[Congressional Record Volume 159, Number 92 (Tuesday, June 25, 2013)]
[House]
[Pages H4021-H4024]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 2050
OBAMACARE
The SPEAKER pro tempore (Mr. Perry). Under the Speaker's announced
policy of January 3, 2013, the Chair recognizes the gentlewoman from
North Carolina (Mrs. Ellmers) for 30 minutes.
Mrs. ELLMERS. Mr. Speaker, I rise today to discuss the upcoming
implementation of ObamaCare.
Prior to coming to Washington, I was a nurse for over 21 years, and
I'm passionate about health care. My husband is a general surgeon, and
he continues to practice in our hometown of Dunn, North Carolina. I'm
very, very proud of that.
A couple of years ago when the President was proposing his
legislation to basically overhaul health care in America, my husband
and I became very active speaking out. That was well before ever
considering running for Congress. As a result, because of our passion
and concern for this country and health care as a whole, I found myself
winning my election and here fighting this fight. We continue with this
fight, and we are 98 days away from the open enrollment process going
into effect for ObamaCare. This is something that the American people
have been sitting back and watching for quite some time, and there are
many, many questions that remain to be answered.
Mr. Speaker, a recent GAO study shined some light on some areas that
we've been asking questions about for a very long period of time.
Serving on the Energy and Commerce Committee, the Energy and Commerce
Committee put forward a request to the GAO to find out where exactly
are we in the implementation of ObamaCare, this takeover of America's
health care affecting one-sixth of our economy and affecting jobs
across this country. It's the number one reason today, Mr. Speaker,
that employers are not hiring, because they're not sure of the effects
that this will have once fully implemented.
There again, this week, the nonpartisan Government Accountability
Office put forward their findings. I just want to highlight some of
those for you:
States have yet to complete 85 percent of the required program
activities. That means essentially, Mr. Speaker, that only 15 percent
of what needs to be in place at the State level for ObamaCare is
actually in place. Core functions of both Federal- and State-based
exchanges have yet to be completed with less than 4 months before open
enrollment, any other missed deadline threats, and timely establishment
of exchanges. Exchanges are not in place, exchanges are not ready to be
implemented, and yet we continue on this timeline path.
HHS has not yet completed the critical steps needed to determine
eligibility for credits and cost-sharing subsidies. There's much
groundwork that still needs to be laid and implementation figured out,
and we don't even have those answers from HHS.
Key data-sharing agreements between the Federal exchange and its
Federal and State counterparts are not complete.
Consumer assistance and outreach activities to individuals and
employers have yet to be implemented and have been delayed.
It cannot simply be a political campaign on the road touting the
virtues of ObamaCare that will implement this program. This is a major,
major concern for all of us who know how important health care is.
I can go on. There are many more pieces to the GAO report, which
basically cites the fact that CMS is not ready. CMS is supposed to come
in and help the States that haven't implemented yet or aren't ready.
Where are they? They're not there. They're not acting. We have these
questions, but who does this affect? What are the questions that need
to be answered?
This afternoon, I had the opportunity to go to National Children's
Hospital and meet with some of the families there, very ill children,
children dealing with diabetes, cancer. I got the opportunity to see a
1-year-old who's waiting for a heart transplant. These are the children
that will be affected by the implementation of ObamaCare. Why? Because
research will be affected, because lifesaving cures and treatments will
be affected.
How can we implement a health care system that no one at this point
can actually state will improve the quality of care of our health care
system? It's very important that when we talk about health care and the
takeover of health care that we separate the two issues: one, health
care pay-for, health care insurance, health care coverage; and then
health care itself. They both suffer as a result of ObamaCare being
implemented.
We simply cannot stand by and allow this to happen. My colleague from
Kentucky, he is here this evening as well, and he has some words. I
yield some of our time to the gentleman from Kentucky.
Mr. GUTHRIE. Mr. Speaker, I thank the gentlelady for yielding.
It seems there's no shortage of red flags regarding ObamaCare. The
one-size-fits-all health care law is proving to be disastrous for
consumers, for employers and health care providers alike.
Just last week, as my friend from North Carolina said, the
nonpartisan Government Accountability Office warned:
Because government officials have missed multiple key
deadlines to set up the new health insurance exchanges, there
is serious concern that the exchanges will not be ready in
October, as scheduled.
Employers and families across Kentucky have expressed serious
concerns about meeting the requirements of the law and wondering if
they will lose their coverage, be forced to choose different providers,
or be saddled with enormous new costs. Now these individuals are left
with even more uncertainty.
When talking with business leaders across my district, I hear a
barrage of questions and concerns. Small businesses, the backbone of
our economy, are likely the hardest to be hit. Some
[[Page H4022]]
local insurers say the law could put them out of business. One
restaurant owner says it will be a challenge for the whole industry and
many will be forced to lay off employees. Others simply say it will be
difficult to insure all of their existing employees.
A Gallup poll released last week showed that 41 percent of small
businesses, the engine of our economic growth, have stopped hiring new
employees because of ObamaCare. The same poll also showed that one-
fifth of those surveyed have reduced their workforce because of the
law.
Citing the uncertainty, these business leaders don't know what type
of insurance programs they might be able to implement or if they will
have to alter the shape of their workforce. The uncertainty seems
likely to continue given the striking, but not surprising, report from
the GAO.
The Government Accountability Office warns that the Center for
Medicare and Medicaid Services still has many duties to complete across
core exchange functions, including eligibility and enrollment. With
enrollment less than 4 months away, these missed deadlines will likely
result in even more confusion as Americans are prepared to be placed
into the exchanges. It's no wonder that this law is so wildly unpopular
and individuals fear being placed in exchanges.
But it's not just families and businessowners who are left in the
dark. Insurance companies don't know what to plan for when the
exchanges open, and some are already fleeing the market.
Aetna recently announced they will not participate in any statewide
exchanges and they will exit the individual insurance market in
California entirely. This mood can set a dangerous precedent: insurers
not being willing to take the financial risk to meet the demands of
ObamaCare and not participating in the exchanges altogether.
With competition dwindling and individuals not knowing what they can
expect in terms of coverage and cost, we are left with a very scary and
unacceptable reality. There are simply too many unknowns in the law
that completely overhauls our Nation's health care system. This has led
to unintended and negative consequences for employers, patients, and
providers.
This law is not the solution to our Nation's health care problems,
especially given the lack of information and tools available for
implementation. Instead, we need to enact a patient-centered plan that
lowers cost and ensures access for all Americans.
{time} 2100
Mrs. ELLMERS. Mr. Speaker, continuing with our discussion about the
implementation of ObamaCare, I think it's important, as my colleague
from Kentucky has cited, that back home, in his district, many
businesses, many individuals, many families are being negatively
affected as this moves towards implementation.
Tomorrow, in the Energy and Commerce Subcommittee on Oversight and
Investigations, we will be holding a hearing that actually discusses
the challenges facing our American businesses. Back in my district and
actually testifying here tomorrow is one of my constituents, Mr. Steve
Lozinsky, who will be here with his wife, Kathy. They actually own a
business, Sparkle & Shine Cleaning Service. It's a family-owned
business, and it's based in Apex, North Carolina. Sparkle & Shine was
started in 1998 with one employee, and, today, it has over 240
employees.
Put simply, Sparkle & Shine cannot afford the $2,000 per employee
fine attached to ObamaCare. My friend, my constituent, back home cannot
provide the health care coverage. He employs low-income workers. They
are entry-level jobs. They are hard workers. Many of these individuals
actually served time in jail and are now on a second chance at life.
Mr. Lozinsky and his wife, Kathy, have given these individuals a second
chance, and now their jobs are in jeopardy because of this devastating
health care law.
To my colleague again from Kentucky, I'm sure that he also has many,
many stories to share.
Mr. GUTHRIE. We hear stories like that all the time when we're home.
We had one in the Energy and Commerce Committee when we had a
gentleman who had a chain of restaurants he's developing in New
England, which isn't where I'm from, but he was before the committee.
His testimony was that he had eight restaurants and planned to open a
ninth, and he decided he had to wait because he has no idea what this
health care bill is going to cost him when he has to provide health
care for his employees. Of the net income of his eight restaurants, he
estimated--if he could come up with it because, as we know, you still
don't know exactly what the health care bill is going to look like. We
know what the bill looks like, but what we don't know is what's really
in it because the rules have not come out to say what you have to
provide your employees. It's supposed to happen in October and be ready
for January 1. So he has decided to just not open a restaurant until
this gets implemented so he can then move forward. He said it's going
to take half of his net income, he has estimated, if what's in the
rules comes out.
If you've ever been in business, it's something you always take home,
but if you're growing a business, hoping to open a ninth, 10th, and so
on and create a chain, the net income is what you put into the business
to grow the business and move forward. It's half of his net income,
according to his estimate and as best as he can estimate, because
nobody knows the details of what's actually going to be required until,
hopefully, we see it before October 1. It's just frustrating for him.
It's frustrating for people. It's frustrating for employees.
A guy stopped me in a store the other day. He just got a job at a
retail store. He said, I was promised 40 hours, and I was just told I'm
going to be working 29 hours. That's the new class of people working,
particularly in retail. He was retired, and he was kind of looking for
extra income, and he's going to be a 29er. That's a term that we hear
quite a bit.
So dealing with health care is something we absolutely have to deal
with but not dealing with it in the way of this bill. They didn't try
to cut costs, and it's actually implemented on top of the system even
more, which is going to cost more. Employers are really concerned, not
about being able to cover their employees, but they're concerned about,
Are they going to be able to afford to stay in business and even have
employees? That's the concern of most of them whom I hear talk about
it.
I'm sure you hear the same. I know our good friend from Texas is now
here on the floor, and I'd like to give this back to my friend from
North Carolina.
Mrs. ELLMERS. Just to follow up on some of the remarks that my
colleague has made, in getting back to the issue of jobs and job
creation, there was a recent Gallup Poll out this week that found that
41 percent of small businesses have stopped hiring because of
ObamaCare. That is a staggering number. Then to the point of good
patient-centered health care, that is not what ObamaCare will provide.
In fact, the CBO has estimated that 31 million in 10 years will still
remain uninsured.
So what are we doing? Why are we creating this system that will be
broken from the start and on which we will only spend hard-earned
taxpayer dollars trying to fix and plenty of time? Who will go without
the good patient-centered health care that every American deserves?
Mr. GUTHRIE. I don't think you were here when we were debating
ObamaCare.
Mrs. ELLMERS. I was at home, watching the TV, ready to put my foot
through it.
Mr. GUTHRIE. When we were debating it, the number was always 40
million people uninsured. So we've completely upended the health
insurance market and have put all this uncertainty into the economy. I
think it's the biggest drag on the economy. Now, we haven't had growth,
and we're going to have 31 million uninsured. That's not even by a
bipartisan group. That's by the nonpartisan Congressional Budget Office
that we're going to have 31 million people uninsured--all of this
because we had 40 million uninsured and, after all of this, 31 million
uninsured.
So did we get our $1 trillion worth?
Mrs. ELLMERS. That's a wonderful question.
I have another constituent who has shared numerous times with me his
concern for the implementation of ObamaCare.
Jerol and Telia Kivett, from Clinton, North Carolina, owned, again, a
family-
[[Page H4023]]
owned business that was started by his father back in the fifties. This
company makes church furniture--church pews for synagogues, funeral
homes, churches. Jerol and his wife are so concerned about this mandate
and are wanting and needing to avoid this government mandate that it
makes it extremely expensive for him to do business. He at one point
had 160 employees. He is now down to about 45 employees.
As you can imagine, in order for him to continue to do his business
in the way that he sees fit, in the way that was started by his father,
how will he continue into the future doing business when he knows that
working his way back up again in this awful Obama economy--for him to
hit that 50th employee--will mean a penalty for him if he is not
providing health care coverage for his employees? If he is able to
provide that health care coverage, it will be devastatingly expensive.
With that, I would like to welcome my colleague from Texas,
Congressman Burgess, for a few comments as well for he is well-versed
in health care and in, again, the devastation that ObamaCare will
bring.
Mr. BURGESS. I thank you for yielding. I really thank you for
bringing this important topic to the floor tonight.
Look, we are 6 months and 6 days away from the full-on implementation
of the Affordable Care Act. We are 3 months and 6 days away from the
open enrollment period of October 1. I just can't help but feel it's
like a fast-moving train that's charging down the tracks, moving toward
a head-on collision with the American economy, and it's going to be the
small business that suffers the devastating effects of that head-on
collision.
We've had opportunities to talk to the people from the agencies to
the extent that they will. I'm worried. I don't see how they can have
that Federal hub up and running by October 1 and have it work the way
it's intended the very first time, especially if they don't have time
to test it before they turn it loose on the American people. I am very
worried about what the world is going to look like after January 1.
I've got to tell you, from the standpoint of a practicing physician
of a small practice--we had five doctors in my practice--well, look.
Remember when part D came? Maybe you don't. I was here on January 1 of
2006. It was rough for the first several weeks, but there we were
talking about the prescription drug benefit for seniors on Medicare,
for maybe 42 million, 45 million people out of 310 million people. We
were just talking about the prescription drug benefit, and that was
difficult to implement.
{time} 2110
There were pharmacists all over the country who basically did not get
paid for the prescriptions that they filled for 1 month to 6 weeks, but
they were able to keep going because they had other prescriptions, they
had other business going on in their pharmacies. But this is going to
be everything from tonsillectomies, to childhood vaccinations, to ER
visits. If the cash flow is disrupted for even just a few weeks, the
small businesses, which are medical practices in this country, will
have a very difficult time enduring.
More importantly--and you all have correctly addressed it--is the
29ers and 49ers in this country, the people who are scared to add one
more than 49 people to their employment rolls or the people who've had
their hours now cut to 29 hours a week so that they will not require a
health care benefit.
That wasn't the way it was supposed to work. The gentleman from
Kentucky nailed it right off. The people of America in 2009 were saying
to us, Whatever you do, don't mess up the system that's working for 65
percent or 70 percent of us. The other thing they said was, If you're
going to do anything at all, please help us with costs. And what have
we done? Exactly the opposite. We've messed up the entire system, and
it's becoming more and more apparent every day. If you don't believe
me, wait until a year from now or 16 months from now, and just see how
bad it is.
The other thing is we didn't do anything to help with cost. If
anything, we've made it worse. By ratcheting up the demand side, not
increasing the number of providers, we've guaranteed that prices are
going to go up not just next year and not just the year after that, but
for every foreseeable year in the future. And I know that's hard for
people to estimate. I know the Congressional Budget Office can't give
us a figure on that. Just do the arithmetic yourself in your head, on
the back of an envelope and you'll be able to see that we are headed
for a significant disaster.
It's all well and good for me to criticize the administration and the
way they've implemented this, but I've got to ask: Where are our
Democratic colleagues? Where are the solutions that they're offering?
Clearly we should do something to help the small business owner who is
having to restrict employment hours to 29 hours a week. Surely we
should do something to help that. Where are the solutions from the
other side? They're nonexistent.
We should do something to help that small employer who wants to grow
beyond 49 employees, but is now frightened to do so. Where are our
Democratic counterparts? Where are the people from the agencies coming
to our committee and talking to us about how this might be managed or
maintained? Why aren't they talking to us about their contingency
plans? You know they've got them. You know they're over there at the
Department of Health and Human Services right now talking about what if
the Federal hub doesn't work, what if it doesn't work the way it was
intended. We'll have to have a way of narrowing the scope, of confining
the number of people we bring into this new ObamaCare environment. But
they won't talk to us about that. The Democrats won't come forward with
a solution.
We're doing what we can to bring people's attention to this very
important topic. To some it may be complaining; but if you don't think
about it, you can't prepare. And If you're not prepared, it is the
unprepared person who is really going to suffer in this new environment
that, again, is created in 6 months and 6 days.
I do thank the gentlelady for bringing this topic to the floor
tonight. I think it is important that we continue to talk about it and
we continue to talk about our ideas and our solutions. There are many
out there. And people need to assess for themselves how they will be
best served in this new environment that's brought by the
administration, or perhaps it's not too late or perhaps there are some
things we can do to alter that course, to move it off that center of
destruction where it's aimed right now.
I thank the gentlelady for having this tonight.
Mrs. ELLMERS. Thank you to my colleague from Texas. His insight on
this very important issue is vital to coming up with the solutions that
we need.
I do want to touch on one of the points that you were making, Dr.
Burgess. Basically, I saw a report this morning put out by the
Republican Study Committee that basically said that there was a study
that is showing that we will have a shortage of 30,000 doctors within
this country in 2 years. That is devastating.
Mr. BURGESS. You know, you're in a medical family. I know because I
hear it everywhere I go. Physicians all across the country are
concerned. They don't know what they're getting into, and they don't
know what the world will look like.
As a consequence, like anyone else, they are reluctant to make those
big decisions, they're reluctant to hire a partner, buy a new piece of
equipment, open a branch office. They are like everyone else: they are
in that hunker-down mode where so many small businesses have been for
the last 4\1/2\ years.
But without expanding the provider core, without expanding the health
care manpower, you can pretty much predict that there is going to be a
price spike because you know you're ratcheting up demand by increasing
coverage, and at the same time you're not providing for areas where
those people can be seen.
What's really unfortunate, by some of the means with which coverage
has been expanded, we already know that there are places in this
country where it is hard to get a new patient appointment if you're a
Medicaid patient. The reimbursement rate is so abysmally low that a
provider can't possibly keep their doors open if they accept those
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levels of payment. As a consequence, they don't. What are those
patients going to do? They do what they've always done and go to the
emergency room, which is the highest cost point of contact care that
you can have.
So instead of solving a problem that every Democrat here talked about
4\1/2\ years ago, we've doubled down and made it worse. Again, as a
consequence, the cost of care is going to go up and providers are going
to drop out just because the frustration is going to get so high that
it will simply not be worthwhile to continue in practice, or you'll go
work in a practice environment where you simply don't have to put in
the number of hours that you would in a solo or small-group practice.
But we've really selected against those practitioners, those men and
women who go to work every day early before the sun comes up and they
work until after the sun goes down taking care of their patients. We're
actually self-selecting against that very type of individual that we
all knew, we all grew up with, we all look to as our leaders in the
medical profession. It will be very difficult for those people to
endure.
We'll look to academic medical centers, perhaps to hospitals, perhaps
to the government itself for that leadership, but it's not going to be
the same thing.
Mrs. ELLMERS. Thank you to the gentleman.
I do want to take a moment to talk about another group of young
individuals in this country, young Americans who are also being
negatively affected as a result of the implementation of ObamaCare: our
students who are paying back student loans.
As we all know, July 1 student interest rates are scheduled to
double, essentially. My staff and I have done some research on this.
And if you all remember back in 2009, when President Obama was
implementing the health care bill, they also took over the student
loans in this country. That was for pay-for. And according to the
Congressional Budget Office, over the next 10 years, $8.7 billion of
that student loan payback will come from those student loans.
Not only are we affecting health care in this country, but we are
also affecting our young people, those individuals who are graduating
from colleges around this country who may or may not have a job to go
to, a job that they have prepared a career for; and yet they too will
be paying for ObamaCare.
Mr. GUTHRIE. That's a great point that I brought up when we were
debating it back in 2009.
What people don't realize, as it didn't get a lot of coverage, Mr.
Speaker, is that the Federal Government took over the student loans.
So you're going to hear a lot about student loans in the next few
days because after July 1 the student loan rates are going to go up.
The House was active. We passed a bill. It's in the Senate. I've heard
the President talk about it.
What people need to realize is that when the health care bill
passed--as my friend just said, the Federal Government can loan money
at a low rate because we can pretty much borrow from ourselves at a low
rate. When we loan it to students, they pay a little over 3 percent;
and the difference, the flow, comes back to the Federal Government, the
profit from loaning to our businesses.
Do you know where $8.7 billion of that is going to? To pay for the
health care bill. Instead of taking $8.7 billion and giving it back to
students who are struggling with affordability of college--I'm in that
world right now because my son is leaving this summer to go off to
college and I have a daughter in college. So most of the people that
are peers of theirs that I see, we talk about the affordability of
college. One of the things that we did is we took money that students
are paying back on their student loans to pay for the health care bill.
Instead of rebating it back to the students to put it in their pockets
to pay for their loans, it goes to the health care bill.
As we hear a lot of people on the other side and in the White House
this week talk about health care and that the Senate hasn't passed a
bill to deal with student loan interest rates that will go up, I want
people to remember, Mr. Speaker, that $8.7 billion of what people are
paying back in interest is going to fund the health care bill.
{time} 2120
Mrs. ELLMERS. With that, I would just say that the good news for the
House is that last month we passed the Smarter Solutions for Students
Act, and now it lies with the Senate for passage as well.
With that, Mr. Speaker, I yield back the balance of my time.
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