[Congressional Record (Bound Edition), Volume 155 (2009), Part 13]
[Senate]
[Pages 17370-17371]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. JOHANNS. Mr. President, late last week, media reports heralded 
the decrease in the pricetag of the HELP Committee's health care 
proposal. But I would suggest that before we uncork the champagne, 
before we celebrate a great accomplishment, let's study more closely 
the untold story. I believe we will find accounting gymnastics that 
have been employed.
  While the headlines may have touted a HELP Committee bill that scored 
at $611 billion over 10 years, the real pricetag, when fully 
implemented, actually totals about $2 trillion.
  That is a big darn difference. An almost $1.5 trillion discrepancy 
simply cannot be swept under the rug. It is too big to be a rounding 
error--even in the Federal Government--and too much of a budget buster 
to be ignored. So where is the difference?
  First, the Congressional Budget Office assumes it will take the 
Federal bureaucrats over 4 years to get the government-run health care 
and other subsidies up and running. So while the $611 billion score 
claims to be a 10-year number, essentially it only covers 6 years of 
the costs.
  If you look at the CBO score for the first 10 years after the program 
is fully implemented, the actual spending is closer to $1.5 trillion. 
In addition, while the press releases were claiming credit for 
increased insurance coverage, they were actually leaving out what it 
actually cost to make that happen.
  That euphoric claim that 97 percent of Americans would be covered 
under the HELP proposal is not even in the HELP Committee proposal. 
Only in Washington can you assume something to be, take credit for the 
accomplishment, and then not pay the bill.
  The 97-percent statistic is based on an assumption. The assumption is 
that Medicaid will be expanded up to 150 percent of the Federal poverty 
level. This expansion is estimated to bring 20 million new people into 
a government-run health care plan.
  However, CBO estimates that it will cost around $500 billion over 10 
years. Nowhere is that cost yet considered. And this is only the 
Federal share of the program. It does not take into account the State 
taxes that will need to be raised in order for each State to pay its 
share of this bill.
  At one point, I was a Governor. In my own State of Nebraska, this 
expansion will cost the State taxpayers $73 million a year when they 
have to assume the costs of the program. That is a lot of money to come 
up with in these tough economic times.
  The American people, I believe, deserve more than budgetary tricks. 
Let's be honest about what we are trying to do here, and let's be very 
candid with people about the real costs, the fully implemented costs of 
the program. Let's also be very upfront about the realities of what a 
government-run program can or cannot accomplish in actually bringing 
down health care costs.
  Some claim that a government-run plan will serve as competition for 
private insurance and, thus, will bring

[[Page 17371]]

down the cost of those insurance premiums. However, the CBO score makes 
it clear that if a government-run plan competes on a truly level 
playing field, it is not going to lower health care costs. The only way 
a government-run program can offer reduced insurance premiums is if 
they pay providers and hospitals at rates equivalent to current 
government programs. But this wouldn't cover costs. Instead, it would 
create cost shifting under private insurance, which is already 
happening today. CBO cautioned that reducing payment rates would only 
increase the access problems we have with current government programs.
  Currently, we know 40 percent of doctors don't take Medicaid 
patients. It is not that they don't want to; it is because the rates 
are so low they don't cover their costs. This directly contradicts 
President Obama's message: If you like your doctors, you will be able 
to keep them.
  The reality is, on this government program--Medicaid--which is due to 
insure more, that is not the case. The CBO score actually confirms that 
many employees would lose their employer-based health care should this 
bill become law.
  Let me put up a chart, if I might.
  In fact, the HELP Committee's bill seems to directly encourage 
employers to dump their employees into a government-run plan. In the 
committee draft, businesses that employ 25 or more employees would be 
required to pay an annual penalty, which is shown here, of $750 for a 
full-time employee, if they choose not to provide private health 
insurance for the employees. When you do the math, though, this isn't a 
penalty at all compared to the cost of private insurance.
  Looking again at the chart, in 2008, the average employer's cost for 
an individual in a group plan was $3,983. So putting their employees on 
the public plan option is actually a savings. It is a savings, as the 
chart shows, of $3,233 a year for each employee for that employer.
  Paying the so-called penalty to get out from underneath the private 
insurance costs looks like a pretty smart business decision. In fact, I 
don't think it is a coincidence that a very large retailer recently 
came out in support of the employer mandate. When I heard this news, my 
initial reaction was, What is the catch?
  Well, I think we found the catch. With over 1.4 million employees, 
this company reports that 51.8 percent of their employees have coverage 
through an employee health care plan. If all of these employees end up 
on the public plan, it would save this company $2.4 billion a year. The 
employees, members of our middle class, lose their insurance plan and 
the promise is not kept.
  It is no surprise the company does very well: $2.4 billion goes to 
the bottom line. Also no surprise, this company is supporting an 
employer mandate. Ultimately, people will not have a choice to keep 
their employer-based coverage and will not receive the same level of 
care when their employer dumps them onto the government plan to make 
their bottom line look better. This will directly impact the ability of 
the middle class to choose the doctor they want. It will inject 
government bureaucrats into their medical decisions because they have 
no choice. It is an employer's choice to move you to the government 
plan. To promise otherwise is misleading.
  False promises will not help us achieve true solutions. Congress has 
been tasked with solving this problem, and we must work together to 
resolve the problem of reining in soaring costs. Adding another $2 
trillion entitlement program onto a budget that is already in serious 
trouble doesn't make sense.
  The American people have sent us to Washington to identify the 
problem and fix it, not exacerbate it. Let's not put together bad 
policy and end up with another financial debacle. This time there is 
far more than money on the line. Americans treasure their ability to 
choose their doctors, to receive treatment, to have control of their 
life. They don't want a Federal bureaucrat in the middle of it. So 
let's be candid with the American people and put together a good bill 
that actually addresses the real problems. Let's get it right this 
time.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Delaware is 
recognized.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent to speak as in 
morning business for 20 minutes.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.

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