Congressional Record, Volume 158 Issue 120 (Monday, September 10, 2012)

[Congressional Record Volume 158, Number 120 (Monday, September 10, 2012)]
[Senate]
[Pages S6038-S6046]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

VETERANS JOBS CORPS ACT OF 2012--MOTION TO PROCEED--Continued

The PRESIDING OFFICER. The Senator from Michigan.

The Farm Bill

Ms. STABENOW. Madam President, as we come back into session this
evening and into September, as Chair of the Agriculture Committee I
have one message for colleagues in the House of Representatives--for
the Speaker, for the Republican leadership--and that is, we need a farm
bill now.
We have 20 days until the farm bill expires--only 20 days. If that
happens, if the Republican leadership does not work with us to pass a
5-year farm bill, they are going to reset the clock for rural America
all the way back to 1949. Because if the farm bill expires, we go back
to Depression-era policies that include government planting
restrictions and expensive price supports--absolutely unacceptable.
Some of those policies even reference prices from before World War I.
This would be terrible for our family farmers and ranchers. It would
throw the markets into complete disarray. There is no reason this
should be allowed to happen. The full Senate has worked together and
passed a bipartisan farm bill. The House Agriculture Committee worked
together and passed a bipartisan farm bill. It is time for the House to
complete its work. The House Republican leadership has refused to let
the bipartisan bill come up for a vote.
Despite our best efforts in speaking with colleagues and working
together over the August break to try to come up with a way to get this
done, we find ourselves in a position now where our only opportunity is
for the House to take up the bill that was passed by their committee
and get this done. I have never seen a situation where a farm bill--
this is my fourth one I have been involved with--comes out of committee
on a bipartisan basis, and then the House will not take it up, which is
exactly where we are.
Instead, they sent us a so-called disaster relief bill that,
unfortunately, only helps some livestock producers with the drought
this year. It does nothing for the rest of the Nation's farmers who
have been hurt so badly this year by frost and freezes. Our farm bill
does that. In fact, our farm bill is better for livestock. It is a
permanent livestock disaster assistance program with a better structure
and support than that which was sent by the House of Representatives.
A full 5-year farm bill gives much more comprehensive disaster
assistance to livestock producers and to other farmers who have been
hit. Other farmers who have watched as their crops withered under the
unforgiving Sun want to know that not only will we have a 5-year policy
in place, but that we are going to strengthen crop insurance, which is
really the backbone of supporting farmers in these kinds of situations.
We strengthen crop insurance and expand it so more farmers can have
access to risk management tools on their farms. That was the No. 1
issue that we heard in all of our hearings, to strengthen crop
insurance. And that is what we did. That is one of the reasons we need
to get a 5-year farm bill done.
I am looking at my colleague from Iowa, the distinguished Senator who
chaired the committee before me. I know he shares the same feeling that
I do, that we need to get this bill done in the House of
Representatives.
We know our farm bill also fixes dairy support so dairies do not go
through what they went through in 2009, when thousands of farms went
bankrupt. Frankly, not changing the policy for dairy is a disaster
waiting to happen. So we need to get the farm bill done.
We also reform programs. We know we have ended direct payments and
altogether four different subsidies, saving $15 billion while
strengthening crop insurance. We streamline and address duplication,
crack down on waste, fraud, and abuse. In the end, our bill saves $23
billion for taxpayers--$23 billion to pay down the debt. The only real
deficit reform we passed in the Senate was our farm bill, which we
worked on together.
Unbelievably, the House Republican leadership still stands in the way
of passing our bipartisan bill or their own committee's bipartisan
bill. On Wednesday we are going to see thousands of farmers around the
country coming to Washington with a simple message: We need a farm bill
now. Members are going to have visits from farmers and ranchers from
their States. House Members will be hearing from members in their
districts. They have one simple message. Those farmers knew when there
is work to be done you do not put it off to another day. Not if you are
going to be successful as a farmer. And we shouldn't be kicking the can
down the road either. They can't say: I don't want to harvest my crops
right now. I think I will do it in a few months or next year or tell
the banker to wait until later so I can figure out what I have to make
decisions on for next year. They know that when the crops need to be
harvested, the work needs to get done now.

Well, we have 19 days left. This is day 20. We are going to count it
down every day because we have to get this done in the House of
Representatives. We did our job in the Senate on a bipartisan basis. I
was very proud to join with our colleague Senator Roberts and all of
our committee who worked so well together and worked so hard, and I
again thank the leadership on both sides of the aisle for giving us the
time to get it done. We got it done, and we did it in enough time to
give the House time to do it in July before the August break. But that
didn't happen. Now it is time to get it done. The House Agriculture
Committee did its job. It is time for the House Republican leadership
to schedule a vote to get this done, to support rural America--our
farmers and ranchers and families who are counting on the safest, most
affordable food system in the world to be able to continue. We don't
need to kick this can down the road and create another crisis for farm
country.
Madam President, I wish to thank my colleagues who are waiting to
talk about another very important subject. I appreciate their giving me
the time for a few words.
Mr. HARKIN. Madam President, would the Senator yield for a question?
Ms. STABENOW. I would be happy to yield.
Mr. HARKIN. Madam President, I would like to compliment the Senator
from Michigan for her great leadership on agriculture policy, food
policy. A big part of this bill is making sure that our kids in America
get adequate nutrition, that our elderly get good nutrition. Our summer
and afterschool feeding programs and feeding programs for our seniors
are all wrapped up in this bill too.
I was in Iowa in August and met with a lot of farmers, and they were
a little perplexed.
They said: Wait a minute. You passed a bill in the Senate?
I said: Yes.
So I ask the Senator from Michigan, did not that bill have the
support of all the major farm organizations?
Ms. STABENOW. Absolutely. We had the support of farm groups and
conservation groups all across the country.
Mr. HARKIN. I ask the Senator from Michigan, did not her bill, the
bill she engineered and got through here, have the support of consumer
groups and parent groups?
Ms. STABENOW. Absolutely.
Mr. HARKIN. It had all that support?
Ms. STABENOW. Absolutely. And because of the wonderful work of the
Senator from Iowa on our school nutrition efforts and the Fresh Fruit
and Vegetable Program, we had the strong support of families,
educators, and schools across the country.
Mr. HARKIN. Conservation groups supported the bill?
Ms. STABENOW. Absolutely.
Mr. HARKIN. Well, what farmers asked me was this: If you had a bill
that passed the Senate, a bipartisan bill supported by all the major
farm groups, supported by consumer and

[[Page S6039]]

conservation groups, why didn't the House just pick it up and pass it?
I didn't have an answer. Does the Senator from Michigan have an
answer? Because I don't understand why the House can't take a bill that
is so widely supported and is such a bipartisan bill and just pass it.
Ms. STABENOW. Well, the distinguished Senator is absolutely right.
One would think this would be the time to just pass it. And frankly, if
not, because we know the House committee has a little different view on
commodities, we offered to sit down all through August to work that out
so we could come back now and come up with something that was a
compromise. But the House committee wasn't able to do that because they
do not have the support of the leadership to get that done. So here is
where we are. What I know is that we have to have movement. We have to
have the House act or we are not going to be able to get this done.
Mr. HARKIN. I say to my friend from Michigan, my leader on
agricultural policy, she knows there is enough anxiety in farm country
now because of the terrible droughts we are having around the country,
the shortages that are looming, that now is not the time to add more
anxiety to farmers and to farm families and our rural communities
across America. So I thank the Senator for her great leadership and for
pointing out that as well as acting. Our committee has acted, the
Senate has acted, and what the House is doing I just can't figure out.
Again, I compliment the chairwoman of our committee for pointing out
that we have 20 days left and we are counting down. I am hopeful the
House will hear the voices of our farm country and the bipartisan
voices here in the Senate and get a bill passed--or agree to the bill
passed in the Senate. I thank the Senator from Michigan.
The PRESIDING OFFICER. The Senator from California.
Mrs. BOXER. Madam President, I ask unanimous consent that when I have
completed my statement, Senator Harkin be permitted to take the floor
at that time.
The PRESIDING OFFICER. Without objection, it is so ordered.

The Ryan Budget

Mrs. BOXER. I wish to thank Senator Harkin because he and I were
spending a little time together in the great State of our Presiding
Officer, and he and I agreed that one of the issues that ought to be
talked about a little bit more involves the stark choice we are facing
in November in large part due to the budget of Paul Ryan, who is now
the Vice Presidential nominee for the Republicans. And Governor Romney
has endorsed and embraced the Ryan budget.
I think it was Senator Harkin's idea that we ought to explain that
Ryan budget, so I am going to do my best to talk about it as the
chairman of the Environment and Public Works Committee, which has the
jurisdiction of highways, bridges, transportation systems, and the
environment, and I will also make a couple of comments about Medicare.
I know Senator Harkin is going to go into that in great depth.
I want to make sure everybody understands that what I am talking
about comes straight from the budget. So if you look at page 78 of the
report accompanying the Ryan budget resolution, Mr. Ryan makes it clear
he wants to make devastating cuts to transportation. What do I mean
when I say that? I mean devastating. I mean a 50-percent cut, which
means about 1 million jobs would be lost if the Ryan budget were to go
into effect. We are talking about construction jobs--an area that has
been hit so hard. We still haven't come back from this recession. And
if there is one thing we learned when we were in the Presiding
Officer's great State at that convention, it was the depth of this
recession--the worst since the Great Depression. What a time Paul Ryan
picks to bring devastating cuts to the construction industry. I am
talking about businesses and jobs mostly in the private sector, not the
public sector.

We have to think about the fact that 70,000 of our bridges are
deficient and 50 percent of our roads are not in good condition. We
know bridges fail. We have seen it happen. We are not only talking
about devastating cuts to the construction industry and its workers but
a devastating situation for people who use our bridges--the 70,000 of
which are structurally deficient--and our roads, which need help. So no
country can lead the world if we can't move people and goods, and we
cannot be a world power when it comes to transportation.
The Ryan budget is a jobs killer. I am talking about 1 million jobs
that would be lost--in the private sector mostly--and it would put our
families at risk by neglecting our bridges, our highways and our
transit systems. Now, President Obama, on the other hand--and, frankly,
a lot of us here on both sides of the aisle--reject the notion that we
can walk away from rebuilding our infrastructure. So this is a very key
issue.
I said I wanted to speak as the chairman of the Environment and
Public Works Committee, and I have talked a little bit about public
works, but what does the Ryan budget do to the environment? What he
does is he undermines the public health protections provided by the
Clean Air Act, the Clean Water Act, the Safe Drinking Water Act, and
other landmark laws.
If we look at pages 13 to page 15 of his budget, we can see he cuts
$62 billion for activities such as protecting our drinking water,
protecting our air, and preserving our public lands. Let's face it:
When kids get asthma, when people are too sick to go to work, when
children are too sick to go to school, and when people die prematurely
from heart attacks because of the air quality, there are no real
savings. He says he is cutting $62 billion from the budget. Let me just
say that for every dollar we spend on clean air protections, we know we
get $30 worth of benefits. In 2010 alone, the Clean Air Act prevented
160,000 premature deaths. Ask a family who stands to lose the
breadwinner in that family: Did we save money? No.
Let me cite some numbers: 1.7 million asthma attacks, 130,000 heart
attacks, 86,000 emergency room visits, 13 million lost workdays, and
3.2 million lost schooldays. In 2010 the Clean Air Act prevented all
that.
So what is the point, Mr. Ryan? What is the point? It will cost the
American public dearly out of their pockets and out of their lives if
they suffer more asthma attacks, emergency room visits, lost workdays,
lost schooldays, and they have more heart attacks and premature deaths.
That is shortsighted. The American Lung Association--and they are not
Republican or Democratic--says that 40 percent of our population lives
in areas with unhealthy levels of smog or toxic soot.
So let's remember that when we look at a budget, there is a set of
values that accompany the numbers. And I don't think it is an American
value to say to our people that we don't care if they get sick, they
miss work, or they go to the emergency room.
Finally, I want to set the stage for Senator Harkin's very in-depth
discussion about health care. I am just going to talk about Medicare
and Medicaid as someone who is privileged to represent, along with
Senator Feinstein, the largest State in the Union, with the most senior
citizens. We have almost 38 million people. So whenever I talk about
this Ryan budget and how many people get hurt, believe me, I speak from
the heart when I say we can't let it happen.
The American people know Medicare, they like it, and they do not want
to change it. Now, the Republicans tell us their plan saves Medicare.
But just ask someone. Ask someone who is going to be the victim of the
Paul Ryan plan if we don't stop it. That person will find they are
getting a voucher; they are not getting Medicare. Medicare will be
gone. They will get a voucher, and experts tell us and the studies show
that voucher will be almost $6,000 a year short. Imagine an older
person who really is struggling for a quality of life having to have
the added worry of not knowing whether he or she will be able to find
health insurance.
Look, putting Republicans in charge of Medicare is like putting the
Cookie Monster in charge of your favorite bakery. And I am not
overstating it. No one would put the Cookie Monster in charge of their
favorite bakery. Well, we can't put the Republicans in charge of
Medicare, and I will prove why. This isn't just rhetoric. Listen. In
1995 Newt Gingrich said he thought Medicare, in his words, should
wither on the vine. In his 1996 Presidential campaign, Senate majority
leader Bob Dole bragged:

[[Page S6040]]

I was there fighting the fight, voting against Medicare,
because we knew it wouldn't work in 1965.

Really? Really. Medicare works. Why would we end it? We are not going
to end it. But if Paul Ryan gets into power, he will have a good chance
of ending it with his friend and Presidential candidate Mitt Romney who
has endorsed the Ryan budget.
Listen to what Michael Steele, the head of the Republican National
Committee, said in 2009:

I mean, the reality of it is this single-payer program
known as Medicare is a good example of what we should not
have happen.

The Ryan budget at page 53 shreds Medicare. As if he hasn't slammed
Medicare enough, look what he does to Medicaid. He cuts it by more than
$800 billion. Where are low-income families going to go?
Senator Harkin is the expert, but I can tell you this. So many of our
elderly rely on Medicaid for nursing home costs. It is a disaster. We
know that in addition to all these terrible cuts--and by the way, when
Paul Ryan attacks President Obama for cutting money from Medicare, what
he isn't telling us is the President has found savings from
overpayments to providers. Do you know what he does with the money? He
puts it right back into Medicare, extends the life of the program for 8
years, closes the doughnut hole to help seniors, and gives senior
citizens preventive health care, well checkups, and the like.
To quote President Clinton, that ``takes a lot of brass.'' Because
the fact is, President Obama has strengthened Medicare and has extended
the life of Medicare. What Paul Ryan does is he takes those cuts and he
gives tax breaks to millionaires and billionaires.
I yield to my friend.
Mr. HARKIN. I thank the Senator for yielding, and I thank the Senator
for her keen eye on the Ryan budget and what it does.
I listened to the Senator's explanation of President Obama's goal to
cut down overpayments, fraud and abuse, and to put that money back into
helping beneficiaries. I ask the Senator, isn't it true that both Ryan
budgets incorporate those very same cuts President Obama wants to do?
Mrs. BOXER. Absolutely. Both his budgets take the same amount. But
instead of putting it back into Medicare, he robs Medicare, and
Medicare will go broke--my understanding--in 2016 under the Ryan plan;
whereas, President Obama puts the money back into Medicare, extends the
life 8 years, and gives more benefits.
I am going to finish up and just say this. However you look at this,
this Ryan budget is a roadmap for disaster for the American people. He
cuts the heart out of things the American people like. The American
people want clean air, they want safe drinking water, they want
Medicare, they want to make sure our seniors can be safe in nursing
homes. The American people want transportation--and they don't want to
be worried if a car is on a bridge that is going to fall down into the
water below. It has happened.
Here is the deal. If we were to say to Mr. Ryan: Are you cutting all
this so you could balance the budget today, he would say: Oh, no; that
is 25 years from now.
What is he doing with the ``savings''? He is giving these huge tax
breaks. I will close with this. People earning more than $1 million a
year are going to receive $400,000 more in tax breaks every year. So he
cuts everything to give these tax breaks to the people who already have
millions and billions, but it is still not enough. As President Obama
has pointed out, he will then have to go after the middle class and
take away middle-class tax deductions, such as the home mortgage
deduction, because he doesn't even get enough money from these
Draconian cuts. He has to go ahead and raise taxes on the middle class.
I watched Presidential nominee Romney be asked this question: What
are you going to cut? He said: Well, we will discuss it later. Mr.
Ryan, the Republican Vice Presidential nominee, said: We will work with
Congress on it. Right.
Listen, they know they have to make Draconian tax increases on the
middle class and the working poor. They have to cut the things America
wants in order to pay for their tax cuts. No wonder Mr. Romney picked
Mr. Ryan. Mr. Romney will be in the 1-percent tax bracket--that is what
the experts say--can you imagine?--while his secretaries and everybody
else pay through the nose.
These next 60 days or so is an important time for us. I wish to thank
my friend from Iowa because I was very interested in laying out some of
these issues and he encouraged me to do so. I am very delighted to be
here with him.
I yield the floor.
The PRESIDING OFFICER. The Senator from Iowa.
Mr. HARKIN. Madam President, let me thank my colleague Senator Boxer
for always being on point and for always being very eloquent in her
focus and explanation of the fallacies of the Ryan-Romney budget and
how it is going to affect our middle-class families in the future.
Since we recessed around the 1st of August and have been out of
session, Congressman Paul Ryan--our colleague in the House--has become
the Vice Presidential nominee of the Republican Party, and, of course,
Mr. Romney has accepted the nomination to be President. Congressman
Ryan is not an unknown quantity. He has been here quite a few years,
and as the head of the Budget Committee he has put forward a couple
budgets. Budgets are blueprints. If one is going to build a building or
a house, they need a blueprint. If you are going to try to move the
country in a certain direction, you need a blueprint, and that
blueprint is a budget. A budget sort of tells us where it is that the
proponent of that budget wants to take us as a country--a Federal
budget. If it was a State budget, we would say that is where they want
to take the State.
So we on this side intend, over the next several days, couple weeks--
however long we are in session--to let the American people know what is
in the Ryan budget and where it would take America: What is the
blueprint they have for America?
Our Nation faces an absolutely fundamental choice in November: Are we
going to rescue, restore, and rebuild the struggling middle class in
this country or are we going to continue to shift even more wealth and
advantage to those at the top at the expense of the middle class?
Republicans have made it very clear where they stand on this
critical choice. They did so when nearly every Republican in Congress
voted in favor of the Ryan budget plan, and Governor Romney embraced
that plan as marvelous--not exactly a word most average Americans would
use to describe something they like. But if you are having tea at the
Ritz, I guess ``marvelous'' kind of fits for some people. Anyway, he
embraced the plan as marvelous.

The very centerpiece of the Ryan budget is a dramatic shift of even
more wealth to those at the top, huge new tax cuts for the richest 2
percent. As the Senator from California pointed out, if we take the
Bush tax cuts and extend those--which Mr. Romney would do and Mr.
Ryan's budget does--then add on to it the tax cuts in the Ryan budget--
which Mr. Romney supports, so I can call it the Romney-Ryan budget or
the Ryan-Romney budget. If we do that and you make over $1 million a
year, you are going to get nearly $400,000 a year in new tax cuts.
Think about it. It takes your breath away--$129,000 in the Bush tax
cuts would be extended, plus an additional $265,000 that would be in
the Ryan budget.
We hear a lot about entitlements; we are going to cut entitlements.
But this is an entitlement. Think about it. If someone makes over $1
million a year, they are entitled to that. They don't have to do
anything else. They don't have to jump through any hoops. They don't
have to show any hurt or anything else. Just if someone makes over $1
million, they are entitled to it. How about this entitlement?
Republicans always want to make it seem as though entitlements only go
to poor people or the elderly or children. They talk about Medicaid as
an entitlement. What about this? This is an entitlement to those who
are rich.
How do the Republicans pay for this? They don't want to say how, but
all we have to do is look at the Ryan budget and that will tell us how
they pay for it. They pay for it by massive Draconian cuts to programs
that undergird the middle class and essential to the quality of life in
this country, such as

[[Page S6041]]

education cuts, student grants and loan cuts, law enforcement, clean
air and clean water, food safety, medical research, highways, bridges
and other infrastructure that was focused on by the Senator from
California--all those would be cut.
The Republican plan would end Medicare, period. It would turn it into
voucher care. So now we have a new word, not Medicare but voucher care,
that would force seniors to pay nearly $6,000 more per year out of
pocket for their health care in future years. We don't get Medicare; we
get a voucher. That plan would strip tens of millions of Americans of
their health care coverage and cut millions of poor kids from nutrition
programs. Their plan would leave America with a less-skilled workforce,
a deteriorating infrastructure, making us less competitive in the
global marketplace.
Lastly, Republicans offset these big new tax cuts by actually raising
taxes on the middle class. That is a dirty little secret you won't find
unless you dig into the Ryan budget. It is true. Here is why: Under the
Republican plan, under the Ryan-Romney budget, middle-class families
are net losers, paying significantly higher taxes. The wealthy are huge
net winners. The nonpartisan Tax Policy Center estimates that under the
Romney-Ryan budget, middle-class families with children would see their
taxes go up, on average, by more than $2,000 a year.
The bottom line is that the Romney-Ryan budget does not reduce the
deficit. I hear Congressman Ryan and Mr. Romney out there talking on
the stump about the budget and the deficit, and they go on and on. Why
don't they own up to it? The Ryan budget keeps us in a deficit for 28
more years. Yes, you heard me right. The Ryan budget keeps us in the
red for 28 more years.
When President Clinton was inaugurated in January of 1993 and we put
through the Clinton budget--which, I might point out, not one
Republican supported--it turned those deficits right around, and within
5 or 6 years we were in a surplus. It doesn't take 28 years. It only
took a Democratic President and a Democratic Congress passing the
legislation in 1993 to end the slide into deficits and turn it into a
surplus in only 5 or 6 years. The Ryan budget keeps us in a deficit for
28 years. Again, the savings they gain by slashing spending and raising
taxes on the middle class go to partially offsetting the $4.5 trillion
in new tax cuts, most of which goes to the wealthiest Americans.
The truth is Representative Ryan is not interested in balancing the
budget. That is not his interest. Even under his most rosy assumptions,
the budget would not balance until 2040. The reality is the Ryan
budget's overriding goal is not to balance the budget but to reduce
taxes on those at the top. Congressman Ryan has turned out to be a true
acolyte of former Vice President Cheney, who famously said in an
unguarded moment: ``Deficits don't matter.'' Do you remember that? Vice
President Cheney, ``Deficits don't matter.'' I guess they didn't to him
and President George W. Bush because look at the deficits they plunged
us into. Now Congressman Ryan is basically, with his budget--he will
not say it publicly, but with his budget he is saying the same thing:
Deficits just don't matter. What matters are tax cuts for the wealthy.

Never in our history have we seen a deficit proposal so radical and
extreme. I was here. I was in the House and then later in the Senate
when President Reagan was President. He was conservative, but he was
not radical and as extreme as this budget. When I tell people back in
Iowa about the Ryan budget, they say: Come on. That approach is so
extreme and unbalanced you must be making it up.
The Romney-Ryan plan is extreme and unbalanced, and I am not making
it up. Don't take my word for it. Listen to former House Speaker Newt
Gingrich. He criticized the Ryan budget. He called it ``rightwing
social engineering.'' All I can say is, Newt, you got that one right.
Representative Ryan believes in radically shrinking the size of
government to what it was over a half century ago. His aim is to use
the deficit crisis as a pretext for degrading and dismantling
everything from Medicare and Medicaid to education, environmental
protection, workplace safety, medical and scientific research, and on
and on. It doubles down, as President Clinton said--it doubles down on
the theory that if we just give more and more of our national wealth to
those at the top, it will magically trickle down.
We have tried that before. It sure does not work.
I would like to focus some more of my remarks this evening on the
devastating impact of the Romney-Ryan budget on Medicare and Medicaid,
but health care more generally. Since he first arrived in Congress,
Representative Ryan has consistently pushed a very radical health care
program--to end Medicare. End Medicare, as we say, ``as we know it''
but to go to voucher care. Give everybody a voucher. Under his
proposal, seniors would no longer have the guaranteed medical benefits
they have enjoyed for decades. Instead, they would get a voucher from
the Federal Government and they can go out and buy individual private
insurance or Medicare.
That is the catchy little thing. We will hear Mr. Ryan and Mr. Romney
say they can buy Medicare if they would like to or they can buy private
insurance. Let's look at that.
They say this is a tough-minded solution to our debt problem, but it
is just a scheme, a scheme to shift costs onto America's seniors rather
than making debt reduction a shared sacrifice for all of us.
Again, let's look at this voucher system. They would get a voucher
program. A senior could buy traditional Medicare or health insurance.
So what is the catch? The voucher will not be enough to cover health
care costs. So seniors' out-of-pocket health care costs will steadily
increase. The nonpartisan Congressional Budget Office has projected
that the Ryan budget proposal could increase annual out-of-pocket costs
for seniors by more than $1,200 in 2030 and $6,000 in 2050.
What this chart shows is the increase in health care costs in today's
dollars, constant dollars, that elderly persons will have to pay for
during their expected lifetime, their average life expectancy from the
time they retire. In 2023 the average senior living an average lifespan
would pay $59,500 more. Senator Boxer rounded that off and said $60,000
more. But look what happens when we get to 2030. The average senior
will pay $124,600 more over their expected lifespan; in 2040, $216,000
more. By 2050, $331,000 more for their retirement years they would have
to pay in health care costs. That is in constant 2012 dollars.
They say: But a senior can go out and buy traditional Medicare or
private health insurance. Here is the catch on that. What they do is
put Medicare in a death spiral. Here is how.
If a person is a very healthy senior they can go out in the private
insurance market and probably get a pretty good deal. If they have no
preexisting conditions, if they have never had cancer, no one in their
family has had it, if they are very healthy, they have never smoked,
they are just in great physical shape, they can probably go out and get
a private, cheap private insurance policy with their voucher.
So who stays in Medicare then? The oldest and the sickest, and
therefore the costs of Medicare spiral up and spiral up and it becomes
untenable. It is a death spiral. That is Mr. Ryan's way of killing
Medicare.
Yes, he says people will get a voucher, and they can buy Medicare or
they can buy private insurance, but it puts Medicare into a death
spiral. The Ryan budget turns this successful, reliable, comprehensive
source of health care that seniors have relied on for decades--and have
paid into, I might add, during their years of hard work--into some
unproven, unpredictable, rightwing, conservative experiment. I do not
want to experiment with the elderly. I want them to have good health
care they can afford, that is universal, and that they can count on.
President Obama has fought to strengthen Medicare, and he believes,
as we do, it is a sacred contract. He has made a commitment to
strengthen Medicare in the Affordable Care Act. For example, by
eliminating the gaps in coverage, closing the doughnut hole--which we
have already started to do--elderly Iowans, I think, received over $600
back this year just from closing the doughnut hole.
Reducing the cost of prescription drugs. According to Medicare's own
actuaries, the Affordable Care Act,

[[Page S6042]]

ObamaCare, extends the program solvency from 2016 to 2024. Again, how?
As the Senator from California said, by fighting waste, fraud, abuse
and by getting rid of wasteful subsidies to insurance companies. Our
plan for Medicare is basically summed up: Mend it but don't end it.
I was taken a little aback yesterday. Over the weekend Governor
Romney stated he would keep some of the popular provisions of the
Affordable Care Act. Like what? Well, like kids staying on their
parents' insurance plans until they are 26 and ensuring coverage for
folks with preexisting conditions.
I said: Wait a second. I thought he said on the first day he was
going to repeal ObamaCare? But now he says he wants to keep those. I
was a little confused, but my confusion was short-lived because his
campaign then came out with a clarifying statement. They clarified what
Governor Romney said, and this is the quote:

Governor Romney will ensure that discrimination against
individuals with preexisting conditions who maintain
continuous coverage is prohibited.

The Washington Post reports that 89 million Americans would be left
out of Romney's preexisting condition plan. Why? They were working and
they had a health plan. They were out of work for a month or two--maybe
went someplace else to work and got a different plan: Sorry, you didn't
have continuous coverage. You don't get covered.

These are the little games that Governor Romney and Congressman Ryan
are playing with the American people.
Mr. DURBIN. Will the Senator from Iowa yield for a question?
Mr. HARKIN. I am delighted to yield to my friend from Illinois.
Mr. DURBIN. I was trying to understand this Republican position. It
used to be crystal clear. In 23 debates we heard Republican candidates
say, one after another after another: First day in office ObamaCare is
gone. But I heard the same thing the Senator did, and I have tried to
understand it.
I do give Governor Romney some credence in this regard. I have said,
when asked, he is the baby daddy of ObamaCare because it was Governor
Romney who created the first version of ObamaCare in the Commonwealth
of Massachusetts, and he understood--I hope the Senator from Iowa can
help me to understand, and those listening--he understood the concept
of insurance. If everyone who bought an insurance policy wrecked their
car or got sick the next day, insurance would not work. The only way it
works is most people are safe drivers. They buy insurance and a small
percentage use it. So there is a pool of money collected from premiums
creating a reserve for accidents.
Here we have a situation where Governor Romney has agreed with us--I
commend him--that people with preexisting conditions when it comes to
health care should not be discriminated against. But the Senator from
Iowa, as chair of the committee that dealt with ObamaCare, knows what
adverse selection means. It means if people wait until they are sick to
buy health insurance the whole system falls apart. So in Massachusetts
they required everybody to buy health insurance.
Mr. HARKIN. I think that is called an individual mandate?
Mr. DURBIN. An individual mandate, some critics might say. Some of us
call it individual responsibility. And we did the same, when it came to
health care reform, keeping in mind if people currently have health
insurance and like their doctor, like their hospital, we are not going
to change their lives one bit. But for those who are out in the
marketplace, the availability of health insurance would be there, but
everyone has the responsibility to buy it.
We don't think twice when we have a closing on a home. We need fire
insurance on this home. My home has never burned down, thank goodness,
but I buy fire insurance. That is individual responsibility so there is
something to pay the mortgage off if the house burns down.
But in this circumstance what I understand Governor Romney to say is
we don't think insurance companies should discriminate against people
with preexisting conditions. OK, I am with him. But then he goes on to
say--I think the point the Senator made--let's kind of bear on this for
a minute--what he goes on to say is so long as people have had
continuous insurance.
What if a person was unlucky enough to lose a job? Out of luck. Their
preexisting conditions just disqualified them from health insurance.
They are stuck, under the Romney approach. What if they had any kind of
interruption whatsoever in their insurance coverage? They are dead in
the water. So when we talk about taking uninsured people, bringing them
into insurance that has quality to it, quality coverage where they
cannot discriminate against people, we are saying whatever their
previous insurance experience we are all going to get into this
together. We are all coming into the tent together and they cannot be
discriminated against because they are a woman, had a baby--all the
different things they have used.
So when we listen closely to it, here was Governor Romney basically
saying he is against the discrimination on preexisting conditions, but
then footnoted down at the bottom of the page--as long as people have
had continuous coverage. It is an empty promise. It doesn't give people
anywhere near the protection and insurance that ObamaCare gives. That
is what I understand to be the difference.
Is that the way the Senator understands Governor Romney's
clarification of his statement of yesterday?
Mr. HARKIN. I thoroughly agree with my friend from Illinois. Governor
Romney makes the statement. It is on a very popular well-viewed Sunday
talk show, ``Meet The Press.'' So the average American says: Oh,
Governor Romney, he is for keeping coverage for preexisting conditions.
That is good. That is nice to know.
They do not hear the clarification that came about later because that
was not on ``Meet The Press.'' That was sort of under the radar, when
they said they wanted to clarify what Governor Romney meant was he
would prevent discrimination against individuals with preexisting
conditions who maintain continuous coverage. As the Washington Post
pointed out, there are 89 million Americans who would be disqualified
because they had a plan, they lost it because they moved or something
like that, and picked up another plan. There goes their coverage. Just
think about that. You are a family. Let's say your spouse has a
preexisting condition--it could be diabetes, it could be cancer, it
could be anything--but you have been covered under a plan. President
Obama, with the Affordable Care Act, ObamaCare, says beginning in 2014,
just as we now cover children, no plan can discriminate against you
because of a preexisting condition. What Romney is saying with his
clarification is only if you have always had that plan. What if you are
a family that moved from one State to another due to a job issue? You
move and your spouse or maybe one of your children who is perhaps still
on your policy and has a preexisting condition won't be covered. They
will not cover them. Mr. Romney didn't say that on ``Meet the Press.''

Mr. DURBIN. I say to the Senator from Iowa that I met so many people
in my State of Illinois who said, I cannot leave my job because I don't
know if I can ever find health insurance again. I am stuck because I
have a child or a spouse with a problem. The real world of human
experience tells us this happens all the time. It makes me wonder
sometimes. There are 8 or 9 million Americans--almost one out of three
Americans--not covered by this Romney plan. How does this solve any
problems? If we are not going to have health insurance we can count on
when we need it, it is worthless. It is a subsidy the insurance company
doesn't pay off when the family needs it.
I didn't mean to interrupt the Senator from Iowa, but I wanted to
make that point very strongly.
Mr. HARKIN. I want to say one other thing about this idea of the
individual mandate then-Governor Romney supported in Massachusetts. We
all have it within us--I think especially as Americans--that we don't
like to be told anything. We don't like to have a mandate put on us.
Well, as the chair of the health committee, and someone who is very
much involved in this process of getting the Affordable Care Act
through, I want to make it very clear, you don't have to buy insurance.
There is no individual mandate that says you have to buy insurance. I
want to make that clear, and I want to keep making

[[Page S6043]]

that point. I have been making that point for months now. You don't
have to buy insurance. It just says if you don't buy it and you get
real sick and want to get in line to get health insurance, you pay a
penalty. They call it a free-rider penalty.
Have we ever seen that before? How about Medicare? We have it in
Medicare. When you turn 65, you don't have to get Part B. No one tells
you that you have to do that. If you wait until you are 67, 68, 69, or
70, you pay more. You will pay a lot more than if you picked it up at
62 or 65 when you retired because it is a free-rider penalty. So we
have to get rid of this idea that this is some kind of individual
mandate that you are forced to do something. No, you are not forced to
do it. But if you are a free rider, and you say I will only go when I
get sick--like the car accident the Senator pointed out--yes, you pay a
penalty. That is all. You don't have a mandate. You just have to pay a
penalty. I think when we describe that, I would say that sounds fair.
If you are not going to be in the insurance pool--it is as though I am
not going to have car insurance, but if I have a wreck, I want to call
the insurance company and they will insure me to the moment right
before the wreck. That is nonsense. Of course, we don't do that.
Well, as I said, I intend to take the floor today, tomorrow, and for
the next several days to point out what the Ryan plan does overall but
basically in health care.
We mentioned Medicare. Let's talk about Medicaid. How about Medicaid?
What does Medicaid do? Basically, as I have said many times, it is
there to give a decent quality of health care and a quality of life to
the hopeless, the helpless, and the hapless. It is for people who
otherwise sort of fall through the cracks, people who need health care
who cannot afford it or who, because of their life situation, have
never been able to get any kind of health care coverage.
Well, here is what he does. I will get into this more. The Medicaid
funding, which the Senator from California mentioned, over 10 years
takes over $810 billion--that is with a ``b,'' not million--out of
Medicare. What does that mean? Who does that hurt? Well, 1 out of every
2 Americans with a disability uses Medicaid. That is who is hurt.
Services in the Medicaid Program allow our citizens with disabilities
to live with dignity and purpose in their homes and in their
communities. Three million seniors and people with disabilities use the
program to avoid having to go into a nursing home.
How about Medicaid for middle-class families? We always think that
Medicaid is just for people with disabilities or just for poor people.
How about Americans in the middle class? How about American middle-
class families? There are hundreds of thousands of American families
who have children with lifelong disabilities such as Down's syndrome or
autism. Medicaid gives them a lifeline or middle-class families would
be paying out of their pockets for the health care costs of their
children for their entire lifetimes. Yes, this is one of the
entitlements they want to cut. Medicaid is an entitlement.
Well, how about that tax plan? If you are a millionaire--that is all
you have to be. All you have to do is have an income of over $1 million
a year and you get huge tax benefits. How about that entitlement? No,
they don't touch that one. At the center of the Ryan budget is his
promise to repeal the Affordable Care Act, ObamaCare, a commonsense
health reform that led the Commonwealth of Massachusetts to have one of
the lowest uninsurance rates in the country. ObamaCare--I know the
Republicans have been using that as a pejorative. I say it proudly.
I was with President Obama in Iowa a couple of weeks ago when he
spoke to a huge group of students at my alma mater, Iowa State
University. There was a big sign in the back that said ``ObamaCare.''
President Obama looked at it and said, yes, ObamaCare. Speaking of
himself in the third person, he said: Yes, Obama does care. He said, I
care about making sure everyone is covered who has a preexisting
condition. I want to make sure that kids can stay on their parents'
policy while they are in college. Yes, I want to make sure that the
elderly have a good, affordable Medicare Program. Yes, I want to make
sure that people have good preventive health care systems in America.
Obama cares, that is what ObamaCare is. Obama cares, and he cares very
deeply that we have a health care system for all and not just for a
few. As was said by President Clinton in his speech, an American policy
based upon ``we're all in this together is much better than the policy
of tough luck, you're on your own,'' which is the Ryan budget
philosophy.
When we get past the political theater and look at what the Ryan
budget actually means, it is not a very pretty picture. The Ryan budget
would repeal the prescription drug doughnut hole closure we are doing.
It would allow insurance companies to charge as much as $300 for
preventive services. One of the key elements we put in ObamaCare: 86
million Americans received at least one free preventive service last
year, and more this year. Almost 1 million Iowans received one free
preventive service in 2011. That means they got preventive care so they
don't get sicker and cost us more money. Again, the Ryan budget would
allow people to deny you coverage or increase your premiums if you have
a preexisting condition.
This protection means a lot to this person right here. This is
Eleanor Pierce from Cedar Falls, IA. I spoke about her before. She was
denied health insurance when she lost her job because of her
preexisting condition of high blood pressure. Without coverage she
racked up $60,000 in medical debt. The Ryan budget would repeal
ObamaCare. They would tell people like Eleanor Pierce: Tough luck, you
are on your own. We are not all in this together. You mean you are not
worth $1 million? Tough luck, you are on your own.
Repeal will allow insurance companies to put limits on the coverage
of more than 100 million Americans, stopping benefits right when they
get sick. Repeal would kick more than 3 million young people off their
parents' policy.
This is Emily Schlichting who testified before the committee. She is
an elegant young woman going to college in Omaha. She said young people
are the future of this country and we are the most affected by reform.
We are the generation that is most uninsured. We need the Affordable
Care Act because it is literally an investment in the future of this
country. She suffers from a rare autoimmune disorder that would totally
make her uninsurable in the old days and under the Ryan budget, which
brings back those old days. Thanks to the Affordable Care Act, she can
stay on her parents' policy until she is 26. By 2014, regardless of her
preexisting condition, she will get affordable health insurance
coverage.
Repeal under the Ryan budget would allow insurance companies to spend
America's premium dollars on CEO bonuses, marketing, and fancy
buildings rather than actual health care. Under the health reform
medical loss ratio requirement, policyholders nationwide will receive
more than $1 billion in rebates from insurers this year. That is $1
billion in rebates this year that goes back to policyholders and
families; otherwise, that $1 billion would be going into CEO bonuses,
marketing, private jets, company planes, fancy buildings, and things
such as that. These are just a few of the ways the Romney-Ryan budget
would repeal ObamaCare and drag America back to the bad old days.
Again, I will repeat that over the last few weeks Representative Ryan
has been telling everyone how the President's health reform plan robs
Medicare. That is totally fallacious. First, the nonpartisan economists
have certified that ObamaCare strengthens the Medicare Program and
extends its solvency by 8 years. What President Obama did--as the
Senator from California previously pointed out--was make the program
more efficient and save money on wasteful overpayments to private
insurance companies and cracking down on fraud.
What Mr. Ryan won't tell us is that the very reforms President Obama
has in our Affordable Care Act are the same he has in his Ryan budget
plan. What he doesn't tell us is that while President Obama takes those
savings and puts them back into Medicare, Mr. Ryan takes those
savings--yes, you guessed it--and puts them into more tax breaks for
the wealthy.

[[Page S6044]]

By repealing the Affordable Care Act, the Ryan plan would again put
Americans at the mercy of insurance companies and deprive more than 30
million people of affordable coverage.
I was just going to get the chart for my own State of Iowa. I had one
here on Iowa I wanted to point out, because I am obviously very
interested in my seniors in Iowa. This chart shows that the Ryan plan
means almost 440,000 Iowa seniors would be forced onto vouchers when
they retire. We have to get those vouchers, right? Sixty thousand Iowa
seniors would be forced back into the prescription drug doughnut hole.
The doughnut hole would open again. Four hundred thousand Iowa seniors
would pay more for preventive services this year.
I can tell my colleagues our seniors in Iowa are flocking to get
their preventive health care services. They know an ounce of prevention
is worth a pound of cure. But before those preventive services cost
money. Now they get them free. It is going to make their lives better
and save us a lot of money.
ObamaCare decreases the deficit by almost $110 billion over the first
10 years and more than $1 trillion in the next decade. Mr. Romney and
Mr. Ryan won't tell us that, but it is true. It reduces the deficit. It
insures more than 94 percent of all Americans. Over 94 percent of all
Americans will have that coverage.
The bottom line is very simple, and I will be talking about this in
the days ahead. President Obama will protect Medicare, will protect
health care not only for our seniors but for young people, for middle-
class Americans and, yes, for those at the bottom rung of the ladder
who need Medicaid to sustain them and to give them quality health care.
The Ryan budget rolls back all of this. So, again, we are faced with
this choice: the Ryan budget or what President Obama has come forward
with in his budget and with his ObamaCare to make sure America remains
a good middle-class country where people on the bottom, at the lowest
rung of the ladder, can get into that middle class; where the middle
class knows they can leave a job and go to another job and not lose
their health care plan; where someone can start a small business and
know they will have health care coverage for themselves and the one or
two or three or four or five workers who work for them or small
businesses now can become more competitive with the big businesses in
America.
I think it is safe to say that if only the American people will study
the Ryan budget, the blueprint, they will find that this is where they
want to take you and me and all of America--back to an America that our
parents moved beyond; where our parents said, no, we are going to move
forward; where we have buttressed ourselves in our own lifetimes, in
moving America forward to a country where we truly are all in this
together; where we are not just a lottery country in which if a person
wins the lottery, they are OK, they have it made; if a person doesn't
win, then tough luck, sucker, they are on their own. That is not the
America our parents fought for in World War II or Korea or Vietnam; it
is not the kind of America Martin Luther King, Jr., marched for and
died for. It is not the kind of America we want to see for our kids and
our grandkids.
We have a choice. The choice is clear. Let's move forward.
I yield the floor, and I note the absence of a quorum.
The PRESIDING OFFICER (Mr. Merkley). The clerk will call the roll.
The assistant bill clerk proceeded to call the roll.
Mr. DURBIN. 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. DURBIN. Mr. President, most commissions appointed in Washington--
at least in my experience--hardly make a ripple, people hardly notice
them. After a lot of hard work, a report is published and that is about
it. Some historian at a later date may look at the work they have done
and the research they have done and that is about it, that is the
extent of it.
There are a few exceptions. I was fortunate enough almost 2 years ago
to be appointed to one of those exceptions and that was President
Obama's deficit reduction commission, the Simpson-Bowles Commission. I
was appointed because I am a member of the Appropriations Committee and
Senator Reid said we should have someone from Finance, Appropriations,
and Budget. I took the assignment of one of the three Democratic
Senators. There were three Republican Senators, three Republican House
Members, three Democratic House Members, and an additional six public
members. The public members consisted of a number of people, including
Alice Rivlin, respected in Washington, as well as a number of business
and community leaders.
We met for about a year and considered the budget deficit and all of
the Federal spending and came to know one another a little bit during
that period of time. One of the members of that commission was Paul
Ryan, a Congressman from Janesville, WI, just over the border from my
State of Illinois. I knew Paul before and got to know him a little
better during the course of that commission. He is a very bright
person. We have some common friends in the Janesville area, and I know
he worked with Senator Feingold, a Democrat from Wisconsin, on some
issues before.
What surprised me at the end of the day was despite his obvious
training and knowledge on the budget deficit, when it came time for a
vote on this bipartisan deficit commission report, all three House
Republican Members, including Congressman Paul Ryan, voted no. I voted
yes. Two out of the three Democratic Senators voted yes. I was
surprised, in a way, because I thought that although the Simpson-Bowles
plan had its shortcomings--things I disagreed with and said so--it was
a dramatic step forward to try to deal with our deficit in a fair
fashion.
Jeb Hensarling of Texas was another Republican Congressman, along
with Dave Camp of Michigan, the chair of the House Finance Committee,
and Congressman Paul Ryan, who all voted no.
I was surprised that at the Republican convention in Tampa, FL,
Congressman Ryan, the Republican Vice Presidential nominee, criticized
President Obama over the Simpson-Bowles Commission report, saying he
had worked hard to implement. I thought that was a curious position for
Congressman Ryan to take, because he had voted against it. Now he was
criticizing President Obama for not working hard enough on the
commission report. But I came to understand that a little more when I
took a closer look at Congressman Paul Ryan's budget plan for America.

Before he was chosen to run as Governor Romney's running mate, 5Paul
Ryan, the Congressman and chairman of the House Budget Committee,
issued his vision of what America should be doing over the next several
years. One of the most controversial sections relates to Medicare.
Medicare, of course, is the insurance policy for the elderly and many
disabled in our country. It is a lifeline for 40 million-plus
Americans. It means even in their old age they will have good
protection for health insurance because they have paid into it during
all of their working years. Paul Ryan observed that the Medicare
Program would come to an end if it weren't changed. We know it has
about 12 years of solvency left and change will be needed. His
proposal, though, would do more than change Medicare; it would end it
as we know it. The Ryan approach would create vouchers--coupons--for
senior citizens to buy health insurance. It would force them to pay
more out of pocket for Medicare. According to the CBO--the
Congressional Budget Office--the Romney-Ryan plan would force Medicare
beneficiaries to pay up to $1,200 more by 2030 and almost $6,000 by
2050. That is about $500 a month, ultimately.
Congressman Ryan said seniors could choose to stay in traditional
Medicare or they could basically go into a private health insurance
market. A senior who is both healthy and wealthy would have an option.
Those not so healthy or wealthy would find the only option traditional
Medicare, and more and more people with a history of illness would be
forced into traditional Medicare, making it a very expensive insurance
program and difficult to maintain.
The Paul Ryan voucher plan puts Medicare in competition with private
insurance companies and, as I said, many seniors would find that the
competition wouldn't want them and they would be stuck with traditional
Medicare, much different than it is today.

[[Page S6045]]

Medicare would be taking care of the seniors whose care costs more, so
Medicare premiums would increase. As they go up and seniors begin to
leave Medicare, it causes premiums to rise further, which would cripple
the program.
The Paul Ryan program eliminates all the consumer protections in the
Affordable Care Act, putting insurance companies back in the driver's
seat. I don't think most Americans believes that is a good place to be,
at the mercy of an insurance company, an adjuster who will decide what
they are covering and how much one will pay.
Young adults would no longer stay on their parents' insurance plan
under the Romney-Ryan proposal to eliminate ObamaCare. People with
preexisting conditions would be denied coverage--going back to the
conversation I had earlier, my dialog with Senator Harkin on the floor.
Families would once again face lifetime limits on coverage, and seniors
would be forced back into the doughnut hole, meaning paying more out-
of-pocket expenses for their Medicare prescription drugs.
I don't think this is a good plan for America and I don't think
Americans, once they hear the details, are going to like it.
The ObamaCare program has already helped a lot of people. A report
today said there was a 16-percent increase in coverage of younger
Americans because of ObamaCare. These are younger Americans up to the
age of 26 who now can stay on their family plans. And 1.6 million
Americans have been added into coverage under their parents' plan
because of this change in the law.
Now, those who say ``I will repeal ObamaCare'' would repeal that
protection, forcing 1.6 million young people, without jobs or coverage,
out of the protection they have today. I cannot imagine 125,000 young
adults in Illinois who have benefited from ObamaCare would believe that
is a good idea, nor would their families.
Since the Affordable Care Act was signed into law, Medicare
beneficiaries in Illinois have saved over $171 million on their
prescription drugs.
There was a discussion earlier about the Medicaid Program. Medicaid
is an important program in Illinois and most States. I asked Julie
Hamos, who administers our program in Illinois, to explain it in a few
words. Here is what she said: One out of three children in Illinois is
covered by Medicaid. That is their health insurance--one out of three.
In Illinois, Medicaid pays for 52 percent of the births; that is,
prenatal care and the delivery of the child--52 percent paid for by
Medicaid. But those two things--child coverage and coverage for new
moms and their babies--do not even represent half the cost of Medicaid
in Illinois.
Sixty percent of the cost of Medicaid in Illinois is for the elderly
and disabled, many of whom are completely out of luck and out of money.
They live on Social Security, Medicare, and Medicaid. They are in
nursing homes and convalescent centers. They do not have anyplace to
turn. So Medicaid is a critical insurance program for some of the most
vulnerable people in America.
Many seniors and disabled people on Medicare also receive State
Medicaid. The ``dual-eligibles'' they are called. That is 15 percent of
Medicaid enrollees, but 39 percent of Medicaid spending--low-income
elderly people who have no place else to turn.
So when Paul Ryan, in his budget, suggests he is going to cut back on
Medicaid payments each year, giving a smaller amount of money to
States, saying: Make do, who is at risk? Children: one out of three in
Illinois is on Medicaid; moms having babies: over half of the moms
having babies in our State; and the elderly folks who have no place to
turn.
Think about what that means. A child without basic health insurance,
Medicaid, in my State or anywhere, is less likely to have a doctor,
immunizations when needed, and an office visit to avoid a trip to an
emergency room. A mother without prenatal care is, unfortunately, more
likely to give birth to a child with a problem. And we do not want to
see that for the sake of the child first, certainly for the mom, for
the family, or for taxpayers, for goodness' sake. There is no money
saved by scrimping on Medicare for new moms. The Ryan plan would force
that kind of scrimping.
The Ryan plan converts Medicaid into a block grant and cuts Federal
funding for the program by 34 percent over the next 10 years--34
percent.
So I would ask Congressman Ryan: Which of those groups do you want to
cut back on in terms of coverage? According to CBO, cuts at the level
the Ryan plan calls for would mean States would have to reduce
eligibility for Medicaid and children's health insurance or cover fewer
services.
I might add--I am sure it is true in the State of Oregon; it is
certainly true in Illinois--one of the most critical areas of medical
need is dental care. I talk to doctors every time I go back home in
emergency rooms at hospitals who have people coming in to see them in
pain because of problems with their teeth, and they end up getting pain
medication but nothing is taken care of.
So when we talk about restricting care, as Paul Ryan has suggested in
his budget, I have to tell you, I think it is extremely shortsighted. A
tooth ache can turn into a life-threatening situation for some people,
not to mention the pain and discomfort they are going through. So if
anything, we ought to review basic Medicaid services to expand at least
into dental care. I would support that. I think it is extremely
shortsighted for us not to include it.
This Paul Ryan budget would not expand Medicaid. It would cut it back
dramatically. States would lower payments to doctors and nurses by one-
third. Can you imagine what that would do? It would reduce the number
of providers, which makes it more difficult.
Just to give you an example, in the Quad Cities in Illinois, there is
a great clinic put together by a friend of mine in the Hispanic section
of Moline. They provide basic, basic primary health care. If you need a
specialist, you are referred, with at least an hour-and-a-half drive,
to Peoria or with an almost 3-hour drive to Chicago. Remember, these
are the poorest people living in our towns. Do they make it to the
specialist? Usually not. The Paul Ryan approach, reducing the amount of
money that is paid to providers, would mean even fewer specialists
would be willing to help those who are poor.
But the thing that troubles me the most about Congressman Ryan is--at
least in his budget views and his deficit views--as he talks a good
game about reducing the deficit and voted against the Simpson-Bowles
Commission report, he comes up with a budget that he produces in the
House and says he and Governor Romney are going to protect the Bush tax
cuts for the wealthiest people in America and increase defense
spending. This does not work. It does not add up. It does not pass what
President Clinton called the arithmetic test. You cannot increase tax
cuts and increase spending on defense without, as President Clinton
said, digging the hole deeper and deeper.
So they sound pretty good when they give the speeches about fiscal
conservatism and that we have to be serious about the deficit, but
their proposals just do not match. The idea of lowering tax rates, as
they proposed, even below the Bush tax cuts--they said: Well, we will
use tax reform to get to it. The estimates suggest that the middle-
income families will end up losing in that. As a result of tax reform
as proposed by Romney-Ryan, they think middle-income families face a
higher tax of $2,000 a year to protect tax cuts for the wealthiest
people. That certainly is not a positive thing in terms of deficit
reduction or helping a lot of working families living paycheck to
paycheck.
We have debated Congressman Ryan's plan for 2 years now. The only
people who seem to like it are some Republicans serving in Congress.
The majority of Americans would oppose the Paul Ryan budget plan to end
Medicare as we know it. The majority of Americans certainly oppose his
idea of raising taxes on middle-income families to pay for tax breaks
for the wealthiest. Congressman Ryan has had his chance to make his
case to the American people for his view of where we are going, and it
will not work. I wish he had joined us in the bipartisan effort of
Simpson-Bowles. His vote in favor of that would have given him more
credibility and maybe a better understanding of the reality of budget
deficit reduction.

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