[Congressional Record Volume 158, Number 47 (Wednesday, March 21, 2012)]
[Senate]
[Pages S1879-S1882]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CARE
Mr. WICKER. Madam President, on Friday of this week 2 years will have
passed since President Obama signed the Patient Protection and
Affordable Care Act into law. This is actually a sad anniversary
because more than enough time has gone by to reveal the failures of
this massive, burdensome piece of legislation.
The fact that 26 of our 50 States--more than half of the States--are
part of the legal challenge currently under review by the Supreme Court
points out the inevitable truth: This is a law that simply does not
work.
The case that will be heard in a few days will be one of the most
consequential Supreme Court cases of my lifetime--consequential not
only because it deals with this massive, burdensome piece of
legislation but because the implications go so much further. The
Supreme Court case will decide the scope of the commerce clause.
Indeed, my colleagues, if the Supreme Court decides this law can
withstand constitutional scrutiny, then this large, massive Federal
Government can, in fact, do almost anything, and there will be hardly
any limitations under the Constitution and the Bill of Rights on the
power of the U.S. Federal Government.
Americans are right to be disappointed with Obamacare, and they are
right to want it repealed. And regardless of the outcome of the Supreme
Court case, this Congress can decide and, as a matter of fact, the
people of the United States will have a chance in November, as we do
every 2 years, to decide.
A recent Gallup poll shows that twice as many Americans think the law
will make things worse for their families than those who believe it
will make things better. Seventy-two percent of Americans believe the
individual mandate is unconstitutional.
The truth is that Americans deserve affordable, high-quality health
care, not a 2,700-page, big-government piece of legislation that taxes,
spends, and regulates. The President's health care law has not lowered
the cost of health care as promised. It has not created jobs as
promised. It has not reduced the deficit as promised. So this week we
mark the anniversary not with progress but with bitter realities.
President Obama, in his joint session speech to Congress in 2009,
asserted that his plan ``will slow the growth of health care costs for
our families, our businesses, and our government.'' In fact, last week
the nonpartisan Congressional Budget Office and Joint Committee on
Taxation updated their outlook of the health care law's impact on the
Federal budget. Not surprisingly, their latest analysis says Obamacare
will cost even more than anticipated. And the anticipated costs were
high, indeed, but they say the health care law will cost nearly $1.8
trillion over the next decade or double the estimated cost that
accompanied the bill when Democratic supermajorities passed it in 2010.
This is hardly the relief President Obama promised.
During his campaign, the President said the plan would reduce health
care premiums by an average of $2,500 per family. Instead, premiums
have grown by nearly that much since he was elected.
I see I am joined by two of my colleagues, the distinguished Senator
from Wyoming and the distinguished Senator from Kansas.
There are a number of other promises we are talking about today, and
I know we don't impugn motives around here--that is against the rules--
but one has to wonder, did advocates of this massive law actually
believe these promises or were they simply duped and misled? And I
don't know which is worse, but I know that my colleague Dr. Barrasso,
himself a physician who is on the front line of this issue, has given
this a great deal of thought, so at this point I ask him to join in
this colloquy.
Mr. BARRASSO. Madam President, I stand here with my friend and
colleague from Mississippi because he and I both attended, in his home
State of Mississippi, a meeting at a hospital where we met with
doctors, also met with patients, and met with people from the community
while the debate and discussion was being conducted about this health
care law. At the time, people were asking all sorts of questions
because they had heard the promises. Would this actually lower the cost
of insurance by $2,500 a family? That is what people wanted. That is
what they expected. The other question: Will I really be able to keep
the care I have and the doctor I have if I like it?
Now here we are a couple of years later, the second anniversary of
this health care law being passed, and I am here with my friend and
colleague from Mississippi, and it just seems to me that the questions
that were asked by his constituents, by the doctors in those
communities who take care of the patients, by the patients, the
hospital administrators whom we talked to that day in his home State of
Mississippi--it does seem that many of these promises have been broken.
The costs seem to go up higher than had this health care law not been
passed at all. The numbers and the statistics we are hearing now from
the budget office on the cost seem to be much, much higher than what
the
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President promised. Parts of this health care law--the so-called CLASS
Act--it now comes out were accounting gimmicks, budget schemes to make
it seem as though the cost of this health care law would be much less
than what American people now know it to be.
So it is no surprise to me--and I see this in Wyoming, and I am sure
the Senator sees it in Mississippi, and I would imagine the Senator
from Kansas who is on the floor has seen the same thing at home because
I know he has gone to hospitals and just--maybe almost every hospital
in the State of Kansas as he has traveled around. We are all seeing
that this health care law is less popular now than when it was passed.
That is what I hear at townhall meetings. When I ask, do you think you
are actually going to pay more under the health care law, every hand
goes up. And when I say, do you think the quality and availability of
your own care at home is going to go down, again, every hand goes up.
So if I could ask my colleague from Kansas if he is hearing the same
things. And I see we are also joined by the Senator from Arizona.
Mr. MORAN. I appreciate the opportunity to be on the floor today,
especially with the Senator from Wyoming, a doctor who is such an
expert on the topic of really not just the moment, not just the day,
but the topic of what our country faces.
I will say that I do spend a lot of time in hospitals across our
State talking to health care providers, talking to patients, doctors,
to administrators, trustees. In fact, there are 128 hospitals in our
State. I have visited all of them, and there is genuine concern about
the future of the ability for health care to be delivered in
communities across our State. And you add to that the physician and
other health care provider community, and this health care reform act
is creating significant challenges.
My interest in public service started a long time ago with the belief
that we live our lives in rural America, in my State of Kansas, in a
pretty special way. When I came to Congress, it became clear to me that
if our communities were going to have a future, it was dependent upon
the ability to deliver health care close to home. And those rural
communities across our Nation often have high proportions of senior
citizen populations where Medicare is the primary determining factor of
whether they can access health care.
When the affordable care act was passed, many promises were made, but
one of the things that was told to the American people--or at least the
attempt was made to sell to the American people--was that there would
be greater access. And I would certainly say that one of the promises
that is not being kept about the affordable care act is the likelihood
that there is going to be greater access for Americans across our
country to health care because this bill is underfunded, it is not paid
for. The consequences are that the administration is already proposing
and Congress will always be looking for ways to reduce spending when it
comes to health care, and the most likely target is the payment
Medicare makes to health care providers, which in many instances
already doesn't cover the cost for providing the service. So when we
look for access to health care, every time we make a decision, every
time a decision will be made in order to try to make this more
affordable, we are going to see fewer and fewer providers able to
provide the services necessary to folks across the country but
especially in rural communities where 60, 70, 80, even 90 percent of
the patients admitted to the hospital are on Medicare.
So one of the problems with the affordable care act is the reality
that it will reduce access to health care for people who live in rural
America and we will see fewer physicians accepting patients on
Medicare, we will see fewer hospital doors remain open; as this bill
takes $500 billion out of Medicare to begin with, the Congress that
passed and the President who signed this legislation set the stage for
there to be less affordable health care available to Americans across
the country but especially for constituents of mine who live in a rural
State such as Kansas.
Mr. WICKER. If I could jump in on the issue of Medicare because I
have a quote here from President Obama, July 29, 2009: ``Medicare is a
government program, but do not worry, I am not going touch it.'' As a
matter of fact, only months later he signed into law Obamacare, which
takes $\1/2\ trillion from Medicare. And it touches on the very issue
the Senator from Kansas was referring to with regard to Medicare access
for people in rural Kansas.
Mr. McCAIN. Madam President, I might point out to my friend from
Mississippi that the first amendment we had on the floor of the Senate
when we were considering ObamaCare was to restore that $500 billion,
and it was voted down on a party-line basis.
I thank my friends for allowing me to engage in this colloquy. I want
to discuss this with my friends. In my view, probably what encapsulates
the problems with this legislation--the commitment began that we would
provide affordable health care to all Americans, which meant we had to
put the brakes on inflation in health care because health care was
becoming unaffordable--the highest quality health care in the world.
Nothing, in my view--and I ask my colleagues this--describes more how
this whole plan went awry than the so-called CLASS Act.
Late in the debate, the CLASS Act was thrown in to provide long-term
care for seniors, which seems like a worthy cause, but the whole thing
was a gimmick. It was described by Senator Conrad, our chairman of the
Budget Committee, as a ``Ponzi scheme of the first order, the kind of
thing that Bernie Madoff would have been proud of.''
They foisted that off on us. Why? Initially, because of CBO scoring,
it would show an increase in finances into revenues and into the whole
ObamaCare program. But as soon as those people who were paying in
became eligible, obviously, the reverse happened. Thank God for former
Senator Gregg of New Hampshire, who had an amendment adopted that
required the Secretary to certify that the program would be solvent for
over 75 years before the program could be implemented. If it hadn't
been for that, the CLASS Act would be here today.
Then, last October, the Secretary of Health and Human Services issued
a report confirming what many of us knew was inevitable: that the
Secretary could not certify the CLASS Act's solvency as required under
law. So we went through this exercise of frantically searching for ways
to increase revenue, at least the way CBO does scoring. So we did the
CLASS Act and, thank God, Senator Gregg of New Hampshire put in an
amendment that they had to certify that it would be viable over 75
years. There was not a snowball's chance in Gila Bend, AZ, that they
were able to certify that for over 75 years it would be a viable
program.
It was kind of entertaining, but late on a Friday night the Secretary
of Health and Human Services said she could not certify that the
program would be solvent throughout a 75-year period. The result of
this was, obviously, that they didn't have the false revenues that CBO
could score. They didn't have a program that could provide long-term
care for seniors. Again, as the Senator from North Dakota aptly pointed
out, this ``Ponzi scheme of the first order'' faced and met a well-
deserved death.
That is why an overwhelming majority of the American people
disapprove of this whole exercise of ObamaCare. They want it repealed.
They don't support it. I am proud to say in this election we will
decide whether we repeal and replace ObamaCare. The American people
care about that.
Mr. WICKER. Madam President, to summarize what the Senator from
Arizona has just said, the CLASS Act was sold to the American people as
a budget deficit reducer. It was going to reduce the deficit. No sooner
was it signed and they started looking at it that the administration
itself said: We know it is unworkable, and we abandon it. We are not
even going to try to enforce it.
Mr. McCAIN. They could have kept it on the books. If it had not been
for the amendment of Senator Gregg from New Hampshire which said they
had to certify its solvency over a 75-year period, we would have the
CLASS Act today, a Ponzi scheme where people would be paying in, and
that is scored as revenues, and some years later when they retire,
obviously, the reverse would have been true.
I have yet to hear one of my colleagues come over and admit that they
[[Page S1881]]
were wrong about the CLASS Act. I would love to hear some of those who
strongly advocated for it. My friend from Iowa, Senator Harkin, said:
So we get a lot of bang for the buck, as one might say,
with the CLASS Act that we have in this bill.
Senator Whitehouse said this:
Certain colleagues on the other side of the aisle have
argued that the CLASS plan would lead to a financially
unstable entitlement program and would rapidly increase the
Federal deficit. That is simply not accurate.
I look forward to my colleagues who supported and voted for the CLASS
Act to come over and agree that it was, as Senator Conrad pointed out,
a Ponzi scheme.
Mr. WICKER. Madam President, I know our friend from South Dakota has
joined us and is eager to join in this discussion. I wonder if he has
anything to add about the broken promises that were made during the
passage of ObamaCare.
Mr. McCAIN. Before that, the whole point of reforming health care was
to reduce the cost of health care. That was the goal. We all know
Medicare cannot be sustained for the American people if the inflation
associated with health care continues. The whole object of this game
was to reduce the cost of health care and preserve the quality of
health care.
Does anybody think that was achieved with this legislation? That is
why the American people have figured it out. I yield for the Senator
from South Dakota.
Mr. THUNE. Madam President, I echo what the Senator from Arizona said
about the CLASS Act. He was here, as was I and many others, debating
this bill and saying this was a program destined to be bankrupt. In
fact, if we look at the independent Actuary, he was saying the CLASS
Act was unworkable. They said it would collapse in short order.
Within the HHS Department, there was a nonpartisan career staff that
called it a ``recipe for disaster.'' There was plenty of advance
warning this wasn't going to work.
The Senator from Arizona correctly pointed out it was used as a
gimmick to make the overall cost look less and, therefore, bring it
into balance. As we know now, the CLASS Act could not work. They have
had to acknowledge that, and the amendment put on by Senator Gregg,
which would have forced them to certify, made that abundantly clear.
To the point of the Senator from Mississippi, the purpose of the
exercise was that we have to do something about the cost of health
care. In fact, the President of the United States, when he was running,
said this:
If you've got health insurance, we are going to work with
you to lower your premiums by $2,500 per family per year. We
will not wait 20 years from now to do it, or 10 years from
now to do it; we will do it by the end of my first term as
President of the United States.
I am sure the Senator from Arizona probably remembers very well many
of these statements. But the facts tell a different story. If we look
at what health care costs are doing, and even what was predicted by the
Congressional Budget Office, they said the law was going to increase
health insurance premiums by 10 to 13 percent, which means families
purchasing coverage were going to pay an additional $2,100 because of
the new law. That has actually been borne out.
If we look at the cost of health insurance for people in this country
today, it has gone up, not down; it has gone up dramatically--since the
President took office, about 25 percent for most Americans. All these
promises about getting costs under control, the promises about keeping
what people have, the promises about this being done in a way that
would protect Medicare--we all know Medicare was going to be slashed
when this was fully implemented, to the tune of $1 trillion, and there
would be $1 trillion in new taxes also.
The American people got a bad deal, and they know it. That is what
the public opinion polls show.
Mr. McCAIN. I ask the Senator, even though we have shut down the
office of the CLASS Act, even though the Secretary of Health and Human
Services said they can't certify that it will be fiscally solvent over
75 years, it is still on the books. Isn't the CLASS Act still on the
books? Does the Senator think it might be appropriate, since we cannot
comply with the law, to maybe repeal that portion of the law? Is that
something we might think about? It might be a pretty good amendment.
Mr. THUNE. It would be, and, by the way, we have that amendment and
would be happy to offer it. We tried to call up the bill, but it was
objected to by the Democrats. The thing about bad ideas around here is
that they tend to come back. This idea ought to be put away once and
for all. Yet it is on the books, as the Senator pointed out. I don't
know why, after all the evidence out there now that has been put
forward, including the Health and Human Services Secretary saying this
will not work. But we continue to maintain it on the books in the hopes
of some in the administration, I am sure, that it can be resurrected in
the future. It was a bad idea then, and it will be in the future. It
just doesn't pencil out. We cannot make it work. It saddles future
generations of Americans with massive amounts of debt.
Mr. WICKER. Madam President, let me ask my colleagues about another
promise. They will call time on us soon.
Does anybody recall hearing this statement from the President of the
United States in 2009? He said this:
If you like your health care plan, you will be able to keep
your health care plan, period. No one will take it away, no
matter what.
That was the President on June 15, 2009. What happened to that?
Mr. BARRASSO. Madam President, when we look at it, even the
administration admits that wasn't true. Small businesses--people who
get their insurance in small businesses--will have a difficult time
continuing to provide coverage for people because of the mandates that
say they have to provide Washington-approved insurance. That is the
problem: that people have what they like, and it may be something they
want, need, and can afford. Now they are being mandated to have
something they may not want, need, or be able to afford.
So, again, we have another broken promise, which is why Senator
Coburn, who practiced medicine for a quarter century, as I did, and I
have come out with a report, released yesterday called, ``Warning, Side
Effects, a Checkup on the Federal Health Law: Fewer Choices.''
That means people cannot choose to keep what they have. There are
fewer choices, higher taxes, more government, and less innovation. None
of that is what the American people have been promised by the
President.
Mr. McCAIN. In addition, I ask the Senator how many new regulations
have been issued, and how many new regulations do we anticipate as a
result of this exercise?
Mr. BARRASSO. This over 2,000-page law will result in over 100,000
pages of regulations. There is one part of the law where, for a couple
of pages--4 to 6 pages--they had 400 pages of regulations and 50 pages
of legal guidance.
When we talk to hospitals--I know those of us who visit with
hospitals in our States--they say they are spending money on
consultants and lawyers to help them understand the law. They say: It
is money we ought to spend on patients and equipment and technology for
our hospital, to provide care in our community.
I know the Senator from Kansas has visited over 100 hospitals in his
State. He has heard the same thing.
Mr. MORAN. That is true. The point made earlier about the goal of the
legislation bending the cost curve down--it didn't do it, it doesn't do
it, and it cannot do it. That created the problem we all face now. How
can we have access to affordable health care if we are not reducing the
cost of health care?
The end result, in my view, is that Americans will have less options
for their own plans. As employers, they will provide either less
options or no options for their employees. So the idea that people are
going to get to keep what they have, that begins to disappear. If they
are a senior citizen and Medicare has been their primary provider, we
go back to the idea that we didn't bend the cost curve. So in order to
make health care affordable--when the legislation fails to do that, we
find other gimmicks to do that. One of the things this bill creates is
IPAB, an independent agency that will make decisions about what is
covered by people's health care plans. The goal will not be to have
better quality health care; the goal of the IPAB will be to reduce
expenditures.
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As the promise was made that people get to keep what they have, it
becomes totally different than what they have experienced in their
health care plans--either in their own private health care insurance or
as a beneficiary of Medicare. Even the President's own Medicare Actuary
estimates that the law will increase overall national health care
expenditures by $311 billion during the first 10 years alone, and that
private health care insurance premiums will rise 10 percent in 2014.
So if we are complaining today about the increase in premium costs,
there is more to come. In 2014, the Medicare Actuary says there will be
another 10 percent increase in your health care premiums. At the Center
for Medicare and Medicaid Services, their economists found the
increasing growth rate in health care spending will occur in every
sector of health care. More recently, the Congressional Budget Office,
our neutral provider of analysis, says the cost of the health care law
may be substantially higher than earlier estimated.
One of the things I would suggest we should have done and that never
happened--if we want folks to be able to keep what they have, if we
want access to health care in rural and urban and suburban places in
the country--we should have done something about fixing permanently the
reduction of payments to physicians--the so-called doc fix. One would
have thought, in health care reform, that would have been front and
center. Because if we don't have a physician providing a service, we
don't have health care. Yet we have a Medicare system that is going to
reduce the payments. In fact, expected this year, the reduced payments
to physicians was going to be 30 percent.
The reality is, no longer will physicians accept Medicare patients.
The option the American people were promised about keeping what they
have disappears one more time. In fact, at a townhall meeting in
Parsons, KS, this year, a physician in the front row said: Senator, you
need to know I no longer accept Medicare and Medicaid. I will take
cash, but I cannot afford to provide the services based upon the
Medicare reimbursement rate I get. When you add in all the paperwork,
trying to comply with Medicare and Medicaid, it is no longer
financially feasible for me in this small town to provide the services
my patients need under Medicare.
So we are going to see a lot less access because, once again, this is
a failure. The promise that was made to bend down the cost curve, to
reduce health care costs, to reduce premiums was totally false.
Mr. WICKER. So the promise was not to touch Medicare, and that
promise has not been fulfilled. The promise was to reduce the deficit,
and that turned out to be an empty promise.
Also, we were told by the President and by Speaker Pelosi this bill
would create jobs. The President said it was a key pillar for a new
foundation for prosperity. How has that turned out? Former Speaker
Pelosi said in its life the health care bill will create 4 million
jobs--400,000 almost immediately.
Of course, neither of those promises has come true. The nonpartisan
CBO has estimated the health care law will reduce America's workforce.
This is the bipartisan CBO. They said it will reduce America's
workforce by 800,000 jobs over the next 10 years. That fact has been
confirmed by the U.S. Chamber of Commerce.
Mr. THUNE. I would say to my colleague from Mississippi that one of
the areas where jobs may be created is in the Federal Government
because it is going to take an awful lot of Federal bureaucrats to
oversee and lots of new IRS agents to implement this legislation. That
would be the only place we will see job creation.
But when it comes to private sector job creation, the thing about
this is, it raises the cost for health insurance coverage for
employers, and it raises taxes on a lot of people who are involved in
health care.
The ACTING PRESIDENT pro tempore. The minority's time has expired.
Mr. THUNE. The combination of those things is only going to cost
jobs.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Iowa.
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