[Congressional Record Volume 158, Number 48 (Thursday, March 22, 2012)]
[House]
[Pages H1536-H1539]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      BROKEN PROMISES IN OBAMACARE

  The SPEAKER pro tempore (Mr. Hultgren). Under the Speaker's announced 
policy of January 5, 2011, the Chair recognizes the gentleman from 
Louisiana (Mr. Fleming) for 30 minutes.
  Mr. FLEMING. Thank you, Mr. Speaker. It is indeed a pleasure to come 
to the floor today to speak to this Chamber about a subject that I 
think is very important on the minds of the American people, and that 
is the 2-year anniversary of the Patient Protection and Affordable Care 
Act, also known as PPACA, and certainly more commonly known as 
ObamaCare.
  I want to give you a little context, Mr. Speaker, of where I come 
from. I'm a Congressman from Louisiana in the 4th District, centered in 
Shreveport Bossier. I have been a family physician for 36 years. I 
still see patients when I have the opportunity. I also have businesses 
on the side that are not related to health care.
  So in my world for many years, and in raising a family, the 
responsibilities of meeting payrolls have included not only running a 
small medical practice but also a growing business dealing with all of 
the regulations, the taxation, and the many different issues--personnel 
problems, human resource problems--that we must deal with. And 
certainly providing health care has been a great challenge over the 
years. And there's no question that the system has not been what it 
should be prior to this time.
  In fact, one of the reasons why I ran for Congress--and many other of 
my colleagues who were physicians--we have 15 just in the Republican 
section alone, and I think we'll have more next year--the reason why 
we've become so activated, if you will, when it comes to Federal policy 
on health care is because of all the failures that we've seen over the 
years and the problems with government trying to micromanage health 
care.
  So what I want to talk about today is broken promises with regard to 
ObamaCare. You may recall that Candidate Obama, Senator Obama, says you 
will not have to change your health care plan if his health care plan 
is brought into law. For those of you, he said, who have insurance now, 
nothing will change under the Obama plan except that you will simply 
pay less.
  Another quote from him is this. This is President Obama in June of 
2009:

       And that means that no matter how we reform health care, we 
     will keep this promise to the American people. If you like 
     your doctor, you will be able to keep your doctor. If you 
     like your health care plan, you will be able to keep your 
     health care plan.

  Well, what is the truth of this? By the administration's own 
estimates, new health care regulations will force most firms and up to 
80 percent of small businesses to give up their current plans by 2013. 
Grandfather plans would be subject to the costly new mandates and 
increased premiums under the President's health care plan.
  Again, my own business is back home. We still cover our employees, 
and we would fall under the grandfather. But here's what we're up 
against. If we change just one dotted ``i,'' one crossed ``t,'' that 
totally nullifies the grandfather rule that applies to our plan. So 
what that means is if we change anything--the cost structure, 
anything--then simply we will fall into the government-mandated plan in 
which we have to choose among the three specified, certified government 
plans that would be chosen for us.
  Now you could say, Well, we could keep exactly what we have without 
changing one scintilla of it. The problem is, what if the cost 
continues to go up--and it will--and we say maybe let's raise the 
deductible, raise copayments, cut some coverage someplace, change the 
way we cover pharmaceuticals, do something to lower that cost so we can 
afford it as a company and our patients can afford it. No. It then 
nullifies the grandfather clause and then it activates, of course, 
ObamaCare, and we will be required to be in it.
  Let's go to broken promise number two. I have many broken promises 
but I'm going to focus on six today.
  Broken promise number two. President Obama in September of 2009 says:

       First, I will not sign a plan that adds one dime to our 
     deficits either now or in the future. I will not sign it if 
     it adds one dime to the deficit now or in the future.

  Well, is that true? An honest accounting of the health care plan 
finds that it will increase the deficit by hundreds of billions in the 
first 10 years alone. For instance, the law double-counts the Medicare 
savings.
  It's interesting the way we have something in Washington, in 
Congress, called the CBO, the Congressional Budget Office. It uses a 
scoring mechanism. It works out of a 10-year budget window. So whatever 
we do, it either costs more or costs less, based on what happens for it 
in the next 10 years.
  And so this was a big challenge for the Obama administration to get 
this bill passed because they saw what we saw, and that is it will add 
billions of dollars to the deficit. So what did they do? They 
manipulated the budget window to make it look like it paid for itself. 
And how did they do that? Well, for one thing, the way the bill is set 
in motion and the way it's implemented is that for the first 4 years--
you've noticed that even though it passed in March of 2010, it hasn't 
been implemented. Why? A very good reason. Because the costs don't 
begin until it's implemented. However, the revenues already began soon 
after the bill passed. So the way it was scored is we have 10 years of 
revenue--that's income--and 6 years of costs.
  Well, Mr. Speaker, I could run any business profitably that way if I 
have 10 years of revenue and only 6 years of cost. That's precisely 
what happened here. However, the law has been rescored and in fact what 
was supposed to be a $900-some billion bill over 10 years is now 
rescored at $1.75 trillion. And next year, which will then stretch it 
out the full 10 years, it will be well over $2 trillion.
  Former CBO Director Douglas Holz-Eakin has written that:

       Under a realistic set of assumptions, the law will increase 
     the deficit by at least $500 billion in the first 10 years 
     and more than $1.5 trillion in the second decade.

  Mr. Speaker, let's go back to where we are with government health 
care pre-ObamaCare. Back in the nineties, the last time that we 
balanced a budget was under President Clinton and after, of course, a 
Republican-controlled House and Congress in general sent a balanced 
budget three times in a row. He vetoed it twice and finally signed it 
the third time.

                              {time}  1520

  How did they do it and we can't do it today? Well, one reason is very 
important, and that is that at that time 30 percent of the budget was 
made up of mandatory spending, that's entitlement spending, which would 
be Medicare, Medicaid, Social Security, and other forms of mandatory 
spending such as welfare, section 8 and so forth. So that meant that 70 
percent was discretionary spending, which means that you could cut 
budgets out of certain departments and agencies and you could begin to 
balance a budget once again.
  Well, today it is 60 percent of the budget that's mandatory or 
entitlement spending--and growing--which means that we have certainly 
much less to work with in order to balance the budget, and it continues 
to grow. The largest piece of that is Medicare itself.
  Mr. Speaker, I guarantee you that most Americans do not realize that 
today Medicare is very much a subsidized and entitlement program. Even 
though its recipients and those of us who are in the workforce paying 
into it, even though we pay premiums into it, the return on those 
premiums are threefold; that is to say, for every dollar you put into 
Medicare, you get $3

[[Page H1537]]

back in benefit. And that applies no matter what your income. Warren 
Buffett is old enough to be on Medicare, and as a result of that, 
Warren Buffett, with his $40 billion, gets the same subsidies as the 
little lady who barely gets by each month.
  So it's important for us to understand that we already have a 
government-run health care system--that is, Medicare--that actuaries, 
the CBO and everyone says becomes insolvent, runs out of money in 4 to 
8 years; it just depends upon which estimate you believe in. And to be 
honest with you, with each year that estimate comes closer and closer 
rather than farther and farther away.
  So, I hate to say it, but promise number one was broken. The 
President promised that there would be nothing to change about your 
health care plan or your doctor. We know that not to be true.
  Broken promise number two is it would not add one dime to the 
deficit. And we know now that it's going to be at least $500 billion, 
perhaps as much as $1.5 trillion over the coming decade.
  So let's move to broken promise number three. President Barack Obama 
said in September 2009:
  And one more misunderstanding I want to clear up. Under our plan, no 
Federal dollars will be used to fund abortions, and Federal conscience 
laws will remain in place.
  Well, is that true? There was a whole lot of drama around here during 
the debate, the original ObamaCare bill--and, by the way, I want to 
point out something about the term ``ObamaCare.''
  I'm often asked in my town halls, Why do you call it ObamaCare? Isn't 
that being derogatory or in some way denigrating to the bill itself or 
to the President? Of course the rhetorical response I have is, Well, if 
it's a law or a bill that you can be proud of, then why are you ashamed 
to name it after President Obama? If it were a bill I was proud of, a 
law I was proud of, I would love it if it were called FlemingCare.
  But, quite honestly, I don't think even the President is proud of 
this bill. And how do I know that? Because on the 2-year anniversary, 
where are the cakes and the candles? Where's the celebration? Remember 
that Speaker Pelosi, when she was Speaker right here in this Chamber, 
said that we have to pass it to know what's in it.
  Well, Mr. Speaker, we now know what's in it, and we're not happy 
about it. Fifty-seven percent of the American people say we want it 
repealed, and only 38 percent--and these are consistent numbers since 
the passage of the law. In fact, they've actually gotten a little worse 
over time. The vast majority of Americans do want it repealed.
  But back to this. What about the funding of abortions?
  When the bill first passed this House, we had protections and 
guarantees. We had a few pro-life Members from the Democrat side, we 
had a vast number of pro-life Members on the Republican side, and we 
came together and said, okay, they're not going to vote for this bill. 
No Republican voted for it. But the Democrats who were pro-life said, 
We're not going to support this bill unless it has protections not to 
prevent abortions but to prevent taxpayer funding of abortions.
  Today we're in a divided Nation when it comes to the question of 
abortions. About half of Americans, 51 percent, are pro-life. They do 
not believe that we should take innocent life. Something near that say, 
Well, we think it's a woman's right to choose. But by a margin of 
around 75 percent, Americans say we do not want to pay for--through our 
taxpayer money, we do not want to pay for abortions.
  And so we were given certain guarantees that that wouldn't happen. 
However, when the bill came back to us from the Senate, all the 
protections, conscience clause protections, protections against 
taxpayer funding of abortions, all of that was stripped away.

  Now, the President would say, even today, and many Democrats would 
say, there's not any taxpayer funding of abortions. Well, again, is 
that true?
  Just recently, the Department of Health and Human Services, under 
Secretary Sebelius, issued a final rule on the State health care 
exchanges providing for taxpayer funding of insurance coverage that 
includes elective abortion. The rule confirms that abortions on demand 
will be included in publicly funded insurance plans. This means that it 
is absolutely required that insurance companies provide abortion 
services.
  Now, even among the pro-choice Americans, they would suggest to you 
and admit to you that while they think a woman should have the right to 
choose, they also would agree we need to reduce the number of abortions 
whenever possible. But while making abortions more and more convenient, 
more and more available and cheaper and cheaper, that's not going to be 
the case. Even though abortions have been coming down year after year 
because young ladies have been deciding for life instead of against 
life, we're going to be seeing those numbers go back up again because 
of the wholesale subsidy of the industry.
  What do I mean by that?
  To comply with the accounting requirement of ObamaCare, plans will 
collect a $1 abortion surcharge for each premium payer. The enrollee 
will make two payments, $1 per month for abortion and another payment 
for the rest of the services. As described in the rule, the surcharge 
can only be disclosed to the enrollee at the time of enrollment. 
Furthermore, insurance plans may only advertise the total cost of the 
premiums without disclosing that enrollees will be charged a $1 per 
month fee to pay and directly subsidize abortions.
  Now, that's kind of technical jargon. What does it mean?
  It basically means that in the most technical sense, the premium 
dollars will not be used to fund abortions. What will happen is that 
you, as Americans, will be charged an extra fee, a surcharge, if you 
will. It will be booked separately, but it still flows directly to 
abortion services. You'll be required to do that.
  Under ObamaCare, all insurance plans must cover, at no charge--to the 
patient, that is; charged to the taxpayer, but not to the patient--
abortion-inducing drugs, contraceptives, sterilization, and patient 
education and counseling for women of reproductive age. Religious 
employers such as Catholic hospitals, Christian schools, and faith-
based pregnancy care centers will have to provide and pay for such 
coverage for their employees regardless of their religious beliefs.
  Now, Mr. Speaker, that is a direct violation of the First Amendment 
to the Constitution. The First Amendment to the Constitution provides 
that government shall establish no religion and that you should have 
the freedom to practice religion in any way you see fit. And we've seen 
this played out over the many years of this country.
  For instance, the Amish are against war. It's against their 
conscience to fight in a war. And if, indeed, an Amish person is asked 
to join the military, to pick up a rifle and go fight, if he declares 
that it's against his religious conscience, then he is not forced to 
fight. And that is a well-respected and a well-observed tradition, and 
it's certainly right down to the very beginning of the core of the 
Constitution.
  But for some reason we're suspending that constitutional right. That 
is to say that a hospital owner, an insurance company owner, a 
physician, even, or nurse who may choose not to provide abortion-
inducing pills, certainly provide abortions themselves, or perhaps for 
whatever fundamental religious reasons, such as in Catholicism it's 
against their religion to practice sterilization or even provide birth 
control pills, that they cannot refuse to provide those. Now the 
question, of course, comes from Democrats on this, well, that means 
that those services will be cut off from Americans.
  Well, today these institutions are not required to produce that. And 
does anybody have a problem finding these services and in an affordable 
way?
  Every State has a program--it's funded both by the State and 
federally--to get free services with regard to obstetrical, 
gynecological care and prevention of pregnancy. So it already exists 
today. It's completely available. There's no reason that we have to 
force health care providers to participate in something that is against 
their religious or moral convictions.

                              {time}  1530

  Now, we recently had a mandate, a rule provided by the President that 
said, look, doesn't matter who you are or where you are or what kind of 
religion you practice, you're going to have

[[Page H1538]]

to provide the abortion or abortion-related services that we dictate to 
you. Then, as a result of the pushback of the Catholic Church, they 
said, well, we'll make an accommodation. But, Mr. Speaker, that 
accommodation never occurred. That was only a statement made by the 
President. The actual rule that was propagated is still the rule today 
and, in fact, it's now been finalized. Nothing was changed. It was 
certainly just spin put on the entire discussion of the rule.
  Let's move along to broken promise number four.
  President Barack Obama, September 2009, in an address to a Joint 
Session of Congress--and I was here--says: ``I will protect Medicare.''
  Now, did he protect Medicare? Well, the first thing that ObamaCare 
does is it cuts $500 billion--a half a trillion dollars--from Medicare 
itself. I repeat, ObamaCare, the first thing it does to finance the 
services that it provides, it cuts $500 billion from Medicare. Part of 
that is taken out of the so-called Medicare Advantage program, which is 
a private part of Medicare where private plans like Humana Gold are 
provided funds. But half or more of that is simply taken out of direct 
services, such as home health, hospice services, many other kinds of 
services. So I don't see how you can remove $500 billion from Medicare 
and begin to say that you're going to protect it.
  In fact, we Republicans have been criticized in the last year that 
for some reason we want to end Medicare. Nothing could be further from 
the truth. Republicans want to save Medicare. But because Medicare--you 
heard me say Medicare will become insolvent in 4 to 8 years, the 
experts tell us. Don't take my word for it. Go to the experts, the 
actuaries and the CBO. They tell us that the system runs out of money, 
the checks start bouncing in 4 to 8 years.
  So what have our Democratic colleagues done to save Medicare? 
Whenever you ask them, all you hear is crickets. What is the 
Republican's answer to that? Well, we submitted in 2011 a budget that 
would not only protect Medicare, but sustain it indefinitely by the use 
of premium support, means testing, and many other things, and opening 
up Medicare to market forces so it would drive costs down and increase 
services. So whether you like the Republican solution or not, we do 
have a solution. Our Democrat friends offer no solution.
  So their plan is no plan. Their plan is sticking your head in the 
sand. And, therefore, their plan is the one that would end Medicare.
  On to broken promise number five. Senator Barack Obama, Candidate 
Obama, said: ``Under my plan, no family making less than $250,000 a 
year will see any form of tax increase.''
  Well, is that true? Well, let me go down the list and you decide for 
yourself, Mr. Speaker:
  $52 billion in fines on employers who do not provide government-
approved coverage;
  $32 billion in taxes on health insurance plans--not a penalty, just, 
simply straightforward, an excise tax which adds up to $32 billion. Mr. 
Speaker, if you think that your premiums are going to go down when the 
taxes on those companies go up, then we need to sit down and talk about 
it;
  $5 billion in taxes from limits on over-the-counter medication;
  $15 billion in taxes from limiting the deduction on itemized medical 
expenses--and that's to everybody, not just people who make over 
$200,000, $250,000 a year;
  $13 billion in taxes from new limits on flexible spending accounts;
  $60 billion in taxes on health insurance plans;
  $27 billion in taxes on pharmaceutical companies;
  $20 billion in taxes on medical device companies. We already hear of 
medical device companies either going out of business or moving their 
business overseas;
  $3 billion in taxes on tanning services;
  $3 billion in taxes on self-insured health plans; and
  $1 billion in new penalties on health savings account distributions.
  Remember that one of the most useful tools in limiting cost that has 
been well received by beneficiaries of private insurance has been 
health savings accounts, which allows you to keep your own money and 
spend your own money and save the first dollar expenses to insurance 
companies, which ultimately lowers your premiums. I know that because 
we instituted that about 7 years ago in our companies; and instead of 
having 15 percent increase year over year in our premiums, they 
flattened out and have never been above 3 percent per year. That means 
more money we can pay our employees and more benefits that they can 
enjoy.
  But here's a couple of really important ones I think everyone needs 
to understand, Mr. Speaker.
  In 2013, the payroll tax will increase .9 percent going to Medicare 
for those making $200,000 to $250,000 a year--that is to say, single 
filers, $200,000; a couple, $250,000.
  Now, Mr. Speaker, most people hearing this might say, Well, that 
doesn't apply to me because I don't make $200,000 a year. But this is 
not indexed, which means that in a few years, through inflation, Mr. 
Speaker, everyone will be included in this, virtually; certainly the 
middle class would be.
  Already today we have a similar problem called AMT, alternative 
minimum tax. It was designed years ago to hit the wealthy, the high-
income earners. Who is it hitting today? It's hitting the middle class 
because it hasn't been indexed.
  But that isn't the worst of it when it comes to taxes. There is a 3.8 
percent tax on the sale of your assets--again, for people who make 
$200,000 for singles, $250,000 for a couple. Again, the question is, 
Well, what do I care? I sell my house, I make some money on it, but I 
don't make $200,000 a year. I sell my stocks, maybe I sell a business, 
I sell some other sort of asset. Should I worry about that? Well, maybe 
today you don't. The average American doesn't make $200,000, $250,000 a 
year. But in a few years, through inflation--and the way we're printing 
money these days, that should be very soon--average Americans will 
easily be making $200,000, $250,000. As a result, they will be captured 
in that. The middle class will be hurt the most by this tax.
  The law also forces people to buy insurance. Then the Federal 
Government taxes employer-provided plans at a 40 percent rate. This tax 
will hit middle-income families especially hard.
  So, you see, Mr. Speaker, we have a bevy of taxes, at least 10 or 
more that I've listed here. The vast majority of them hit the middle 
class and even lower than that. There's no way that this promise was 
ever kept, and, in my opinion, it was ever intended to be kept.
  Broken promise number six, Senator Barack Obama, February 2008--
again, Candidate Obama--said in Columbus, Ohio: ``If you've got health 
insurance, we're going to work with you to lower your premiums by 
$2,500 per family per year.'' I think this is perhaps the cruelest 
promise of all.
  What has actually happened?
  The annual Kaiser Family Foundation survey of employer-provided 
insurance found that average family premiums totaled $12,860 in 2008, 
$13,375 in 2009, $13,770 in 2010, and $15,073 in 2011. Premiums have 
already risen by $2,213 since President Obama took office, and much of 
that increase was as a direct result from ObamaCare. Why? Because the 
mandates create more cost.
  Oftentimes, Mr. Speaker, folks will say to me, Well, look, if you 
Republicans want to repeal ObamaCare, will you keep coverage for 
preexisting illness? Will you keep coverage for folks who are up to 26 
years old and living in their household? My answer is this: We 
certainly can, and, in fact, we could have been doing that all along.

                              {time}  1540

  But if, Mr. Speaker, we add more mandates, we take caps off, all that 
does is raise the premium. The marketplace has to deal with that one 
way or another. So you have to decide for yourselves, as consumers, do 
you want more benefits, less caps, or do you want less benefits, more 
caps? You're going to have to pay for it either way.
  So I would say, Mr. Speaker, yes, we would love to keep those. But 
what we'd rather do, more than that, is to make it a choice for the 
American citizens. They can choose whichever one they want. If you want 
a plan that, for instance, has no lifetime caps, fine. But you are 
going to have to pay incrementally more in your premiums in order to 
receive that benefit.
  The CBO projects that the law's new benefit mandates will raise 
premiums

[[Page H1539]]

in the individual market by $2,100 per family. The increase is because 
people will be forced to buy richer coverage, which will encourage them 
to consume even more health care.
  So, you see, Mr. Speaker, the President, when he was a candidate, 
promised that the cost of premiums would go down by $2,500 per year per 
family. It has already gone up that much, so that's a spread of about 
$5,000 per year, and it's expected to go up even another $2,100 as 
ObamaCare fully kicks in.
  Mr. Speaker, these are the main six points that I wanted to bring out 
today. In closing, I would just like to say that we'll be posting, Mr. 
Speaker, on our Web site these promises and the others that have been 
broken. And I pledge, with many of my colleagues here in the House, 
that we will, hopefully, the beginning of next year fully repeal 
ObamaCare and replace it with something that's common sense, that's 
market-driven, that re-establishes the doctor-patient relationship and 
puts the choice back into the hands of the American citizen.

                          ____________________