[Congressional Record (Bound Edition), Volume 160 (2014), Part 7]
[Senate]
[Pages 9479-9482]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. LEAHY:
  S. 2428. A bill to amend title 38, United States Code, to ensure that 
the Department of Veterans Affairs provides temporary care in the most 
cost effective manner when patients are relocated during medical 
facility construction and renovation projects, and for other purposes; 
to the Committee on Veterans' Affairs.
  Mr. LEAHY. Mr. President, following the resignation of Secretary 
Shinseki last week, it is time for some deep soul-searching about the 
future of the Department of Veterans Affairs. As details slowly emerge 
from the inspector general's investigation, I am struck by a disturbing 
aspect of organizational culture within the VA that prioritizes meeting 
goals and checking boxes instead of providing true quality care for 
veterans. Secretary Shinseki himself was a decorated veteran, and I am 
sure he must have been as frustrated as all of us to find some of the 
things that were happening.
  There is an overwhelming current rushing toward the path of least 
resistance for ``reporting'' care for the men and women who served this 
Nation admirably and with dedication. But we should not lose sight of 
the hard work and commitment of the many men and women working in the 
VA system every day striving to provide effective and timely care to 
veterans. We have to tell ourselves that there is really no shortcut to 
quality care for veterans. The VA has rightly been under intense 
pressure and scrutiny to live up to the promise we made to veterans 
when they agreed to serve.
  We have many people in this body and the other body who voted for a 
war that I think historians will call a disaster--the war in Iraq. For 
the first time in America's history, they voted for a war and did not 
do anything to pay for it--no tax to pay for it or anything else. Ten 
years later, though, they say: We have to watch the cost of VA health 
care and all that; we have to find the money. Well, that did not bother 
them when they sent these men and women to war. Let's take care of them 
now.
  It has become apparent that at facilities across the United States 
some VA employees have decided to choose to simply tell those above 
them and those of us with oversight responsibility what they want to 
hear, over providing quality care in a timely fashion. And that is 
appalling and unacceptable.
  But most VA employees are tireless servants. Many are veterans 
themselves. For those men and women who give their all for our 
veterans, it is becoming evident that the system of incentives and 
disincentives may have worked against them. For example, it appears 
that the criteria for bonuses are too weighted towards reported 
metrics, rather than toward taking the time to understand the outcomes 
behind the statistics. What sort of message is sent to good employees 
when their ``success'' depends only on a small part of the picture of 
veterans' care?
  There should be no shortcut to quality care for veterans in 
Washington policymaking circles either. The mere replacement of a 
cabinet secretary results in neither accountability nor reform. Even 
widespread firing of SES-level government employees will not 
automatically result in providing quality care for veterans. Other 
meaningful and more comprehensive reforms are needed, and without 
delay. Earlier this year my distinguished colleague from Vermont 
Senator Sanders introduced an expansive collection of many needed 
reforms. Unfortunately, like so many bills we have tried to consider 
this year, partisan objections stalled progress based on procedural 
rather than substantive matters. Some of the same people who have been 
so critical of this administration and the VA were the same ones who 
voted to block going forward with needed reforms.
  Well, the Senate is going to get another opportunity to consider a 
comprehensive collection of reforms. It must prompt some meaningful 
bipartisan action here in the Senate. Let's not play ``gotcha.'' Let's 
play ``help you'' to the veterans. That is what we need to do. Congress 
has an obligation to consider, debate, and vote on the reforms needed 
to make our system of care for veterans both efficient and effective.
  My wife began her nursing career as a brand new registered nurse in a 
VA hospital. I know how hard she and those around her worked. They were 
veterans of a different generation, but they needed help and care just 
as much as everybody else.
  So I look forward to the Senate's consideration of the legislation 
introduced yesterday by Senator Sanders. I am proud to cosponsor it. 
Many reforms are needed within the VA, and the Ensuring Veterans Access 
to Care Act takes important steps toward achieving these changes.
  Of course, additional reforms are needed. So today I am introducing 
legislation to address one shortfall at the VA that has existed far too 
long. Current law provides a disincentive to cost-effective, onsite 
medical care solutions when operating rooms are refurbished or rebuilt 
within a VA hospital or care facility. Because the VA must report any 
major medical facility costs exceeding $10 million to Congress, the VA 
is encouraged to pay for veterans care at outside facilities, including 
travel to and from those facilities, out of the medical services 
account. It is robbing Peter to pay Paul. It is a different pot of 
money. So that way they do not have to have an extensive report. But 
the best solution for veterans and the bottom line may very well be a 
temporary onsite facility.
  The bill is simple but attempts to take the allure of a shortcut away 
by ensuring that the expenses of temporary offsite care are also 
calculated and reported.
  Senator Sanders, the chairman of the Veterans' Affairs Committee, has 
said: ``If you think it's too expensive to take care of our veterans, 
then don't send them to war.'' He is right. We paid for two unfunded 
wars on a credit card. Now it is time we invest in those who put 
themselves in harm's way to protect our security. It is time for us to 
worry about some of the things we need to do here at home. It is time.
                                 ______
                                 
      By Mr. ROBERTS:

[[Page 9480]]

  S. 2430. A bill to establish the Office of the Special Inspector 
General for Monitoring the Affordable Care Act, and for other purposes; 
to the Committee on Health, Education, Labor, and Pensions.
  Mr. ROBERTS. Mr. President, I first congratulate my colleague Senator 
Isakson for doing a good job of summarizing exactly where we are and 
the problems we are experiencing with the complexity of the Affordable 
Care Act and the hope that the new Secretary will be responsive, as the 
Senator so eloquently pointed out when he questioned her when she came 
before the committee. I thank the Senator for making an excellent 
speech and making excellent points, and I will endeavor to do the same, 
as we are talking about the same subject.
  My remarks are once again on the Affordable Care Act. I know we have 
other issues, many important issues--the Veterans' Administration, the 
release of terrorists in an exchange--but it is equally important we 
continue to shed light on the many failings of this law.
  During the very first debate on the Affordable Care Act, I distinctly 
remember comparing this rush to government health care as akin to 
riding hell-for-leather into a box canyon to find the only alternative 
would be to turn around, ride back out, and get on a more realistic, 
market-oriented health reform trail.
  Then I put it another way. I said: There are a lot of cactuses out 
there. We didn't have to sit on every one of them.
  We never even saw the bill before we voted on it. I think everybody 
understands that. I voted no and so did every Republican Senator and 
Member of Congress. This was not a bipartisan effort.
  I regret to say to my colleagues that I told you so, and here we are 
in a box canyon. Until the administration provides us more details to 
the contrary, we have to assume that more Americans are losing the care 
they liked, through cancellation notices, than they have enrolled in 
the exchanges. They are in a box canyon.
  It is now estimated that ObamaCare will cost the Nation nearly $2 
trillion and has created higher premiums, higher taxes, less choice, 
confusion, delays, and problem after problem. Unfortunately, the 
President and his allies in the Congress continue to protect this law, 
despite its toll on our economy, our patients, and our providers.
  The President promised, as we all remember: We'll lower premiums for 
a typical family by $2,500 per year.
  Valerie from Wichita, KS, wrote me a letter to share her story on 
this broken promise. She writes:

       I wanted to let you know that I had to drop my company 
     health insurance due to the Affordable Care Act. My premium 
     before the Act was $250 a month and my employer paid $100 a 
     month toward the premium.
       My insurance year expired April 1st and the new year is 
     under the ACA health insurance. The new plan is now much 
     higher at $565 a month and my employer can only afford to 
     pitch in $150 a month. I had to drop my plan due to 
     unaffordability. I could not pay the $415 a month.

  The President also promised, highly publicized: ``If you like your 
health care plan, you'll be able to keep your health care plan, 
period,'' and, ``If you like your doctor, you'll be able to keep your 
doctor.''
  This law has significantly disrupted the individual health insurance 
market by imposing mandates and causing at least 5 million Americans to 
lose the insurance they had or have.
  Doug, also from Wichita, wrote to share his personal story on this 
one. He said:

       I am a small business owner who just got my family's health 
     insurance cancelled. I have talked it through with [the 
     insurance company] and at a minimum I will be paying 63% more 
     per month for coverage that has a deductible 3 times greater 
     than what I had and my doctor may or may not be in the 
     network.

  Doug continues on to say:

       The only topic that matters in Washington is stopping the 
     insanity of [ObamaCare].

  Most important, the President promised, ``I will protect Medicare.'' 
This law cuts over $700 billion from Medicare to pay for ObamaCare. 
Part of those cuts come from the establishment, the establishment of an 
Independent Payment Advisory Board--what a wonderful acronym for this 
board--IPAB. This Board is supposed to be made up of 15 unelected 
bureaucrats who will decide which treatments in Medicare coverage 
should be taken away with regard to reimbursement. As I have stated on 
the Senate floor before, the IPAB has no accountability and their 
decisions are practically impossible to overturn.
  The administration continues to give us piecemeal data on exchange 
enrollments, delays provisions of the law that they can't implement on 
time or simply wants to delay--a large serving of politics involved--
and is providing exclusive waivers and special deals to unions and 
others from the yoke of ObamaCare.
  In fact, the nonpartisan Congressional Research Service confirmed 
that the administration has missed half of the mandated deadlines of 
this law. Most recently, press reports have indicated the government 
may be paying incorrect subsidies to more than 1 million Americans for 
their health care plans in the new Federal insurance exchanges, and 
they have so far been unable to fix the errors. Obviously, this poses a 
lot of problems for a lot of people.
  Unfortunately, the President and his allies in Congress continue to 
protect this law despite its toll on our economy, patients, and 
providers.
  A new Health and Human Services Secretary has been nominated, Sylvia 
Mathews Burwell, as Senator Isakson referred to, but with ObamaCare, 
nothing will alter. We are headed for socialized medicine. ObamaCare is 
the President's legacy. The President will unilaterally change what 
suits him best.
  The hard-working taxpayers who are paying for this law, in large part 
from the 21 tax increases contained in it, have a right to some 
answers. That is right, I said 21 tax increases. Just some of these 
taxes include the following: the individual mandate tax, where people 
have to pay the government for not having insurance, even if they can't 
afford it; the employer mandate tax, where an employer pays a tax 
because they may have chosen to forgo providing insurance to their 
employees instead of having to lay off workers; the health insurance 
tax, which will be passed along to individuals in the form of higher 
premiums; the medical device tax.
  I could go on and on. Many of these taxes have bipartisan support to 
be repealed, but we can't even get a vote on those.
  With a $1.8 trillion pricetag, this bill is so far-reaching it is 
difficult to find a Federal agency that doesn't have a hand in this 
pot; from your doctor's office to your wallet, to your privacy. That is 
why I am introducing today a bill to require a special inspector 
general for monitoring the Affordable Care Act. We call it the SIGMA 
Act. It is the Special Inspector General for Monitoring the Affordable 
Health Care Act.
  While all of the Federal agencies charged with implementing the 
Affordable Care Act have Offices of the Inspector General--and they do, 
they are all investigating this law in their own silo--where have we 
heard that before with a lot of problems within the Federal 
Government--the Health and Human Services inspector general isn't 
talking to the Treasury IG or the Department of Labor IG or the 
Homeland Security IG or any one of those with each other.
  This bill would give appropriate authority to investigate and to 
audit any programs or activities related to this law across the many 
Federal departments, State exchanges, and private contractors.
  The legislation will require a report to be submitted to Congress and 
the American people 6 months after enactment and quarterly reports for 
the duration of time the Affordable Care Act is on the books. They have 
broad authority to review all aspects of the law. Things such as the 
following:
  Changes in the health insurance marketplace, the amount of folks who 
have seen their premiums and out-of-pocket costs increased, shrinking 
physician and other provider networks. We have a right to know that.
  The employer mandate, its effect on worker hours, employers' hiring, 
and

[[Page 9481]]

the number of businesses subjected to the penalty. We have a right to 
know that.
  The healthcare.gov Web site, its security, functionality, and 
verification systems. We have read a lot about that, but we have a 
right to know.
  Duties of the Internal Revenue Service, plans for calculating subsidy 
overpayments and underpayments, how they will notify these individuals 
and what their plans are for recapturing these overpayments.
  Medicare cuts via the IPAB, they will provide an analysis of the 
impact on medical outcomes for our seniors as a result of these cuts. 
We should know that.
  All of these questions could and should be answered by a special 
inspector general. The bill would equip the special IG with the same 
investigative and law enforcement authority as standing inspectors 
general, including subpoena and audit powers to compel responses from 
the administration.
  President Obama has claimed that his--his--is ``the most transparent 
administration in history'' and that his administration is committed to 
creating an unprecedented level of openness in government. Given these 
statements, I think the President should embrace the idea of a special 
inspector general for his health care law. After all, we need to know 
the outcomes of the 41 changes he has already made to the law.
  It would provide increased transparency so the general public has a 
better understanding about this law. It would protect taxpayer dollars, 
and by providing an independent analysis of this law, it will allow the 
administration and Congress to make more informed decisions and work 
together on how we move forward with reforms to our health care system. 
I believe we need to do everything possible to repeal and replace this 
law with real health care reform--reforms that lower costs and restore 
the all-important relationship between a patient and a doctor.
  However, as long as this law is on the books, we need a watchdog or a 
special inspector general to investigate the implementation of this law 
and ensure that our scarce taxpayer dollars are being spent in an 
appropriate manner. I encourage all of my colleagues to join me in 
support of this bill in calling for increased oversight of the 
affordable--or unaffordable--health care law.
  Let's ride out of the box canyon. Let's get on a better health care 
reform trail, and on the way we certainly don't have to sit on every 
cactus that comes along.
                                 ______
                                 
      By Ms. WARREN (for herself, Mr. Franken, Mr. Harkin, Mr. Reed, 
        Mr. Durbin, Ms. Baldwin, Mr. Rockefeller, Mr. Reid, Mrs. 
        Feinstein, Mrs. Boxer, Mrs. Murray, Ms. Landrieu, Ms. Stabenow, 
        Mr. Cardin, Mr. Brown, Ms. Klobuchar, Mr. Whitehouse, Mr. Udall 
        of Colorado, Mrs. Shaheen, Mrs. Hagan, Mr. Merkley, Mr. Begich, 
        Mr. Bennet, Mrs. Gillibrand, Mr. Blumenthal, Mr. Schatz, Mr. 
        Murphy, Ms. Hirono, Ms. Heitkamp, Mr. Markey, Mr. Booker, Mr. 
        Udall of New Mexico, Mr. Heinrich, Mr. Sanders, Mr. Menendez, 
        and Mr. Schumer):
  S. 2432. A bill to amend the Higher Education Act of 1965 to provide 
for the refinancing of certain Federal student loans, and for other 
purposes; read the first time.
  Ms. WARREN. Mr. President, outstanding student loans now total more 
than $1.2 trillion and millions of young people are struggling to keep 
up with their payments. But we have a chance to give those borrowers 
immediate relief by cutting the interest rates on existing student 
loans. Make no mistake--this is an emergency. Federal watchdog agencies 
such as the Federal Reserve, the Consumer Financial Protection Bureau, 
and the Treasury Department are already sounding the alarm.
  Forty million Americans are saddled with student loan debt. It is 
holding them back, and it is holding our economy back too. Crushing 
student loan debt is keeping many young people from moving out of their 
parents' homes, from saving for a downpayment, from buying homes, 
buying cars, starting small businesses, saving for retirement, or 
making the purchases that grow our economy.
  It doesn't have to be this way. Congress set artificially high 
interest rates on old student loans that generate extra money for the 
government. The GAO recently projected that just the slice of Federal 
student loans issued between 2007 and 2012 will generate $66 billion 
for the U.S. Government. Those are the kinds of profits that would make 
a Fortune 500 CEO proud.
  These young people didn't go to the mall and run up charges on a 
credit card. They worked hard and learned new skills that will benefit 
this country and help us build a stronger America. They deserve a fair 
shot at an affordable education. We can give them a fair shot by 
cutting those interest rates and cutting those government profits.
  Along with more than 30 of my colleagues, I introduced the Bank on 
Students Emergency Loan Refinancing Act to do just that. The idea is 
simple. With interest rates near historic lows, homeowners, businesses, 
and even local governments have refinanced their debts. But a graduate 
who took out an unsubsidized loan before July 1 of last year is locked 
into an interest rate of nearly 7 percent. Older loans run 8 percent, 9 
percent, 10 percent, and even higher. We need to bring those rates 
down, and we need to do it now. The Bank on Students bill would give 
student loan borrowers the opportunity to lower their interest rates on 
old loans to match the rates the government offers to new borrowers 
today. That is 3.8 percent for undergraduate loans, 5.41 percent for 
graduate loans, and 6.41 percent for PLUS loans.
  I want to be clear. These rates are still higher than what it costs 
the government to run the student loan program. The government won't be 
subsidizing student loans. In fact, the government will be making a 
profit on these loans--just a much smaller profit. And let's also be 
clear that our work is not done until we eliminate all of the profits 
from the student loan program.
  But this is a step that both Republicans and Democrats can easily 
support right now. Last year nearly every Republican in Congress in 
both the House and the Senate voted for the exact same loan rates that 
are in this legislation. If Republicans believe that 3.86 percent is 
good enough for new undergraduate borrowers, then it should be good 
enough for all the existing undergraduate borrowers. There is no reason 
on Earth to say that some kids could get a better deal than others when 
they all worked hard to do exactly what we wanted them to do--get an 
education.
  Passing this bill would have a real impact for people who are 
struggling to make it--college students, young graduates who are only 
starting to build their lives, parents who are juggling their own 
student loans and trying to figure out how they are going to pay for 
their kids' educations, and parents who guaranteed their kids' student 
loans. Student loan refinancing can save real money for millions of 
Americans, and they are voicing their support. Letters, emails, and 
phone calls are already pouring in, and petitions for the bill's 
passage have already garnered hundreds of thousands of signatures. 
Think tanks such as Demos and the Center for American Progress, student 
groups such as Generation Progress and Young Invincibles, and teachers 
groups such as the AFT and NEA have all come forward and endorsed this 
proposal.
  Today the Congressional Budget Office announced that the bill 
actually saves billions of dollars and reduces the Federal deficit. 
That is because the refinancing proposal is fully paid for by 
implementing the Buffett rule, which limits the ability of millionaires 
and billionaires to exploit tax loopholes and pay a lower tax rate than 
middle-class families.
  Later today we will introduce an updated version of this legislation 
in the hopes that we will be able to consider it on the floor of the 
Senate very soon.

[[Page 9482]]

  I am encouraged by the fact that some Republicans have also come 
forward to say they are open to considering a refinancing proposal. I 
want to be clear. This should not be a partisan issue. I am eager to 
work with any of my colleagues regardless of party who believe that we 
need to do something about this growing debt crisis. If they have 
issues with the proposal, if they want to suggest different offsets or 
policy changes, they should bring their ideas forward. We are ready to 
hear them.
  What we cannot do is continue to ignore this problem and hope that it 
will go away on its own. Congress made this mess by setting 
artificially high interest rates that are crushing our kids. It is 
Congress's responsibility to clean it up. Refinancing won't fix 
everything that is broken with our higher education system, but the 
need for comprehensive reform must not blind us to the urgency of 
addressing massive debt that is already crushing young people.
  This is personal for me. I grew up in an America that made it a 
priority to invest in young people, and it opened a million doors for 
me. I will keep fighting to make sure that every kid who works hard and 
plays by the rules gets a fair shot. I urge my colleagues to join me in 
supporting this bill. Student loan borrowers don't have armies of 
lobbyists to fight for them, but they have their voices and they are 
asking for our support. Let's give it to them.

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