[Congressional Record (Bound Edition), Volume 158 (2012), Part 3]
[Senate]
[Pages 4193-4194]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. CORKER. Mr. President, today I rise to speak about the subject 
our Nation is focused on as the Supreme Court takes up some of the 
constitutional provisions of the health care law that was passed a 
couple of years ago in this body.
  Obviously, the courts will decide whether the law that was passed is 
constitutional. There are a number of challenges. That will take place 
by the end of June, according to what we hear.
  Secondly, there is an election process underway where the candidates 
running for the Republican nomination have talked about the things they 
will do in the event they are elected as it relates to the health care 
bill.
  I want to talk about the fact that regardless of the Supreme Court 
and regardless of what may happen in the electoral process, I have yet 
to meet a person on either side of the aisle--and maybe today will be 
the first time--who believes this bill can work as it was passed. What 
that leads me to say is that regardless of what happens, I think most 
of us are aware that the financial data that was used to put together 
this bill is flawed, and the fact that it is flawed, it will not work 
over the longer haul.
  For the same reasons I railed against the highway bill for breaking 
the Budget Control Act we just put in place last August, I voted 
against this bill--the fact that we used 10 years' worth of revenues 
and 6 years' worth of costs, which greatly exacerbates the problem in 
the outyears; the fact that we took $529 billion in savings from 
Medicare to create this problem and yet left behind the issue we deal 
with in this body almost every year and a half, which is the 
sustainable growth rate that we deal with with physicians; and then, 
thirdly, the fact that we placed an unfunded mandate on States.
  The State of Tennessee has actually been highly progressive as it 
relates to health care. In the State of Tennessee, dealing with 
citizens who are in need, we created a program called TennCare. It went 
through lots of problems but over the last several years has been 
functioning in a stable way. But what this bill did was mandate to the 
State of Tennessee that in order to keep the Medicaid funding that 
funds TennCare, the State has to, on its own accord, match Federal 
grants with over $1.1 billion in costs. So from 2014 to 2019, what this 
bill does is mandate that the State of Tennessee use $1.1 billion of 
its own resources to expand the Medicaid Program to meet the needs this 
bill has put in place.
  This is the point of my being on the floor here today. Again, I do 
not know of anybody here who believes this bill will cost only what was 
laid out as we debated. As a matter of fact, we have had so many 
people--the McKenzie Group and others--who have laid out how many 
private companies in our country will basically get rid of their health 
care and put people out on the public exchange. And the cost of that is 
going to be tremendous.
  Our own former Governor, a Democrat, who has spent a lot of his 
lifetime in health care on health care issues, projected that the State 
of Tennessee, if it decided that it wanted to put its own employees out 
on the public exchange, could save $160 million--by putting its 
employees away from its own health care plan and out on the exchanges. 
Obviously, I doubt that is something States are going to do. But his 
point is this: In a free market system, people are going to respond 
based on what is best for their company and what is best for their 
employees.
  If you look at the subsidy levels that this bill lays out--up to 400 
percent of poverty--they are massive subsidies. We are talking about 
people who are earning over $78,000 a year. So when you look at the 
subsidies this bill has put in place, what employers are going to 
quickly find, especially because we put a subsidy in place on the one 
hand and on the other hand, because this bill lays out the type of 
coverage companies have to have in place--there are attributes that 
cause those costs to rise, and we have already seen that happening 
throughout our private sector; I think that is undeniable--what is 
going to happen is the companies are going to say: We would be better 
off paying the $2,000 penalty. Our employees get these massive 
subsidies, by the way, that are paid for by all taxpayers in America.
  What that means is that there are going to be far more people on 
these public exchanges than ever were anticipated when this bill was 
being put in place.
  My point is that the bill, when it was being constructed, used 10 
years' worth of revenues and 6 years' worth of cost, and that made it 
neutral. Anybody can see that in the outyears that is obviously going 
to create a tremendous problem, a fiscal problem for this government, 
for our country. But the problem is that when it was laid out, the 
amount of people who were then thought would go on the plan was much 
lower than is actually going to be the case.
  Again, I think what you are going to see throughout our Nation, if 
this bill stays in place as it is, is a massive exodus by private 
employers from the health care business. What that is going to do is 
put them on these public exchanges with the subsidies, and, in fact, 
what it is going to do is drive up the cost even more than people ever 
anticipated.
  So this is my point. There is going to be a Supreme Court judgment 
this June. None of us knows what it is going to be. We have pundits on 
the left who say they are confident the bill is going to stay in place. 
We have pundits on the right who say they are confident, 
constitutionally, it is going to be overturned. We will have an 
election in November that may change the course of history as it 
relates to this bill.
  Even if those two events have no effect on this bill, I wish to come 
back to

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my base premise, which is that there is no possible way this bill is 
going to work as it was laid out during the debate. There is no way the 
projections that were laid out as to what the cost of this bill is 
going to be are going to be what the actual costs are.
  What I say is, regardless, this body is going to be pressed with 
replacing this legislation with something that makes common sense. 
There was actually a lot of bipartisanship, prior to us passing this 
piece of legislation, about what those commonsense measures should be. 
We ended up instead with something that was far more sweeping, 
something most Americans find offensive, something that, no question, 
will cause this Nation tremendous fiscal distress.
  My point is, yes, we are going to be watching this June as the 
Supreme Court rules. Yes, we are going to pay attention to the 
elections in November. Regardless of those outcomes, it is my belief 
this body will have to come together and put into place a different 
piece of health care legislation that actually fits the times and the 
American people and allows the freedom of choice the people are 
accustomed to and is built on premises that will cause our country to 
be fiscally sound. I stand ready to work with people on both sides of 
the aisle when that time comes to make that happen.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Mississippi is 
recognized.
  Mr. COCHRAN. Mr. President, the harsh realities of the health care 
reform law are coming home to roost.
  My State is bracing for the impact of the so-called affordable care 
act.
  Under the health care reform law, enrollment under an expanded 
Medicaid Program is projected to increase in my State of Mississippi by 
as much as 44 percent in 2014. Thousands of people will be forced onto 
the Medicaid rolls. The legislature in my state is wrestling with 
serious budget pressures from the cost of the Medicaid Program.
  Mississippi has the highest Federal matching assistance percentage in 
the country at approximately 75 percent. But over the course of the 
next 10 years, our State match requirement will increase by $127 
million each year for a total of $1.3 billion by the year 2020. Our 
State's budget can't handle that burden. Other States are facing 
similar constraints.
  The affordable care act is essentially taking aim at State 
governments. The maintenance-of-effort requirements for the Medicaid 
Program are particularly restrictive. They inhibit a State's ability to 
spend taxpayer money wisely, and they ignore the inherent problems 
within the Medicaid Program. Mississippi faces the prospect of 
expending all of its resources keeping up with an unfunded mandate that 
increases its dependency on the Federal Government, while being forced 
to cut other important services, such as education.
  In addition, physician services cannot keep up with the demands of an 
expanded Medicaid population. This law does nothing to address the 
decreasing physician participation rates and quality-of-care issues 
that are rampant in the Medicaid Program.
  Another charge to States in these difficult fiscal times is the 
creation of health insurance exchanges. My State's efforts to develop 
an exchange began well before the affordable care act was enacted, and 
the State is on track to set up a health insurance exchange by the 
January 2014 deadline. We are committed to creating an exchange that 
can serve Mississippians well, but the state needs flexibility in order 
to do that. The Mississippi Department of Insurance is working to avoid 
defaulting to a federally-run exchange, but bureaucratic red tape 
threatens to hinder their progress. I am concerned that the deadlines 
put forth in the affordable care act are unrealistic due to the amount 
of time and resources that are required for such a large project.
  These are just a few of the problems the affordable care act poses 
for my State and others as well. It is proving to be an increasingly 
expensive statute that is making health care more costly for 
individuals, businesses, and State governments. It is my hope that 
relief can be found at the Supreme Court to avoid the potentially 
devastating impact of this law.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Manchin). Without objection, it is so 
ordered.
  Mr. ROCKEFELLER. Mr. President, I ask unanimous consent to speak in 
morning business for up to, or perhaps 1 or 2 minutes over, 20 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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