[Congressional Record (Bound Edition), Volume 158 (2012), Part 3]
[Senate]
[Pages 3759-3762]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. WICKER. Madam President, on Friday of this week 2 years will have 
passed since President Obama signed the Patient Protection and 
Affordable Care Act into law. This is actually a sad anniversary 
because more than enough time has gone by to reveal the failures of 
this massive, burdensome piece of legislation.
  The fact that 26 of our 50 States--more than half of the States--are 
part of the legal challenge currently under review by the Supreme Court 
points out the inevitable truth: This is a law that simply does not 
work.
  The case that will be heard in a few days will be one of the most 
consequential Supreme Court cases of my lifetime--consequential not 
only because it deals with this massive, burdensome piece of 
legislation but because the implications go so much further. The 
Supreme Court case will decide the scope of the commerce clause. 
Indeed, my colleagues, if the Supreme Court decides this law can 
withstand constitutional scrutiny, then this large, massive Federal 
Government can, in fact, do almost anything, and there will be hardly 
any limitations under the Constitution and the Bill of Rights on the 
power of the U.S. Federal Government.
  Americans are right to be disappointed with Obamacare, and they are 
right to want it repealed. And regardless of the outcome of the Supreme 
Court case, this Congress can decide and, as a matter of fact, the 
people of the United States will have a chance in November, as we do 
every 2 years, to decide.
  A recent Gallup poll shows that twice as many Americans think the law 
will make things worse for their families than those who believe it 
will make things better. Seventy-two percent of Americans believe the 
individual mandate is unconstitutional.
  The truth is that Americans deserve affordable, high-quality health 
care, not a 2,700-page, big-government piece of legislation that taxes, 
spends, and regulates. The President's health care law has not lowered 
the cost of health care as promised. It has not created jobs as 
promised. It has not reduced the deficit as promised. So this week we 
mark the anniversary not with progress but with bitter realities.
  President Obama, in his joint session speech to Congress in 2009, 
asserted that his plan ``will slow the growth of health care costs for 
our families, our businesses, and our government.'' In fact, last week 
the nonpartisan Congressional Budget Office and Joint Committee on 
Taxation updated their outlook of the health care law's impact on the 
Federal budget. Not surprisingly, their latest analysis says Obamacare 
will cost even more than anticipated. And the anticipated costs were 
high, indeed, but they say the health care law will cost nearly $1.8 
trillion over the next decade or double the estimated cost that 
accompanied the bill when Democratic supermajorities passed it in 2010. 
This is hardly the relief President Obama promised.
  During his campaign, the President said the plan would reduce health 
care premiums by an average of $2,500 per family. Instead, premiums 
have grown by nearly that much since he was elected.
  I see I am joined by two of my colleagues, the distinguished Senator 
from Wyoming and the distinguished Senator from Kansas.
  There are a number of other promises we are talking about today, and 
I know we don't impugn motives around here--that is against the rules--
but one has to wonder, did advocates of this massive law actually 
believe these promises or were they simply duped and misled? And I 
don't know which is worse, but I know that my colleague Dr. Barrasso, 
himself a physician who is on the front line of this issue, has given 
this a great deal of thought, so at this point I ask him to join in 
this colloquy.
  Mr. BARRASSO. Madam President, I stand here with my friend and 
colleague from Mississippi because he and I both attended, in his home 
State of Mississippi, a meeting at a hospital where we met with 
doctors, also met with patients, and met with people from the community 
while the debate and discussion was being conducted about this health 
care law. At the time, people were asking all sorts of questions 
because they had heard the promises. Would this actually lower the cost 
of insurance by $2,500 a family? That is what people wanted. That is 
what they expected. The other question: Will I really be able to keep 
the care I have and the doctor I have if I like it?
  Now here we are a couple of years later, the second anniversary of 
this health care law being passed, and I am here with my friend and 
colleague from Mississippi, and it just seems to me that the questions 
that were asked by his constituents, by the doctors in those 
communities who take care of the patients, by the patients, the 
hospital administrators whom we talked to that day in his home State of 
Mississippi--it does seem that many of these promises have been broken.
  The costs seem to go up higher than had this health care law not been

[[Page 3760]]

passed at all. The numbers and the statistics we are hearing now from 
the budget office on the cost seem to be much, much higher than what 
the President promised. Parts of this health care law--the so-called 
CLASS Act--it now comes out were accounting gimmicks, budget schemes to 
make it seem as though the cost of this health care law would be much 
less than what American people now know it to be.
  So it is no surprise to me--and I see this in Wyoming, and I am sure 
the Senator sees it in Mississippi, and I would imagine the Senator 
from Kansas who is on the floor has seen the same thing at home because 
I know he has gone to hospitals and just--maybe almost every hospital 
in the State of Kansas as he has traveled around. We are all seeing 
that this health care law is less popular now than when it was passed. 
That is what I hear at townhall meetings. When I ask, do you think you 
are actually going to pay more under the health care law, every hand 
goes up. And when I say, do you think the quality and availability of 
your own care at home is going to go down, again, every hand goes up.
  So if I could ask my colleague from Kansas if he is hearing the same 
things. And I see we are also joined by the Senator from Arizona.
  Mr. MORAN. I appreciate the opportunity to be on the floor today, 
especially with the Senator from Wyoming, a doctor who is such an 
expert on the topic of really not just the moment, not just the day, 
but the topic of what our country faces.
  I will say that I do spend a lot of time in hospitals across our 
State talking to health care providers, talking to patients, doctors, 
to administrators, trustees. In fact, there are 128 hospitals in our 
State. I have visited all of them, and there is genuine concern about 
the future of the ability for health care to be delivered in 
communities across our State. And you add to that the physician and 
other health care provider community, and this health care reform act 
is creating significant challenges.
  My interest in public service started a long time ago with the belief 
that we live our lives in rural America, in my State of Kansas, in a 
pretty special way. When I came to Congress, it became clear to me that 
if our communities were going to have a future, it was dependent upon 
the ability to deliver health care close to home. And those rural 
communities across our Nation often have high proportions of senior 
citizen populations where Medicare is the primary determining factor of 
whether they can access health care.
  When the affordable care act was passed, many promises were made, but 
one of the things that was told to the American people--or at least the 
attempt was made to sell to the American people--was that there would 
be greater access. And I would certainly say that one of the promises 
that is not being kept about the affordable care act is the likelihood 
that there is going to be greater access for Americans across our 
country to health care because this bill is underfunded, it is not paid 
for. The consequences are that the administration is already proposing 
and Congress will always be looking for ways to reduce spending when it 
comes to health care, and the most likely target is the payment 
Medicare makes to health care providers, which in many instances 
already doesn't cover the cost for providing the service. So when we 
look for access to health care, every time we make a decision, every 
time a decision will be made in order to try to make this more 
affordable, we are going to see fewer and fewer providers able to 
provide the services necessary to folks across the country but 
especially in rural communities where 60, 70, 80, even 90 percent of 
the patients admitted to the hospital are on Medicare.
  So one of the problems with the affordable care act is the reality 
that it will reduce access to health care for people who live in rural 
America and we will see fewer physicians accepting patients on 
Medicare, we will see fewer hospital doors remain open; as this bill 
takes $500 billion out of Medicare to begin with, the Congress that 
passed and the President who signed this legislation set the stage for 
there to be less affordable health care available to Americans across 
the country but especially for constituents of mine who live in a rural 
State such as Kansas.
  Mr. WICKER. If I could jump in on the issue of Medicare because I 
have a quote here from President Obama, July 29, 2009: ``Medicare is a 
government program, but do not worry, I am not going touch it.'' As a 
matter of fact, only months later he signed into law ObamaCare, which 
takes $\1/2\ trillion from Medicare. And it touches on the very issue 
the Senator from Kansas was referring to with regard to Medicare access 
for people in rural Kansas.
  Mr. McCAIN. Madam President, I might point out to my friend from 
Mississippi that the first amendment we had on the floor of the Senate 
when we were considering ObamaCare was to restore that $500 billion, 
and it was voted down on a party-line basis.
  I thank my friends for allowing me to engage in this colloquy. I want 
to discuss this with my friends. In my view, probably what encapsulates 
the problems with this legislation--the commitment began that we would 
provide affordable health care to all Americans, which meant we had to 
put the brakes on inflation in health care because health care was 
becoming unaffordable--the highest quality health care in the world. 
Nothing, in my view--and I ask my colleagues this--describes more how 
this whole plan went awry than the so-called CLASS Act.
  Late in the debate, the CLASS Act was thrown in to provide long-term 
care for seniors, which seems like a worthy cause, but the whole thing 
was a gimmick. It was described by Senator Conrad, our chairman of the 
Budget Committee, as a ``Ponzi scheme of the first order, the kind of 
thing that Bernie Madoff would have been proud of.''
  They foisted that off on us. Why? Initially, because of CBO scoring, 
it would show an increase in finances into revenues and into the whole 
ObamaCare program. But as soon as those people who were paying in 
became eligible, obviously, the reverse happened. Thank God for former 
Senator Gregg of New Hampshire, who had an amendment adopted that 
required the Secretary to certify that the program would be solvent for 
over 75 years before the program could be implemented. If it hadn't 
been for that, the CLASS Act would be here today.
  Then, last October, the Secretary of Health and Human Services issued 
a report confirming what many of us knew was inevitable: that the 
Secretary could not certify the CLASS Act's solvency as required under 
law. So we went through this exercise of frantically searching for ways 
to increase revenue, at least the way CBO does scoring. So we did the 
CLASS Act and, thank God, Senator Gregg of New Hampshire put in an 
amendment that they had to certify that it would be viable over 75 
years. There was not a snowball's chance in Gila Bend, AZ, that they 
were able to certify that for over 75 years it would be a viable 
program.
  It was kind of entertaining, but late on a Friday night the Secretary 
of Health and Human Services said she could not certify that the 
program would be solvent throughout a 75-year period. The result of 
this was, obviously, that they didn't have the false revenues that CBO 
could score. They didn't have a program that could provide long-term 
care for seniors. Again, as the Senator from North Dakota aptly pointed 
out, this ``Ponzi scheme of the first order'' faced and met a well-
deserved death.
  That is why an overwhelming majority of the American people 
disapprove of this whole exercise of ObamaCare. They want it repealed. 
They don't support it. I am proud to say in this election we will 
decide whether we repeal and replace ObamaCare. The American people 
care about that.
  Mr. WICKER. Madam President, to summarize what the Senator from 
Arizona has just said, the CLASS Act was sold to the American people as 
a budget deficit reducer. It was going to reduce the deficit. No sooner 
was it signed and they started looking at it that the administration 
itself said: We know it is unworkable, and we abandon

[[Page 3761]]

it. We are not even going to try to enforce it.
  Mr. McCAIN. They could have kept it on the books. If it had not been 
for the amendment of Senator Gregg from New Hampshire which said they 
had to certify its solvency over a 75-year period, we would have the 
CLASS Act today, a Ponzi scheme where people would be paying in, and 
that is scored as revenues, and some years later when they retire, 
obviously, the reverse would have been true.
  I have yet to hear one of my colleagues come over and admit that they 
were wrong about the CLASS Act. I would love to hear some of those who 
strongly advocated for it. My friend from Iowa, Senator Harkin, said:

       So we get a lot of bang for the buck, as one might say, 
     with the CLASS Act that we have in this bill.

  Senator Whitehouse said this:

       Certain colleagues on the other side of the aisle have 
     argued that the CLASS plan would lead to a financially 
     unstable entitlement program and would rapidly increase the 
     Federal deficit. That is simply not accurate.

  I look forward to my colleagues who supported and voted for the CLASS 
Act to come over and agree that it was, as Senator Conrad pointed out, 
a Ponzi scheme.
  Mr. WICKER. Madam President, I know our friend from South Dakota has 
joined us and is eager to join in this discussion. I wonder if he has 
anything to add about the broken promises that were made during the 
passage of ObamaCare.
  Mr. McCAIN. Before that, the whole point of reforming health care was 
to reduce the cost of health care. That was the goal. We all know 
Medicare cannot be sustained for the American people if the inflation 
associated with health care continues. The whole object of this game 
was to reduce the cost of health care and preserve the quality of 
health care.
  Does anybody think that was achieved with this legislation? That is 
why the American people have figured it out. I yield for the Senator 
from South Dakota.
  Mr. THUNE. Madam President, I echo what the Senator from Arizona said 
about the CLASS Act. He was here, as was I and many others, debating 
this bill and saying this was a program destined to be bankrupt. In 
fact, if we look at the independent Actuary, he was saying the CLASS 
Act was unworkable. They said it would collapse in short order.
  Within the HHS Department, there was a nonpartisan career staff that 
called it a ``recipe for disaster.'' There was plenty of advance 
warning this wasn't going to work.
  The Senator from Arizona correctly pointed out it was used as a 
gimmick to make the overall cost look less and, therefore, bring it 
into balance. As we know now, the CLASS Act could not work. They have 
had to acknowledge that, and the amendment put on by Senator Gregg, 
which would have forced them to certify, made that abundantly clear.
  To the point of the Senator from Mississippi, the purpose of the 
exercise was that we have to do something about the cost of health 
care. In fact, the President of the United States, when he was running, 
said this:

       If you've got health insurance, we are going to work with 
     you to lower your premiums by $2,500 per family per year. We 
     will not wait 20 years from now to do it, or 10 years from 
     now to do it; we will do it by the end of my first term as 
     President of the United States.

  I am sure the Senator from Arizona probably remembers very well many 
of these statements. But the facts tell a different story. If we look 
at what health care costs are doing, and even what was predicted by the 
Congressional Budget Office, they said the law was going to increase 
health insurance premiums by 10 to 13 percent, which means families 
purchasing coverage were going to pay an additional $2,100 because of 
the new law. That has actually been borne out.
  If we look at the cost of health insurance for people in this country 
today, it has gone up, not down; it has gone up dramatically--since the 
President took office, about 25 percent for most Americans. All these 
promises about getting costs under control, the promises about keeping 
what people have, the promises about this being done in a way that 
would protect Medicare--we all know Medicare was going to be slashed 
when this was fully implemented, to the tune of $1 trillion, and there 
would be $1 trillion in new taxes also.
  The American people got a bad deal, and they know it. That is what 
the public opinion polls show.
  Mr. McCAIN. I ask the Senator, even though we have shut down the 
office of the CLASS Act, even though the Secretary of Health and Human 
Services said they can't certify that it will be fiscally solvent over 
75 years, it is still on the books. Isn't the CLASS Act still on the 
books? Does the Senator think it might be appropriate, since we cannot 
comply with the law, to maybe repeal that portion of the law? Is that 
something we might think about? It might be a pretty good amendment.
  Mr. THUNE. It would be, and, by the way, we have that amendment and 
would be happy to offer it. We tried to call up the bill, but it was 
objected to by the Democrats. The thing about bad ideas around here is 
that they tend to come back. This idea ought to be put away once and 
for all. Yet it is on the books, as the Senator pointed out. I don't 
know why, after all the evidence out there now that has been put 
forward, including the Health and Human Services Secretary saying this 
will not work. But we continue to maintain it on the books in the hopes 
of some in the administration, I am sure, that it can be resurrected in 
the future. It was a bad idea then, and it will be in the future. It 
just doesn't pencil out. We cannot make it work. It saddles future 
generations of Americans with massive amounts of debt.
  Mr. WICKER. Madam President, let me ask my colleagues about another 
promise. They will call time on us soon.
  Does anybody recall hearing this statement from the President of the 
United States in 2009? He said this:

       If you like your health care plan, you will be able to keep 
     your health care plan, period. No one will take it away, no 
     matter what.

  That was the President on June 15, 2009. What happened to that?
  Mr. BARRASSO. Madam President, when we look at it, even the 
administration admits that wasn't true. Small businesses--people who 
get their insurance in small businesses--will have a difficult time 
continuing to provide coverage for people because of the mandates that 
say they have to provide Washington-approved insurance. That is the 
problem: that people have what they like, and it may be something they 
want, need, and can afford. Now they are being mandated to have 
something they may not want, need, or be able to afford.
  So, again, we have another broken promise, which is why Senator 
Coburn, who practiced medicine for a quarter century, as I did, and I 
have come out with a report, released yesterday called, ``Warning, Side 
Effects, a Checkup on the Federal Health Law: Fewer Choices.''
  That means people cannot choose to keep what they have. There are 
fewer choices, higher taxes, more government, and less innovation. None 
of that is what the American people have been promised by the 
President.
  Mr. McCAIN. In addition, I ask the Senator how many new regulations 
have been issued, and how many new regulations do we anticipate as a 
result of this exercise?
  Mr. BARRASSO. This over 2,000-page law will result in over 100,000 
pages of regulations. There is one part of the law where, for a couple 
of pages--4 to 6 pages--they had 400 pages of regulations and 50 pages 
of legal guidance.
  When we talk to hospitals--I know those of us who visit with 
hospitals in our States--they say they are spending money on 
consultants and lawyers to help them understand the law. They say: It 
is money we ought to spend on patients and equipment and technology for 
our hospital, to provide care in our community.
  I know the Senator from Kansas has visited over 100 hospitals in his 
State. He has heard the same thing.
  Mr. MORAN. That is true. The point made earlier about the goal of the 
legislation bending the cost curve down--

[[Page 3762]]

it didn't do it, it doesn't do it, and it cannot do it. That created 
the problem we all face now. How can we have access to affordable 
health care if we are not reducing the cost of health care?
  The end result, in my view, is that Americans will have less options 
for their own plans. As employers, they will provide either less 
options or no options for their employees. So the idea that people are 
going to get to keep what they have, that begins to disappear. If they 
are a senior citizen and Medicare has been their primary provider, we 
go back to the idea that we didn't bend the cost curve. So in order to 
make health care affordable--when the legislation fails to do that, we 
find other gimmicks to do that. One of the things this bill creates is 
IPAB, an independent agency that will make decisions about what is 
covered by people's health care plans. The goal will not be to have 
better quality health care; the goal of the IPAB will be to reduce 
expenditures.
  As the promise was made that people get to keep what they have, it 
becomes totally different than what they have experienced in their 
health care plans--either in their own private health care insurance or 
as a beneficiary of Medicare. Even the President's own Medicare Actuary 
estimates that the law will increase overall national health care 
expenditures by $311 billion during the first 10 years alone, and that 
private health care insurance premiums will rise 10 percent in 2014.
  So if we are complaining today about the increase in premium costs, 
there is more to come. In 2014, the Medicare Actuary says there will be 
another 10 percent increase in your health care premiums. At the Center 
for Medicare and Medicaid Services, their economists found the 
increasing growth rate in health care spending will occur in every 
sector of health care. More recently, the Congressional Budget Office, 
our neutral provider of analysis, says the cost of the health care law 
may be substantially higher than earlier estimated.
  One of the things I would suggest we should have done and that never 
happened--if we want folks to be able to keep what they have, if we 
want access to health care in rural and urban and suburban places in 
the country--we should have done something about fixing permanently the 
reduction of payments to physicians--the so-called doc fix. One would 
have thought, in health care reform, that would have been front and 
center. Because if we don't have a physician providing a service, we 
don't have health care. Yet we have a Medicare system that is going to 
reduce the payments. In fact, expected this year, the reduced payments 
to physicians was going to be 30 percent.
  The reality is, no longer will physicians accept Medicare patients. 
The option the American people were promised about keeping what they 
have disappears one more time. In fact, at a townhall meeting in 
Parsons, KS, this year, a physician in the front row said: Senator, you 
need to know I no longer accept Medicare and Medicaid. I will take 
cash, but I cannot afford to provide the services based upon the 
Medicare reimbursement rate I get. When you add in all the paperwork, 
trying to comply with Medicare and Medicaid, it is no longer 
financially feasible for me in this small town to provide the services 
my patients need under Medicare.
  So we are going to see a lot less access because, once again, this is 
a failure. The promise that was made to bend down the cost curve, to 
reduce health care costs, to reduce premiums was totally false.
  Mr. WICKER. So the promise was not to touch Medicare, and that 
promise has not been fulfilled. The promise was to reduce the deficit, 
and that turned out to be an empty promise.
  Also, we were told by the President and by Speaker Pelosi this bill 
would create jobs. The President said it was a key pillar for a new 
foundation for prosperity. How has that turned out? Former Speaker 
Pelosi said in its life the health care bill will create 4 million 
jobs--400,000 almost immediately.
  Of course, neither of those promises has come true. The nonpartisan 
CBO has estimated the health care law will reduce America's workforce. 
This is the bipartisan CBO. They said it will reduce America's 
workforce by 800,000 jobs over the next 10 years. That fact has been 
confirmed by the U.S. Chamber of Commerce.
  Mr. THUNE. I would say to my colleague from Mississippi that one of 
the areas where jobs may be created is in the Federal Government 
because it is going to take an awful lot of Federal bureaucrats to 
oversee and lots of new IRS agents to implement this legislation. That 
would be the only place we will see job creation.
  But when it comes to private sector job creation, the thing about 
this is, it raises the cost for health insurance coverage for 
employers, and it raises taxes on a lot of people who are involved in 
health care.
  The ACTING PRESIDENT pro tempore. The minority's time has expired.
  Mr. THUNE. The combination of those things is only going to cost 
jobs.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Iowa.

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