[Congressional Record Volume 160, Number 86 (Wednesday, June 4, 2014)]
[Senate]
[Pages S3426-S3428]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. LEAHY:
S. 2428. A bill to amend title 38, United States Code, to ensure that
the Department of Veterans Affairs provides temporary care in the most
cost effective manner when patients are relocated during medical
facility construction and renovation projects, and for other purposes;
to the Committee on Veterans' Affairs.
Mr. LEAHY. Mr. President, following the resignation of Secretary
Shinseki last week, it is time for some deep soul-searching about the
future of the Department of Veterans Affairs. As details slowly emerge
from the inspector general's investigation, I am struck by a disturbing
aspect of organizational culture within the VA that prioritizes meeting
goals and checking boxes instead of providing true quality care for
veterans. Secretary Shinseki himself was a decorated veteran, and I am
sure he must have been as frustrated as all of us to find some of the
things that were happening.
There is an overwhelming current rushing toward the path of least
resistance for ``reporting'' care for the men and women who served this
Nation admirably and with dedication. But we should not lose sight of
the hard work and commitment of the many men and women working in the
VA system every day striving to provide effective and timely care to
veterans. We have to tell ourselves that there is really no shortcut to
quality care for veterans. The VA has rightly been under intense
pressure and scrutiny to live up to the promise we made to veterans
when they agreed to serve.
We have many people in this body and the other body who voted for a
war that I think historians will call a disaster--the war in Iraq. For
the first time in America's history, they voted for a war and did not
do anything to pay for it--no tax to pay for it or anything else. Ten
years later, though, they say: We have to watch the cost of VA health
care and all that; we have to find the money. Well, that did not bother
them when they sent these men and women to war. Let's take care of them
now.
It has become apparent that at facilities across the United States
some VA employees have decided to choose to simply tell those above
them and those of us with oversight responsibility what they want to
hear, over providing quality care in a timely fashion. And that is
appalling and unacceptable.
But most VA employees are tireless servants. Many are veterans
themselves. For those men and women who give their all for our
veterans, it is becoming evident that the system of incentives and
disincentives may have worked against them. For example, it appears
that the criteria for bonuses are too weighted towards reported
metrics, rather than toward taking the time to understand the outcomes
behind the statistics. What sort of message is sent to good employees
when their ``success'' depends only on a small part of the picture of
veterans' care?
There should be no shortcut to quality care for veterans in
Washington policymaking circles either. The mere replacement of a
cabinet secretary results in neither accountability nor reform. Even
widespread firing of SES-level government employees will not
automatically result in providing quality care for veterans. Other
meaningful and more comprehensive reforms are needed, and without
delay. Earlier this year my distinguished colleague from Vermont
Senator Sanders introduced an expansive collection of many needed
reforms. Unfortunately, like so many bills we have tried to consider
this year, partisan objections stalled progress based on procedural
rather than substantive matters. Some of the same people who have been
so critical of this administration and the VA were the same ones who
voted to block going forward with needed reforms.
Well, the Senate is going to get another opportunity to consider a
comprehensive collection of reforms. It must prompt some meaningful
bipartisan action here in the Senate. Let's not play ``gotcha.'' Let's
play ``help you'' to the veterans. That is what we need to do. Congress
has an obligation to consider, debate, and vote on the reforms needed
to make our system of care for veterans both efficient and effective.
My wife began her nursing career as a brand new registered nurse in a
VA hospital. I know how hard she and those around her worked. They were
veterans of a different generation, but they needed help and care just
as much as everybody else.
So I look forward to the Senate's consideration of the legislation
introduced yesterday by Senator Sanders. I am proud to cosponsor it.
Many reforms are needed within the VA, and the Ensuring Veterans Access
to Care Act takes important steps toward achieving these changes.
Of course, additional reforms are needed. So today I am introducing
legislation to address one shortfall at the VA that has existed far too
long. Current law provides a disincentive to cost-effective, onsite
medical care solutions when operating rooms are refurbished or rebuilt
within a VA hospital or care facility. Because the VA must report any
major medical facility costs exceeding $10 million to Congress, the VA
is encouraged to pay for veterans care at outside facilities, including
travel to and from those facilities, out of the medical services
account. It is robbing Peter to pay Paul. It is a different pot of
money. So that way they do not have to have an extensive report. But
the best solution for veterans and the bottom line may very well be a
temporary onsite facility.
The bill is simple but attempts to take the allure of a shortcut away
by ensuring that the expenses of temporary offsite care are also
calculated and reported.
Senator Sanders, the chairman of the Veterans' Affairs Committee, has
said: ``If you think it's too expensive to take care of our veterans,
then don't send them to war.'' He is right. We paid for two unfunded
wars on a credit card. Now it is time we invest in those who put
themselves in harm's way to protect our security. It is time for us to
worry about some of the things we need to do here at home. It is time.
______
By Mr. ROBERTS:
S. 2430. A bill to establish the Office of the Special Inspector
General for Monitoring the Affordable Care Act, and for other purposes;
to the Committee on Health, Education, Labor, and Pensions.
Mr. ROBERTS. Mr. President, I first congratulate my colleague Senator
Isakson for doing a good job of summarizing exactly where we are and
the problems we are experiencing with the complexity of the Affordable
Care Act and the hope that the new Secretary will be responsive, as the
Senator so eloquently pointed out when he questioned her when she came
before the committee. I thank the Senator for making an excellent
speech and making excellent points, and I will endeavor to do the same,
as we are talking about the same subject.
My remarks are once again on the Affordable Care Act. I know we have
other issues, many important issues--the Veterans' Administration, the
release of terrorists in an exchange--but it is equally important we
continue to shed light on the many failings of this law.
During the very first debate on the Affordable Care Act, I distinctly
remember comparing this rush to government health care as akin to
riding hell-for-leather into a box canyon to find the only alternative
would be to turn around, ride back out, and get on a more realistic,
market-oriented health reform trail.
Then I put it another way. I said: There are a lot of cactuses out
there. We didn't have to sit on every one of them.
We never even saw the bill before we voted on it. I think everybody
understands that. I voted no and so did every Republican Senator and
Member of Congress. This was not a bipartisan effort.
I regret to say to my colleagues that I told you so, and here we are
in a box canyon. Until the administration provides us more details to
the contrary, we have to assume that more Americans are losing the care
they liked,
[[Page S3427]]
through cancellation notices, than they have enrolled in the exchanges.
They are in a box canyon.
It is now estimated that ObamaCare will cost the Nation nearly $2
trillion and has created higher premiums, higher taxes, less choice,
confusion, delays, and problem after problem. Unfortunately, the
President and his allies in the Congress continue to protect this law,
despite its toll on our economy, our patients, and our providers.
The President promised, as we all remember: We'll lower premiums for
a typical family by $2,500 per year.
Valerie from Wichita, KS, wrote me a letter to share her story on
this broken promise. She writes:
I wanted to let you know that I had to drop my company
health insurance due to the Affordable Care Act. My premium
before the Act was $250 a month and my employer paid $100 a
month toward the premium.
My insurance year expired April 1st and the new year is
under the ACA health insurance. The new plan is now much
higher at $565 a month and my employer can only afford to
pitch in $150 a month. I had to drop my plan due to
unaffordability. I could not pay the $415 a month.
The President also promised, highly publicized: ``If you like your
health care plan, you'll be able to keep your health care plan,
period,'' and, ``If you like your doctor, you'll be able to keep your
doctor.''
This law has significantly disrupted the individual health insurance
market by imposing mandates and causing at least 5 million Americans to
lose the insurance they had or have.
Doug, also from Wichita, wrote to share his personal story on this
one. He said:
I am a small business owner who just got my family's health
insurance cancelled. I have talked it through with [the
insurance company] and at a minimum I will be paying 63% more
per month for coverage that has a deductible 3 times greater
than what I had and my doctor may or may not be in the
network.
Doug continues on to say:
The only topic that matters in Washington is stopping the
insanity of [ObamaCare].
Most important, the President promised, ``I will protect Medicare.''
This law cuts over $700 billion from Medicare to pay for ObamaCare.
Part of those cuts come from the establishment, the establishment of an
Independent Payment Advisory Board--what a wonderful acronym for this
board--IPAB. This Board is supposed to be made up of 15 unelected
bureaucrats who will decide which treatments in Medicare coverage
should be taken away with regard to reimbursement. As I have stated on
the Senate floor before, the IPAB has no accountability and their
decisions are practically impossible to overturn.
The administration continues to give us piecemeal data on exchange
enrollments, delays provisions of the law that they can't implement on
time or simply wants to delay--a large serving of politics involved--
and is providing exclusive waivers and special deals to unions and
others from the yoke of ObamaCare.
In fact, the nonpartisan Congressional Research Service confirmed
that the administration has missed half of the mandated deadlines of
this law. Most recently, press reports have indicated the government
may be paying incorrect subsidies to more than 1 million Americans for
their health care plans in the new Federal insurance exchanges, and
they have so far been unable to fix the errors. Obviously, this poses a
lot of problems for a lot of people.
Unfortunately, the President and his allies in Congress continue to
protect this law despite its toll on our economy, patients, and
providers.
A new Health and Human Services Secretary has been nominated, Sylvia
Mathews Burwell, as Senator Isakson referred to, but with ObamaCare,
nothing will alter. We are headed for socialized medicine. ObamaCare is
the President's legacy. The President will unilaterally change what
suits him best.
The hard-working taxpayers who are paying for this law, in large part
from the 21 tax increases contained in it, have a right to some
answers. That is right, I said 21 tax increases. Just some of these
taxes include the following: the individual mandate tax, where people
have to pay the government for not having insurance, even if they can't
afford it; the employer mandate tax, where an employer pays a tax
because they may have chosen to forgo providing insurance to their
employees instead of having to lay off workers; the health insurance
tax, which will be passed along to individuals in the form of higher
premiums; the medical device tax.
I could go on and on. Many of these taxes have bipartisan support to
be repealed, but we can't even get a vote on those.
With a $1.8 trillion pricetag, this bill is so far-reaching it is
difficult to find a Federal agency that doesn't have a hand in this
pot; from your doctor's office to your wallet, to your privacy. That is
why I am introducing today a bill to require a special inspector
general for monitoring the Affordable Care Act. We call it the SIGMA
Act. It is the Special Inspector General for Monitoring the Affordable
Health Care Act.
While all of the Federal agencies charged with implementing the
Affordable Care Act have Offices of the Inspector General--and they do,
they are all investigating this law in their own silo--where have we
heard that before with a lot of problems within the Federal
Government--the Health and Human Services inspector general isn't
talking to the Treasury IG or the Department of Labor IG or the
Homeland Security IG or any one of those with each other.
This bill would give appropriate authority to investigate and to
audit any programs or activities related to this law across the many
Federal departments, State exchanges, and private contractors.
The legislation will require a report to be submitted to Congress and
the American people 6 months after enactment and quarterly reports for
the duration of time the Affordable Care Act is on the books. They have
broad authority to review all aspects of the law. Things such as the
following:
Changes in the health insurance marketplace, the amount of folks who
have seen their premiums and out-of-pocket costs increased, shrinking
physician and other provider networks. We have a right to know that.
The employer mandate, its effect on worker hours, employers' hiring,
and the number of businesses subjected to the penalty. We have a right
to know that.
The healthcare.gov Web site, its security, functionality, and
verification systems. We have read a lot about that, but we have a
right to know.
Duties of the Internal Revenue Service, plans for calculating subsidy
overpayments and underpayments, how they will notify these individuals
and what their plans are for recapturing these overpayments.
Medicare cuts via the IPAB, they will provide an analysis of the
impact on medical outcomes for our seniors as a result of these cuts.
We should know that.
All of these questions could and should be answered by a special
inspector general. The bill would equip the special IG with the same
investigative and law enforcement authority as standing inspectors
general, including subpoena and audit powers to compel responses from
the administration.
President Obama has claimed that his--his--is ``the most transparent
administration in history'' and that his administration is committed to
creating an unprecedented level of openness in government. Given these
statements, I think the President should embrace the idea of a special
inspector general for his health care law. After all, we need to know
the outcomes of the 41 changes he has already made to the law.
It would provide increased transparency so the general public has a
better understanding about this law. It would protect taxpayer dollars,
and by providing an independent analysis of this law, it will allow the
administration and Congress to make more informed decisions and work
together on how we move forward with reforms to our health care
system. I believe we need to do everything possible to repeal and
replace this law with real health care reform--reforms that lower costs
and restore the all-important relationship between a patient and a
doctor.
However, as long as this law is on the books, we need a watchdog or a
special inspector general to investigate the implementation of this law
and ensure that our scarce taxpayer dollars are being spent in an
appropriate manner. I encourage all of my colleagues to join me in
support of this bill in calling for
[[Page S3428]]
increased oversight of the affordable--or unaffordable--health care
law.
Let's ride out of the box canyon. Let's get on a better health care
reform trail, and on the way we certainly don't have to sit on every
cactus that comes along.
______
By Ms. WARREN (for herself, Mr. Franken, Mr. Harkin, Mr. Reed,
Mr. Durbin, Ms. Baldwin, Mr. Rockefeller, Mr. Reid, Mrs.
Feinstein, Mrs. Boxer, Mrs. Murray, Ms. Landrieu, Ms. Stabenow,
Mr. Cardin, Mr. Brown, Ms. Klobuchar, Mr. Whitehouse, Mr. Udall
of Colorado, Mrs. Shaheen, Mrs. Hagan, Mr. Merkley, Mr. Begich,
Mr. Bennet, Mrs. Gillibrand, Mr. Blumenthal, Mr. Schatz, Mr.
Murphy, Ms. Hirono, Ms. Heitkamp, Mr. Markey, Mr. Booker, Mr.
Udall of New Mexico, Mr. Heinrich, Mr. Sanders, Mr. Menendez,
and Mr. Schumer):
S. 2432. A bill to amend the Higher Education Act of 1965 to provide
for the refinancing of certain Federal student loans, and for other
purposes; read the first time.
Ms. WARREN. Mr. President, outstanding student loans now total more
than $1.2 trillion and millions of young people are struggling to keep
up with their payments. But we have a chance to give those borrowers
immediate relief by cutting the interest rates on existing student
loans. Make no mistake--this is an emergency. Federal watchdog agencies
such as the Federal Reserve, the Consumer Financial Protection Bureau,
and the Treasury Department are already sounding the alarm.
Forty million Americans are saddled with student loan debt. It is
holding them back, and it is holding our economy back too. Crushing
student loan debt is keeping many young people from moving out of their
parents' homes, from saving for a downpayment, from buying homes,
buying cars, starting small businesses, saving for retirement, or
making the purchases that grow our economy.
It doesn't have to be this way. Congress set artificially high
interest rates on old student loans that generate extra money for the
government. The GAO recently projected that just the slice of Federal
student loans issued between 2007 and 2012 will generate $66 billion
for the U.S. Government. Those are the kinds of profits that would make
a Fortune 500 CEO proud.
These young people didn't go to the mall and run up charges on a
credit card. They worked hard and learned new skills that will benefit
this country and help us build a stronger America. They deserve a fair
shot at an affordable education. We can give them a fair shot by
cutting those interest rates and cutting those government profits.
Along with more than 30 of my colleagues, I introduced the Bank on
Students Emergency Loan Refinancing Act to do just that. The idea is
simple. With interest rates near historic lows, homeowners, businesses,
and even local governments have refinanced their debts. But a graduate
who took out an unsubsidized loan before July 1 of last year is locked
into an interest rate of nearly 7 percent. Older loans run 8 percent, 9
percent, 10 percent, and even higher. We need to bring those rates
down, and we need to do it now. The Bank on Students bill would give
student loan borrowers the opportunity to lower their interest rates on
old loans to match the rates the government offers to new borrowers
today. That is 3.8 percent for undergraduate loans, 5.41 percent for
graduate loans, and 6.41 percent for PLUS loans.
I want to be clear. These rates are still higher than what it costs
the government to run the student loan program. The government won't be
subsidizing student loans. In fact, the government will be making a
profit on these loans--just a much smaller profit. And let's also be
clear that our work is not done until we eliminate all of the profits
from the student loan program.
But this is a step that both Republicans and Democrats can easily
support right now. Last year nearly every Republican in Congress in
both the House and the Senate voted for the exact same loan rates that
are in this legislation. If Republicans believe that 3.86 percent is
good enough for new undergraduate borrowers, then it should be good
enough for all the existing undergraduate borrowers. There is no reason
on Earth to say that some kids could get a better deal than others when
they all worked hard to do exactly what we wanted them to do--get an
education.
Passing this bill would have a real impact for people who are
struggling to make it--college students, young graduates who are only
starting to build their lives, parents who are juggling their own
student loans and trying to figure out how they are going to pay for
their kids' educations, and parents who guaranteed their kids' student
loans. Student loan refinancing can save real money for millions of
Americans, and they are voicing their support. Letters, emails, and
phone calls are already pouring in, and petitions for the bill's
passage have already garnered hundreds of thousands of signatures.
Think tanks such as Demos and the Center for American Progress, student
groups such as Generation Progress and Young Invincibles, and teachers
groups such as the AFT and NEA have all come forward and endorsed this
proposal.
Today the Congressional Budget Office announced that the bill
actually saves billions of dollars and reduces the Federal deficit.
That is because the refinancing proposal is fully paid for by
implementing the Buffett rule, which limits the ability of millionaires
and billionaires to exploit tax loopholes and pay a lower tax rate than
middle-class families.
Later today we will introduce an updated version of this legislation
in the hopes that we will be able to consider it on the floor of the
Senate very soon.
I am encouraged by the fact that some Republicans have also come
forward to say they are open to considering a refinancing proposal. I
want to be clear. This should not be a partisan issue. I am eager to
work with any of my colleagues regardless of party who believe that we
need to do something about this growing debt crisis. If they have
issues with the proposal, if they want to suggest different offsets or
policy changes, they should bring their ideas forward. We are ready to
hear them.
What we cannot do is continue to ignore this problem and hope that it
will go away on its own. Congress made this mess by setting
artificially high interest rates that are crushing our kids. It is
Congress's responsibility to clean it up. Refinancing won't fix
everything that is broken with our higher education system, but the
need for comprehensive reform must not blind us to the urgency of
addressing massive debt that is already crushing young people.
This is personal for me. I grew up in an America that made it a
priority to invest in young people, and it opened a million doors for
me. I will keep fighting to make sure that every kid who works hard and
plays by the rules gets a fair shot. I urge my colleagues to join me in
supporting this bill. Student loan borrowers don't have armies of
lobbyists to fight for them, but they have their voices and they are
asking for our support. Let's give it to them.
____________________