[Congressional Record (Bound Edition), Volume 161 (2015), Part 4]
[Senate]
[Pages 4932-4934]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            SGR LEGISLATION

  Mr. CORNYN. Mr. President, hopefully this afternoon we will take up a 
very important piece of legislation coming over from the House of 
Representatives that received an overwhelming vote of Republicans and 
Democrats alike--a package negotiated at the highest levels of the 
House leadership between Speaker Boehner and his staff and Nancy Pelosi 
and her staff.
  What could it be that brings the political parties and the leaders of 
the parties in the House together to try to build a consensus and come 
up with a solution? Well, it is really to right a wrong or remedy a 
mistake Congress made back in 1997. Basically, at that time, Congress 
decided, in order to save money on health care costs, it would begin 
periodically to cut the amount of money that was reimbursed to health 
care providers--primarily doctors and

[[Page 4933]]

hospitals. That is how Congress thought way back then we were going to 
save money.
  What has happened in 17 of the 18 times these cuts will have been 
implemented? Well, Congress has realized it was a mistake. Here is the 
problem. When you tell doctors in rural parts of Texas ``You are going 
to earn 20 percent less to treat a Medicare patient tomorrow than you 
did today,'' well, what they are going to decide is ``Can I afford to 
keep my doors open? Can I afford to pay the bills? And maybe I can't 
afford to see any more Medicare patients.'' When doctors simply refuse 
or are unable to afford to see Medicare patients, then our seniors lack 
access to health care they need and they deserve.
  So in very difficult, contentious times politically, I think this so-
called sustainable growth rate--or doc fix--bill I am alluding to which 
is over here from the House and which I hope we will vote on this 
afternoon actually represents a commonsense solution to one of our big 
challenges and certainly will get Congress out of this embarrassing 
position of every 6 months to a year or so having to come back and 
backfill and fix a problem we ourselves created back in 1997.
  Hopefully, we will be able to pass this legislation and get it done 
and give physicians and health care providers the certainty they need 
about the reimbursement rates under Medicare and thus will allow more 
of them to see more seniors and provide them health care benefits under 
Medicare.
  Now, some people may say: Well, this bill is not perfect. They would 
be right. It is not perfect. But actually there is no such thing as a 
perfect piece of legislation, particularly when it is the product of 
bipartisan negotiations where both sides had to give in a little in 
order to get to an agreement. But I do commend Speaker Boehner and 
Leader Pelosi for working in a bipartisan way and producing something 
that has received resounding support from the House of Representatives.
  As I said, this legislation provides our health care professionals 
with a predictable expectation for reimbursement rates--an idea that 
has, sadly, only been a dream for many physicians in Texas and across 
the country and one that Congress can now and should make a reality.
  But this legislation also does something else very significant. It 
not only addresses the reimbursement rate of doctors, it also 
introduces other changes to Medicare that will help reduce the deficit 
over the long term--not just for the next 10 years but 20 years out and 
beyond.
  Now some people might say: Well, if Congress passes this legislation 
now, can't they come back and undo it next year? The pattern has 
actually been when there have been negotiated bipartisan agreements on 
things as important as Medicare and Social Security that they tend to 
stick and they tend to stay in place. So I believe that while this 
negotiation certainly was no easy task and while it is a modest first 
step, the good news is it does represent real meaningful entitlement 
reform--something the President of the United States said he supports 
and something now that both parties here in Washington and Congress 
have been able to support.
  This bill does make important strides on a difficult issue. When I 
said a moment ago it is not perfect, let me explain exactly what I mean 
by that. Not all of this bill is paid for. Today I plan on offering an 
amendment that would keep our country from growing into greater debt by 
offering a pay-for for this piece of legislation.
  How would we do that? Well, my amendment--which I hope, again, we 
will vote on this afternoon in a series of as many as eight votes and 
final passage of the bill--would repeal the individual mandate from 
ObamaCare. That would, according to the Congressional Budget Office, 
free up literally close to $400 billion that could then be used to 
satisfy the deficit for this so-called doc fix.
  Many have rightly demanded an offset for the bill. I am very 
sympathetic to that, and my amendment is designed to address it, 
because--as the Presiding Officer knows, given his long service not 
only in the Bush administration, at OMB, and in the Congress as well as 
the Senate--we have to do something about the long-term debt and 
unfunded liabilities of the Federal Government. I am amazed almost 
daily about the lack of urgency. Perhaps that is because interest rates 
are relatively low and we are not feeling the drain of debt service 
payments to our country's creditors because they buy our debt and they 
demand to be paid interest or debt service on that debt. When interest 
rates begin to creep back up again, as they invariably will, that is 
going to put a real dent in everything from national security to the 
safety net programs that we all believe are important. So my amendment 
will repeal the individual mandate in ObamaCare and help pay for this 
appropriate fix in doctor reimbursement rates in Medicare.
  You may ask, well, isn't that a pretty dramatic or controversial 
thing to do, to repeal the individual mandate in ObamaCare? I asked my 
staff to go back and get some quotes from a candidate running for 
President in 2008, who happens to be the current occupant of the White 
House. Here is what then-Senator Obama said on February 28, 2008, on 
one TV show:

       Here's the concern. If you haven't made it affordable, how 
     are you going to enforce a mandate. I mean, if a mandate was 
     the solution, we can try that to solve homelessness by 
     mandating everybody to buy a house.

  Well, as the Presiding Officer knows, the President actually said 
when we passed ObamaCare--frankly, without my support and the support 
of this side of the aisle--the President claimed it would lower health 
care premiums by $2,500 a year for a family of four. That has proven 
not to be the case. But quite clearly, the President himself, when he 
was running for office in 2008, opposed the individual mandate.
  Here is another quote from CNN in 2008. This is Senator Obama running 
for President. He said:

       In some cases there are people who are paying fines and 
     they still can't afford it, so now they are worse off than 
     they were. They don't have health insurance and they are 
     paying a fine.

  That is what the individual mandate is all about, as you know. I will 
go on with the quote. ``And in order for you to force people to get 
health insurance, you've got to have a very harsh, stiff penalty.''
  So President Obama, back when he was candidate Obama, back when he 
was Senator Obama, opposed the individual mandate. All my amendment 
would do would be to repeal the individual mandate and allow us to 
obtain a savings to pay for this legislation.
  I will read one more quote, because I find the irony pretty rich. 
Senator Obama said--and this was when he was running against then-
Senator Clinton, who apparently is now again running for President. 
Senator Obama said in 2008:

       She believes that we have to force people who don't have 
     health insurance to buy it, otherwise there will be a lot of 
     people who don't get it. I don't see those folks, and I think 
     that it is important for us to recognize that if you're going 
     to mandate the purchase of insurance and it's not affordable, 
     then there's going to have to be some enforcement mechanism 
     that government uses. And they may charge people who already 
     don't have healthcare fines or have to take it out of their 
     paychecks. And that I don't think is helping those without 
     health insurance.

  So my amendment that would offer to pay for this bill would repeal 
the mandate that then-Senator Obama, candidate for President, was so 
critical of. It would repeal a tax on the American people that coerces 
our citizens into purchasing health care they apparently don't want or 
they wouldn't otherwise buy but for the threat of government coercion.
  The better way to do it, in my view, is to make health care more 
affordable, not to make it more expensive and say if you don't buy the 
government-approved care--even if you don't want what it provides--then 
we are going to coerce you to do it. We are going to penalize you for 
it. This is bad for America and hurts people instead of giving them the 
helping hand they need when it comes to health care.
  We are going to have a lot more to say about how we need to repeal 
and replace ObamaCare with more affordable health insurance that gives 
people

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access to the doctors and services they want and need. But on the 
present bill, no one denies the need for a long-term permanent solution 
to the way we pay health care providers under Medicare. So for the 
benefit of physicians, our seniors, and the American people, we need to 
do this, but we also need to find a way to pay for it.
  I am hoping we pass this legislation today. I believe the current 
provision expires at midnight tonight. It is important that we stop 
kicking the can down the road and we allow our family doctors to do 
what we want them to do most, which is to focus on what they do best 
and what our families need the most. At the same time, it will ensure 
seniors access to the care they need. Such a meaningful solution is 
long overdue.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Ms. STABENOW. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Lankford). Without objection, it is so 
ordered.
  The Senator from Michigan.

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