American Recovery And Reinvestment Act Of 2009
Floor Speech
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Mr. GRASSLEY. Madam President, first of all, let me express great appreciation to the chairman for giving me an opportunity to use some of his time when I am going to be speaking against the legislation. It is very much brotherly love and I appreciate that.
Today I wish to talk about some of the questionable spending in this bill and some of the amendments we aren't going to be able to vote on. First of all, there is $87 billion in Medicaid funds in this bill. As I have said on this floor several times, it is more than States need to pay for enrollment-driven increases in Medicaid spending due to the recession. We all accept the fact that there needs to be more money for Medicaid, as long as it is directly related to an increase in unemployment. However, I explained last week how the facts show that this amount is far more than States need for the cost of the new Medicaid enrollment resulting from a downturn in the economy. What the nonpartisan Congressional Budget Office determined was that what States need to pay for increases in Medicaid enrollment is not the $87 billion in the bill but a lot smaller amount--$10.8 billion--directly related to an increase of unemployment Medicaid use.
So the question is, Why does the bill provide almost eight times what the States actually need for the new enrollment resulting from that downturn? I say we shouldn't kid ourselves. This bill gives States, in a sense, a slush fund. Now, I am willing to admit States might need money for other programs, but it shouldn't be covered up by saying it is Medicaid money.
On Friday night, I had an amendment to ensure that Medicaid funds would have been distributed fairly. Amazingly, 17 Members of the Senate voted to give their States less money, but at least in that case, I was able to get a vote. I had several other amendments that were never allowed to be made pending. All day Wednesday we were prevented from making amendments pending. Retreats and signing ceremonies got in the way. Thursday evening we spent more time arguing over whether amendments would be made pending rather than actually processing amendments. It seems contrary to what President Obama said on Monday night. He said the Republicans have a lot of good ideas and we ought to make this a bipartisan bill. So we get to 10 o'clock on Friday morning. We were encouraged to bring our amendments to the floor so they could be debated. For some reason, the first amendment was not allowed until 4 1/2 hours later.
So I am disappointed that several amendments on this side of the aisle, including some of my own, would not receive a vote. I am not convinced the majority wanted to have open debate and take votes on many of these amendments, including mine. It is too bad because this bill still can be made a bipartisan bill, and this bill can still be made a more effective bill.
Congress is giving States, then, $87 billion for Medicaid and resting on the hope that States don't strip the health care safety net for low-income families and then pocket money. For instance, in my State of Iowa I recently read in the paper that they are going to cut $20 million out of Medicaid. So if we can do things with all the money we are going to give to the States to make sure these programs aren't cut, it seems to me, for that additional $76 billion, we ought to get some of that assurance. I use the word ``hope'' that they don't do that because the underlying bill doesn't do enough to make sure States do what is best with the Medicaid Program. Does the bill prevent States from getting Medicaid Programs? It does not. The bill only prevents States from cutting Medicaid on one of three propositions, this one being income eligibility. So that is a good thing. But if Congress is giving States $87 billion and telling them not to cut Medicaid eligibility, shouldn't Congress also tell States they can't cut benefits? If Congress is giving States $87 billion and telling them not to cut Medicaid eligibility, then shouldn't Congress also tell States they can't cut payments to providers? Will Medicaid beneficiaries who are elderly or disabled be able to receive home- and community-based services? Will there be enough pharmacists taking Medicaid? Will there be enough rural hospitals or public hospitals taking Medicaid patients? Will there be enough community health centers taking Medicaid people? Will Medicaid beneficiaries who are elderly or disabled be able to get into nursing homes? Will States cut mental health services because Congress didn't prevent them from doing so in this bill? Will there be pediatricians or children's hospitals there for children on Medicaid?
So if the Senate does nothing to protect access to these vital providers, nobody will be able to assure the people who count on Medicaid that the care they need will be there. I filed an amendment that prevents States from generally cutting eligibility and benefits and providers. In other words, I am
building on what the bill's authors did. They said don't cut eligibility. I agree with that. But shouldn't we, at the same time, not allow States to cut benefits and providers while all the time the States are getting $87 billion, which is about $75 billion, $76 billion more than what the recession-driven unemployment qualifiers for Medicaid need? The other day, if we had a chance, Members could have voted, in other words, to protect Medicaid providers and people who are on it. That should have had a vote.
The bill provides in addition a COBRA subsidy to involuntarily terminated employees. The bill places no limits on the eligibility for the subject. Why? I haven't quite figured it out. I know the amendment we are now considering lowers the subsidy, but it still has no limits on eligibility for that subsidy.
Last week, President Obama and his administration issued guidelines for capping compensation paid to CEOs whose institutions receive taxpayers' dollars through the TARP program, but the fact of the matter is this: Former Wall Street CEOs and hedge fund managers who have made millions of dollars while running our economy into the ground will get a taxpayers' subsidy equal to now 50 percent of their health care insurance. It seems to me that is outrageous.
I filed an amendment that simply said if a worker who was voluntarily terminated from their job earned income in excess of $125,000 for individuals or $250,000 for families as a whole, this worker would not be eligible to receive the subsidy. What is magic about $250,000? It is the same level President Obama in the campaign said that people above that level should have tax increases. So I figured $250,000: You shouldn't be eligible for a subsidy for your health insurance, particularly if you are coming from a company that as a CEO you drove into the ground. That amendment should have had a vote.
It is not just the health care amendments. This bill could be improved by increasing the tax credit for education expenses. Senator Schumer and I filed an amendment--now, that is a bipartisan amendment--that would have done just that. It would have increased the American Opportunity Tax Credit from $2,500 to $3,000. It was a bipartisan amendment. It should have had a vote.
I also remain deeply concerned about the oversight of this bill. On the front page of today's Washington Post, there is a story with this headline: ``If Spending Is Swift, Oversight May Suffer.'' Well, a person such as I was very interested. I spend more time on oversight than I do on legislating because I don't think we do enough of it here. The article says:
The Obama administration's economic stimulus plan could end up wasting billions of dollars by attempting to spend money faster than an overburdened government acquisition system can manage and oversee it.
When there is a potential for waste, fraud, and abuse, Congress needs to be proactive, not reactive. This is why I filed an amendment to ensure Congress has the ability to get information from the executive branch and respond to the allegations that will inevitably come in. The amendment would ensure that any agency that gets funding under this bill would be required to provide records upon written request by a chairman or ranking member of a committee of Congress. The committee records should not be kept secret from the elected representatives of the people. I have always tried to focus on good Government issues such as waste, fraud, and abuse. That is what my amendment did. That should have had a vote.
I know a lot of people have worked very hard putting this bill together. I have done some of that myself, so I know what work it takes. I know a lot of people worked very hard putting a substitute amendment together. I respect that they have worked hard. Hard work doesn't mean, though, that it is necessarily good work. We should all have been allowed to consider and vote on more amendments than we have. I would say on all the amendments I have discussed in my remarks today, giving $87 billion, even though that is as much as eight times what they need to stay ahead of enrollment-driven Medicaid increases, is still not well thought out. Giving States $87 billion while still allowing them to cut their Medicaid Programs is still not well thought out.
Giving a COBRA subsidy to millionaires is still not well thought out. It is still not well thought out. It is still out of control.
The Senate should have been allowed to vote on the numerous amendments I have discussed today to address the shortcomings that occur when partisan bills are moved too quickly. We could still do that. We could process these amendments today. But as we have seen throughout, the majority is not interested in true bipartisanship or in process that allows for full and open debate on amendments. We have the House of Representatives and the ``House of Representatives in training,'' given how this debate has been run.
Today we are being told ``just do it,'' at the expense of doing this very important and urgent legislation in a way that does right by the American people in the short and longer term.
I yield the floor.
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Mr. GRASSLEY. Madam President, today I want to talk about some of the questionable spending in this bill and some of the amendments that we aren't going to be voting on.
First of all, there is $87 billion in Medicaid funds in this bill.
That is a huge payment to the states.
And as I have said on this floor several times, it is more than States need to pay for enrollment-driven increases in Medicaid spending due to the recession.
I explained last week how the facts show that this amount is far more than States need for the cost of new Medicaid enrollment resulting from the economy.
What the nonpartisan Congressional Budget Office determined was that what States need to pay for increases in Medicaid enrollment is not $87 billion but $10.8 billion. That is about $76 billion less than what this stimulus bill gives the States.
So the question is, why does this bill provide almost eight times what the states actually need for the new enrollment resulting from the downturn?
Let's not kid ourselves; this bill gives States a slush fund. This outlandish sum of money is not needed for Medicaid.
It is a slush fund for the States.
I thought that money should be spent fairly. I thought there should be some accountability.
On Friday night, I had an amendment to insure the Medicaid funds would have been distributed fairly.
Amazingly, 17 Members of the Senate voted to give their States less money.
But at least in that case, I was able to get a vote.
I had several other amendments that were never allowed to be made pending.
All day Wednesday, we were prevented from making amendments pending.
Retreats and signing ceremonies got in the way.
Thursday evening, we spent more time arguing over which amendments would be made pending rather than actually processing amendments.
At 10 o'clock Friday morning, we were encouraged to bring our amendments to the floor so they could be debated.
For some reason, the first amendment was not allowed until 4 1/2 hours later.
I am disappointed that several of my amendments will not receive a vote.
I am not convinced the majority wanted to have open debate and take votes on many of my amendments.
It is too bad, because this bill still needs fixing.
Congress is giving States $87 billion and just resting on hope that States don't strip the health care safety net for low income families and then pocket the money.
I use the word ``hope'' because the underlying bill doesn't do enough to make sure States do what is best for the Medicaid Program.
Does the bill prevent States from cutting their Medicaid programs?
It does not.
The bill only prevents States from cutting Medicaid income eligibility.
But if Congress is giving States $87 billion and telling them not to cut Medicaid eligibility, shouldn't Congress also tell States they can't cut benefits?
If Congress is giving States $87 billion and telling them not to cut Medicaid eligibility, shouldn't Congress also tell States they can't cut payments to providers?
States can't change income eligibility, but under the bill as written, they can cut provider payments or benefits to providers.
Will there be Medicaid beneficiaries who are elderly or disabled able to receive home and community based services?
If we want to keep seniors and the disabled in their homes, rather than institutions, paying direct care workers to provide home and community based services is critical.
Will there be enough pharmacists taking Medicaid?
Will there be enough rural hospitals or public hospitals taking Medicaid?
Will there be enough community health centers taking Medicaid?
Will Medicaid beneficiaries who are elderly or disabled be able to get into nursing homes?
Will States cut mental health services because Congress didn't prevent them from doing so in this bill?
Will there be pediatricians or children's hospitals there for children on Medicaid?
If the Senate does nothing to protect access to these vital providers, nobody will be able to assure the people who count on Medicaid that the care they need will be there for them.
I filed an amendment that prevents States from generally cutting eligibility and benefits and provider payment rates while they are receiving the $87 billion in additional aid.
Members could have voted to really protect Medicaid.
That should have had a vote.
As written, the bill gives states $87 billion also in the hope that States don't take actions that are contrary to economic growth.
I use the word ``hope'' because the bill doesn't do enough to make sure States do what is best for our economy either.
We should ask for more guarantees that States will spend the money appropriately and not make decisions that work against economic recovery.
If Congress gives states $87 billion and tells them not to cut Medicaid, should Congress also tell States not to raise taxes?
If states react to their deficits by increasing taxes, they will defeat the goal of economic recovery.
It makes no sense for us to leave the door wide open for States to raise taxes while getting an $87 billion windfall from the Federal Government.
I filed an amendment that prevents States from raising income, personal property or sales taxes as a condition of the receipt of $87 billion in federal assistance.
That should have had a vote.
If Congress gives states $87 billion and tells them not to cut Medicaid, should Congress also tell States not to raise tuition at State universities?
If States can price young people out of an education, that does nothing for preparing our workforce for the 21st century.
I filed an amendment that prevents States from raising tuition rates at State colleges and universities as a condition of the receipt of $87 billion in Federal assistance.
That should have had a vote.
For $87 billion, what does this bill do to ensure that all those Federal taxpayer dollars are being spent appropriately?
Almost nothing.
Senator Cornyn and I filed an amendment that requires States to do something to improve their waste, fraud and abuse in exchange for the $87 billion in Federal taxpayer's money.
It provides a list of eight options to combat waste, fraud and abuse, and the Secretary can provide more options as well.
These are all very reasonable steps States could and should take if Congress is going to send them 87 billion in additional Medicaid dollars.
They don't have to do all of these various options.
Just four.
Just show the American people that States can take four simple steps to reduce fraud, waste and abuse.
Shouldn't Congress at least ask that much of States for $87 billion?
That should have had a vote.
If Congress passes all this Medicaid spending, what guarantee do we have that the fiscal challenges facing Medicaid in the future will be solved?
Sooner rather than later, we must recognize that our entitlements are unsustainable as currently constructed.
President Obama has acknowledged this himself on numerous occasions recently.
One of my concerns about the additional Medicaid funding that is in this bill is that it places too much emphasis on Medicaid in the here and now and ignores future fiscal challenges.
Just last year, the CMS Office of the Actuary reported that Medicaid costs will double over the next decade. That is simply unsustainable.
It is critical that both the Federal Government and States recognize the fiscal challenges we face and take action now.
Senators Cornyn and Hatch and I filed an amendment that requires States to submit a report to the Secretary detailing how they plan to address Medicaid sustainability.
It is critical that we look at the future of Medicaid if Congress is to give States $87 billion in additional Medicaid funding.
That should have had a vote.
The bill provides a COBRA subsidy to involuntarily terminated employees.
The bill places no limits on the eligibility for the subsidy. Zilch, Zero. Why? I haven't quite figured it out.
I know the amendment we are now considering lowers the subsidy, but it still has no limits on eligibility for the subsidy.
Frankly, I am surprised my Democratic colleagues--and especially the Obama administration--have not tried to place limits on the availability of the subsidy.
After all, the subsidy is paid for with taxpayer dollars.
Last week, the Obama administration issued guidelines for capping compensation paid to CEOs whose institution receives taxpayer dollars through the TARP program.
But the fact of the matter is this, former Wall Street CEOs and hedge fund managers who have made millions of dollars--while running our economy into the ground--will get a tax payer-funded subsidy equal to now 50 percent of their health insurance policy.
That is outrageous.
I filed an amendment that simply said that if a worker who was involuntarily terminated from their job earned income in excess of $125,000 for individuals and $250,000 for families during 2008, this worker would not be eligible to receive the subsidy.
Some of my colleagues may ask why we set the cap at $125,000 and $250,000.
Well, when Candidate Obama was campaigning to be President Obama, he continually said that he wanted to raise taxes on families making over $250,000 a year.
Why?
Because then, Candidate Obama felt that these people are too ``rich'' to pay lower taxes.
If these families are too ``rich'' to receive a tax benefit in the form of lower taxes, aren't these people too ``rich'' to receive a taxpayer-funded subsidy for health insurance?
That should have had a vote.
And it is not just the health care amendments.
This bill could be improved by increasing the tax credit for education expenses.
Senator Schumer and I filed an amendment that would have done just that.
It would have increased the American opportunity tax credit from $2,500 to $3,000.
Senator Schumer has shown great leadership in the area of education, and I thank him for partnering with me to help families better afford college through the tax code.
It was a bipartisan amendment.
That should have had a vote.
I also remain deeply concerned about the oversight of this bill.
On the front page of today's Washington Post, there is a story with this headline: ``If spending is swift, oversight may suffer.''
The article says,
The Obama administration's economic stimulus plan could end up wasting billions of dollars by attempting to spend money faster than an overburdened government acquisition system can manage and oversee it.
When there is a potential for waste, fraud, and abuse Congress needs to be proactive, not reactive.
We have created a special inspector general for the TARP program and we have the Government Accountability Office reporting to Congress every 60 days on the use of that money as well.
However, there is nothing like that for the money in this bill.
That is why I introduced an amendment to ensure that Congress has the ability to get information from the executive branch and respond to the allegations that will inevitably come in.
The amendment would ensure that any agency that gets funding under this bill would be required to provide records upon written request by a chairman or ranking member of a committee of Congress.
In my experience, the executive branch consistently misinterprets a number of statutes in order to claim that it is legally prohibited from complying with oversight requests from Congress.
This amendment would make the will of the Congress clear that when we ask for records, the agencies have an obligation to comply.
The public's records should not be kept secret from the elected representatives of the people.
The idea that only the majority should be able to request documents from the executive branch is just an invitation for a timid legislative branch.
The President's choice to head the Office of Legal Counsel at the Justice Department, Dawn Johnson, wrote in July 2007:
With regard to Congress, oversight obviously tends to be least effective when the President's political party dominates.......
Now that the White House and the Congress are controlled by the same party, I am worried that oversight will suffer, just like Dawn Johnson said it would.
I have always tried to focus on good government issues like waste, fraud, and abuse.
That's what my amendment did.
That should have had a vote.
I know a lot of people have worked very hard putting this bill together.
I know a lot of people worked very hard putting the substitute amendment together.
I respect that they have worked hard.
Hard work doesn't mean that it is good work.
And we should have been allowed to consider and vote on all of the amendments I have discussed here today.
Giving States $87 billion even though that is as much as eight times what they need to stay ahead of enrollment-driven Medicaid increases is still not well thought out.
Giving States $87 billion while still allowing them to cut their Medicaid programs is still not well thought out.
Giving States $87 billion while still allowing them to raise taxes or tuition is still not well thought out.
Giving States $87 billion without requiring them to do a better job of addressing fraud, waste, and abuse is still not well thought out.
Giving States $87 billion without making them address the fiscal sustainability of their Medicaid programs is still not well thought out.
Giving a COBRA subsidy to millionaires is still not well thought out.
It is still not well thought out. It is still out of control.
The Senate should have been allowed to vote on the numerous amendments I have discussed today to address the shortcomings that occur when partisan bills are moved too quickly.
We could still do that.
We could process these amendments today.
But as we have seen throughout, the majority is not interested in true bipartisanship or in process that allows for full and open debate on amendments.
One of the key questions in the stimulus debate has been whether one side or the other is acting in a partisan manner.
To put a finer point on it, you could break it down to two precise questions. The first question would be: Has the majority party, meaning my friends on the Democratic side, ever invited my side, the Republicans to the negotiating table?
That is, has an offer, with an intent to negotiate, ever been extended by the Democrats? If the answer to the first question is yes, then the second question would be: Has the minority party, the Republicans, ever responded to the offer and taken the next step in the negotiating process.
These are the fundamental questions that need to be asked and answered to determine whether the stimulus bill before us is a bipartisan process.
Let's go to the first question. It is a basic question. My friends on the other side did very well in the last election. We congratulated our new President, Barack Obama, on his victory. The Democrats have robust majorities in both houses of Congress.
They have their biggest majority in the House since 1993. They have the biggest majority since the Carter administration. We Republicans recognize they set the agenda.
It is kind like the role of the point guard in a basketball game. They have the ball. Just as a point guard runs the plays, so too does the Democratic Leadership in both bodies decide the plays. Republicans don't have the ball.
We are in a position of responding. That's all we can do. It's really up to the Democratic majority to make the first move. So, with the context in mind, let's bear down on that first question. Did the House Democrats make an offer?
Did the Senate Democrats make an offer?
Maybe I missed something, but I don't recall receiving an offer. As I said in committee and in the opening floor debate, my friend, Chairman Baucus, courteously and professionally consulted with me. But consultation is not the same thing as negotiation. They are very different actions.
As a former chairman, I know well the pressure from the leadership, the caucus, the House, and an administration of one's own party.
You really have to push uphill to get a bipartisan deal. The benefit of a bipartisan deal is the policy is likely to stand the test of time. The leadership, caucus, and administration are likely to understand that benefit in the abstract, but unlikely to take concrete actions to realize it.
All of those partisan pressures will look to pull apart any bipartisan plan. I know my friend, Chairman Baucus understands that dynamic. He would probably prefer a bipartisan process and product, but the partisan edge is too great. The expectations on the Democratic side are too high. It's like the old saying: ``our way or the highway.''
So, Madam President, we can't get to the second question. That question, whether Republicans have engaged in a bipartisan process, can't be answered. It can't be answered because the process was never started. An offer was never made. We were not invited to the negotiating table.
We have the House of Representatives and the House of Representatives-in-training given how this debate has been run.
Today we are being told ``just do it'' at the expense of doing this very important and urgent legislation in a way that does right by the American people in the short and longer term.
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