[Congressional Record Volume 161, Number 173 (Tuesday, December 1, 2015)]
[Senate]
[Pages S8212-S8216]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
OBAMACARE
Mr. ALEXANDER. Mr. President, let me take my colleagues back 5\1/2\
years to February 25, 2010, and the White House health care summit at
the Blair House--the same place where Senator Arthur Vandenberg sat
down with George Marshall. They met privately to discuss the postwar
plans after World War II. The result of that discussion became the
Marshall Plan. It was the perfect setting--it is the perfect setting
for a serious, bipartisan discussion for how to improve health care for
Americans.
Thirty-six Members of Congress went to the Blair House that day at
the invitation of President Obama. We were there to discuss the health
care bill passed by the Democrats, what is now known as Obamacare. We
stayed there all day. The President stayed there too. It was televised
continuously. Both then-Minority Leader Boehner and Republican Leader
McConnell asked me to lead off in speaking for Republicans.
I said to the President that day that I was there not only to
represent the view of Republicans but that I was there also as a former
Governor and that I would like to have a chance to speak for the
Governors as well because Governors managing States had a big stake in
all of this.
I also said that I was at the summit to represent the views of a
great many of the American people who have tried to say in every way
they knew how--through town meetings, through surveys, through
elections in Virginia and New Jersey and Massachusetts--that they
oppose the health care bill that was passed in the Senate in the middle
of a snowstorm on Christmas Eve.
I warned the President then about the unfortunate consequences of
Obamacare for millions of Americans. I said to the President that this
would send an unfunded Medicaid mandate to States. I said:
[[Page S8213]]
``It will cut Medicare by about half a trillion dollars and
spend most of that on new programs. . . . It means there will
be about a half trillion dollars of new taxes in it. It means
that for millions of Americans, premiums will go up, because
when people pay those new taxes, premiums will go up, and
they will also go up because of the government mandates.''
That is what I said 5\1/2\ years ago. I said directly to the
President then that instead of this partisan plan passed without the
support of a single Republican in the Senate, we Republicans were
prepared to work with him to reform health care. I said 5\1/2\ years
ago to the President that we need to start over and go step-by-step in
a different direction toward the goal of reducing health care costs. I
said then that this means working together in the way that General
Marshall and Senator Vandenberg did following World War II, and it
means going step-by-step together to re-earn the trust of the American
people. Those were my words to the President of the United States at
the health care summit 5\1/2\ years ago.
The President and the congressional Democrats listened all day, but
they didn't take any of my advice and hardly any of the advice of my
Republican colleagues about what the disastrous outcomes of Obamacare
would be. So now, 5\1/2\ years after the law was passed and 2 years
into its implementation, we can say one thing without question: The
unfortunate reality for the American people is that they are struggling
with Obamacare and that 5\1/2\ years ago Republicans were right.
Obamacare was and is an historic mistake. Republicans agreed with the
President and his party that our health care system was broken. We
agreed that it needed to be fixed, but we argued that the President was
moving in the wrong direction. What Obamacare did was to expand a
broken system that everyone knew was too expensive. Republicans said so
at the summit in February of 2010, and the facts today show we were
right.
Let's take a closer look at what Republicans said then, nearly 6
years ago, and what unfortunately came true. Let's look also at what
Democrats predicted back then--or better put, what they promised--and
which of their predictions and promises came true. Let's go through
them one by one.
First, Medicaid. During my opening remarks at the Blair House at the
summit, I said this: ``Nothing used to make me madder as Governor than
when Washington politicians would get together, pass a bill, take
credit for it, and send me the bill to pay.'' That is exactly what
Obamacare does with the expansion of Medicaid. In addition, it dumps 15
to 18 million low-income Americans into a Medicaid program that none of
us would want to be a part of because 50 percent of the doctors won't
see new patients. So it is like giving someone a ticket to a bus line
when the bus runs only half the time.
That is what I said 5\1/2\ years ago. Medicaid had already always
been one of the Federal Government's biggest unfunded mandates, and
expanding that mandate on States would only wreak more havoc on State
budgets that, especially at that time during the height of the
recession, were already struggling. Our former Tennessee Governor Phil
Bredesen, a Democrat, said that the proposed Medicaid expansion under
Obamacare would represent ``the mother of all unfunded mandates.''
When I was Governor of Tennessee in the 1980s, Medicaid made up only
about 8 percent of Tennessee's State budget. By last year it was 30.6
percent. States paying more and more to expand Medicaid means having
less to spend on other priorities like higher education, roads, and
schools. In 2012, I said that over the prior 10 years, Tennessee's
Medicaid costs had gone up 43 percent, forcing the State to decrease
its funding to colleges and universities by 11 percent. As a result,
tuition went up 120 percent over those 10 years.
According to the Congressional Budget Office, the law will add $14
million new beneficiaries to struggling State Medicaid programs by
2025, at an extra cost of $46 billion to States and $847 billion to
Federal taxpayers by 2025. Why is that so bad? I said at the time--and
it is still true today--Medicaid's reimbursement rates are so low that
only about one-half of the doctors will even see Medicaid patients and
many of those aren't accepting new ones. It is not hard to see why
expanding a failed program isn't good for Americans who need better
health care.
Another thing to consider is that States still haven't had to pay yet
for covering the new Medicaid enrollees under the expansion. The
Federal Government promised to pay 100 percent for the first few years,
but starting in 2017--in just a couple of years--States will have to
start paying 5 percent and eventually up to 10 percent in 2020. That
may not seem like much in Washington terms, but it is a lot of money in
State budgets. States may have to start raising income taxes or gas
taxes or find some other place to find the money. Regardless of how it
is paid for, expanding Medicaid puts a huge dent in State budgets. Does
that mean less money for teachers' salaries? Does that mean tuition is
going to have to go even higher at community colleges and State
universities?
Tennessee hasn't expanded Medicaid, but in its proposal to expand the
program called Insure Tennessee, Governor Haslam anticipated an
additional $35.6 million in costs to the State in 2017. In Illinois,
Medicaid expansion will cost the State $208 million in 2020. In
Kentucky's expansion, the State will have to pay $74 million in 2017
and an estimated $363 million in 2021. Governor-elect Bevin hasn't
started looking for ways to pay for that increase yet because he plans
to try to repeal it. If you look at the figures you can see why he is
thinking about it. We were right about Obamacare's enormous impact on
Medicaid and in turn Medicaid's huge negative effect on State budgets.
Second, higher premiums. When my turn came at the White House summit,
this is what I said directly to the President: ``The Congressional
Budget Office report says that premiums will rise in the individual
market'' as a result of Obamacare. The President turned to me and said
I was wrong about that.
A little bit later in the day, I gave the President a letter from the
Congressional Budget Office showing that they predicted I would be
right, that new non-group policies would be about 10 to 13 percent
higher in 2016 than the average for non-group coverage in that same
year under the current law. In that same letter, I reminded the
President, that his own Chief Actuary for the Centers for Medicare &
Medicaid Services agreed with the Congressional Budget Office.
You might be thinking that things would have turned out better than
what I, the Congressional Budget Office, the Joint Committee on
Taxation, and the Chief Actuary for CMS had predicted, but we all,
unfortunately, were right. We were all right. Obamacare's premiums were
and are higher for Americans with individual health care plans. We are
talking about nearly 16 million Americans who purchase these individual
plans. They buy these policies for themselves, and the cost of these
plans is going through the roof.
On June 1, 2015, the U.S. Department of Health and Human Services
announced that nearly 700 individual and small-group health plans in 41
States plus the District of Columbia had requested double-digit premium
increases for 2016. In Tennessee, the rate hike was 36 percent; in
Maryland, 26 percent. On average, 2016 premium increases for Oregon's
biggest insurer on the State health exchange will be over 25 percent;
for some smaller providers, more than 30 percent; for South Dakotans,
the will pay 63 percent higher premiums for health insurance through
the exchange. The list of States experiencing health care spikes goes
on.
A recent report of the National Bureau of Economic Research confirmed
this, going back to the nonpartisan Congressional Budget Office, which
predicted in 2010 the premiums would go up. They said recently that
premiums on the Obamacare exchange will increase by 6 percent on
average every year between 2016 and 2024. Yet 5\1/2\ years ago, the
President and congressional Democrats told Republicans time and time
again during the debate that we were wrong, that the law would decrease
premiums, when in fact our predictions, the administration's own
estimates, estimates from the National Bureau of Economic Research and
the nonpartisan Congressional Budget Office, all confirmed premiums for
individual policies are going through the roof.
Third, Republicans said 5\1/2\ years ago that Obamacare would
increase taxes.
[[Page S8214]]
It did. Obamacare added 21 tax increases to the Tax Code. That is $1
trillion over 10 years, according to the Congressional Budget Office. A
dozen of these target middle-income Americans, in clear violation of
what the President had promised.
Then there was our fourth prediction: Obamacare will cost jobs. A few
years after the law passed, I met with a large group of chief
executives of restaurant companies in America. The service and
hospitality industries are the largest employers in our country.
Usually their employees are low-income, usually minority Americans.
In the meeting, the chief executive of Ruby Tuesday, Inc., which has
about 800 restaurants, said to me--and said he didn't mind being
quoted--that the cost to his company of implementing the new health
care law was equal to or more than his net profit for that year, and as
a result, he wasn't planning to build any new restaurants in the United
States.
An even larger restaurant company represented at the meeting said
that because of their analysis of the law, instead of operating their
store with 90 employees, their goal would be to operate it with 70
employees. That means fewer employees and fewer jobs because of
Obamacare.
More recently, another franchise business which has 550 employees
told me: We have already begun cutting the hours of our employees to
get well below the 30-hour threshold, and all of our new job postings
are for part-time employees.
This has a bad effect on the employer-employee relations, and, as
many Tennesseans have told me, 30 hours of work isn't enough to support
a family. Those lost hours are because of Obamacare.
These are just a few examples of basic economics. It heaps costs on
employers. They have less money to expand, so there is less money to
hire workers. They heap on even higher costs. They cut hours. With
higher costs, they lay off employees. We have seen all three as a
result of the employer mandate that says employers with more than 50
full-time employees need to provide health insurance.
What is more, Obamacare went a step further and for the first time in
our history defined ``full time'' as a 30-hour workweek. I asked the
former Democratic chairman of our HELP Committee: Where did that come
from? France? Nobody knew where that came from. Full-time work in the
United States has not been typically considered 30 hours, but it is in
Obamacare. It is causing large numbers of employees to work only 28 or
29 hours because their employers can't afford to hire them as full-time
employees.
The Congressional Budget Office has projected that Obamacare will
result in 2 million fewer jobs in 2017 and 2.5 million fewer full-time
jobs by 2024. At least 450 employers across the Nation, including 100
school districts, have said Obamacare forced them to cut positions or
reduce worker hours.
What we Republicans said would happen years ago was this: that
Medicaid would destroy State budgets--it did; that premiums and taxes
would go up--they have; and that jobs would be lost--they have. It has
all, unfortunately, come true.
What did President Obama and congressional Democrats promise us about
this law at about the time of the health care summit 5\1/2\ years ago?
Were they right or were they wrong? One of the most infamous promises,
which PolitiFact named--and I will use their words--as the 2013 ``Lie
of the Year,'' was the President's ``If you like your plan, you can
keep it.''
When Obamacare was fully implemented in 2014, millions of Americans
learned very quickly that they wouldn't be able to keep the plans they
liked.
In October 2013, I received a letter from a woman, Emilie, whom I
met. She lives in Middle Tennessee, and she has lupus. She was one of
16,000 Tennesseans who were part of a plan called CoverTN. She wrote me
about her chronic illness. She said she was deemed uninsurable and that
the only way to insure her was through CoverTN. She was glad to have
that coverage, and she was glad to hear about Obamacare. Then she
learned the truth:
``I cannot keep my current plan because it does not meet
the standards of coverage. This alone is a travesty. CoverTN
has been a lifeline [for me].
With the discontinuation of CoverTN, I am being forced to
purchase a plan . . . that will increase [my costs] by a
staggering 410%. My out of pocket expense will increase by
more than $6,000.00 a year. Please help me understand how
this is `affordable.' ''
This was Emilie in Middle Tennessee.
We could spend all day telling stories of Americans who liked their
health care plans but weren't able to keep them under Obamacare.
In November 2013 that looked as if it might be as many as 5 million
Americans. The administration then did some last-minute regulatory
fixes and lowered that number. But still, many Americans lost their
plans, as Emilie did.
The President also said:
``Medicare is a government program. But don't worry: I'm
not going to touch it.''
The problem was he did touch it; $700 billion worth was taken from
Medicare to finance Obamacare.
I said during the debate in 2009 that Obamacare would cut ``grandma's
Medicare to spend on somebody other than grandma--a new entitlement
program.'' I said Obamacare would do that at a time when the Medicare
trustees have told us that Medicare is going broke if we don't fix it.
That is their job to tell us that. I said then: ``I think what they are
saying to us is if you are going to cut grandma's Medicare, you ought
to at least spend it on grandma instead of spending it on somebody
else.''
Again, the President went against the promise he repeated over and
over and raided a program that serves over 55 million older Americans.
In summary, unfortunately Republicans were right when we said 5\1/2\
years ago that Obamacare would force spikes in State Medicaid spending,
increase premiums and taxes, and hurt jobs. As right as we were, the
Democrats were wrong. They said that you could keep your plan if you
liked it, and they were wrong about that. They said Medicare wouldn't
be affected, and they were wrong about that.
Finally, we all agreed that health care needed to be fixed. So how
did we end up with a law that was such an historic mistake? Well, one
big reason is the debate over Obamacare wasn't really a debate. If it
had been, we might not find ourselves in a mess today.
The Senate Democratic leader then had a filibuster-proof majority. He
didn't think he needed Republican ideas; so they didn't take them. They
passed a Democratic bill. They voted for it; we voted against it. We
sat here in a snowstorm on Christmas Eve when they had 60 votes, and
they unveiled a bill filled to the brim with items from each Democratic
Members' wish list.
Along with our warnings about what would happen, we offered a lot of
thoughtful ideas about how to fix the health care system in a way that
we thought would lower costs and expand access, while making sure
patients didn't lose control over their own health care. But Democrats
also had a majority in the House. They had a Democratic President. They
didn't need our ideas, and so we got Obamacare.
So what do we Republicans have to offer Americans?
Mr. President, how much time do I have remaining?
The PRESIDING OFFICER (Mr. Lankford). The Senator has 9 minutes
remaining.
Mr. ALEXANDER. I thank the Presiding Officer. I will wrap up. I see
the Senator from Washington on the floor.
Throughout the Obamacare debate, Senator McConnell, who was the
minority leader at the time, was criticized for not coming up with a
comprehensive plan of his own. We told the President and the
congressional Democrats not to hold their breath waiting for
``McConnell Care.'' Don't hold your breath waiting for Senator
McConnell to come down to the Senate floor with a wheelbarrow filled
with a 2,700-page bill of his own, because that is not how we believe
the health care system ought to be fixed. We are policy sceptics. We
doubt that anyone in Washington--Republicans, Democrats, Independents--
have the wisdom to fix such a complex system everywhere in America all
at once.
The wisest course would be to try to fix our health care system step
by step in a way that emphasizes more choices and lower costs. This
approach to health care reform is not something
[[Page S8215]]
that Republicans cooked up last month. In fact, if you examine the
Congressional Record, you will find that Republican Senators proposed a
step-by-step approach to confronting our Nation's health care problems
and other challenges 173 different times on the floor of the Senate
during the year 2009. Some 173 times we talked about our step-by-step
different direction for health care--almost none of which was included
in Obamacare because they had the votes and they didn't need our ideas.
I had hoped the President would listen to us and work with us at
Blair House, emphasize more freedom, more choices and lower costs. But
that didn't happen. We suggested allowing individuals to buy a health
care plan in any State that meets their needs. We suggested reducing
junk lawsuits against doctors, which only increase costs. We suggested
expanding health savings accounts and other mechanisms, allowing
individuals to control how they spend their own health care dollars. We
suggested returning power to the States to regulate their own markets
and lower costs. We suggested allowing small businesses to assist
employees in purchasing the insurance and look at other ways to support
employers offering health care benefits to their employees. We had
specific legislative proposals to do these things. We suggested
lowering barriers at the Food and Drug Administration so that
innovative drugs and devices could get to the market faster and putting
the health sector in charge of health information technology. We
suggested insuring Americans with pre-existing conditions in a way
through high-risk pools and other insurance incentives. And there are
many other ideas that we thought then and we think now we could work
together on in a bipartisan way to lower costs, to increase access, and
to put patients back in charge of their own health care.
This week, though, we are talking about repealing Obamacare, but for
the last 6 years we have also been talking about a completely different
path of providing health care at a lower cost to more Americans. Those
steps were outlined in 2009, 2010, and 2011, and they are the same
steps that we should be taking today.
I have been saying since 2009 that the historic mistake with
Obamacare was that we had deliberately expanded a broken health care
system that already cost too much instead of moving step by step to
create a system where millions of Americans had choices of plans that
fit their needs and fit their budgets.
The way we should accomplish this is the same way we passed Medicare,
the same way we passed Social Security, the same way the Congress
passed the Civil Rights Act, and in the same way--I hope and the
Senator from Washington hopes--we will pass a broad reauthorization of
the Elementary and Secondary Education Act in the next couple of weeks.
None of this is done by cramming a bill down the throats of the
American people with 60 votes during a snowstorm on Christmas Eve.
I renew our invitation to the President of the United States, and if
he doesn't accept our invitation, to the next President of the United
States.
To our colleagues on the other side of the aisle: Let's forget about
party; let's forget about this side or that side. Let's side with the
American people whose premiums have gone up, who lost plans they like,
whose Medicare has been raided, whose State budgets have been
destroyed, and whose jobs have been lost. Work with Republicans in
Congress to fix the damage Obamacare has done to health care in
America. Work with us to replace Obamacare with real reforms at lower
costs so more Americans can afford to buy insurance.
Mr. President, I ask unanimous consent to have printed in the Record
my comments at the health care summit in February of 2010 and the
letter that I handed to President Obama following our debate at the
health care summit in 2010.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[Thursday, February 25, 2010]
Alexander Gives Republican Health Care Remarks at White House Summit
Outlines Republican Steps to Fix Health Care, Challenges Democrats to
Take Reconciliation Off the Table
Washington.--U.S. Senator Lamar Alexander (R-Tenn.),
chairman of the Senate Republican Conference, today delivered
the following opening remarks on behalf of Republican members
of Congress attending the White House health care summit:
``Mr. President, thank you very much for the invitation.
Several of us were a part of the summits that you had a year
ago, and so I've been asked to try to express what
Republicans believe about where we've gotten since then. As a
former governor, I also want to try to represent governors'
views, because they have a big stake in this; I know you met
with some governors just in the last few days. We also
believe that our views represent the views of a great number
of the American people who have tried to say in every way
they know how--through town meetings, through surveys,
through elections in Virginia and New Jersey and
Massachusetts, that they oppose the health care bill that
passed the Senate on Christmas Eve.
``And more importantly, we believe we have a better idea.
And that's to take many of the examples that you just
mentioned about health care costs and make that our goal:
reducing health care costs. We need to start over and go step
by step toward that goal. And we would like to briefly
mention--others will talk more about it as we go along--what
those ideas are.
``I would like to begin with a story. When I was elected
governor, some of the media went up to the Democratic leaders
in the legislature and said, `What are you going to do with
this new young Republican governor?' And they said, `We're
going help him, because if he succeeds, our state succeeds.'
And they did that--that's the way we worked for eight years.
But often, they had to persuade me to change my direction to
get our state where it needed to go. I would like to say the
same thing to you. I mean, we want you to succeed. Because if
you succeed, our country succeeds. But we would like
respectfully to change the direction you're going on health
care costs, and that's what I want to mention here the in
next few minutes.
``I was trying to think if there were any kind of event
that this could be compared with. And I was thinking of the
Detroit Auto Show, that if you had invited us out to watch
you unveil the latest model that you and your engineers had
created, and asked us to help sell it to the American people.
When we look at it, it's the same model we saw last year. We
didn't like it, and neither did they, because we don't think
it gets us where we need to go, and we can't afford it. As
they also say in Detroit, `We think we have a better idea.'
``Your stories are a lot like the stories I heard when I
went home for Christmas after we had 25 days of consecutive
debate and voted on Christmas Eve on health care. A friend of
mine from Tullahoma, Tennessee, said, `I hope you'll kill
that health care bill.' Then before the words rattled out of
his mouth, he said, `But, we've got to do something about
health care costs. My wife has breast cancer. She got it 11
years ago and our insurance is $2,000 a month. We couldn't
afford it if our employer weren't helping us do that. So
we've got to do something.' That's where we are, but to do
that, we have to start by taking the current bill and putting
it on the shelf and starting from a clean sheet of paper.
``Now, you have presented ideas. There's an 11-page memo--I
think it's important for the people to understand that
there's not a presidential bill; there are good suggestions
and ideas on the web. It's a lot like the Senate bill. It has
more taxes, more subsidies, more spending. So what that means
is, when it's written, it will be 2,700 pages, more or less.
It will probably have a lot of surprises in it. It means it
will cut Medicare by about half a trillion dollars and spend
most of that on new programs, not on Medicare and making it
stronger, even though it's going broke in 2015. It means
there will be about a half trillion dollars of new taxes in
it. It means that for millions of Americans, premiums will go
up, because when people pay those new taxes, premiums will go
up, and they will also go up because of the government
mandates. It means that from a governor's point of view, it's
going to be what our Democratic governor calls the `mother of
all unfunded mandates.'
``Nothing used to make me madder as a governor than when
Washington politicians would get together, pass a bill, take
credit for it, and send me the bill to pay. That's exactly
what this does, with the expansion of Medicaid. In addition,
it dumps 15 to 18 million low-income Americans into a
Medicaid program that none of us want to be a part of,
because 50 percent of doctors won't see new patients. So it's
like giving someone a ticket to a bus line where the buses
only run half the time.
``When fully implemented, the bill would spend about $2.5
trillion a year, and it still has sweetheart deals in it--one
is out, some are still in. What's fair about taxpayers in
Louisiana paying less than taxpayers in Tennessee? What's
fair about protecting seniors in Florida and not protecting
seniors in California and Illinois and Wyoming?
``Our view, with all respect, is that this is a car that
can't be recalled and fixed, and that we ought to start over.
But we'd like to start over. When I go down to the Senate
floor, I've been there a lot on this issue, some of my
Democratic friends will say, `Well, Lamar, where's the
Republican comprehensive bill?' And I say back, `Well, if it
[[Page S8216]]
you're waiting for Mitch McConnell to roll in a wheelbarrow
with a 2,700-page Republican comprehensive bill, it's not
going to happen because we have come to the conclusion
Congress doesn't do comprehensive well.' We have watched
the comprehensive economy-wide, cap and trade; we have
watched the comprehensive immigration bill, we have the
best Senators we have got working on that in a bipartisan
way; we have watched the comprehensive health care bill.
And they fall of their own weight.
``Our country is too big, too complicated, too
decentralized for Washington to write a few rules about
remaking 17 percent of the economy all at once. That sort of
thinking works in a classroom, but it doesn't work very well
in our big, complicated country. It doesn't work for most of
us and if you look around the table--and I'm sure it's true
on the Democratic side--we have got shoe store owners and
small business people and former county judges and we've got
three doctors. We've got people who are used to solving
problems, step by step.
``That's why we said `step by step' 173 times on the Senate
floor in the last six months of last year in support of our
step-by-step plan for reducing health care costs. I would
like to just mention those in a sentence or two:
First, you mentioned Mike Enzi's work on the small business
health care plan. That's a good start. It came up in the
Senate. He will explain why it covers more people, costs
less, and helps small businesses offer insurance.
Two, helping Americans buy insurance across state lines.
You've mentioned that yourself. Most of the governors I've
talked to think that would be a good way to increase
competition.
Number three, put an end to junk lawsuits against doctors.
In our state, half the counties' pregnant women have to drive
to the big city to have prenatal health care or to have their
baby, because the medical malpractice suits have driven up
the insurance policies so high that doctors leave the rural
counties.
Number four, give states incentives to lower costs.
Number five, expanding health savings accounts.
Number six, House Republicans have some ideas about how my
friend in Tullahoma can continue to afford insurance for his
wife who has had breast cancer; because she has a preexisting
condition, it makes it more difficult to buy insurance.
``So there're six ideas--they're just six steps. Maybe the
first six, but combined with six others and six more and six
others, they get us in the right direction.
``Now, some say we need to rein in the insurance companies;
maybe we do. But I think it's important to note if we took
all of the profits of the health insurance companies entirely
away, every single penny of it, we could pay for two days of
health insurance for Americans. And that would leave 363 days
with costs that are too high. So that's why we continue to
insist that as much as we want to expand access and to do
other things in health care, that we shouldn't expand a
system that's this expensive, that the best way to increase
access is to reduce costs.
``Now, in conclusion, I have a suggestion and a request for
how to make this a bipartisan and truly productive session.
And I hope that those who are here will agree, I've got a
pretty good record of working across party lines, and of
supporting the president when I believe he's right, even
though other members of my party might not on that occasion.
And my request is this: before we go further today, that the
Democratic Congressional leaders and you, Mr. President,
renounce this idea of going back to the Congress and jamming
your bill through on a partisan vote through a little-used
process we call reconciliation.
``You can say that this process has been used before, and
that would be right, but it's never been used for anything
like this. It's not appropriate to use to rewrite the rules
for 17 percent of the economy. Senator Byrd, who is the
constitutional historian of the Senate, has said that it
would be an outrage to run the health care bill through the
Senate like a freight train with this process. The Senate is
the only place where the rights to the minority are
protected, and sometimes, as Senator Byrd has said, the
minority can be right.
``I remember reading Alexis de Tocqueville's book Democracy
in America, in which he said that the greatest threat to the
American democracy would be the `tyranny of the majority.'
``When Republicans were trying to change the rules a few
years ago, you and I were both there. Senator McCain was very
involved in that--getting a majority vote for judges. Then-
Senator Obama said the following, `What we worry about is
essentially having two chambers, the House and the Senate,
who are simply majoritarian, absolute power on either side.
That's just not what the founders intended.' Which is another
way to saying that the founders intended the Senate to be a
place where the majority didn't rule on big issues.
``Senator Reid in his book, writing about the `Gang of 14,'
said that the end of the filibuster requiring 60 votes to
pass a bill `would be the end of the United States Senate.'
And I think that's why Lyndon Johnson, in the '60s, wrote the
civil rights bill in Everett Dirksen's office, the Republican
Leader, because he understood that by having a bipartisan
bill, not only would pass it, but it would help the country
accept it. Senator Pat Moynihan has said before he died that
he couldn't remember a big piece of social legislation that
passed that wasn't bipartisan.
``And after World War II, in this very house and in the
room back over here, Democratic President Truman's Secretary
of State, General Marshall, would meet once a week with
Senator Vandenberg, the Republican Chairman of the Senate
Foreign Relations Committee, and write the Marshall Plan. And
General Marshall said that sometimes Van was my right hand,
and sometimes he was his right hand.
``And we know how [Congressmen] John Boehner and George
Miller did that on No Child Left Behind. [Senators] Mike Enzi
and Ted Kennedy wrote 35 bills together; you mentioned that
in your opening remarks. You and I and many other others
worked together on the America COMPETES Act. We know how to
do that--and we can do that on health care as well.
``But to do that, we'll have to renounce jamming it through
in a partisan way. And if we don't, then the rest of what we
do today will not be relevant. The only thing bipartisan will
be the opposition to the bill, and we'll be saying to the
American people--who I've tried to say this in every way they
know how--town halls and elections and surveys--that they
don't want this bill, that they would like for us to start
over. So if we can do that--start over--we can write a health
care bill. It means putting aside jamming it through. It
means working together the way General Marshall and Senator
Vandenberg did. It means reducing health care costs and
making that our goal for now, not focusing on the other
goals. And it means going step by step together to re-earn
the trust of the American people. We would like to do that,
and we appreciate the opportunity that you have given us
today to say what our ideas are, and to move forward. Thank
you very much.''
____
U.S. Senate,
Washington, DC, February 25, 2010.
Hon. Barack Obama,
President, The White House,
Washington, DC.
Dear Mr. President, During today's discussion on health
care, you and I disagreed about whether the health care bill
that passed the Senate on a party-line vote on December 24
would cause health insurance premiums to rise even faster
than if Congress did not act. I believe premiums will rise
because of independent analysis of the bill:
On November 30, the non-partisan Congressional Budget
Office (CBO) wrote in a letter to Senator Bayh that ``CBO and
JCT estimate that the average premium per person covered
(including dependents) for new nongroup policies would be
about 10 percent to 13 percent higher in 2016 than the
average premium for nongroup coverage in that same year under
current law.''
When you asserted that CBO says premiums will decline by 14
to 20 percent under the Senate bill, you are leaving out an
important part of CBO's calculations. These reductions are
overwhelmed by a 27 to 30 percent increase in premiums due to
the mandated coverage requirements in the legislation. CBO
added those figures together to arrive at a net increase of
10 to 13 percent--as shown in their chart in that same
letter.
In that same letter, CBO wrote, ``The legislation would
impose several new fees on firms in the health sector. New
fees would be imposed on providers of health insurance and on
manufacturers and importers of medical devices. Both of those
fees would be largely passed through to consumers in the form
of higher premiums for private coverage.''
On December 10, the chief actuary for the Centers for
Medicare and Medicaid Services--who works for your
administration--concurred with the CEO. In his analysis, the
actuary said, ``We anticipate such fees would generally be
passed through to health consumers in the form of higher drug
and device prices and higher insurance premiums.'' He also
said, ``The additional demand for health services could be
difficult to meet initially with existing health provider
resources and could lead to price increases, cost-shifting,
and/or changes in providers' willingness to treat patients
with low-reimbursement health coverage.''
For these reasons, the Senate-passed bill will, indeed,
cause Americans' insurance premiums to rise, which is the
opposite of the goal I believe we should pursue.
Sincerely,
Lamar Alexander.
Mr. ALEXANDER. Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from Washington.
____________________