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Floor Speech
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Mr. GRASSLEY. But before I get to that, I want to say, first of all, it is not easy for me to stand here and object to something the Senator from Maryland wants to bring up, because he is a gentleman in the 100 percent way in the U.S. Senate. So it is not easy to go against his ideas.
But I want you to know, I have been working on the this with Representative Burgess, the leader in the House of Representatives, and we offered four amendments to him. In the negotiations, he agreed to two of them, and two of them he didn't agree to. And we agreed not to push for that amendment.
So we felt that we had good discussions with Representative Burgess. But now we are working on the House bill here, and none of those things that Burgess agreed to could be. So where we are is that, even though Burgess agreed to some compromise, Senators over here have issues with preventing Congress from depositing savings into the Medicare Improvement Fund in budget years 11 through 30, based upon CBO estimates of preventing health savings legislation.
Now, I have no doubt that preventive medicine saves money, but putting money in a fund for 11 to 30 years out can only lead to what we know happens too often here in the U.S. Senate of budget gimmicks, saying that we are going to use funds in a certain fund. Well, that is a perfectly legitimate thing to do, but you have to have confidence that what CBO says about that is going to be legitimate and have credibility.
And so what I have been trying to work out with Representative Burgess is just exactly to do that: Put this fund out there. As you say, it is going to save money. But I want to make sure that CBO, when they say something, we have a way of verifying that.
So I want to say that I appreciate the intentions of this bill. Increasing preventive healthcare to improve health outcomes and help patients and taxpayers avoid costly treatment and services down the road is a laudable goal. However, I am concerned that, as currently constructed, this bill will lead to budget gimmicks that will ultimately increase rather than decrease health spending.
The sponsors are well aware of my concerns. I worked in good faith to offer up ideas to address my budget gimmick concerns. I made it clear I am willing to compromise. I have already done so with my most recent offer and dropped commonsense budget process reform provisions that I thought were important. And these budget process reforms were what was in the famous Enzi-Whitehouse bill that Senator Enzi--former-Senator Enzi--and, now, Senator Whitehouse worked out in Budget Committee reform. And I have said that Burgess was willing to go along with my changes to establish commonsense guardrails and to prevent budget gimmicks. But these changes have been rejected in the Senate, and my concerns haven't been addressed.
The bill before us contains no commonsense guardrails, such as requiring a disclaimer that a supplementary estimate doesn't replace a CBO 10-year cost estimate, ensuring supplementary estimates are separate and distinct from the 10-year cost estimates, and requiring the Congressional Budget Office to be transparent in their modeling.
That latter point is based on the proposition that we expect CBO to show us how they arrived at figures dealing with cost savings of some particular preventive medicine program.
The bill also doesn't address concerns about how supplementary analysis could be used for budget gimmicks in the future, such as depositing uncertain out-year savings into the Medicare and Medicaid Improvement Funds.
The bill needs commonsense guardrails to prevent budget gimmicks. So I would like to suggest this alternative.
So I ask the Senator from Maryland to modify his request to include my amendment, which is at the desk; that the amendment be considered and agreed to; that the bill, as amended, be considered read a third time and passed; and that the motion to reconsider be considered made and laid upon the table.
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Mr. GRASSLEY. I would like to--
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Mr. GRASSLEY. Around here, we use the words ``budget gimmickry'' pretty freely. And I want to say, as an example, that every Senator in this Senate knows the term ``Medicare sequester'' as a budget gimmick, so something at the end of the 10-year window we are going to draw in to spend money today. That is one example of a budget gimmick. I just want to make sure that we don't widen that down the road.
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