[Congressional Record (Bound Edition), Volume 156 (2010), Part 8]
[Senate]
[Pages 11481-11483]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Ms. MURKOWSKI. Mr. President, I rise to speak about the health care 
debate that has gone on in the Congress throughout the past year. 
President Obama promised that the Democrats' health care bill would 
reduce the spiraling cost of health care. The promise was made that if 
one likes their health care plan, they can keep it. Not necessarily 
every day but just about every other day there is yet another report 
released that confirms what many of us who opposed a Federal takeover 
of the health care system feared all along--higher costs, less access, 
and unsustainable spending. The President and this Democratically 
controlled Congress need to repeal this bill and put in place 
meaningful health care reform measures that will allow individuals to 
exercise more control over their health benefits and see their premiums 
actually go down instead of up.
  I wish to speak to some of the reports that have been coming out. 
Let's start with a government report that came out 4 weeks after the 
health care bill was signed into law. It was from the President's own 
Chief Actuary at the Centers for Medicare and Medicaid Services, CMS, a 
gentleman by the name of Rick Foster. He released his report saying 
that President Obama's new health care reform law will actually 
increase national health care spending by $311 billion over the next 10 
years. Foster's report also said about 14 million people would lose 
their employer coverage by the year 2019, largely as a result of small 
employers terminating coverage and workers who currently have employer 
coverage enrolling in Medicaid.
  Mr. Foster also reports that the $530 billion in Medicare cuts may 
not be what he calls ``realistic and sustainable,'' potentially driving 
15 percent of all hospitals, nursing homes, and similar providers into 
the red within 10 years. This would cause providers who depend on 
Medicare for a substantial part of their business to be forced to drop 
out of the program, ``possibly jeopardizing access to care''--those are 
Mr. Foster's words: ``jeopardizing access to care''--for our senior 
citizens.
  The situation in my home State of Alaska is particularly dire. I have 
stood on this floor and I have discussed and certainly spoke to the 
statistics. Back in March of 2009, the Institute for Social and 
Economic Research at the University of Alaska reported that just 13--
13--out of 75 primary care physicians in Anchorage were accepting new 
Medicare patients. Anchorage is our State's largest community, and we 
had 13 out of 75 primary care physicians who were accepting new 
Medicare patients. Just 15 months after this report

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was done by ISER, that number has dropped to the single digits.
  Further cuts to Medicare will only worsen this situation for the most 
vulnerable Alaskans--our senior and disabled citizens. This is one of 
the main reasons I simply could not support the health care bill that 
came forward. The issue, as it relates to access for those who are 
Medicare eligible, has been a crisis in our State that only continues 
to worsen. But there are some other reasons for my objections.
  In May--so last month--the neutral government scorekeeper, the 
Congressional Budget Office, or CBO, revised its initial cost estimate 
of the bill to say that the law will likely cost $115 billion more in 
discretionary spending over 10 years than the original projection. So 2 
months after the law was enacted, the American people learn from yet 
another new government report that their Congress has passed a bill 
that would increase their health care costs and reduce their benefits. 
Again, this was something Republicans warned about over and over again 
during the last year as we discussed health care.
  The small businesses in this country stand to lose the most under 
this health care bill. They were promised a pipedream, filled with tax 
credits to save small businesses money, but the bill is simply not 
having that effect. In fact, it is having the opposite effect. The 
Associated Press released a ``fact-check'' article last month that 
stated point blank: The small business tax credit included in the 
health care reform falls short.
  The story interviews a gentleman by the name of Zach Hoffman. I know 
this story has been repeated on the Senate floor, but it is worth 
repeating.
  Mr. Hoffman is the owner of an Illinois furniture company. He has 24 
employees. They earn an average of $35,000 a year--clearly, a very 
modest wage by any standard. Yet the amount of the credit Mr. Hoffman 
calculated he would receive under this new law as a small business 
would be zero to him.
  The AP article points out, the ``fine print''--which many small 
businesses will not qualify for the credit--was left out of the 
administration's press releases that touted the credit's ``broad 
eligibility.'' But you really just need to go back to the individuals 
who are being impacted by this or had hoped they would be impacted 
positively. Go back to the Illinois small business owner and look at 
his comment. He says:

       It leaves you with this feeling of bait-and-switch.

  But thinking of how Mr. Hoffman could be eligible for the tax credit, 
he learned that all he needed to do was to cut his workforce to 10 
employees and cut their wages. To this, the small business owner says: 
This does not make sense. He says:

       That seems like a strange outcome, given we've got 10 
     percent unemployment.

  I think we would all agree it is a strange outcome. An unacceptable 
outcome is what it is.
  This Illinois employer's situation is no different than any other 
employer regardless of what State they are in. In States such as Alaska 
and other particularly high-cost localities--whether it is New York 
City, San Francisco--where wages are higher because of the cost of 
living, the employers stand to lose because they will not be able to be 
eligible for these tax credits simply because they pay their employees 
higher wages than are allowed for in the health care bill.
  Since enactment of the health care law, we have also heard from well-
respected health care consulting firms that have released information 
showing that businesses fear the law's new employer mandate penalties. 
According to a report, more than one in four employers--about 26 
percent--and nearly two in five retailers may not be in compliance with 
provisions requiring coverage of all employees working over 30 hours 
per week. Of those, a majority--54 percent--said they would consider 
changing their business practices ``so that fewer employees work 30 
hours or more per week.'' This would be a devastating blow--a 
devastating blow--to an already ravaged economy.
  We have another well-known consulting firm, Mercer. They released a 
survey of the impact of the new health care law on employers just last 
month. The survey shows there is near unanimous belief by employers 
that the new law will raise employees' premiums. Only 3 percent of 
employers that responded said they believed the legislative changes 
would not cause their premiums to rise. This does not demonstrate very 
much faith in how this is going to benefit them.
  One-quarter of respondents believed the bill would raise premiums by 
at least 3 percent over and above this year's normal rise in costs due 
to medical inflation.
  Last week, there was a PricewaterhouseCoopers report that stated the 
cost for businesses providing health care coverage to employees will 
jump by 9 percent next year, in 2011, which analysts predict employers 
will shift more of the cost to workers next year. For the first time, 
most of the American workforce is expected to have health insurance 
deductibles of $400 or more.
  Also, last week, the administration's new regulations on 
grandfathered health plans were released, outlining the various ways in 
which existing employer health plans will be forced to change under the 
new law. According to the Obama administration report, these 
regulations could result in nearly 7 out of 10 workers--and 80 percent 
of workers at small businesses; so 80 percent of the workers in our 
small businesses--would see changes in their plans.
  In other words, under the new health care bill, more than half of 
those who get insurance through their jobs may be forced to change 
their plans whether they want to or not. Internal administration 
documents reveal that up to 51 percent of employers may have to 
relinquish their current health care coverage because of the health 
care bill--which takes me back again to the statement the President 
initially made: If you like your health care plan, you can keep it. 
That simply is not what we are seeing. It is not translating in the 
real world.
  Then, of course, we have the CBO letter that just came out. This is 
dated June 21--just the day before yesterday. This letter comes from 
Mr. Elmendorf, the Director of the Congressional Budget Office, in 
responding to the ranking member on the HELP Committee about the high-
risk pools. That letter confirms that an additional $5 billion to $10 
billion would be needed to fully fund all eligible enrollees in the 
high-risk pool expansion, and, further, that the new high-risk pool 
program, which was supposed to be providing health insurance coverage 
to Americans--but to date the government has failed to provide any 
funding for these new high-risk programs and those with preexisting 
coverage have not been able to enroll in these new high-risk pools--
but, again, coming from the Congressional Budget Office, with these new 
estimates, in fact, the funding available for the subsidies is simply 
not sufficient to cover the costs of all applicants and then the 
additional cost that is anticipated, an additional $5 billion to $10 
billion to cover all eligible enrollees.
  With new government reports telling us this bill will not reduce the 
premiums, and with employer groups looking at how they can minimize the 
hits they are taking under this new law, we have put American 
businesses, particularly our small businesses, in peril of dropping 
employees to avoid the $2,000-per-employee penalty, called the employer 
mandate. We have put these small businesses in peril of reducing 
employee wages in order to qualify for small business credits. We have 
passed a bill that hurts our small businesses during one of the worst 
economic downturns in the history of our Nation.
  Last week, Investor's Business Daily stated that small firms will be 
even more likely to lose existing plans. In fact--this is their 
statement--the ``midrange estimate is that 66% of small employer plans 
and 45 percent of large employer plans will relinquish their 
grandfathered status by the end of 2013.''
  So in the worst-case scenario, 69 percent of employers--again, 80 
percent of

[[Page 11483]]

smaller firms--would lose that status, exposing them to far more 
provisions under the new health care law.
  Again, it makes you ask the question: Was this what the President 
envisioned in health care reform when he said: ``If you like what you 
have, you can keep it''? I think this new law has failed--has clearly 
failed--to keep the President's promise to the people.
  It was for these reasons I objected at the time this bill was moving 
through the process. I have stood up and strongly supported the efforts 
of the State of Alaska and other States to strike the most egregious 
provisions of the law through a multistate lawsuit. Again, it is why I 
voted to repeal the entire law when we had that opportunity this past 
March.
  This law is not what the American people wanted, and it is not what 
our President promised. I believe the legislation has to be repealed. 
It has to be replaced with sensible alternatives that are widely 
supported. We know what so many of those are: buying across State 
lines; implementing medical malpractice reform; reimbursing for quality 
of service, not quantity of service. This is what the people wanted. 
This is what the American people expected. Yet this is not what was 
delivered.
  It is time to help our economy rather than to kill it with this 
legislation that was passed.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant editor of the Daily Digest proceeded to call the roll.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KAUFMAN. Mr. President, I ask unanimous consent to speak in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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