[Congressional Record (Bound Edition), Volume 154 (2008), Part 2]
[Senate]
[Pages 2513-2514]
[From the U.S. Government Publishing Office, www.gpo.gov]




            EQUALIZING THE TAX TREATMENT OF HEALTH INSURANCE

  Mr. ENZI. Mr. President, I wish to congratulate the Senator from 
North Dakota, Mr. Dorgan, and the Senator from Alaska, Ms. Murkowski, 
on the piece of legislation we just passed. It is extremely critical to 
a number of people in the United States, the Native Americans.
  It was an extremely difficult piece of legislation to do because it 
is such a diverse group of people. There are Native Americans who are 
living in cities, there are Native Americans living on reservations, 
and there is even a difference in reservations because there are some 
that have a lot of land and a few people, and some have a lot of people 
and very little land. To come up with a one-size-fits-all is not 
possible. This bill takes care of all of those people wherever they are 
and under the circumstances they are under, and it does meet the 
promise that was given. It culminates 15 years of work that should have 
been done 15 years ago, but because of the diversity, it was extremely 
difficult to do. And the chairman and the ranking member, working 
together, were able to pull that together. So I congratulate both of 
them for their efforts and their capability of working with everybody 
in this body, with probably about 100 amendments that were thought 
about, though not all were offered. The solutions, the ways to solve a 
lot of those problems are included in the bill. I think it is a very 
good bill, and they deserve a lot of credit for the way they worked on 
it and the effort they put into it and the result they got. I am 
looking forward to getting it resolved on both ends of the building and 
the President signing it, and I congratulate both of them.
  I do rise today, however, to talk about finding other solutions to 
our health care crisis. That is a part of it. We have extended the 
children's health insurance plan until March of 2009, so that part has 
been partly solved, but my wife Diana and I travel to different parts 
of Wyoming most weekends, and the No. 1 issue on people's minds is 
their health care. They all ask me what I am going to do to make sure 
they have the health care they need. I am able to tell them a lot of 
things I am working on, but I am not able to tell them very much about 
things actually getting accomplished. This troubles me because our 
constituents deserve our help. It is time for real action, and I hope 
we are able to do something on health care this year.
  As the senior Republican on the Committee on Health, Education, Labor 
and Pensions, I spend a lot of time working on health care issues. I 
have spoken to this body many times about a bill that I am working on, 
that I have been working in conjunction with anybody in this Chamber 
who is interested in health care, and trying to pull together the idea 
so that we can do some things in health care, any one of which would 
help us to get closer to a solution for all Americans.
  The bill I have put together is one called Ten Steps to Transform 
Health Care in America. That will fix many of the common complaints I 
hear from my constituents. Why ten steps? Well, I have discovered over 
the course of the years I have been in this Chamber that if you try to 
put together one massive comprehensive bill that solves everything, you 
will have one piece that 5 people don't like, another piece 8 people 
don't like, another 11 people don't like, and another 3 people don't 
like, until pretty quickly you are at 51 votes and you can't get the 
bill done. When you try to do something comprehensively, it often looks 
revolutionary. And we don't do things revolutionarily; we do them 
evolutionarily. So I put together 10 pieces, any one of which gets us 
closer to having every American insured. All 10 would get every 
American insured. So I hope people will take a look at it.
  Today, I am just going to focus on one step; that is, the first, and 
that is equalizing the tax insurance treatment for all Americans, not 
just the ones who get health insurance at work. I encourage everyone 
watching to look at my Web site, enzi.senate.gov, to learn more about 
all the steps of the bill. Again, I emphasize that these are bipartisan 
ideas people have given me.
  Because the chairman of the committee has been so involved in the 
education portion--and we are making progress on the education portion, 
having sent several pieces to the President already, and we are going 
to finish the higher education bill, and we are going to finish No 
Child Left Behind--I have been given the flexibility to look into this 
health care area. The chairman and I sat down and worked on principles 
of health care, and then I have sought to get ideas from both sides of 
the aisle and incorporated them as much as I can into 10 steps.
  Before I go into the details of step 1, I wish to say a few things 
about the entire proposal.
  If the Ten Steps bill were to become law, the end result would be an 
insurance card for everyone. Now, lots of people have insurance cards--
Members of Congress have them, people who work for big companies have 
them, the kids in Wyoming who participate in the State Children's 
Health Insurance Program have them. Lots of people have them, and most 
of those people who have insurance cards are happy with the care they 
are getting. They do not want change. And the bill doesn't

[[Page 2514]]

change that. If you have an insurance card now, you can keep that card 
and keep getting the exact same care you are getting. The problem is 
the 47 million or so Americans who don't have an insurance card. My 
bill gives all those people cards. If they can't afford the cards 
because they are low income, this bill helps them by giving them the 
money they need to purchase the insurance card. The bottom line is that 
everyone has a card and everyone will be able to get the care they 
need.
  So how does the bill get everyone an insurance card, and will we bust 
the budget in the process of getting everyone an insurance card? The 
bill won't bust the budget. It won't be free, but it won't bust the 
budget. So how is this possible? Well, in order to understand how the 
bill works, it is important to review a few facts about the history of 
health insurance in this country.
  Right now, about 60 percent of the folks under age 65 are getting 
their health insurance through their job. The question is why. Why are 
60 percent of Americans getting their health insurance through their 
job? Well, the short answer to that question is, because of the way 
employer-sponsored health insurance is treated for tax purposes.
  Our current health insurance system is biased toward employer-based 
coverage due to a historical accident.
  During World War II, we had wage controls. Wage controls increased 
competition among employers for recruiting the best employees, and 
health care incentivized employers by allowing them to offer health 
benefits instead of prohibited wage increases.
  In 1954, Congress codified a provision declaring that such a 
contribution would not count as taxable income--an added incentive. 
This tax policy made it very favorable for individuals to get their 
health benefits through their employers and consequently has penalized 
individuals who get their coverage through the individual market.
  We must eliminate the unfair tax treatment of health insurance, which 
will expand choices in coverage and give all Americans more control 
over their own health care.
  The Joint Committee on Taxation estimated that removing this tax 
bias--and a few related health care tax policies--would save the 
Federal Government $3.6 trillion over the next 10 years. That is a lot 
of money--even around here, that is a lot of money--that can and should 
be used to expand choices and access and give individuals more control 
over their health care.
  Ten Steps ensures that every American can benefit from this savings 
whether they get their health care from their employer, from the 
individual insurance market, or they decide they want to get off of 
Medicaid and switch to private insurance. So how does the bill do this? 
The plan gives all Americans who have at least a certain amount of 
health insurance a standard deduction. The national above-the-line 
standard deduction for health insurance would equal $15,000 for a 
family and $7,500 for an individual. The bill also gives low-income 
folks a tax credit equal to $5,000 for a family or $2,500 for an 
individual. The subsidy amount phases out as income gets higher, so 
folks won't be eligible for the subsidy at all, but everyone is 
eligible for the standard deduction. Because the bill takes this hybrid 
approach to coupling the standard deduction proposal with the tax 
credit proposal, no particular population is adversely affected. The 
Tax Code would no longer penalize folks who don't get their insurance 
through their job.
  Let me be clear. My goal is not to erode employer-based health 
insurance, given that Ten Steps does not alter the way employers treat 
health insurance. Rather, I wanted to provide more options for 
individuals who don't currently have insurance through their employer. 
Correcting a flawed tax code would make it easier for working Americans 
to buy health insurance. Jobs don't need health insurance, people need 
health insurance. American families who aren't insured through their 
employers should have the same accesses to care. Everyone should be 
treated equally.
  I hope we can move forward quickly on making these changes so that 
every American can get health insurance. It is time for real action. We 
need to do something. It isn't necessary to wait for the end of a 
Presidential election to solve basic problems for the American people. 
These 10 steps will take care of a lot of things. We can do any one of 
them and make a difference now and show that Congress can get things 
done.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Wisconsin is 
recognized.

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