[Congressional Record (Bound Edition), Volume 157 (2011), Part 3]
[Senate]
[Pages 4110-4112]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            A SECOND OPINION

  Mr. BARRASSO. Madam President, we are just about 1 year to the day 
from the day the President signed into law the health care law that is 
going to have an impact on all the people of this country. Here we are, 
1 year later and we know a lot more about this law and people all 
around the country know a lot more about this law.
  I spent part of the weekend visiting folks in Buffalo, WY, attending 
the Buffalo health fair. A health fair is a place in the community 
where people get together and get their blood tested ahead of time. It 
is very inexpensive. It is based on prevention and early detection--
issues this health care law was supposed to address but has failed 
miserably at. At the health fair, I talked to people who were getting 
their blood results back, checking their cholesterol, checking their 
blood sugars to see about diabetes, checking their thyroid levels, and 
as these people were getting their blood tested--and many people, 
probably half the population of Buffalo, turned out to have their blood 
tested--they started asking me questions about the health care law, the 
kind of questions any American would be concerned about: Am I going to 
lose my freedoms? Am I still going to be able to keep my doctor? Will 
it truly get the cost of care down?
  Regrettably, this health care law, now 1 year since it has been 
signed, turns out to actually be bad for patients, bad for providers--
the nurses and the doctors who take care of those patients--and bad for 
the taxpayers, the people left footing the bill because we know a lot 
more now, 1 year after the law was passed, than we did when it was 
passed.
  People remember this as the law that was crammed through the Senate 
in the dead of night, written behind closed doors, and all the unseemly 
bargains that were cut to convince Senators to vote for it, getting by 
on the barest number of votes. There were things such as the cornhusker 
kickback, the Louisiana purchase--the sort of things that offended 
people all across this country. So people are upset with this health 
care law, No. 1, in the way it was passed: In spite of the fact the 
President promised it would be seen on C-SPAN, all the discussions were 
held behind closed doors and despite the fact that many Americans never 
had a chance to read this 2,700-page law.
  When the President made his initial speech about what he was aiming 
to accomplish in health care reform, I said that would be great. I am 
an orthopedic surgeon, practiced medicine for 25 years, and I think we 
need to do the sorts of things the President initially addressed. 
Unfortunately, the health care law went in the opposite direction. When 
people worked their way through the 2,700-page bill, they found that 
instead of lowering the cost of care, the cost of their care was going 
to go up; instead of allowing people to keep the doctor they wanted, 
they were going to, unfortunately, have to change that situation. That 
is why I have been coming to the floor week after week with a doctor's 
second opinion about this health care law.
  So here we are, 1 year later. We know the cost of health care is 
going up. The President said health care premiums would be lower for 
families by $2,500. No family has seen that--or none that I know of; 
certainly none I have talked to in Wyoming, not one. Instead, people 
have seen the cost of their health insurance going up, not down.
  The President said he was never going to raise taxes. It turns out, 
in fact, there are a lot of tax increases as part of this health care 
law. Even the 1099 form Senator Johanns has championed on the part of 
small businesses around the country, the efforts to remove these 
onerous obligations on our small businesses, have nothing to do with 
health care. That got crammed into this bill in the dead of night so 
those who support the bill can claim it was going to lower the cost. 
Even the Congressional Budget Office admits costs are going up, not 
down, and this is absolutely impacting jobs.
  The President promised there would be efforts for small businesses to 
have some advantages and some tax credits and some help, but what we 
found out is that if you have a small business with 10 employees and 
that number climbs to 11, you are going to lose some of those benefits. 
If you are paying your employees an average of over $25,000 a year and 
you want to give them a raise, you start losing some of the benefits. 
So in spite of the fact the President had 4 million postcards sent out 
to small business owners, very few of them have been able to take 
advantage of what was promised to them.
  Now here we are where additional waivers are being given. We are at a 
point where over 2.5 million Americans have been given waivers from 
participating in the health care law. Interestingly enough, these are 
the very people, for the most part--a significant number--who lobbied 
for the bill. Once they found out what was in it, they said no, I don't 
want this to apply to me. Now we see that the State of Maine, the 
entire State of Maine, has been given a waiver.
  I come to the floor today, a year after this has passed into law, and 
I say everybody in the country ought to be able to get a waiver and opt 
out of this health care law, opt out completely. These are decisions 
that should be made at the State level, at the local level. 
Washington's ``one size fits all'' has hardly ever worked for anything 
and it surely does not work for health care.
  In Wyoming, at the Wyoming Health Fair in Buffalo, as I visited with 
people and talked to them, do you know what they are worried about? 
They are worried about losing their freedoms, losing their choice, 
losing their doctor, losing the health care plan they like. In spite of 
the President's promises, we know that about 80 percent of people who 
get their health insurance through small businesses are not going to be 
able to keep the health care they like. Why? Because of government 
mandates. Government has said we know what is best for you. You do not, 
we do. The government says: We know what is best for your family. 
Government doesn't know what is best. These ought to be local 
decisions. That is why Senator Lindsey Graham and I and a number of 
other cosponsors have introduced legislation to allow States to opt out 
of this health care law, opt out of the individual mandate, the 
requirement that forces Americans to buy government-approved insurance.
  Let States make that decision if people in their own State need to 
live under those laws. Let States decide if the employers, the people 
who are the job creators in our communities, if they have to supply 
government-approved insurance to the people who live there. Let people 
make decisions at the local level.
  You can lift any newspaper and look at what the Medicaid mandates are 
doing to our States and the budgets of the States. States such as 
Wyoming, where we balance our budgets every year and live within our 
means, are being crushed by these Medicaid mandates. But it is not just 
small States such as Wyoming, in terms of population--California, New 
York, States all across the country are saying to this body: Let us 
out, let us opt out. We cannot live under these mandates.
  The President's solution is to cram more people onto Medicaid, a 
program

[[Page 4111]]

that doesn't work, where many doctors will not see these patients, 
where the reimbursements are so low hospitals say we cannot afford to 
see these patients because of the impact it will have. Even the 
actuaries, the people who look at this in the fair and appropriate way 
to look at the numbers, say 15 percent of the hospitals in this country 
10 years from now may not be able to be open because of the way this 
health care law is going. That is not going to provide more access. It 
is providing less access.
  Why have seniors rejected this so overwhelmingly? Seniors have looked 
at this and they see $500 billion in Medicare cuts, in things such as 
Medicare Advantage. There is an advantage to being in that program. 
That is why one out of four seniors has set up that program and chosen 
that program. It is because they want choice.
  This health care law is one that is taking choice out of the hands of 
the American families, taking freedom out of the hands of the American 
families. Something I continue to hear from the people in Wyoming and 
across the country: We need to repeal and replace with commonsense 
solutions to allow people to buy insurance across State lines, make it 
legal to do that; to allow small businesses to pool their resources; to 
give incentives to individuals who go to something like the Wyoming 
Health Fair; and work on prevention and early detection of problems. 
Give those people the opportunity to make individual choices. Expand 
health savings accounts. Those are the sorts of things we can deal with 
in a responsible way to help American families get the care they want 
from the doctor they need at a price they can afford.
  That is all the American people are asking for: the care they need 
from the doctor they want at a price they can afford. They are not 
getting it under this health care law. It has now been enacted for a 
full year. The American people know the truth.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Nebraska.
  Mr. JOHANNS. Madam President, I rise today to also speak about the 
health care bill.
  The first anniversary of a new law should be a time to celebrate good 
policy, one would think. The mood surrounding the new health care law 
is much different. One year later, Americans are demanding as loudly as 
ever that we repeal it. That is not surprising, considering the almost 
constant flow of bad news, broken promises, higher costs, and sky-
rocketing health insurance premiums.
  We did not need a year of bad news and broken promises to know this 
new law was bad policy. It was fraught with problems even before it hit 
the Senate floor. Many of us pointed out the inevitable problems within 
this legislation. We warned how this law was predicated on faulty 
accounting that would exacerbate our current and future fiscal 
problems.
  It is simply irresponsible and short-sighted to argue that 
legislation will reduce the debt when it is filled with budget 
gimmicks. But that is exactly what Congress did when passing this 
legislation, and we are paying the price.
  The administration now admits that the funding elements of this law 
do not add up. For example, in testimony before the Finance Committee, 
HHS Secretary Sebelius described the newly created CLASS Act 
entitlement as ``totally unsustainable.'' Furthermore, in recent 
congressional testimony, Secretary Sebelius was asked whether the 
Medicare cuts in the law are used to save Medicare or pay for the 
health care law. Remarkably, she responded ``both.'' Even a young child 
knows you can't spend a dollar on a new toy and then spend that exact 
same dollar to buy an ice cream cone. It is wonderland accounting and 
even the administration's own Medicare actuary seems to agree. He said 
the Medicare reductions in the law ``cannot be simultaneously used to 
finance other Federal outlays (such as the coverage expansions . . . ) 
and to extend the trust fund.''
  Double-counting this money is completely illogical and the American 
people can see through the smoke-screen long ago. But the fiscal 
problems with this legislation are not even the half of it. As a former 
Governor, I shared my concern that putting 16 million people into the 
broken Medicaid Program is a fatal flaw of this law. Medicaid 
beneficiaries already have a huge problem finding doctors to treat 
them. Nationwide, 40 percent of doctors will not see a Medicaid 
patient.
  The Medicaid expansion is like giving someone a free bus ticket, and 
then taking the bus away.
  But instead of addressing this problem, the law exacerbates the 
problem by doubling the number of people on the broken system--
Medicaid. If you have an airplane that is already overweight, you 
wouldn't decide to double the number of passengers to solve the 
problem, yet that is exactly what the law prescribes.
  But even if you overlook the access nightmares created by this 
expansion, our States simply cannot afford it. States are already 
struggling to pay their bills and now we are heaping more obligations 
on them. As a former Governor it breaks my heart we are making those 
problems even greater.
  That is why cash-strapped States are begging us for relief from the 
crushing Medicaid mandate headed their way.
  One didn't have to be a fortune teller to predict the budgetary panic 
spreading from State capitol to State capitol.
  And for what benefit? One year later, many of the promises that were 
used to sell this law have been debunked. For example, remember the 
President saying ``if you like your plan, you can keep it''? Turns out, 
that's not exactly true. Again, the administration's own Medicare 
actuary concluded that the President's promise is ``not true in all 
cases.'' Turns out truth seems to be more the exception than the rule 
with this law. One of the administration's own estimates projects as 
many as 80 percent of small businesses being forced to give up their 
current coverage within the next 2 years.
  Remember the President promising that he would not sign into law any 
legislation that did not bring down the cost curve?
  In June 2009, President Obama claimed that any health care 
legislation must control costs. He said, ``If any bill arrives from 
Congress that is not controlling costs, that's not a bill I can 
support. It's going to have to control costs.'' One is left to wonder 
why the President signed this law since his own actuaries estimated it 
would increase Federal health care spending by $310 million.
  Earlier this year, the Medicare actuary provided a moment of sad 
truth. He testified that President Obama's promise that the health care 
law would lower costs was ``false, more so than true.'' That is so 
astonishing that I will repeat it again--the administration's own 
experts said the President's promise was false, more so than true. That 
is astonishing.
  Remember how the President promised that the health care law would 
bring down the cost of insurance premiums? As a presidential candidate, 
President Obama promised no fewer than 20 times that he would cut 
premiums by $2,500 for the average family by the end of the first term. 
Yet the average employee's health insurance premium has risen by nearly 
$1,100 per family since President Obama took office. A recent New York 
Times article highlighted this missed opportunity:

       Groups of 20 or more workers have been experiencing premium 
     increases of around 20 percent, insurance agents say, while 
     smaller groups are seeing increases of 40 percent to 60 
     percent or more.

  Finally, the first year of implementing this law provides clear 
evidence that the administration does not think this health care bill 
is good for everyone. The administration has now granted over one 
thousand waivers to certain States, employers, unions, and insurance 
companies, allowing them to be exempt from several of the law's new 
mandates.
  The plans approved for waivers cover nearly 3 million individuals. If 
the law is so popular and so beneficial, why are we exempting almost 3 
million people while the other 300 million have to live with its higher 
premiums and mandates? This and many other questions have yet to be 
answered by the administration.

[[Page 4112]]

  However, the President's recent budget request does outline his game 
plan to advance this flawed policy. The current strategy seems to be 
spending more taxpayer dollars to continue to try to convince a 
skeptical public that the health care law is good policy; and if they 
don't agree, use an enforcement hammer to ensure compliance.
  Buried within the President's budget is a request for a 315 percent 
increase for the public affairs office at the Department of Health and 
Human Services. One of the primary tasks of the Public Affairs Office 
is to sell the health care reform law to the American people. 
Furthermore, they also requested a whopping 1,270 new Internal Revenue 
Service agents to implement the law and to enforce its individual 
mandate and other related provisions.
  While Speaker Pelosi may have advocated passing the bill so that we 
could learn what is in it, many Americans were not so naive. They 
understand that you can't spend the same dollar twice. They understand 
that if something sounds too good to be true, it probably is. They know 
when someone shows up from the government offering a carrot, there is 
probably a stick not far behind.
  Last year, a real opportunity to craft health care policy on a 
bipartisan basis was squandered. That missed opportunity will continue 
to haunt us.
  Unfortunately, I worry that the second year under the oppressive 
provisions of this law will be no better than the last. It is 
regrettable that we have reached this point, having known so many of 
these problems existed before this law passed. But of course we were 
warned.
  So, I will use the occasion of the solemn first anniversary to 
redouble my efforts to right the wrong.
  We will work to wipe this misguided law from the books to protect the 
rights of Americans to choose their doctor, select their insurance, and 
trust in their own good judgment. Many are committed to the cause. I 
believe it will happen.
  I yield the floor.

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