[Congressional Record (Bound Edition), Volume 159 (2013), Part 9]
[Senate]
[Pages 12935-12936]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               OBAMACARE

  Mr. RUBIO. I wish to speak briefly about ObamaCare once again. This 
is an issue that is now coming to the forefront over the next few 
weeks.
  As we get ready to start to implement portions of it across the 
country, we are starting to see the implications of it.
  There is so much coverage given to this as a partisan fight between 
Republicans and Democrats or liberals and conservatives, but I actually 
think this issue goes much farther than that because it is impacting 
all Americans.
  I understand the President was here yesterday and individuals from 
the White House as well. According to the press reports, they were here 
to reassure nervous Democrats about the implementation of ObamaCare and 
what it could mean.
  I understand why people are nervous about this bill. They have the 
right to be. For example, the exchanges, health care exchanges which, 
if you can't get insurance, you are supposed to be able to go to them 
and buy health insurance, are not going as planned. Only yesterday 
there was a news report that in Georgia they have asked for an 
emergency extension because they won't be up and running by October 1.
  There are more news reports of more people being pushed from full-
time work to part-time work. The reason why is because ObamaCare says 
if a company has more than 50 employees at full-time status, there are 
certain rules to follow that are going to cost money. We are starting 
to see evidence that people are being moved from full time to part 
time. Some major companies are announcing that they are moving more 
people to part time. There are reports of impending rate increases.
  In my home State of Florida 2 days ago, the insurance commissioner 
announced that the individual market rates, if you are buying as an 
individual, are going to go up 30 or 40 percent.
  We know there are many people in the middle class, hard-working 
Americans who are happy with the health insurance coverage they have 
now. They are probably going to lose that coverage. They are going to 
have to go to an exchange or another company their company is now 
offering. This doesn't mean you lose only the insurance with which you 
are happy, it means you lose the doctor, potentially, because you can 
only go to a doctor that is in the network on your insurance plan. If 
your new insurance doesn't have that doctor, you can't keep going to 
that doctor. There are a lot of reasons to be nervous.
  Add to this a lot of the original supporters of this; for example, 
the labor unions. The Teamsters came out 2 weeks ago saying they want 
this suspended or repealed because it is breaking the promises it made 
in terms of the 40-hour workweek and the whole argument I made about 
full time to part time.
  Here is the irony. The labor union that represents the IRS workers is 
asking to be exempted from ObamaCare. This is ironic, because they are 
the very workers who are in charge of enforcing the law. The people who 
are going to be in charge of enforcing ObamaCare have asked to be 
exempted from ObamaCare. There are a lot of reasons to be nervous about 
it if you are a supporter.
  One more reason is the impact it is going to have on our insurers. We 
haven't heard a lot of talk about this yet, but I will focus on one 
group of seniors in particular, and that is seniors who are on 
something called Medicare Advantage. Medicare Advantage is the Medicare 
Program where basically you contract with a private company to 
administer your benefits under Medicare. How these companies compete 
for your business is they add all sorts of value-added services.
  One example is transportation. My mom is on Medicare Advantage. One 
of the reasons they get her business is that in addition to good 
doctors, they actually will pick her up from home, because she can't 
and doesn't drive. They take her to her doctors' appointments. These 
are the kinds of benefits Medicare Advantage offers.
  The problem is ObamaCare cuts about $156 billion out of Medicare 
Advantage--not to save Medicare; it throws it into the overall budget 
on ObamaCare.
  Who uses Medicare Advantage? This is an interesting statistic: Forty 
percent of African Americans on Medicaid use Medicare Advantage, 53 
percent of Hispanic beneficiaries who are on Medicare use Medicare 
Advantage, and 38 percent of people on Medicare Advantage make less 
than $30,000 a year.
  What is the impact of taking $156 billion out of Medicare Advantage? 
It is about $11 billion this year alone being taken out of the Medicare 
Advantage Program.
  This means--and the President would say we are going to pay less 
money to these insurance companies. Fine. What is the impact of that? 
Let me describe

[[Page 12936]]

to you the impact of what it is going to be.
  First, you are going to see reductions in benefits, meaning a lot of 
these companies are going to have to save that money somewhere. Where 
they are going to save it is by reducing the benefits they offer you on 
Medicare Advantage.
  For example, maybe there won't be anymore transportation in my mom's 
Medicare Advantage plan. We don't know.
  There will be increases in copays, the amount of money seniors are 
going to have to pay every time they go to the doctor or hospital. They 
are going to have to tighten physician networks, which means the number 
of doctors available is going to shrink. If you have a doctor now who 
has been seeing you, and he or she gets kicked out of the network 
because they are tightening the network, you may not be able to keep 
going to the same doctor. That is the disruption it has.
  One study found that by 2017, seniors on Medicare Advantage could 
lose on an average about $1,841 a year. This is the impact.
  I will say why this is pernicious, why this hurts. Medicare Advantage 
has some things about it that need to be fixed, but it is a good 
program. It has good outcomes. The fact is these companies want you to 
go to your doctors' appointments. They want you to be getting your flu 
shots and your vaccine against pneumonia and other things. Why? Because 
they want you to stay healthy. They need you to stay healthy in order 
for the plan to work. We see it in the results.
  Medicare Advantage patients have 39 percent fewer hospital 
readmissions. When people leave the hospital, there is a 39-percent 
reduction in people who go back because something went wrong. There are 
24 percent fewer emergency room visits and 20 percent fewer hospital 
days.
  Medicare Advantage is the program that works. I say this firsthand 
because I see it in my mom's life, and I see it in the lives of 
thousands of seniors in Florida who are on Medicare Advantage.
  You may ask yourself: Well, if this is so bad why haven't we heard 
any of this before? The reason is the insurance companies, because of a 
gag order, are prohibited from talking about any of this until you 
start getting your benefits letter, and they are coming. If you are a 
senior on Medicare Advantage, the chances are that soon you will open 
your mail to the bad news that the Medicare Advantage you have and are 
happy with has been changed in a negative way for you because of 
ObamaCare. They don't know that yet, because the companies have not 
been allowed to tell them yet, but they will have to tell them soon. 
When they do, this will add one more concern that people should 
rightfully have about ObamaCare and the impact it is going to have on 
our people, particularly on seniors. This is why, my colleagues, I have 
become so passionate about this issue, one more reason why it is so 
important that we stop ObamaCare.
  One may say what can we do to stop it? It is already the law. It is 
already in place. A lot of people have told me this. The answer is 
there is something we can do and it comes as soon as September. In 
September, in order for this government to continue to function, we 
have to pass a short-term budget. I wish it were a long-term budget 
that was balanced, but it looks as though it is going to be a short-
term budget.
  We should pass the budget. We have to. We can't shut down the 
government. I am not for shutting down the government. When we do this 
short-term budget, let's fund the government. Let's make sure Social 
Security checks go out. Let's make sure we are funding defense to keep 
our Nation safe. Let's make sure we fund the government, but let's not 
keep funding ObamaCare. Let's not keep pouring money into a program 
that even the unions are now against. Let's not keep pouring money into 
a program that not even the IRS workers, who are going to enforce this, 
want for themselves. Let's not keep funding this program that is going 
to hurt seniors on Medicare Advantage. Let's not keep funding it.
  I will say what the blowback is: Oh, you are threatening to shut down 
the government. No, I am not. I don't want to shut down the government. 
In fact, the only people who are talking about shutting down the 
government are the people who go around saying: We will not support a 
short-term budget unless it funds ObamaCare. Those are the people who 
are threatening to shut down the government. Their position, basically, 
is that ObamaCare is so important we can't possibly fund government 
without funding it.
  So if the government is shut down--and I hope that doesn't happen--
because of ObamaCare, that is an unreasonable position, especially in 
light of all the problems we know this program has. And this idea that 
unless we fund ObamaCare we must shut down the government is a false 
choice. That is not true.
  Let me just say every single Republican opposes ObamaCare. And I must 
share with you that there are a growing number of Democrats who are at 
least nervous about ObamaCare and would love for it to go away in some 
way, shape, or form. In fact, one of them is the President. The 
President has actually delayed a major portion of ObamaCare because he 
knows it is going to be a disaster.
  I would just suggest to those who oppose ObamaCare to ask themselves 
this question: How can I possibly go back to the people who sent me 
here--to the people who are going to be hurt by this, to the people 
being moved from full-time to part-time employment, to the businesses 
that can't grow, to the individuals who are going to lose the coverage 
they are happy with and the doctor they have gotten to know, to the 
seniors on Medicare Advantage who are going to see their benefits 
reduced and their out-of-pocket costs go up--and say to them I did 
everything I could to prevent these things from happening? How can I 
possibly say that to them if I vote for a budget that pays for this?
  This September gives us the last best chance to slow this down or to 
stop it. Once this law starts kicking in and starts hurting our 
economy, we will start crossing some points of no return.
  To my colleagues on the Republican side, I would just say: Look, if 
we are not willing to draw a line in the sand on this issue, what issue 
are we willing to draw a line in the sand on? If we are not willing to 
fight on this issue, what issue are we willing to do it on?
  Right now I can think of nothing that is hurting our economy and 
nothing that is hurting job creation more than the uncertainty and the 
fear this law is imposing on our small businesses, on our middle class, 
on our working class, and on our seniors. I hope we will not let this 
last best chance go by. I hope we will take this opportunity to stop 
this law from hurting Americans, especially the millions of seniors who 
rely on Medicare Advantage for their health care.
  Mr. President, I yield the floor.

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