[Congressional Record Volume 163, Number 116 (Tuesday, July 11, 2017)]
[Senate]
[Pages S3889-S3890]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                           EXECUTIVE CALENDAR

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will proceed to executive session to consider the Nye 
nomination, which the clerk will report.
  The senior assistant legislative clerk read the nomination of David 
C. Nye, of Idaho, to be United States District Judge for the District 
of Idaho.
  The ACTING PRESIDENT pro tempore. The Senator from Iowa.


                         healthcare legislation

  Mr. GRASSLEY. Mr. President, I am going to speak for about 5 minutes. 
Before I begin, I will reference an item that I ask unanimous consent 
be printed in the Record following my speech.
  I rise to share real stories of real hardships from hard-working 
families in my home State of Iowa. Seven years ago, Americans were 
promised that the Affordable Care Act would make health insurance 
cheaper and healthcare more accessible. Well, I will not pretend to 
break any news here. The facts speak for themselves: ObamaCare is not 
living up to its promises. When passing the law, the other side made 
promises they knew could not be kept.
  The irony is, the so-called Affordable Care Act is anything but 
affordable. I have heard from many Iowans who tell me, in no uncertain 
terms, that they cannot afford to buy health insurance because 
ObamaCare is unaffordable. In fact, 72,000 Iowans can't even get help 
from the exchange because there isn't an insurance company to service 
them.
  One Iowan wrote to me:

       I am forced to pay $230 a month for a healthcare plan that 
     covers nothing until I reach $11,000 in deductible. So on top 
     of paying 100 percent of my medical bills anyway, now I also 
     have to pay for insurance I can't use.

  How did we get to this point?
  Seven years ago, I spoke right here on the Senate floor and predicted 
what would happen to the cost of insurance if ObamaCare passed. So 
let's go back to that period of time when I spoke in October of 2009. 
This is my own quote from that speech:

       And while some of the supporters of these partisan bills 
     may not want to tell their constituents, we all know that as 
     national spending on health care insurance increases, 
     American families will bear the burden in the form of higher 
     premiums. So let me be very clear, as a result of the current 
     pending health care proposals, most Americans will pay higher 
     premiums for health insurance.

  That is the end of my quote from a speech in the Senate in October of 
2009.
  Now, I don't have a magic crystal ball, but it was easy to read the 
writing on the wall. I knew that layers of new taxes and burdensome new 
mandates in ObamaCare would lead us to where we find ourselves today: a 
broken healthcare system that is not better off than it was 7 years 
ago, and for millions of Americans--including those 72,000 Iowans--it 
is much worse.
  So where do we go from here? After 7 years of rising premiums, 
soaring deductibles, and climbing copays, Republicans are committed to 
fixing the damage caused by the Affordable Care

[[Page S3890]]

Act. Not only is it unaffordable for too many people, it is 
unsustainable. ObamaCare is unable to fulfill its promises to the 
American people.
  Here is what every lawmaker in Congress ought to agree on: Insurance 
isn't worth having if patients can't afford to use that insurance. The 
facts are clear. A one-size-fits-all, government-run plan from 
Washington, DC, is driving insurers out of the exchanges, driving up 
premiums, driving away customers, and driving up the tab to the tax-
paying public.
  ObamaCare has overregulated, overtaxed, and oversold its promises to 
the American people. ObamaCare has not healed what ails the U.S. 
healthcare system. It is time to move forward.
  Mr. President, I also want to speak about Medicaid for a moment.
  Medicaid, as we know it, is not sustainable. The Federal Government 
and States spent $553 billion on Medicaid in 2016. That amount is very 
close to $593 billion spent on the No. 1 responsibility of the Federal 
Government--our Nation's defense.
  Every decade since Medicaid started, it has grown faster than the 
economy. Medicaid is now unmatched as a driver of the deficit of our 
country. We cannot sit by and leave this kind of debt to our children 
and our grandchildren.
  Dollars are not the only metric by which we measure Medicaid. 
Medicaid is a program that should supply healthcare to diverse 
populations and should have quality measured, but it does not.
  Medicaid dollars should be spent efficiently, but they are not. 
Activists in Washington, DC, are fighting to preserve the status quo 
and, of course, in the process, scaring the daylights out of the 
American people.
  Yet Iowans tell me that there are waiting lists for Medicaid waivers 
to obtain services for children with disabilities. Others tell me that 
medicines that will cure diseases are rationed to be used only with 
those with the most advanced disease. In other words, you have to get 
really sick for Medicaid to cover medical expenses.
  It is a fact that Medicaid is not working the way it should for 
everyone. The time to act to preserve and improve Medicaid as the 
safety net for the most vulnerable citizens is right now.
  I am holding up a letter here because, under a Democratic President, 
proposing to do what we are doing, 46 Democrat Senators wrote to 
President Clinton and expressed their ``strong support'' for Medicaid 
per capita caps. The letter went on to say that it would give States 
the flexibility to achieve savings without cuts to essential services. 
That is what the current proposal aims to do as well.
  We are proposing per capita caps as a way to make sure tax dollars 
are spent wisely on the most vulnerable people in our Nation. Medicaid 
dollars should be spent on a child with cystic fibrosis who needs a 
blockbuster drug. A person with severe mental illness should be able to 
rely on Medicaid for care.
  Medicaid cannot continue to be a limitless credit card for the States 
to spend money without any accountability to the people who need it. I 
urge my colleagues to put aside partisan dogma and work to solve this 
problem for the American people.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                               Washington, DC,

                                                December 13, 1995.
     President William J. Clinton,
     The White House,
     Washington, DC.
       Dear Mr. President: We are writing to express our strong 
     support for the Medicaid per-capita cap structure in your 
     seven-year budget. We have fought against Medicaid block 
     grants and cuts in the Senate, and we are glad you 
     acknowledge the importance of our position.
       We support a balanced budget. We are glad you agree with us 
     that we can balance the budget without undermining the health 
     of children, pregnant women, the disabled, and the elderly.
       The savings level of $54 billion over seven years included 
     in your budget will require rigorous efficiencies and 
     economies in the program. However, after consulting with many 
     Medicaid Directors and service providers across the country, 
     we believe a reduction of this level is possible to achieve 
     without dramatic limits on eligibility or cuts to essential 
     services. States will need flexibility to achieve these 
     savings, and you have taken steps toward granting it in your 
     bill.
       We were encouraged that your Medicaid proposal does not pit 
     Medicaid populations against one another in a fight over a 
     limited pot of federal resources.
       We were further encouraged to hear Chief of Staff Panetta 
     relay your commitment to veto any budget not containing a 
     fundamental guarantee to Medicaid for eligible Americans.
       We commend you on the courage you have exercised in making 
     these commitments to Americans eligible for Medicaid. There 
     is a bottom line when it comes to people's health; do not 
     allow the current Congressional leadership to further reduce 
     our commitment to Medicaid beneficiaries.
       Your current proposal is fair and reasonable, and is 
     consistent with what we have advocated on the Senate floor. 
     We urge you in the strongest possible terms to hold fast to 
     these commitments in further negotiations. We are prepared to 
     offer any assistance you may need in this regard.
           Sincerely,
       Bob Graham; John Breaux; Jay Rockefeller; Herb Kohl; 
     Patrick Leahy; Frank R. Lautenberg; Ted Kennedy; Tom Daschle; 
     Patty Murray; Barbara Boxer; David Pryor; Barbara A. 
     Mikulski; Max Baucus; Paul Simon; Kent Conrad; Wendell Ford; 
     Harry Reid; Paul Wellstone; Richard H. Bryan; Ernest 
     Hollings; Dianne Feinstein; Tom Harkin; Byron L. Dorgan; 
     Chris Dodd; J. Bennett Johnston; Joe Lieberman; Paul 
     Sarbanes; Carol Mosely-Braun; John Glenn; Jeff Bingaman; Carl 
     Levin; Bill Bradley; John F. Kerry; Bob Kerrey; Joe Biden; 
     Daniel K. Akaka; Dale Bumpers; Daniel Inouye; Chuck Robb; J. 
     James Exon; Howell Heflin; Claiborne Pell; Russ Feingold; 
     Daniel P. Moynihan; Sam Nunn; Robert C. Byrd.

  Mr. GRASSLEY. Mr. President, I yield the floor.