[Congressional Record Volume 157, Number 55 (Thursday, April 14, 2011)]
[Senate]
[Pages S2472-S2474]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            A SECOND OPINION

  Mr. BARRASSO. Madam President, I come to the floor as someone who has 
practiced medicine in Wyoming, taking care of families all across the 
Cowboy State for almost one-quarter of a century. I come as a doctor 
giving a second opinion, as I have done week after week about this 
broken health care law that people all around the country are now very 
concerned about and the impact it is going to have on their own 
personal lives.
  We started the whole discussion and debate about health care that the 
American people knew what they wanted: They wanted the care they need, 
from a doctor they want, at a cost they can afford. What we have gotten 
is something that does not provide that at all.
  I saw today in the Washington Post, under the headline ``Budget 
Showdown,'' comments about the President's speech yesterday to the 
Nation. He did talk about Medicare and did talk about Medicaid. I 
believe that speech was very short, inadequate on the details.
  It was interesting to see what the Washington Post said about 
Medicaid. It said:

       . . . a senior administration official, speaking to 
     reporters on the condition of anonymity, said that . . . 
     ``the details have not been worked out.''

  So we have an anonymous source, working in the White House, talking 
to reporters, admitting that the details have not been worked out.
  Yesterday, people heard the President's speech on spending, but it 
seemed to be higher on political attacks than it was on substantive 
speech--the things we need to be seriously discussing and debating in 
this country about a huge debt problem with which we are living. The 
President did mention one bit of substance, though, that should concern 
the American people. He said:

       We will slow the growth of Medicare costs by strengthening 
     an independent commission of doctors, nurses, medical 
     experts, and consumers who will look at all the evidence and 
     recommend the best ways to reduce unnecessary spending while 
     protecting access to the services seniors need.

  What this is is a Washington commission--a commission created in the 
health law that many know as IPAB. It may sound harmless. It stands for 
the Independent Payment Advisory Board. Americans, I believe, need to 
know more about the details as to how this will actually work.
  Many Americans may not remember that the health care law created this 
unelectable, unaccountable board of Washington bureaucrats who will be 
appointed by the President, and the sole purpose is to cut Medicare 
spending based on arbitrary budget targets. These are cuts above and 
beyond the $500 billion that was taken from a nearly bankrupt Medicare 
Program, not to save Medicare for our seniors but to create a whole new 
government entitlement program for someone else. This board empowers 15 
unelected Washington bureaucrats to make these Medicare cuts, all 
without full transparency and accountability to America's seniors and 
to elected officials.
  So, once again, this board proves that the President and the 
Democrats in Congress who voted for the health

[[Page S2473]]

care law simply didn't have the political courage to make the tough 
spending decisions themselves. Instead, they took the easy road. They 
pulled the classic Washington maneuver--to create a board and punt the 
decisions to them.
  Congress gave this board its authority to manage Medicare spending. I 
didn't vote for it. Members of my side of the aisle didn't vote for it. 
But this is part of the health care law that was crammed down the 
throats of the American people. Congress abdicated its responsibility 
to explain to the American people specific payment changes necessary to 
keep Medicare solvent.
  Let's take a look at what happens when this board actually makes a 
recommendation. The recommendation becomes law. The recommendation 
becomes law. How can we prevent that from becoming law? The 
recommendation will become law unless the House and the Senate each 
adopt--not by simple majority--each adopt by a three-fifths majority a 
resolution to block them. That is not enough. First, three-fifths of 
the House, then three-fifths of the Senate, resolutions to block what 
this board is recommending. Then the House and Senate have to pass 
legislation to achieve equivalent savings of what this board claims to 
be saving by the care they deny.
  This is an incredible concentration of power that should belong in 
Congress to a board of unelected--unelected--individuals who are 
appointed by the President.
  Is there concern about this? In the House of Representatives, there 
is. There has been a repeal provision created that would repeal this 
board, and I will tell my colleagues it is a bipartisanly cosponsored 
attempt to repeal this provision.
  So that is what we are looking at now. Why? Because the President and 
the Democrats refused to take a leadership role and chose to punt this 
down the road. They simply threw up their hands and said let someone 
else do it. This is not health reform that is good for patients, for 
the providers, the doctors and nurses who take care of those patients, 
or for the taxpayers.
  Fortunately, Senator Cornyn of Texas has introduced the Health Care 
Bureaucrats Elimination Act. This bill would repeal this board in order 
to ensure that the doctor-patient relationship that is important to 
quality health care for all Americans is maintained. I am happy to 
cosponsor that with Senator Cornyn. We will continue to fight to repeal 
and replace this very broken health care law.
  Thank you, Madam President. I yield the floor.
  The PRESIDING OFFICER. The Senator from Maryland.
  Mr. CARDIN. Madam President, shortly we are going to be having three 
votes. One vote will be on the budget for our current fiscal year that 
began on October 1 and ends on September 30 of this year. I think we 
have talked about that vote at some length. I took the floor yesterday 
and explained how the negotiated budget for this year is far better 
than the Republican-passed budget in the House of Representatives, the 
original H.R. 1. I pointed out how a budget represents the vision for 
our future, that it is a policy document. I far prefer the agreement 
that was reached that preserves America's ability to have a competitive 
workforce.
  I pointed out yesterday, and I will repeat again today, that the 
budget we will vote on will maintain most of the funding for NIH basic 
research, which is critically important for innovation in America. That 
is the basic research that is used by our high-tech companies so 
America can outinnovate our competitors, whereas the House-passed 
budget would have cut $1.4 billion from NIH research, or how the 
agreed-to budget will provide for job training and Job Corps pretty 
much at the current rates, whereas the Republican-passed House budget 
would have eliminated most of the funds for job training and 40 percent 
of the funds for the Job Corps; or, for our students and Pell grants, 
maintaining the funding so students can continue to receive $5,550 
maximum under Pell grants. As I pointed out, college education tuition 
is going up. The House-passed budget would have cut 15 percent off of 
that program.
  I think perhaps the one that really points to the major difference 
between where the Republicans were on the budget and what we finally 
ended up with is the Head Start Program. The Head Start Program has 
worked very effectively in all of our States. Children who participate 
in Head Start do much better in life. We know that. The House-passed 
budget would have cut the number of children in Head Start by 218,000, 
eliminating 55,000 teachers and assistants from the Head Start Program. 
I am pleased the agreement reached will maintain all services at Head 
Start so all of our children can continue in that program.
  The list goes on and on about the compromises that were reached. I 
wish to make clear this was a true compromise. It is not what the 
Democrats wanted or what the Republicans wanted. It is going to be 
painful. There is a lot I would like to have seen done differently.
  I wish to point out that the GSA budget is going to be reduced by $1 
billion. At the White Oak facility in Maryland for the FDA, we are 
doing some critically important construction work to bring together the 
different participants for the safety of Americans. That program is 
going to be severely slowed as a result of the cut to the GSA budget.
  I pointed out yesterday that on the environmental front regarding the 
Endangered Species Act, there is a provision that delists the great 
wolf. That shouldn't be targeted for congressional action. That is a 
dangerous precedent for us to set.
  I pointed out that the Community Development Block Grants are cut. 
Even though the EPA budget which would have been cut by 30 percent with 
the House-passed budget--we bring that down by 50 percent, so it is 
only a 15-percent cut, but a 15-percent cut is too large of a cut for 
the Environmental Protection Agency. The good news is we were able to 
remove those policy riders that would have prevented the Environmental 
Protection Agency from protecting the environment, protecting our 
public health. Those were eliminated.

  I wish to speak for the next few minutes about the other two votes 
that will be taking place on the floor in a few moments. They are votes 
on what are called correcting resolutions. Let me explain this, because 
I think it might surprise some of the people to learn we are not 
talking about the amount of dollars that is going to be appropriated in 
this current year's budget. These are restrictions as to how money can 
be spent, so it deals with a philosophical agenda, not a budget agenda. 
This is not about reducing the deficit; this is about trying to impose 
a philosophical position on the budget for this year. Let me talk about 
the two correcting resolutions which I am going to urge my colleagues 
to vote against. One would restrict funds going to Planned Parenthood--
women's health care issues--which I call the war on women. This deals 
with title X funding.
  Title X funding is used for preventive health services such as 
cervical cancer screenings, breast cancer screenings, immunizations, 
diabetes and hypertension testing, sexually transmitted disease testing 
and treatment, HIV testing and referrals. Not one dime of Federal money 
can be used for abortions. That is the current law, the current 
prohibition.
  Currently, there are approximately 5 million people who benefit from 
title X funding with over 4,500 clinics across the Nation. Ninety-one 
percent of the people who take advantage of these clinics have no 
health insurance. Less than 25 percent of title X funds go to Planned 
Parenthood. Planned Parenthood spends approximately 3 percent of its 
total budget on abortion services, not one dime of which is Federal 
funds--not one dime of which is Federal funds. So this is not about 
abortion; this is about whether we are going to be able to provide 
preventive care to our most vulnerable in America. It is an attack on 
women, because women are the basic beneficiaries of title X funds. It 
is going to cost us more money for the use of emergency room services. 
It makes no sense at all. It is certainly counter to what we all say we 
want, and that is gender equity in health care in America.
  I urge my colleagues to vote no on that correcting resolution.
  The second correcting resolution is an attempt to repeal the 
affordable

[[Page S2474]]

care act that we celebrated the anniversary of a few weeks ago. If you 
are a senior, you should be concerned about this vote, because now you 
have a wellness exam annually under Medicare that is reimbursed, so you 
can take care of your own health care needs. That would be put in 
jeopardy.
  If you are one of the 3.2 million Americans who fall within the so-
called doughnut hole, or the coverage gap for prescription drug 
coverage, you should be concerned about the repeal. If you got $250 
last year, you are going to get 50 percent of the cost of your 
brandname prescription drugs covered and, by 2020, we are going to 
close the doughnut hole altogether. That would be eliminated if this 
correcting resolution were passed. Seniors should be pleased that at 
least we were able to extend the solvency of the Medicare Program by 10 
years.
  Frankly, you should be worried about whatever efforts are being made 
here to privatize the Medicare system, making seniors pay more for 
their health care. It starts with this vote later today where we can 
reject the efforts to turn back the clock on Medicare where seniors 
would have to pay more.
  If you are a small business owner, you should be pleased by the tax 
credits that are now available and which this correcting resolution 
would take away, making it more expensive for employers to provide 
health care for their employees.
  If you are a consumer and are now able to cover your child up to age 
26--1.2 million Americans--the correcting resolution would turn the 
clock back on the progress we have made on fighting the abusive 
practices of private insurance companies in dealing with preexisting 
conditions. If you have a child with asthma, now you can get full 
coverage. If we turn the clock back by approving that correcting 
resolution, you will be at the mercy of private insurance companies to 
provide coverage, which is very unlikely to happen.
  I can talk about emergency room visits where some insurance companies 
require preauthorization. I don't know how you get preauthorization 
when you need to go to an emergency room. We corrected that in the 
affordable care act. Once again, the correcting resolution we are being 
asked to vote on will turn the clock back on that, putting people at 
the mercy of private insurance companies as to whether they will cover 
emergency room visits.
  If you are a taxpayer, which is what we are talking about today with 
the budget, you should be very much concerned about this correcting 
resolution because by turning back the clock on the affordable care 
act, it will cost the taxpayers over $1.5 trillion over the next 20 
years. So it is tailored to your need. If you have pride, as I do, that 
America has at long last said that health care is a right, not a 
privilege, and recognize that we need to do more to improve our health 
care system, you want us to move forward and talk about the health care 
issues and try to improve our health care system; you don't want us to 
turn the clock back.

  The large number of people who have no health insurance or have 
restricted coverage because of the abusive practices of private 
insurance companies or the inability to cover children after they 
graduate from college--that has now been corrected. We certainly don't 
believe a correcting resolution would take that away from us.
  We are going to have three votes. I urge my colleagues to vote 
against both of these correcting resolutions. They are attacks on 
women's health care issues and attacks on quality health care for all 
Americans. We need to pass the budget, and these correcting resolutions 
should be defeated.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa is recognized.
  Mr. GRASSLEY. Madam President, I ask unanimous consent for 5 
additional minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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