[Congressional Record (Bound Edition), Volume 161 (2015), Part 7]
[Senate]
[Pages 9760-9761]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          AFFORDABLE CARE ACT

  Mr. ISAKSON. Mr. President, before he leaves the floor, I thank the 
distinguished Senator from Wyoming, a physician himself, not just for 
his good remarks today but for his litany of good remarks throughout 
the debate on the Affordable Care Act.
  For 6 years he has been an outspoken voice for what is right for the 
American people and what the American people want, which is affordable, 
quality health care. I appreciate his contribution, not just to the 
debate today but to the debate we have had in the past and the one we 
are about to have in the future. He is right that we must come 
together--Republicans and Democrats alike--and make sure that the 
broken promises of the Affordable Care Act are fixed; that affordable, 
accessible, quality health care is available to the American people; 
that it is deliverable by private industry and by private and 
competitive free enterprise system; and that government mandates that 
force prices up and quality down go away. So I thank the Senator for 
his contribution and all the great work he does.
  He is not quite as old as I am, but he might like the movie I like, 
``Butch Cassidy and the Sundance Kid.'' There is a great line in 
``Butch Cassidy and the Sundance Kid'' where they are sitting in a cave 
after having robbed a bank. Butch looks over at Sundance and says: 
``Boy, I just love it when a plan comes together.''
  Well, 6 years later, as we look back on the Affordable Care Act, the 
plan is unravelling. It is costing the American people more. Health 
care is less accessible. Deductibles are higher. It is time that we fix 
it and that we fix it right.
  If the King v. Burwell case is decided--as it will be in the next few 
weeks--we have an obligation to keep the first promise the President 
did not keep. Do you remember? President Obama said: If you like your 
insurance, you can keep it? If Burwell loses and if King wins and the 
Court rules that the subsidies are illegal, approximately 9.5 million 
Americans who have gotten insurance and have it through subsidies 
through the Affordable Care Act would be threatened to lose their 
insurance immediately upon its decision. We can't let that happen. We 
have to see that we build a bridge from where we are today to a future 
of better health care, more accessible health care, and more affordable 
health care.
  So we must remember as Republicans, who have so often criticized the 
President for that remark that if you like your health care you can 
keep it, to make sure that we don't become an unwitting accomplice in 
this decision if King wins, by, first and foremost, assuring the 9.5 
million who have coverage that we will work to see that you can keep 
your coverage and that you have a bridge to a better, more competitive, 
more affordable health care system. It is important for us to remember 
that.
  No. 2, it is important for us to remember that we can't recreate a 
system that the President created in terms of paying for the health 
care. Have you ever thought about how the Affordable Care Act is paid 
for? It is paid for in the following ways: higher copayments, less 
benefits, and higher premiums. But even worse, there is a revenue 
system that actually punishes free enterprise, an 85-percent medical 
loss-ratio mandate which cut out every private sector insurance 
salesperson who sold medical plans to the American people, because when 
you take 85 percent as the maximum loss ratio, then you only have 15 
percent for administration. There is nothing left to compensate someone 
for selling the policy.
  No. 3, when we were short $19 billion, the President decided to 
create the HIT tax. What is the HIT tax? It is an arbitrary tax against 
small and medium-sized group medical companies, charging them not only 
on their premiums, not only on their revenues but on their percentage 
of market share. Where in the world has the government ever decided to 
take market share as an indicator of how much you pay? It makes no 
sense unless you were trying to find dollars to make sense. And the 
President did it. I can go over litany after litany after litany.
  The medical device tax on orthopedists deals with devices in 
everything that they do. The medical device tax is not a tax on net 
profit on medical devices. It is a 2.3 percent surcharge on the gross 
revenues of the device manufacturer.
  I tell the story about my visit to South Africa 2 years ago. I got a 
call from our Governor. He said: You are in Johannesburg, South Africa. 
Would you go to the chamber of commerce there and visit with a Georgia 
company from Kennesaw, GA, a small medical device manufacturer that is 
selling their products. Just tell them thank you for their business.
  I said sure. I went by that evening for a reception, found the 
gentleman from Kennesaw, and said: Thank you so much for doing your 
business in Georgia.
  He said: Oh, I have moved.
  I said: Oh, I am sorry. The Governor's office called me.
  He said: Well, I just announced that I am moving this week. They 
don't know it yet.
  I said: Where are you moving?
  He said: Madrid.
  I said: Madrid, Spain?
  He said: Yes.
  I said: Why?
  He said: Because the medical device tax is making it impossible for 
me to do what I need to do in terms of innovation, in terms of 
marketing, and in terms of distribution.
  So it was an ill-conceived act with the best of intentions but the 
worst of results. How bad? It is just like what Senator Barrasso said a 
minute ago.
  In Georgia, one plan is going up 38 percent--one plan. That is the 
highest we know of--not 4, not 10, not 17 but 38 percent. There are 
10,796 Georgians who have that plan who now have the alternative of 
going to find something else or paying 38 percent more. I don't know 
about everybody else, but wages aren't growing by 38 percent, and 
opportunity is not growing by 38 percent. But the cost of your health 
care, which you want to have, goes up 38 percent and you have to find a 
way to pay it. What does that do? It hurts the economy, it hurts 
family, and it hurts the American people.
  So as we look at the results of what is going to happen with King v. 
Burwell, if King is ruled in favor of and the courts throw out the 
subsidies on the Affordable Care Act, we need, first of all, to do no 
harm. We need to make sure that nobody arbitrarily, immediately loses 
the insurance that they planned on. We need to keep the promise 
President Obama made and never kept. That is No. 1.
  No. 2, we need to get everybody in the same room--Republicans and 
Democrats alike, providers and beneficiaries alike. Let's build a 
health care system for the 21st century for America that rewards the 
best health care system in the world by allowing it to innovate, by 
encouraging it to compete, and not making arbitrary decisions on cost 
and taxation that drive people out of the marketplace and out of 
business.
  I am at that age where I care about my health care. I enjoy my health 
care. I like the policy I have. It costs me a lot more than it did 
before the Affordable Care Act. Health insurance is important. But 
there is a limit to what I can absorb. There is a limit to what the 
American people can absorb, and there is a limit to what government can 
do to try to fit a square peg in a round hole. I learned in Boy Scouts 
that doesn't work.
  The Affordable Care Act is a square peg that for 6 years we have 
tried to fit in a round hole, and it doesn't fit. It is time that we 
rounded that peg, took into consideration the American people, the 
taxpayers, the patients, and the physicians and did what is right for 
the American people.
  Don't break our promises. Let's keep our promises. Let's allow them 
to have the choice of insurance policies that, once they buy them, they 
can keep and a system that doesn't mandate increases but instead 
encourages competition, quality, and makes sure it is health care the 
American people want, is accessible, affordable, available, and 
delivered in a competitive, free enterprise market by the private 
sector.
  I yield the floor.

[[Page 9761]]

  The PRESIDING OFFICER. The Senator from Indiana.

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