners everywhere are rightfully concerned
that the unconstitutional new mandates, countless rules and
new taxes in the health care law will devastate their
business and their ability to create jobs.
That is the National Federation of Independent Business. The National
Association of Manufacturers says that manufacturers remain adamantly
opposed to the employer mandates and to the Medicare hospital insurance
tax increases. These employers who are faced with incorporating the
first round of health care changes are grappling and having difficulty
with how to comply with the long list of new rules.
These are not scare tactics. These are not unwarranted fears by a
confused public. These are people who work with health care every day
and are telling us that this Congress has made a mistake. In fact,
there are already real consequences of this health care reform law.
Abbott Laboratories said it is cutting about 1,900 jobs. It is just a
fact. The job cuts come ``in response to changes in the health care
industry, including U.S. health care reform and the challenging
regulatory environment.'' That is simply a fact. It is not conjecture.
Blue Shield California Health Insurer recently stunned individual
policyholders with a huge rate increase, effective March 1, seeking
cumulative hikes of as much as 59 percent in premiums for tens of
thousands of their customers. That San Francisco-based Blue Shield said
the increases were the result of fast-rising health care costs and
other expenses relating to the new health care law.
Again, just a fact, Madam President. It is also an absolute certainty
that State taxes are going to go up, and they are going to go up big
time unless we repeal this health reform law.
In my State of Mississippi, the legislation will cost the State $1.7
billion over 10 years, including $443 million in year 10 alone. From
fiscal year 2014 to fiscal year 2020, the massive expansion of Medicaid
will cost Mississippi taxpayers $225 million to $250 million extra each
year. Our Governor--one of the staunchest opponents of tax hikes I have
ever heard of--has stated that this law will certainly force the State
of Mississippi to increase its taxes unless it is repealed. Again,
these costs are simply facts. They result from the mandate.
Madam President, there is also bipartisan opposition to this law. We
didn't see much bipartisan support for its repeal in the other body,
and I was disappointed by that. But when you get off of Capitol Hill
and out to individuals, it is not a Republican or Democratic issue.
There is a bipartisan American opposition to this law.
I have repeatedly quoted former Governor Phil Bredesen, a Democrat of
Tennessee, someone who ran as a Democrat in his State successfully
twice and ran as the standard bearer for his party three times--a loyal
Democrat who, of course, called this law the ``mother of all unfunded
mandates.''
After the law was enacted, he wrote an op-ed in the Wall Street
Journal on October 21, 2010. I ask unanimous consent that it be printed
in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the Wall Street Journal, Oct. 21, 2010]
ObamaCare's Incentive To Drop Insurance
(By Philip Bredesen)
One of the principles of game theory is that you should
view the game through your opponent's eyes, not just your
own.
This past spring, the Patient Protection and Affordable
Care Act (President Obama's health reform) created a system
of extensive federal subsidies for the purchase of health
insurance through new organizations called ``exchanges.'' The
details of these subsidies were painstakingly worked out by
members of my own political party to reflect their values:
They decided who was to benefit from the subsidies and what
was to be purchased with them. They paid a lot of attention
to their own strategies, but what I believe they failed to
consider properly were the possible strategies of others.
Our federal deficit is already at unsustainable levels, and
most Americans understand that we can ill afford another
entitlement program that adds substantially to it. But our
recent health reform has created a situation where there are
strong economic incentives for employers to drop health
coverage altogether. The consequence will be to drive many
more people than projected--and with them, much greater
cost--into the reform's federally subsidized system. This
will happen because the subsidies that become available to
people purchasing insurance through exchanges are
extraordinarily attractive.
In 2014, when these exchanges come into operation, a
typical family of four with an annual income of $90,000 and a
45-year-old policy holder qualifies for a federal subsidy of
40% of their health-insurance cost. For that same family with
an income of $50,000 (close to the median family income in
America), the subsidy is 76% of the cost.
One implication of the magnitude of these subsidies seems
clear: For a person starting a business in 2014, it will be
logical and responsible simply to plan from the outset never
to offer health benefits. Employees, thanks to the exchanges,
can easily purchase excellent, fairly priced insurance,
without pre-existing condition limitations, through the
exchanges. As it grows, the business can avoid a great deal
of cost because the federal government will now pay much of
what the business would have incurred for its share of health
insurance. The small business tax credits included in health
reform are limited and short-term, and the eventual penalty
for not providing coverage, of $2,000 per employee, is still
far less than the cost of insurance it replaces.
For an entrepreneur wanting a lean, employee-oriented
company, it's a natural position to take: ``We don't provide
company housing, we don't provide company cars, we don't
provide company insurance. Our approach is to put your
compensation in your paycheck and let you decide how to
spend it.''
But while health reform may alter the landscape for small
business in unexpected ways, it also opens the door to what
is a potentially far larger effect on the Treasury.
The authors of health reform primarily targeted the
uninsured and those now buying expensive individual policies.
But there's a very large third group that can also enter and
that may have been grossly underestimated: the 170 million
Americans who currently have employer-sponsored group
insurance. Because of the magnitude of the new subsidies
created by Congress, the economics become compelling for many
employers to simply drop coverage and help their employees
obtain replacement coverage through an exchange.
Let's do a thought experiment. We'll use my own state of
Tennessee and our state employees for our data. The year is
2014 and the Affordable Care Act is now in full operation.
We're a large employer, with about 40,000 direct employees
who participate in our health plan. In our thought
experiment, let's exit the health-benefits business this year
and help our employees use an exchange to purchase their own.
First of all, we need to keep our employees financially
whole. With our current plan,
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they contribute 20% of the total cost of their health
insurance, and that contribution in 2014 will total about $86
million. If all these employees now buy their insurance
through an exchange, that personal share will increase by
another $38 million. We'll adjust our employees' compensation
in some rough fashion so that no employee is paying more for
insurance as a result of our action. Taking into account the
new taxes that would be incurred, the change in employee
eligibility for subsidies, and allowing for inefficiency in
how we distribute this new compensation, we'll triple our
budget for this to $114 million.
Now that we've protected our employees, we'll also have to
pay a federal penalty of $2,000 for each employee because we
no longer offer health insurance; that's another $86 million.
The total state cost is now about $200 million.
But if we keep our existing insurance plan, our cost will
be $346 million. We can reduce our annual costs by over $146
million using the legislated mechanics of health reform to
transfer them to the federal government.
That's just for our core employees. We also have 30,000
retirees under the age of 65, 128,000 employees in our local
school systems, and 110,000 employees in local government,
all of which presents strategies even more economically
attractive than the thought experiment we just performed.
Local governments will find eliminating all coverage
particularly attractive, as many of them are small and will
thus incur minor or no penalties; many have health plans that
will not meet the minimum benefit threshold, and so they'll
see a substantial and unavoidable increase in cost if they
continue providing benefits under the new federal rules.
Our thought experiment shows how the economics of dropping
existing coverage is about to become very attractive to many
employers, both public and private. By 2014, there will be a
mini-industry of consultants knocking on employers' doors to
explain the new opportunity. And in the years after 2014, the
economics just keep getting better.
The consequence of these generous subsidies will be that
America's health reform may well drive many more people than
projected out of employer-sponsored insurance and into the
heavily subsidized federal system. Perhaps this is a
miscalculation by the Congress, perhaps not. One principle of
game theory is to think like your opponent; another is that
there's always a larger game.
Mr. WICKER. Madam President, among other things, Governor Bredesen,
who was still Governor at the time, said:
Our Federal deficit is already at an unsustainable level,
and most Americans understand that we can ill afford another
entitlement program that adds substantially to it. But our
recent health reform has created a situation where there are
strong economic incentives for employers to drop health
coverage altogether. The consequence will be to drive many
more people than projected--and with them, much greater
cost--into the reform's federally subsidized system.
The Democratic-elected Governor of Tennessee criticized this act. He
pointed out other facts that are wrong. In his subsequent book on the
subject, Phil Bredesen also criticizes the health care law, saying it
will cause deficits to go up, costs to continue increasing, employers
to drop coverage, State costs to increase, governments to grow, and
will make our current problems worse.
``Obamacare is not what the doctor ordered,'' according to Governor
Bredesen.
My time is limited. I could go on and on, and Members of the Senate
and House could and will go on and on as we face this issue, if we
don't win it today.
The facts are there. This is a terribly flawed piece of legislation.
Facts are stubborn. The consequences have already started to mount up.
Opposition is strong. Support for repeal is strong and bipartisan, and
for those reasons I will vote in favor of the McConnell amendment when
we consider it later today.
The PRESIDING OFFICER. The Senator from Illinois.
Mr. DURBIN. Madam President, I can't say with any certainty anything
about the critics of the government's affordable health care plan,
except one thing: Each of the critics on the Republican side of the
aisle of what they call government-administered health insurance--every
single Senate Republican critic is currently protecting his or her
family with government-administered health care. In other words, what
is good enough for their families should not be good enough for the
rest of America.
As a show of good faith, I think the Republican Senators should come
to the floor today and say: Not only are we going to vote for repeal of
health care reform, we are going to show our personal commitment by
walking away from the Federal Employees Health Benefits Program, a
government-administered health insurance program. I would admire them
so much if their actions as Senators reflected their speeches on the
floor. But they don't. They are denying to the rest of America what
every single Member of Congress has available today to protect their
families. That, to me, is indefensible.
A judge in Florida this week decided that this Affordable Health Care
Act was unconstitutional. Before we get carried away with that
decision, step back. This law has been challenged 16 times in Federal
courts. Twelve courts have dismissed the challenges on procedural
grounds, saying the person who filed the suit didn't have standing in
court. Four of the Federal courts decided it on the merits. Two of the
Federal courts decided it was a constitutional law, and two said it was
unconstitutional.
You say to yourself: Wow, two Federal district courts said this law
was unconstitutional. Aren't you worried? Well, I don't take anything
for granted, but I do understand a little bit of history. What other
laws in America were found unconstitutional by lower courts and then
constitutional by the Supreme Court? Anything significant? Social
Security was found unconstitutional; then the Supreme Court said, no,
it is constitutional. The Federal minimum wage law was found
unconstitutional by a lower court, and the Supreme Court said it was
constitutional. The Civil Rights Act of 1964 was found unconstitutional
by a lower court, and the Supreme Court said it was constitutional.
Let's not get carried away with lower court decisions that are
clearly split on this issue. We had a hearing in the Judiciary
Committee today that I chaired where we had constitutional experts from
across the United States. There was a lot of difference of opinion
between Democrats and Republicans. I think the case is clear and strong
that we have the power, under article I, section 8 of the
Constitution--the enumerated powers of Congress--to regulate commerce.
Is there anybody on the Republican side who will stand here and argue
that the health care industry, which represents 18 percent of the
economy of America, is not commerce? Of course it is. Then, of course,
we have the authority in that same section to pass laws necessary and
proper, to carry out the responsibilities and authority given us.
Here is what we are trying to do. We are trying to make sure
everybody in America has health insurance. We say to the 83 percent of
Americans who currently are insured: You don't have to worry about this
argument. You already have health insurance. For the 17 percent who are
uninsured, many of them are people who have preexisting conditions and
have been denied coverage or they can't afford it. Some are people who,
frankly, cannot afford coverage even if they don't have a preexisting
condition.
This law moves us to a point where more Americans will be covered
with health insurance. We say those who can afford health insurance,
and don't buy it, will pay a tax because of that decision. Is that
heartless? Is that a Federal mandate on people who want to be left
alone? If they were just being left alone, that is one thing, but human
experience teaches us that these people who want to go it alone--don't
bother me, I am on my own--will get sick someday. When they go to the
hospital, they will be treated. When they can't pay for their
treatment, do you know who will pay? All of the rest of us. Everybody
else paying health insurance premiums has to absorb the cost of those
who are freeloading on the system. It is not fair.
It used to be that conservative Republicans preached personal
responsibility. When we put personal responsibility in this law, all of
a sudden they don't like it. I think personal responsibility still
counts. I believe it is clearly constitutional to include it. I have
listened to some of the arguments about repealing this law. I heard the
Senator from Mississippi say how bipartisan the support is for it. I
would have liked to have asked him how he explains the fact that four
out of five people in America--80 percent of Americans--oppose repeal.
They don't think the law is perfect. Many say improve it if you can,
but 80 percent oppose repeal.
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The signature issue for the House Republicans, and now the Senate
Republicans, is the repeal of affordable health care. It would be
devastating if we did. The first thing you will notice, if you read the
amendment--three pages--filed by Senator McConnell, the Republican
leader, is that on the second page he manages to include the Statutory
Pay-As-You-Go Act of 2010, as passed and printed by the House of
Representatives. Unless you are a person who follows closely what is
going on around here, you may not know what that says.
What it says is that Senator McConnell wants us to ignore the fact
that repeal of the Health Care Act will add $230 billion to our
national deficit over the next 10 years and more than $1 trillion in
the decade after that. A party that comes to the floor every single day
telling us of their passionate determination to end our deficits and
address our debt with the McConnell amendment will add $230 billion to
our national deficit over 10 years and $1 trillion more in the next 10
years.
This is a budget buster amendment. This will add more to the deficit
in one fell swoop than any single thing we have done in Congress in the
time I have served. And it is being offered by the party of so-called
fiscal responsibility.
When we talk about premium increases currently taking place under
health insurance policies across America, I understand it. We have all
lived through it. We have seen it. Businesses see it all the time.
There is a provision in our Affordable Health Care Act which addresses
that issue that would be repealed by the McConnell amendment. The
provision is called medical loss ratio. It says a health insurance
company has to spend 80 to 85 percent of premium dollars on actual
health care. They cannot take it away in advertising, in administrative
costs, in salaries and bonuses for their CEOs.
One of the things that will happen if the Republicans have their way
and repeal health care is that health insurance companies will be
allowed to raise premiums at any level as quickly or as much as they
want without being held to this medical loss ratio.
That may not be the worst thing, though. Any person in America who
has been raised in a family where someone in the family suffers from
what is known as a preexisting condition knows that you always live in
fear that you will not have health insurance and fear that if you have
to go out and buy it on the open, public market, you will never be able
to afford it.
This law that Senator McConnell and the Republicans want to repeal
today says no health insurance company in America can discriminate
against anyone under the age of 18 who has a preexisting condition.
That is something any parent would appreciate. You never know if that
beautiful son or daughter of yours is going to have problems with
asthma, diabetes, cancer, or mental illness. And you certainly want
that child, that love of your life, to have health insurance coverage.
Senator McConnell and the Republicans want to repeal the protection
for families who have children with a preexisting condition. That is
fact. It is not as though they are offering exclusions and saying: No,
no, we will keep that. They eliminate the entire law with this 3-page
amendment. They eliminate the protections.
How about protections for those who get diagnosed with a serious
illness and health insurance companies cutting them off completely,
putting a cap on the amount of money they will spend to provide for
medical services and treatment, saying at some point they are going to
eliminate their policies altogether because they failed to make a
disclosure on the application form? It happens too often.
In my State, we sadly lead the Nation in what is called rescissions--
health care insurance companies that cancel coverage when people get
seriously ill. How would you like to be in that predicament? How would
you like to face a serious illness that keeps you awake at night
tossing and turning about whether you are going to live or die and then
fight the insurance company in daylight hours in the hopes they will
cover the prescriptions and treatment you need to stay alive?
That is a reality addressed by the Health Care Act, a reality that
will be repealed by Senator McConnell and the Republicans' efforts
today. Those are the real results of what they want to do. It is not
about who wins the political debate and has the largest cheering
section when it is over. It is about real life changes.
How about senior citizens under Medicare? Many of them struggle to
pay for prescription drugs. Even with the Medicare prescription drug
plan there is a gap in coverage called the doughnut hole. We start to
close that gap and say to seniors: If you have expensive prescription
drugs, we are going to make sure ultimately they are covered completely
from the first of the year to the end of the year. Now there is a gap
in the coverage.
The Republicans and Senator McConnell want to repeal that provision
of the Health Care Act which provides for seniors not only more
coverage for their prescription drugs, but also an opportunity for an
annual physical and the kind of preventive care they need to stay
healthy, strong, and independent in their homes for a longer period of
time. That is what Senator McConnell and the Republican Senators want
to do with the repeal of this law.
What about job creation? The Senator from Mississippi talked about
one company cutting some employees. I am not sure of the particulars in
that company, but one of the things we did in this law was to take a
look at tax subsidies to medical device and pharmaceutical companies,
if they were duplicative or overly generous, to make sure they got
closer to a reality of what a company needs in incentives to grow. It
is true some of those tax subsidies were eliminated and some of the
companies were not happy about it. The bottom line is we were trying to
make sure that health care is affordable. We cannot afford to provide
massive subsidies to profitable companies on an unlimited basis.
This bill the Republicans want to repeal will crack down on fraud in
Medicare and Medicaid. It will simplify paperwork for private insurers,
it invests in prevention, it creates a pathway for generic biologic
drugs, and tests new ways to pay health care providers to reward value
rather than volume.
If the law is repealed, we will have fewer jobs and higher costs for
families and businesses. The No. 1 complaint of Illinois small
businesses across our State is the cost of health insurance. If the
Republicans have their way and repeal this law we passed, the cost of
health insurance will grow, the cost to businesses will grow, the
number of employees will shrink.
A 1-percent or 1.5-percent growth in health care costs above the
rates under the new law will prevent employers from creating 2.5 to 4
million jobs over the next 10 years. Talk about a job destroyer.
The Republican repeal amendment does just that. Repeal means going
back to the same broken system we have had for so long with insurance
companies once again free to overcharge families and businesses to
protect their corporate profits and CEO bonuses; the same broken system
with workers seeing their paychecks shrink as more and more of their
hard-earned wages are deducted to cover skyrocketing premiums; the same
broken system with seniors being forced to shoulder the full cost of
prescription drugs in the doughnut hole; and the same broken system
with small businesses closing their doors and laying off workers
because they cannot afford the crushing cost of health insurance.
The Republican claim that this health care bill is a job killer is
just plain false. The economy has been gaining private sector jobs
since President Obama signed the bill a year ago after losing jobs for
a long period of time before. Since the President signed the bill, we
have created more than 1.1 million private sector jobs. By contrast, in
the 10 years before health reform was enacted, we lost 3.3 million
private sector jobs.
Average real incomes for Americans are back on the rise after years
of being stalled under the old health care system. Just this week, the
Commerce Department reported that average real disposable income has
risen 1.3 percent over the past year, after falling one-tenth of 1
percent in each of the previous 2 years.
I will close by saying that our hearing today before the Senate
Judiciary
[[Page S468]]
Committee on the constitutionality question makes it clear to me that
the Supreme Court, if it follows the clear precedents that have been
handed down for decades, if Supreme Court Justices who have spoken
eloquently and directly on the commerce clause will view this Health
Care Act in the same context, they will find it constitutional. Then
perhaps we can move on. Perhaps at that point the Republicans will stop
beating this drum on repealing health care, will join us in making it
an even stronger bill, and will focus on creating jobs instead of
killing jobs as this McConnell amendment would do.
I yield the floor.
The PRESIDING OFFICER. The Senator from Illinois.
Mr. KIRK. Madam President, I wish to talk about two topics today,
first on this health care bill and then on the situation in Egypt.
I rise today in support of the amendment to repeal the health care
law. We made a mistake last year in passing this law, and a large
majority of American people know it. In the face of the largest debt in
our history, it was the height of folly to create a new spending
program, offering subsidized health care to 30 million Americans. It is
a promise we cannot afford to keep and one that our lenders may force
us to retract.
Before losing our credit rating or suffering the humiliation of
foreign lenders denying us new loans, we should take the decisive
action now to end this entitlement. Congress should replace this
mistaken law with bipartisan reforms that prohibit the government from
overriding the decisions you make with your doctor, that defend your
right to buy insurance from any State in the Union, and to make lawsuit
reforms to lower the costs of defensive medicine.
The failed health care law now ruled as unconstitutional by two
Federal courts uses the commerce clause of the Constitution to create
an unlimited government that could require Americans to buy what they
do not want. The very heart of the Constitution was the creation of a
limited government that could only accomplish its defined missions,
leaving all else to the people and to the States.
These courts are right, the law is unconstitutional. It spends over
$2.6 trillion, it hurts small businesses, it cuts senior health care
under Medicare, and levies billions in new taxes against our economy in
the teeth of the great recession.
Recently, I visited Decatur Memorial Hospital in Decatur, IL. Their
president, Ken Smithmier, warned me that the Medicare cuts required by
the new health care law would cut $10 million annually from their
hospital, resulting in the loss of over 200 jobs. Decatur is not alone
in its troubles. In nearly half of my State's counties, hospitals are
among the top three employers. They are the backbone of our local
economies, and their employment would be greatly harmed by this health
care law.
We made a promise to seniors who depend on Medicare that we would
take care of them. This law cuts Medicare and hurts them. We should
honor, instead, our promises to defend the Nation, to support seniors
on Social Security and who depend on Medicare before making an
extravagant promise that is irresponsible and cannot be kept under the
health care law.
Egypt
Madam President, I also wish to take this time to speak on an
entirely different subject, which is what is going on in Egypt.
I entitle this discussion ``The Muslim Brotherhood: Its Leaders in
Their Own Words.''
Will Egypt follow Poland or Georgia to foster a new democratic
government or will it follow Iran's revolution, converting Egypt into a
state sponsor of terror?
While U.S. policy should support human rights and democracy, we face
the risk that the Muslim Brotherhood, the al-Ikhwan al-Muslimun, could
seize power. Who is part of the brotherhood and what are its political
objectives?
A detailed study shows why these questions should command the
attention of the Congress and the President. With so much at stake in
the Middle East, Americans must be clear-eyed about the Muslim
Brotherhood and its radical Islamic agenda with a pledge of jihad
against the West and the State of Israel.
The Muslim Brotherhood is the largest Islamist movement in the Middle
East and is widely described as the most organized political force in
Egypt. Its membership is estimated at over 600,000.
Although it claims to be nonviolent, this conservative organization,
the Muslim Brotherhood, has profoundly influenced Islamic terrorist
organizations such as al-Qaida, Islamic Jihad, and Hamas. One of its
disciples was the prominent Islamist theologian Sayyid Qutb who
provided the intellectual underpinnings of al-Qaida. Ayman al-Zawahiri,
al-Qaida's second in command, was once a member of Egypt's Muslim
Brotherhood.
As recently as 2004, the organization's motto was as follows:
Allah is our objective.
The Prophet is our leader.
Qur'an is our law.
Jihad is our way.
Dying in the way of Allah is our highest hope.
The Muslim Brotherhood was founded in 1928 by Hassan al-Banna. Banna
is famously quoted as saying that ``it is the nature of Islam to
dominate, not to be dominated, to impose its law in all nations and to
extend its power to the entire planet.''
The Muslim Brotherhood has a violent history. Back in 1946, the U.S.
Army issued an intelligence report stating that the Muslim Brotherhood
``maintains commando units and secret caches of arms.''
Throughout the 1940s, the paramilitary branch of the movement carried
out targeted bombings and assassinations. In 1948, the Muslim
Brotherhood was implicated in the murder of Egyptian Prime Minister
Mahmoud Naqrashi. In 1954, the group allegedly tried to assassinate
then-Prime Minister Gamal Abdel Nasser. The government banned the
brotherhood as a political party that very same year.
The Muslim Brotherhood went underground only to resurface during the
1980s. It claimed to disavow violence and attempted to win political
power as a religious and social organization. It was increasingly
successful with allied candidates, winning 17 seats in the Parliament
in 2000 and then a stunning 88 seats, or 20 percent of Egypt's
Parliament, in 2005.
The Muslim Brotherhood is not a monolithic organization, but it does
maintain a leadership structure and a core set of beliefs. Its leader
is called the general guide. He has several deputy guides. Below them
is a guidance council, comprised of 15 to 16 senior leaders as well as
a broader body, the Shura, comprised of roughly 100 members.
Mohammed Badi was elected as the eighth general guide of the Muslim
Brotherhood in January of 2010. As noted by the U.S. Government's Open
Source Center, Badi is ``influenced by the writings of famous Muslim
Brotherhood idealogue Sayyid Qutb, and is known for his conservative
views.''
In an April interview in 2010, Mr. Badi said:
We will continue to raise the banner of Jihad and the Koran
in our confrontation with the enemy of Islam. The Muslim
Brotherhood still considers the Zionists to be its main and
only enemy. The Jews who occupy Palestine have their eyes set
on Egypt.
Two days ago, a leading member of the Muslim Brotherhood, Muhammed
Ghannem, reportedly told Al-Alam Iranian news network that he ``would
like to see the Egyptian people prepare for a war against Israel,''
adding that the world should understand ``the Egyptian people are
prepared for anything to get rid of this regime.'' He went on to say
that the Suez Canal should be ``closed immediately'' and that the flow
of gas from Egypt to Israel should cease ``in order to bring about the
downfall of the Mubarak regime.''
In 2007, the Muslim Brotherhood released a political platform which
contained a number of indications on how this organization would govern
Egypt if it came to power. According to the Congressional Research
Service, the platform called for ``the establishment of a board of
religious scholars with whom the President and the legislature would
have to consult before passing laws.''
As noted by Mohamed Elmenshawy--the editor-in-chief of Taqrir
Washington and Arab Insight:
Reminiscent of Iran's Guardian Council, this
undemocratically selected body could have the power vested by
the state to veto
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any and all legislation passed by the Egyptian parliament and
approved by the president that is not compatible with Islamic
Shari'a law.
The same document raises the important question of the Muslim
Brotherhood's commitment to a pluralistic society. Despite pledges to
treat minorities and women as equals, the platform allows neither to
hold high public office. As stated in the platform: ``Nonmuslims are
excused from holding this mission.'' For women, the post of President
or Prime Minister would ``contradict her nature, social and other
humanitarian roles.'' The draft also cautions against ``burdening women
with the duties against their nature or role in the family.''
The people of Egypt and apparently its army are mandating the fall of
the Mubarak regime. While we support human rights and democracy, we
must heed the growing warnings about the Muslim Brotherhood, their
leaders, and plans for taking Egypt all the way back to the 13th
century. We, as Americans, have seen this movie before--in Iran, in
Lebanon, and in Gaza.
To prevent a strategic reversal on the scale of what happened in
Iran, the United States and her allies should do all they can to
support Egypt's armies and secular leaders, ensuring no future for the
Muslim Brotherhood. Egypt, locked under Shari'a law and oppressing
women, Christians, and Jews, would be a catastrophic setback for
progress in the Middle East. Such a state could renounce the Camp David
peace accords or even start yet another war with Israel.
Decisive action and influence now will benefit the national security
and economy of the United States later. The defeat of the Muslim
Brotherhood and victory for Egyptian secular nationalists would be the
best way to avoid war and restore economic confidence in the Middle
East and the wider world.
Mr. ENZI. Madam President, I rise to urge my colleagues to vote to
repeal the new health care law. Repeal is the only way we can prevent
the job losses, insurance premiums increases and devastating Medicare
cuts that are a direct consequence of the new health care law.
We are just now beginning to see many of the consequences resulting
from this poorly conceived, hurriedly drafted 2,700 page law. Rather
than taking the time to get it right, the majority rushed to enact this
new law, despite the many warning signs pointing out serious flaws in
the new law.
These consequences are a result of the majority willfully ignoring
those who criticized their proposals and deciding that folks in
Washington knew what was best for small businesses and families across
the country.
One example of this kind of unintended but easily predicted
consequence is the impact on child only health plans. Last week, my
staff conducted a survey, and found that the new law and the
regulations implementing it have caused many health insurers to stop
selling child only plans.
As a direct result of the new law, insurance plans in 34 States have
stopped offering child-only plans, and parents in at least 20 states
are no longer able to purchase any child only plans. This is a
devastating problem for parents who need to buy health insurance plans
for their children.
Many parents need to buy child only plans for their children, because
their jobs provide insurance for them but not for family members.
Before the new law took effect, these parents could buy child only
policies for their kids. Unfortunately, because of the new law, parents
in 20 States no longer have this option.
For other parents the cost of getting a family plan is too expensive,
and their family budget can only afford to buy health insurance for
their kids. Again, because of the new law these parents in 20 States no
longer have the ability to buy health insurance for their children.
I recently got a letter from a disabled Veteran in Wyoming. He wrote
to tell me that because of the new law, he can't get health insurance
for his kids. He gets his health care from the VA so he doesn't need a
family policy. He needs a policy for his two kids. Because of how the
law was drafted and then implemented, this veteran now cannot get
health insurance for his children.
I discussed this issue with Secretary Sebelius at a hearing last week
in the HELP Committee and her reply was that kids can enroll in SCHIP
or the new high-risk pools. In fact, the veteran in Wyoming doesn't
qualify for either. While some low income kids are eligible for public
programs like SCHIP or Medicaid and some sick kids are eligible for
high-risk pools, many children are ineligible for any of these plans,
and will now go without insurance as a result of the new law.
Another unintended but easily predicted consequence of the new law is
how the new law is undermining the economy and the preventing the
creation of new jobs. During that same HELP Committee hearing, we also
heard the testimony of Mr. Joe Olivo, who owns a small printing company
in Moorestown, NJ.
Mr. Olivo told us how the new law will actually restrict his ability
to expand his business and hire new workers. While he currently has 46
employees, he will do everything he can to not hire 5 more people, in
order to avoid the new law's mandate to offer health insurance to his
employees or pay a new tax. Small businesses across the country are
being forced to make similar decisions, in order to avoid the $52
billion in new taxes that the new law attempts to place on employers.
A study by the National Federation of Independent Business estimates
that the employer mandate will eliminate 1.6 million jobs at a time
when over 15 million Americans are searching for new jobs, most of
which are small businesses.
We need to be encouraging our businesses to grow, not discouraging
them. Over the last 2 years our economy has lost almost 3 million jobs.
Unfortunately, the health reform law makes a bad employment situation
even worse.
Another consequence of the new health care law will be to increase
the health insurance premiums paid by millions of Americans. During the
health care debate, GOP Senators highlighted how the new health care
law will cause millions of Americans to pay higher health insurance
premiums.
In November of 2009, the Congressional Budget Office estimated that
the new law will increase health insurance premiums by 10 to 13
percent. This means families purchasing coverage on their own will have
to pay $2,100 a year more because of the new law.
The Joint Committee on Taxation estimates that many of the new taxes
included in the health care reform law will be passed on directly to
consumers. This means that each of these new taxes, including the $60
billion tax on health plans, the $20 billion tax on medical devices,
and the $27 billion tax on prescription drugs, will further increase
premiums for Americans.
In addition to CBO and JCT, six additional private actuarial analyses
published by Oliver Wyman, PriceWaterhouseCoopers, the Hay Group,
Milliman, Wellpoint and Lewin have all shown that the new law could
increase premiums, with increases ranging as high as 60 percent.
Additional studies by Milliman determined that because Medicaid pays
doctors and hospitals below costs, these providers must increase their
costs to everyone else, thereby costing the average American family an
extra $1,700 per year. Forcing 16 million more people on to Medicaid
will further increase insurance premiums for many Americans, as
providers try to shift the costs resulting from inadequate Medicaid
reimbursements
The estimates of the law increasing insurance premiums are already
being born out in the market. I heard from a small business owner in
Saratoga, WY, whose health insurance premiums are going up by 30
percent.
A 30-percent increase in health insurance premiums could tip him over
the edge of staying in business or closing his doors. He wrote to me to
tell me that he is considering closing the doors of his construction
company because he is having trouble making ends meet; he urged me to
repeal the new health care law.
Blue Shield of California--a nonprofit health insurer--recently filed
a 59-percent premium increase for some of their individual market plans
and said that at least a portion of its increase was a direct result of
the new law. They estimate premiums will increase by 4 percent to
comply with the new mandated benefit.
[[Page S470]]
Another unintended yet easily predicted consequence is the impact of
cutting $500 billion from the Medicare Program. You can't cut a program
by a $\1/2\ trillion and not expect to see decreases in covered
benefits or access to providers.
Republicans understand how important Medicare is to nearly 46 million
seniors and disabled Americans. We want to protect and strengthen it.
We all know Medicare faces tremendous challenges in the near future.
Yet the law cuts over $500 billion from Medicare, not to strengthen
Medicare, but to fund new entitlement spending. More importantly, the
new law fails to address even the most basic problems with the Medicare
Program, such as the broken physician payment formula.
I have already heard from seniors in Wyoming about how the new law is
hurting them. A lady from Thermopolis, WY, wrote to tell me that she
got a letter from her Medicare Advantage plan saying her premiums were
drastically increasing because of the changes made in the new law.
She wrote say ``unfortunately, my former policy was $0. The ones
available now--even the most expensive one--have fewer benefits than
what I was getting for free before ObamaCare took so much money from
Part C. For instance, $45 for a specialist instead of $35; $10 for a
generic drug instead of $6; and up to $350 for tests, when the old
policy had a flat rate of $16 for tests. I can't afford the premiums on
my Social Security and am considering dropping Part B, which would save
me $97 per month.''
These are real life examples of the impact this new law is having on
everyday Americans. I get letters every day from my constituents asking
me to repeal this new health care law that is limiting their freedoms
and emptying their pocketbooks. The Senate will soon vote on whether or
not to repeal the new health care law. I urge my colleagues to listen
to their constituents and vote in favor of repeal.
Madam President, we need to pursue a step by step, bipartisan,
approach to health reform that will reduce costs, expand coverage and
allow our economy to expand. Using that process will allow us to
thereby avoid the unintended consequences of this deeply flawed new
law.
Mr. LEAHY. Madam President, the 112th Congress began just 1 month
ago, with both sides of the political aisle voicing a renewed
commitment to cooperation. It is not hard to understand why I am
disappointed that at the first opportunity, Senate Republicans have
chosen to manipulate the open amendment process. The Senate minority is
demanding a vote on an amendment to repeal the health care reform law
in its entirety--an issue totally unrelated to the bill we are
considering, the FAA Transportation Modernization Safety Improvement
Act, which creates jobs, makes airline travel safer and more efficient,
and offers consumers a `passenger bill of rights.'
The Senate's vote today follows the carefully staged show vote a few
weeks ago by the new Republican majority in the House of
Representatives. The American people have the right to know what a vote
to repeal the Affordable Care Act really means. Repeal of this law
would take away the rights of millions of patients and would eliminate
insurance coverage for millions more, from the aging and elderly, to
men and women with preexisting conditions, to the most vulnerable
children.
When you boil away the rhetoric, the only alternative offered to the
American people by advocates of repeal is: Don't get sick.
This amendment would turn back the clock to a time when, once again,
women would have to pay more for health insurance than men, insurance
companies could rescind a health insurance policy because someone gets
sick, and coverage could forever be denied to someone born with a
disease or ailment. In Vermont, repeal would mean nearly 2,000 young
adults would no longer have coverage through their parents' insurance
plans, more than 5,000 Vermont seniors would see an increase in the
price of their prescriptions, and 350,000 Vermonters with private
insurance could have lifetime limits slapped on how much insurance
companies will spend on their health care.
Some in Congress want to drain federal spending on domestic programs
while looking the other way in supporting a repeal amendment that will
accelerate the health cost spiral and add to our ballooning deficit.
The nonpartisan Congressional Budget Office estimates that repeal of
the Affordable Care Act would boost the federal debt and deficits by
$230 billion. The economic turmoil would reach beyond the overall costs
of repeal by removing vital antifraud provisions I have long advocated
that have helped the Obama administration recover billions of taxpayer
dollars. Repealing the Affordable Care Act would remove these fiscal
safeguards and reopen the floodgates to insurance discrimination, by
putting insurance companies back in charge.
Opponents of the Affordable Care Act have gone to new lengths to
repeat and prolong this political battle. Not only do they want to
replay a 2-year long debate on a law that was enacted by a decisive
majority, but some opponents are also replaying the debate in the
courts. These political opponents seek to achieve in the courts what
they could not in Congress. They want judges to override legislative
decisions properly assigned by the Constitution to Congress, the
elected representatives of the American people.
Today, the Judiciary Committee held a hearing on the
constitutionality of the historic Affordable Care Act. A dozen federal
courts have dismissed challenges to the law. Another four courts have
heard arguments about its constitutionality; two have upheld the law as
constitutional, and two have not. Legal challenges to the law are
expected to reach the U.S. Supreme Court.
As I concluded during the debate on the Affordable Care Act, I have
no doubt that Congress acted well within the bounds of its
constitutional authority in working to secure affordable health care
for all Americans through this plan that is based on the long
established health insurance marketplace. The testimony we heard today
from constitutional scholars makes clear that the language and spirit
of the Constitution provides for such a response to a clearly
established national need, as do judicial precedent and prior acts of
Congress that also protect hardworking Americans in the national health
care market and promote the general welfare.
The Senate should not be spending its valuable time relitigating a
law that has already helped millions of Americans and will help
millions more as the law is fully implemented. The American people
rightly expect us to work together and make progress on so many
challenges that we face today.
I will not support a return to less protection, less coverage, less
fairness and higher costs. The Affordable Care Act extended health
insurance to millions of families in Vermont and across the country.
Those who represent the American people in Congress should stand ready
to get to work for their constituents. This is not a time to cobble
back together a broken system that has burdened most American
households with health coverage uncertainty and crippling costs.
Mr. LEVIN. Madam President, we are here today, holding this debate,
preparing for this vote, because our Republican friends believe a
collection of myths. Some of them say they want to repeal a law that
amounts to a ``government takeover'' of health care. Some of them say
they want to repeal a bill that violates the Constitution. They say
they want to repeal a law that will cut the benefits on which Medicare
recipients depend. Others say they want to repeal a bill that will
explode the deficit, or that they want to repeal the law because it
will kill jobs.
If such a law existed, I would want to repeal it too. Thankfully, the
law Republicans describe is a fiction.
The Affordable Care Act, the law Republicans want us to repeal, does
not take over the health care system; it strengthens and protects our
existing private health insurance system. The independent fact checkers
at Politifact.com found that the law ``is, at its heart, a system that
relies on private companies and the free market,'' and called the claim
that government would take over the system Politifact's ``Lie of the
Year.''
This bill does not violate the Constitution. Opponents claim that the
individual mandate included in this bill
[[Page S471]]
violates the Constitution because it requires citizens to purchase
insurance; under their arguments, many other programs, including
Medicare, would violate the Constitution. Perhaps that is what these
opponents believe, but it is emphatically not what most Americans
believe, and it is contrary to decades of legal precedent.
This law does not reduce care for Medicare beneficiaries. In fact,
most Medicare recipients already enjoy expanded benefits under the
Affordable Care Act. As a result of this law, Medicare beneficiaries
now receive preventive care such as annual check-ups with no out-of-
pocket costs, and starting last year this law began to shrink the
``donut hole'' that hits so many seniors with significant drug costs.
The law strengthens Medicare by beginning to rein in the enormous costs
that threaten to swamp the system in coming years, and it does so by
encouraging efficiency and reducing waste and abuse, not by cutting
benefits.
The Affordable Care Act does not explode the deficit. The
independent, nonpartisan Congressional Budget Office has found that
repeal of the Affordable Care Act would increase the deficit by $143
billion over the first decade, and by significantly more in the years
to follow. It is ironic in the extreme that Senators who describe the
2010 election as a mandate to reduce the deficit could now try to add
$143 billion to that deficit as their first major action of the new
Congress by repealing the Affordable Care Act.
This law does not kill jobs. Again, independent observers have
dismissed this claim as patently false. The independent FactCheck.org
called the claim ``exaggerated and misleading'' and that Republicans
have ``badly misrepresented'' findings by the Congressional Budget
Office in making their arguments.
We should leave the realm of myth and discuss what the Affordable
Care Act does, in fact, do.
This law protects Americans from abuses by insurance companies, such
as denial of coverage for preexisting conditions or gender. It allows
parents to keep children covered under their insurance plan until age
26. It requires that coverage include preventive care at no out-of-
pocket cost. It limits the unilateral power of insurance companies to
arbitrarily impose annual or lifetime coverage limits. Those arbitrary
limits have forced families to choose between foregoing much-needed
care and bankruptcy. Families will be protected from unexplained
premium increases, and they will get clear, easy-to-read summaries of
their options. Small businesses will receive tax credits to help them
provide affordable insurance coverage to their workers. And insurance
companies will be prevented from rescinding coverage when patients need
it most, when they get sick.
This law is not a government takeover of health care. It is sensible,
moderate reform that in the coming years will make health insurance
more affordable and secure for those who have it today, and make
affordable coverage available for millions of Americans who are now
without it. It will reduce the deficit, protect the Medicare benefits
that seniors depend on now and in the future, and help ensure that
families can afford the insurance coverage they need. It is unfortunate
that so many of our colleagues subscribe to the mythical notions about
this law. But here, in the real world, we need to preserve and protect
the Affordable Care Act.
I yield the floor.
The PRESIDING OFFICER. The majority leader.
Mr. REID. Madam President, I ask unanimous consent that at 5:15 p.m.
today, the Senate proceed to votes in relation to the following
amendments to S. 223, the FAA authorization bill, in the order listed
below:
Levin amendment relative to repeal of 1099, the text of which is at
the desk; the Stabenow amendment No. 9, repeal of 1099; and the
McConnell amendment No. 13, which is the repeal of health care reform;
that no other amendments, points of order or motions be in order to
these amendments prior to the votes, except that a budget point of
order, if applicable, remain in order to each of these amendments, and
if one is raised, a motion to waive the budget point of order be in
order; that if the motion to waive is agreed to, the amendment be
considered agreed to; and the Senate then proceed to vote in relation
to the next amendment in the sequence; further, that the Levin
amendment be subject to a 60-vote threshold for its adoption and if it
fails to achieve 60 affirmative votes, the amendment be withdrawn.
Finally, that there be 2 minutes of debate, equally divided, prior to
each vote; and that all votes after the first vote be limited to 10
minutes each.
The PRESIDING OFFICER. Is there objection? Without objection, it is
so ordered.
Mr. KIRK. Madam President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. LEVIN. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Amendment No. 28
Mr. LEVIN. Madam President, there is, I believe, overwhelming
bipartisan support for repeal of the recent changes to the 1099
reporting requirement. Small businesses in my State and across the
country have told us that the new reporting requirements they face
under the Affordable Care Act will create an unnecessary burden that
can make already tough times even tougher.
I believe there may even be a consensus among our colleagues that we
should act, but I strongly oppose one of the methods proposed to
address this problem. That method would undermine Congress's role in
the constitutional scheme of separation of powers among the branches of
government and it would abdicate Congress's responsibility to decide on
the spending of taxpayer dollars. We can and we should remove the 1099
burden on small businesses. We can and we should do so without
abandoning our role in determining Federal spending. The power of the
purse should not be handed to the President, any President. The
challenge we face is that repealing the section 1099 provision carries
a cost of about $22 billion over 10 years. The mechanism that some
support to meet that cost would empower the Director of the Office of
Management and Budget to decide by himself which funds we have
appropriated but that have not yet been obligated--which of those
unobligated funds should be cut to pay the cost of repeal.
To some this may be a convenient way to relieve Congress of its
responsibility to make difficult choices. To others it may be a
convenient way to shift the blame for the painful impact of any cuts
from Congress onto the President. But what is convenient is not always
right. The Constitution places in our hands and ours alone the
authority to appropriate funds. We cannot statutorily pass that buck,
and we should not.
The Framers of the Constitution consciously and deliberately placed
the power of the purse in the hands of the Congress. James Madison
described this authority as, ``the most complete and effectual weapon
with which any Constitution can arm the immediate representatives of
the people.''
We do not know what programs the Director of OMB will decide to
reduce under the approach that some have proposed, but I do know that
what they are proposing is that this would be his decision and his
decision alone. What are some areas the OMB Director could unilaterally
cut? What is the universe of the potential cuts? Do we care? We surely
should, because the implications for our constituents will be
significant.
Disaster Relief Enhancement Funds were set aside to help States
affected by natural disasters in 2008. According to the Appropriations
Committee, 13 States received such funding and they all have
unobligated balances. Would the Senators from those States turn over to
the OMB Director the decision whether to eliminate the unobligated
balances affecting their States? I would not. But that is what could
happen under the proposal that is going to be considered here later.
The Appropriations Committee tells us that the EPA has $624 million
in unobligated balances in the Clean Water State Revolving Fund and
$343 million in the Drinking Water State Revolving Fund. In addition,
there is $388 million unobligated in specific State sewer programs
approved by Congress. The two
[[Page S472]]
State revolving funds, $967 total, include projects in all 50 of our
States. So there is a $1.3 billion target that could affect sewer and
drinking water infrastructure in every one of our States. We
appropriated those funds and if they are going to be cut, then we
should do the cutting and not hand that power over to the executive
branch, to the President's OMB Director.
According to our Appropriations Committee, the Department of Justice
had a total of $1.25 billion in unobligated funds as of November 30
last year. It is probably lower now, but what is it? What programs are
part of it? Do we know? Do we care? We surely should. Will the OMB
Director decide to cut funding for U.S. Attorneys' investigations and
prosecutions? What about U.S. Marshals, who provide security to our
courthouses? Will the OMB Director decide to reduce funding for Project
Gunrunner, which is focused on firearms enforcement along the Southwest
border?
NASA had a total unobligated balance of $155 million as of the end of
January. About $10 million of that is for Constellation, the follow-on
manned space vehicle to the shuttle.
According to the Appropriations Committee, in recent years spending
for the Women, Infants and Children Program, the WIC Program, has
totaled more than $6 billion. Is the OMB Director going to decide to
cut unobligated balances in the WIC Program? He could do so if we adopt
the approach that is going to be before us after the vote on our
amendment. I might agree to some of these cuts in a larger package but
I would surely want to know what is in the whole package so we can
adopt some priorities.
I favor the repeal of the 1099 reporting requirement and I favor
paying the cost of repeal, whether through spending reductions or
closing tax loopholes. But I strongly oppose paying for the repeal by
abdicating our power of the purse, the power we have under the
Constitution. We cannot and we should not abdicate this to the
executive branch to unilaterally make spending cuts to programs we have
previously enacted.
The provisions we are going to debate today but hopefully not adopt
must also be understood in a larger context, one that foresees the
difficult decisions ahead on how we will return to fiscal discipline.
There are many, perhaps even some in this Chamber, who believe that we
in the Senate and here in the Congress are incapable of making these
decisions. They point out there are only two ways of lowering the
deficit, reducing spending or increasing taxes, and that neither of
these is popular with our constituents. They argue we will prove unable
to muster the political courage to make decisions that we know will be
unpopular, and there is some truth in those sentiments. Restoring
fiscal balance will be painful and we are in the fiscal hole we are in
because spending is popular and so are tax cuts, and we have provided
plenty of both. It would certainly be easier for all of us if we could
hand somebody else the authority to decide how to remedy the excesses
of the past. But we cannot and should not run from this responsibility.
Justice Kennedy once put it this way: ``Failure of political will
does not justify unconstitutional remedies.'' He added: ``The
Constitution is a compact, enduring for more than our time, and one
Congress cannot yield up its own powers. . . . Abdication of
responsibility,'' he said, ``is not part of the constitutional
design.''
We must not run from painful decisions. Difficult or not, only the
Congress can decide how to pay for repeal of these reporting
requirements. And difficult or not, only Congress can decide the larger
issue of how to bring our spending in line with our revenues. If we
cannot today exercise our responsibility on the finding of $22 billion
to pay for the repeal of these reporting requirements, how can we
expect to tackle the much larger budget deficit we face?
There is an alternative amendment which we are offering today. I,
along with Senator Inouye and others, am proposing today an amendment
which will make specific decisions on spending cuts and revenue
increases to account for the cost of repealing this provision. We would
reform unjustified tax expenditures related to oil and gas production
by large oil companies, companies that are enormously profitable with
or without these tax expenditures. Our amendment will reform a loophole
that provides tax credits to filers who pay taxes both in the United
States and in foreign countries, and our amendment will eliminate some
unintended loopholes used to avoid clearly intended rules on gift tax
exemptions.
If there are better alternatives than the ones we are proposing,
fine. Let's consider them. But what we cannot support is the abdication
of our responsibility to make these decisions. It was the will and the
wisdom of the Framers of the Constitution to give us that
responsibility and I urge our colleagues not to shrink from it but to
exercise it.
I will yield the floor but first I call up our amendment and ask for
its consideration.
The PRESIDING OFFICER (Mr. Whitehouse). The clerk will report.
The legislative clerk read as follows:
The Senator from Michigan [Mr. Levin], for himself, Mr.
Inouye, Mr. Leahy, Mr. Sanders, Mr. Rockefeller and Mrs.
Feinstein, proposes an amendment numbered 28.
The amendment is as follows:
(Purpose: To repeal the expansion of information reporting requirements
under the Patient Protection and Affordable Care Act, and for other
purposes)
On page 335, after line 20, insert the following:
TITLE XI--ADDITIONAL PROVISIONS
SEC. 1101. REPEAL OF EXPANSION OF INFORMATION REPORTING
REQUIREMENTS.
Section 9006 of the Patient Protection and Affordable Care
Act, and the amendments made thereby, are hereby repealed;
and the Internal Revenue Code of 1986 shall be applied as if
such section, and amendments, had never been enacted.
SEC. 1102. DENIAL OF DEDUCTION FOR MAJOR INTEGRATED OIL
COMPANIES FOR INCOME ATTRIBUTABLE TO DOMESTIC
PRODUCTION OF OIL, GAS, OR PRIMARY PRODUCTS
THEREOF.
(a) In General.--Subparagraph (B) of section 199(c)(4) of
the Internal Revenue Code of 1986 is amended by striking
``or'' at the end of clause (ii), by striking the period at
the end of clause (iii) and inserting ``, or'', and by
inserting after clause (iii) the following new clause:
``(iv) in the case of a taxpayer which is a major
integrated oil company (as defined in section 167(h)(5)(B)),
oil related qualified production activities (within the
meaning of subsection (d)(9)(B)).''.
(b) Conforming Amendment.--Section 199(d)(9)(A) of the
Internal Revenue Code of 1986 is amended by inserting
``(other than a major integrated oil company (as defined in
section 167(h)(5)(B))'' after ``taxpayer''.
(c) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2010.
SEC. 1103. MODIFICATIONS OF FOREIGN TAX CREDIT RULES
APPLICABLE TO DUAL CAPACITY TAXPAYERS.
(a) In General.--Section 901 of the Internal Revenue Code
of 1986 (relating to credit for taxes of foreign countries
and of possessions of the United States) is amended by
redesignating subsection (n) as subsection (o) and by
inserting after subsection (m) the following new subsection:
``(n) Special Rules Relating to Dual Capacity Taxpayers.--
``(1) General rule.--Notwithstanding any other provision of
this chapter, any amount paid or accrued by a dual capacity
taxpayer to a foreign country or possession of the United
States for any period with respect to combined foreign oil
and gas income (as defined in section 907(b)(1)) shall not be
considered a tax to the extent such amount exceeds the amount
(determined in accordance with regulations) which would have
been required to be paid if the taxpayer were not a dual
capacity taxpayer.
``(2) Dual capacity taxpayer.--For purposes of this
subsection, the term `dual capacity taxpayer' means, with
respect to any foreign country or possession of the United
States, a person who--
``(A) is subject to a levy of such country or possession,
and
``(B) receives (or will receive) directly or indirectly a
specific economic benefit (as determined in accordance with
regulations) from such country or possession.''.
(b) Effective Date.--
(1) In general.--The amendments made by this section shall
apply to taxes paid or accrued in taxable years beginning
after December 31, 2010.
(2) Contrary treaty obligations upheld.--The amendments
made by this section shall not apply to the extent contrary
to any treaty obligation of the United States.
SEC. 1104. RULES RELATING TO FOREIGN OIL AND GAS INCOME.
(a) Separate Basket for Foreign Tax Credit.--Paragraph (1)
of section 904(d) of the Internal Revenue Code of 1986 is
amended by striking ``and'' at the end of subparagraph (A),
by striking the period at the end of subparagraph (B) and
inserting ``, and'', and by adding at the end the following:
``(C) combined foreign oil and gas income (as defined in
section 907(b)(1)).''
(b) Coordination.--Section 904(d)(2) of the Internal
Revenue Code of 1986 is amended by redesignating
subparagraphs (J) and (K) as
[[Page S473]]
subparagraphs (K) and (L) and by inserting after subparagraph
(I) the following:
``(J) Coordination with combined foreign oil and gas
income.--For purposes of this section, passive category
income and general category income shall not include combined
foreign oil and gas income (as defined in section
907(b)(1)).''
(c) Conforming Amendments.--
(1) Section 907(a) of the Internal Revenue Code of 1986 is
hereby repealed.
(2) Section 907(c)(4) of such Code is hereby repealed.
(3) Section 907(f) of such Code is hereby repealed.
(d) Effective Dates.--
(1) In general.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2010.
(2) Transitional rules.--
(A) Carryovers.--Any unused foreign oil and gas taxes which
under section 907(f) of the Internal Revenue Code of 1986 (as
in effect before the amendment made by subsection (c)(3))
would have been allowable as a carryover to the taxpayer's
first taxable year beginning after December 31, 2010 (without
regard to the limitation of paragraph (2) of such section
907(f) for first taxable year) shall be allowed as carryovers
under section 904(c) of such Code in the same manner as if
such taxes were unused taxes under such section 904(c) with
respect to foreign oil and gas extraction income.
(B) Losses.--The amendment made by subsection (c)(2) shall
not apply to foreign oil and gas extraction losses arising in
taxable years beginning on or before the date of the
enactment of this Act.
SEC. 1105. REQUIRED MINIMUM 10-YEAR TERM, ETC., FOR GRANTOR
RETAINED ANNUITY TRUSTS.
(a) In General.--Subsection (b) of section 2702 of the
Internal Revenue Code of 1986 is amended--
(1) by redesignating paragraphs (1), (2), and (3) as
subparagraphs (A), (B), and (C), respectively, and by moving
such subparagraphs (as so redesignated) 2 ems to the right,
(2) by striking ``For purposes of'' and inserting the
following:
``(1) In general.--For purposes of'',
(3) by striking ``paragraph (1) or (2)'' in paragraph
(1)(C) (as so redesignated) and inserting ``subparagraph (A)
or (B)'', and
(4) by adding at the end the following new paragraph:
``(2) Additional requirements with respect to grantor
retained annuities.--For purposes of subsection (a), in the
case of an interest described in paragraph (1)(A) (determined
without regard to this paragraph) which is retained by the
transferor, such interest shall be treated as described in
such paragraph only if--
``(A) the right to receive the fixed amounts referred to in
such paragraph is for a term of not less than 10 years,
``(B) such fixed amounts, when determined on an annual
basis, do not decrease relative to any prior year during the
first 10 years of the term referred to in subparagraph (A),
and
``(C) the remainder interest has a value greater than zero
determined as of the time of the transfer.''.
(b) Effective Date.--The amendments made by this section
shall apply to transfers made after the date of the enactment
of this Act.
The PRESIDING OFFICER. The Senator from Hawaii.
Mr. INOUYE. Mr. President, I rise today in support of the Levin
amendment, which I believe is a far superior alternate to the Stabenow
amendment as it currently stands. The amendment offered today by
Senator Stabenow proposes to rescind $44 billion from unobligated
balances of appropriated funds that are designated for specific
purposes in various appropriations bills previously enacted by
Congress. The Senator offers these rescissions in order to offset the
loss of revenues resulting from an amendment.
This amendment is a perfect representation of what I expect to be a
flood of similar amendments and stand-alone bills that seek to
eviscerate the nondefense functions of the Federal Government. With the
exception of the proposal from the junior Senator from Kentucky, which
had the courage to list each and every cut he proposed, I expect many
other bills and amendments will be blanket rescissions that leave it to
the executive branch to decide how the taxpayers' moneys will be spent.
These bills and amendments turn the constitutional separation of powers
on its head and provide a terribly dangerous precedent.
In the specific case of the Stabenow amendment, it simply provides
for generic rescission of funds, with the authority and decisionmaking
on the programs to be impacted delegated entirely to the executive
branch. Rescinding funds in this manner, as pointed out by Senator
Levin, may be politically convenient as it simply cites the top line
number of $44 billion, but it is also thoughtless and rash. It will
serve to shelter those who vote in its favor from the righteous anger
of Americans whose lives are disrupted when important and, in some
cases, vital projects and programs are shut down as they inevitably
will be, should the amendment be agreed to.
I can also promise that if this amendment is enacted into law, the
force of these cuts will be felt in each of the 50 States, and the
capricious nature of the cuts will only deepen the pain.
I know that because we are in the middle of the second quarter of the
fiscal year operating under a CR. Consequently, as I explained in
November, the only unobligated balances remaining outside of those for
operating under a CR in 2011 are those accounts that have slow spend
rates, such as construction and infrastructure accounts. That is why it
is taking $44 billion in rescissions to pay for a $19 billion problem.
As a result, we will be cutting deeply into our nondefense
discretionary programs without congressional guidance and without any
analysis of the ultimate costs and impacts. This approach is simply
irresponsible.
While we cannot say with certainty what the cuts will be because the
executive branch will have complete authority over what programs will
be impacted, I believe the following cuts are likely: State and local
law enforcement will face cuts of $200 million to $300 million in grant
programs, including $82 million in Violence Against Women grants, $81
million in Byrne and other Office of Justice grants, and $10 million in
Juvenile Justice grants. Cutting these grant funds will take funding
from programs already expected to be awarded, and will fall
particularly hard on States with large problems with crime.
A cut of $95 million from the DEA would mean halting efforts to go
after and take down Mexican drug cartels, to enforce narcoterrorist
investigations, and information sharing, and to address emerging
technologies used by drug traffickers. The TSA stands to lose $674
million of funds to procure and install over 200 explosive detecting
systems at airports across the Nation.
Finally, the U.S. Marshals would face a cut of $48.7 million,
bringing an end to courthouse security equipment projects and also
halting Marshals' operations in the Southwest border where they engage
in activities such as tracking fugitives.
Supporters of the Stabenow amendment would claim that I am using
scare tactics, painting a dark picture when the real cuts are not as
devastating.
How can anyone stand here and claim we can cut $44 billion and not
have it hurt our States and our constituents? This amount is equivalent
to funding the entire Department of Homeland Security, which covers
everything from the Coast Guard to FEMA, from the Secret Service to the
Border Patrol.
No one denies that waste, fraud, and abuse exist and that we need to
continue to enact reforms that will lesson waste, convict those who
would defraud the government, and eliminate abuses of programs that are
designed to help those who need it most. But if this amendment is
signed into law, then 60 days later we will all get a harsh reminder
that campaigning against waste, fraud, and abuse is not the same thing
as implementing a policy that cuts billions of dollars in useful
spending. These rescissions will hurt individuals, they will hurt
communities and jeopardize safety of life and our security.
Let me also point out to my colleagues that if this amendment is
enacted, we cannot stop rescissions of unobligated balances from a
single account we may view as vital because the amendment gives sole
decisionmaking power in identifying cuts to the executive branch.
I will say this again. This amendment is not in the best interests of
the Senate, it is not in the best interests of our democratic
priorities, and it is certainly not in the best interests of the
American people.
If it is indeed the will of the Senate to eviscerate these critical
programs, let's stop hiding behind generic rescissions. Let's instead
support the Levin amendment, which offsets a revenue loss with a
revenue gain, which eliminates unnecessary tax loopholes, and which
will leave important national priorities intact.
I yield the floor.
The PRESIDING OFFICER. Under the previous order, there will be 2
minutes of debate equally divided prior to
[[Page S474]]
a vote in relation to amendment No. 28, offered by the Senator from
Michigan, Mr. Levin.
Mr. LEVIN. Mr. President, I have just spoken on this. I ask unanimous
consent that we be allowed to yield back the time on both sides.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. LEVIN. Mr. President, I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There is a sufficient second.
The question is on agreeing to the amendment.
The clerk will call the roll.
The assistant legislative clerk called the roll.
Mr. DURBIN. I announce that the Senator from Connecticut (Mr.
Lieberman) and the Senator from Virginia (Mr. Warner) are necessarily
absent.
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 44, nays 54, as follows:
[Rollcall Vote No. 7 Leg.]
YEAS--44
Akaka
Baucus
Bennet
Blumenthal
Boxer
Brown (OH)
Cantwell
Cardin
Carper
Casey
Coons
Durbin
Feinstein
Franken
Gillibrand
Hagan
Harkin
Inouye
Johnson (SD)
Kerry
Klobuchar
Kohl
Lautenberg
Leahy
Levin
Manchin
McCaskill
Menendez
Merkley
Mikulski
Murray
Nelson (FL)
Reed
Reid
Rockefeller
Sanders
Schumer
Shaheen
Stabenow
Tester
Udall (CO)
Udall (NM)
Whitehouse
Wyden
NAYS--54
Alexander
Ayotte
Barrasso
Begich
Bingaman
Blunt
Boozman
Brown (MA)
Burr
Chambliss
Coats
Coburn
Cochran
Collins
Conrad
Corker
Cornyn
Crapo
DeMint
Ensign
Enzi
Graham
Grassley
Hatch
Hoeven
Hutchison
Inhofe
Isakson
Johanns
Johnson (WI)
Kirk
Kyl
Landrieu
Lee
Lugar
McCain
McConnell
Moran
Murkowski
Nelson (NE)
Paul
Portman
Pryor
Risch
Roberts
Rubio
Sessions
Shelby
Snowe
Thune
Toomey
Vitter
Webb
Wicker
NOT VOTING--2
Lieberman
Warner
The PRESIDING OFFICER. On this vote, the yeas are 44, the nays are
54. Under the previous order requiring 60 votes for the adoption of
this amendment, the amendment is withdrawn.
Amendment No. 9
The PRESIDING OFFICER. Under the previous order, there will now be 2
minutes of debate, equally divided, prior to a vote in relation to
amendment No. 9, offered by the Senator from Michigan, Ms. Stabenow.
The Senator from Michigan.
Ms. STABENOW. Mr. President, we all know that small business is the
engine of the economy. This amendment will address a burdensome
regulation we have all talked about. We need to repeal an unnecessary,
burdensome provision in the law that would require 40 million
businesses in America, most of them small businesses, to file 2,000
percent more paperwork with the IRS. We have a chance to do something
about that with this amendment.
I wish to thank Senator Baucus and his staff for their work. I wish
to thank Senator Johanns for his work and my colleagues who are
cosponsoring this amendment. I also wish to thank the 11 business
organizations supporting this, including the Chamber, the Farm Bureau,
the Motor & Equipment Manufacturers Association, the National
Association of Manufacturers, Realtors, NFIB, the Small Business &
Entrepreneurship Council.
This is an amendment that is fully paid for without raising taxes,
while it protects our Nation's defense, our veterans, and our Social
Security. So I would hope we would all join in supporting this effort
to make a needed change that eliminates burdensome paperwork for our
small businesses.
The PRESIDING OFFICER. The Senator's time has expired.
Who yields time in opposition?
The Senator from Hawaii.
Mr. INOUYE. Mr. President, I yield back my time. But I make a point
of order that the pending amendment violates section 311 of S. Con.
Res. 70, the concurrent resolution on the budget for fiscal year 2009.
The PRESIDING OFFICER. The Senator from Michigan.
Ms. STABENOW. Mr. President, pursuant to section 904 of the
Congressional Budget Act of 1974, the waiver provisions of applicable
budget resolutions, and section 4(g)(3) of the Statutory Pay-As-You-Go
Act of 2010, I move to waive all applicable sections of those acts and
applicable budget resolutions for the purposes of the pending
amendment, and I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second? There is a
sufficient second.
The question is on agreeing to the motion.
The clerk will call the roll.
The bill clerk called the roll.
Mr. DURBIN. I announce that the Senator from Connecticut (Mr.
Lieberman) and the Senator from Virginia (Mr. Warner) are necessarily
absent.
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The yeas and nays resulted--yeas 81, nays 17, as follows:
[Rollcall Vote No. 8 Leg.]
YEAS--81
Alexander
Ayotte
Barrasso
Baucus
Begich
Bennet
Bingaman
Blumenthal
Blunt
Boozman
Boxer
Brown (MA)
Brown (OH)
Burr
Cantwell
Cardin
Casey
Chambliss
Coats
Coburn
Cochran
Collins
Conrad
Coons
Corker
Cornyn
Crapo
DeMint
Ensign
Enzi
Feinstein
Graham
Grassley
Hagan
Hatch
Hoeven
Hutchison
Inhofe
Isakson
Johanns
Johnson (SD)
Johnson (WI)
Kerry
Kirk
Klobuchar
Kohl
Kyl
Landrieu
Lee
Lugar
Manchin
McCain
McCaskill
McConnell
Menendez
Merkley
Moran
Murkowski
Nelson (NE)
Nelson (FL)
Paul
Portman
Pryor
Risch
Roberts
Rockefeller
Rubio
Sessions
Shaheen
Shelby
Snowe
Stabenow
Tester
Thune
Toomey
Udall (CO)
Udall (NM)
Vitter
Webb
Wicker
Wyden
NAYS--17
Akaka
Carper
Durbin
Franken
Gillibrand
Harkin
Inouye
Lautenberg
Leahy
Levin
Mikulski
Murray
Reed
Reid
Sanders
Schumer
Whitehouse
NOT VOTING--2
Lieberman
Warner
The PRESIDING OFFICER. On this vote, the yeas are 81, the nays are
17. Three-fifths of the Senators duly chosen and sworn having voted in
the affirmative, the motion is agreed to.
The motion to waive having been agreed to, the amendment is agreed to
under the previous order.
Amendment No. 13
The PRESIDING OFFICER. Under the previous order, there will now be 2
minutes of debate equally divided prior to a vote in relation to
amendment No. 13 offered by the Republican leader.
The PRESIDING OFFICER. The Senator from North Dakota.
Mr. CONRAD. Mr. President, I rise to make a point of order that the
pending amendment violates section 311 of S. Con. Res. 70, the
concurrent resolution on the budget for fiscal year 2009.
Mr. President, the amendment will significantly worsen the deficit--a
fact confirmed by the CBO in a letter to Speaker Boehner on January 6.
The CBO letter says clearly they estimate that enacting the health care
law repeal would increase Federal deficits in the decade after 2019 by
an amount that is in the broad range around one-half percent of GDP for
that period. The GDP for that period is $293 trillion. Mr. President,
one-half of 1 percent is an increase in the deficit and debt of this
country of more than $1.4 trillion.
We have heard colleagues on all sides say we have to get our deficits
and debt under control. Yet one of the first measures is to explode the
deficits and debt, add $1.4 trillion to the debt. That is not just
irresponsible, it is reckless. I urge my colleagues to support the
budget point of order.
The PRESIDING OFFICER. The Republican leader is recognized.
Mr. McCONNELL. Mr. President, only in Washington could you argue with
a straight face that starting a new multitrillion-dollar entitlement
program is going to save money. CBO could only look at the proposition
that was presented to it, which frontloads tax increases in Medicare
cuts and backloads benefits.
[[Page S475]]
Therefore, pursuant to section 904 of the Congressional Budget Act of
1974 and section 4(G)(3) of the Statutory Pay-As-You-Go Act of 2010, I
move to waive all applicable sections of those acts and applicable
budget resolutions for purposes of my amendment and ask for the yeas
and nays.
Mr. REID. Mr. President, we are going to have no more votes tonight.
We have an amendment that Senator Whitehouse is waiting to offer, and
there are a number of other FAA-related amendments. We hope to have a
productive day tomorrow. In the near future, we hope to develop a
finite list of amendments so we can conclude this bill.
The PRESIDING OFFICER. Is there a sufficient second? There is a
sufficient second.
The question is on agreeing to the motion to waive. The yeas and nays
have been ordered. The clerk will call the roll.
The assistant legislative clerk called the roll.
Mr. DURBIN. I announce that the Senator from Connecticut (Mr.
Lieberman) and the Senator from Virginia (Mr. Warner) are necessarily
absent.
The PRESIDING OFFICER (Mr. Bennet). Are there any other Senators in
the Chamber desiring to vote?
The yeas and nays resulted--yeas 47, nays 51, as follows:
[Rollcall Vote No. 9 Leg.]
YEAS--47
Alexander
Ayotte
Barrasso
Blunt
Boozman
Brown (MA)
Burr
Chambliss
Coats
Coburn
Cochran
Collins
Corker
Cornyn
Crapo
DeMint
Ensign
Enzi
Graham
Grassley
Hatch
Hoeven
Hutchison
Inhofe
Isakson
Johanns
Johnson (WI)
Kirk
Kyl
Lee
Lugar
McCain
McConnell
Moran
Murkowski
Paul
Portman
Risch
Roberts
Rubio
Sessions
Shelby
Snowe
Thune
Toomey
Vitter
Wicker
NAYS--51
Akaka
Baucus
Begich
Bennet
Bingaman
Blumenthal
Boxer
Brown (OH)
Cantwell
Cardin
Carper
Casey
Conrad
Coons
Durbin
Feinstein
Franken
Gillibrand
Hagan
Harkin
Inouye
Johnson (SD)
Kerry
Klobuchar
Kohl
Landrieu
Lautenberg
Leahy
Levin
Manchin
McCaskill
Menendez
Merkley
Mikulski
Murray
Nelson (NE)
Nelson (FL)
Pryor
Reed
Reid
Rockefeller
Sanders
Schumer
Shaheen
Stabenow
Tester
Udall (CO)
Udall (NM)
Webb
Whitehouse
Wyden
NOT VOTING--2
Lieberman
Warner
The PRESIDING OFFICER. On this vote, the yeas are 47, the nays are
51. Three-fifths of the Senators duly chosen and sworn not having voted
in the affirmative, the motion is rejected.
The motion to waive having been rejected, the point of order is
sustained and the amendment falls.
____________________