History Of The Medical Insurance Industry
Floor Speech
BREAK IN TRANSCRIPT
Mr. GRASSLEY. Thank you, Mr. President.
Mr. President, I come to the floor to address the issue of health care reform. In order to demonstrate the complicated issues that face us, I have with me the House of Representatives health care reform bill, approximately 2,000 pages; I have over here the Senate HELP Committee bill, approximately 1,000 pages; and over here, the Senate Finance Committee bill, approximately 1,500 pages.
Some on the other side of the aisle are saying their bills do not represent a government takeover of the health care system. I want to believe that. I would really like to believe it, but the facts seem to tell a different story. If we look at the specifics of the bill reported by the Senate HELP Committee or the House bill released last week, I don't see how one could call it anything but a government takeover.
So I wish to start with the Senate HELP Committee bill.
On September 17, the HELP Committee finally released what I previously said was a bill containing about 1,000 pages--more accurately, 839 pages--over 2 months after the majority party on the HELP Committee voted to report it. When I was back in my State of Iowa for the August recess, I held 17 townhall meetings. Due to the controversial health care bill the HELP Committee and the three House committees had just voted on, the attendance was the highest I have seen in the 2,871 townhalls I have held during my years in the Senate.
Many of the people who attended were citing sections from the health reform bills. They had good questions. I heard repeatedly about the new powers being granted to the government in these bills. So I decided we should have a catalog of how many times these bills grant new powers to the Secretary of Health and Human Services.
Well, I have the HELP Committee bill with me today, and there is a lot going on in the 839 pages of that bill. We have gone through the 20,725 lines of legislative text just to see how many new government authorities it creates, and here is what we found: This bill creates a total of 87 new government programs.
In addition to the 87 new government programs created by this legislation, a substantial amount of new regulatory authority has been granted to the Secretary of Health and Human Services. I know the other side doesn't like to hear that this bill calls for a government takeover of our health care system, but let's let the facts speak for themselves. If it isn't a government takeover of our health care system, why does the word ``Secretary''--meaning Secretary of HHS--appear 982 times in this bill? Maybe the other side needs a reminder that the Secretary of Health and Human Services is an agent of the Federal Government appointed by the President, confirmed by the Senate.
Iowans keep telling me that Congress needs to just slow down, consider all ideas, and, of course, common sense tells us to actually read the legislation. But the HELP Committee bill makes it clear that the majority leadership and the White House would rather push something through quickly and leave the important decisions to an unelected, unaccountable government official.
The long list of new powers granted to the Secretary begin on page 11 of the HELP Committee bill, and I quote:
The Secretary shall by regulation establish a minimum size for community ratings areas.
So let me put it in common language rather than statutory language.
This bill includes a number of controversial rating reforms, and one of those reforms would set a 2-to-1 age rating band. That means premiums for the oldest person could be no more than twice the cost of the premiums to the youngest person. Now, that is going to reduce premiums substantially for older people, and that is a fine goal, but the money has to come from somewhere. So to pay for those lower premiums for older people means much higher premiums for younger people. It is a new hidden tax being imposed on young people. It will increase premiums for young people by at least 50 percent.
This bill would give the Secretary the regulatory power to draw the map in each State for these rating areas, and that is where we go back to the quote I just cited:
The Secretary shall by regulation establish a minimum size for community rating areas.
Keep in mind, under current law this sort of policy is presently decided by 50 different State legislatures or by 50 different insurance commissioners. But some in Congress want to take this responsibility away from the States and turn it over to unelected bureaucrats in Washington, DC.
I spoke on the Senate floor earlier last week about how the Democratic proposals for health care will increase premiums and overall health care spending. Quite the opposite: I think to most people hearing us talk in Washington, DC, about health care reform, the word ``reform'' would mean to them not increasing premiums and overall health care spending.
To offset the increase in premiums, they say they will subsidize them using taxpayer dollars. But guess who is given the power to decide what benefits are eligible for these new subsidies? I will read the answer straight from the bill on page 90, line 11. It says:
The Secretary shall establish ..... the essential health care benefits eligible for credits. .....
My friends on the other side of the aisle claim their proposal will increase choice and competition in the health insurance industry. But after reading this bill, it is clear that only 1 percent will have a choice, and that person is the Secretary of HHS.
On page 74, line 17, the Secretary is given the power to regulate what type of health plan works best for you and your family. I will read that quote:
The Secretary shall, by regulation, establish criteria for certification of health plans as qualified health plans.
After the Secretary chooses what plan works best for you and your family, the Secretary can choose what conditions your doctor must meet in order to contract with the plan chosen for you.
On page 80, line 14, it says that a qualified health plan may contract with `` ..... a health care provider if such provider implements such mechanisms to improve health care quality as the Secretary may by regulation require.''
That means if you want to purchase coverage through a new exchange established by this bill, the Secretary of HHS will be deciding what health plan and what doctor is best for you and your family.
This bill also extends the Secretary's influence into classrooms, where our future doctors are being trained. On page 685 of the bill, line 10, it says:
The Secretary shall support development, evaluation, and dissemination of model curricula for ..... use in health professions schools ..... and for other purposes determined appropriate by the Secretary.
That is a lot of power in a sentence of the law that says ``and for other purposes determined appropriate by the Secretary.''
Are all of these new requirements and regulations going to help our health care system? Will they make Americans healthier? The truth is, we have no way of knowing since so much in this bill, including what I have highlighted, is left to the regulatory decisions of an unelected government bureaucrat.
The proponents of this bill say it isn't a government takeover of health care. But after reading only a fraction of the bill out loud, as I have done, it is hard to argue the fact that the Secretary of HHS is granted a lot of power over our health care system.
The Secretary will determine the size of new rating areas. The Secretary will decide what benefits health care plans have to cover. The Secretary will decide what health plan works best for you and your family. The Secretary will decide what conditions your doctor must meet to be included in your plan. The Secretary will decide what curriculum should be taught in our medical schools.
You may be tired of hearing me say ``Secretary,'' because I am tired of saying it. I have only said it 25 times in this speech. But this bill uses the word ``Secretary'' another 957 times, which is an indication that the HELP Committee bill is moving control of our health care system in what many people in this country consider the wrong direction.
That brings me to the House bill that was released last week. The House bill, right here--2,000-some pages--seems to be heading in the wrong direction also. In fact, a spokesman for the small business industry said to the Hill newspaper:
[The House bill] is a ``how to'' on how not to do health care reform.
That is pretty disappointing, since the bill costs about $2.2 million per word. You would think we would be getting something for that kind of investment.
The Wall Street Journal today calls the House bill ``the worst bill ever.'' Quoting, ``Epic new spending and taxes, pricier insurance, rationed care, dishonest accounting: the Pelosi bill has it all.''
Again, that was from the Wall Street Journal.
Let's start with what is in the 2,000 pages and $1 trillion in spending in this new bill.
The bill includes a government-run insurance provision. All the caveats aside, it is still a government insurance plan--or let me say government insurance company, plain and simple.
Interestingly, after all the promises about lower costs, the Congressional Budget Office has said that premiums in the government-run plan would be more expensive than premiums in the private market. That report just came out within the last couple of days.
The bill also locks every American with an income below 150 percent into Medicaid. Today, a family of 4 with an income of $33,000 is at 150 percent of the poverty level. Under this new House bill, that family would not get any assistance to get private health coverage. In other words, they would not have choice.
Let me point out that Medicaid is already financially unsustainable in its current form. This is the biggest expansion of Medicaid in its history. With this Medicaid expansion, the new House bill continues to leave States liable for a significant share of that new spending--a share States cannot afford. Ultimately, that will force States to raise taxes to pay for their share of this expansion of Medicaid. That is a hidden tax, although it will come separately among the 50 States.
The bill also proposes a host of new Federal insurance market reforms that will actually raise costs for most individual Americans.
With the creation of a new unelected Federal bureaucrat, called the ``health choices commissioner,'' the Federal Government will now be in charge of deciding what insurance you have to buy.
If this isn't a government takeover of health care, I don't know what it is. If you don't like what the new health choices commissioner comes up with or you cannot afford it, you will be hit with a new individual mandate tax penalty, and that will be enforced by the IRS.
Despite all the promises about being able to keep what you have, the bill cuts more than $150 billion from Medicare Advantage plans, endangering the existing coverage for millions of seniors.
Don't take my word for it, because the Office of the Actuary--that is a professional office, not a political office--at the Department of Health and Human Services said that with this level of cuts ``enrollment in [Medicare Advantage] plans would decrease by 64 percent.''
The CBO has taken a look at some of the changes in the Medicare Part D drug benefit and concluded that the changes will actually raise premiums.
So whether you are in Medicare Advantage, Medicare Part D, or private insurance, this new House bill means higher costs, more government interference, and less choice. I don't think that is what people in my State of Iowa have in mind when they ask us to fix the health care system.
The House bill also includes a part that is called the CLASS Act, which creates a new long-term care entitlement. I happen to be very supportive of taking steps to improve long-term care for Americans. But the CLASS Act is fiscally irresponsible. I am not going to name the prominent Senate Democrat, but one has been quoted as calling the CLASS Act a Ponzi scheme that Bernie Madoff would have been proud of.
Finally, I hope everyone out there pays special attention to what House Democrats call ``shared responsibility.''
If you make money in America, the House Democrats expect you to do some extra sharing. Lots. The bill includes a massive tax increase to pay for it.
Now I wish to go to what is not in the bill. Even though President Obama continues to support medical liability reform, as I do, the House still refuses to consider it. In the ``devil's in the details'' category, I find it particularly worrisome that the House bill failed to include a prohibition on rationing that was in their original discussion draft. The discussion draft of H.R. 3200 stated that the committee should ``ensure that essential benefit coverage does not lead to rationing of health care.''
Every time you get the government more involved in health care, the issue at grassroots America comes up: Will we have rationing? A lot of committees have tried to say that there would not be any rationing coming from this, and that was in the original House bill. But as it is put together as one final package, as it is here, that section, unfortunately, was dropped. In other words, the prohibition on rationing is not in this bill.
This is what the latest House bill proposes: more taxes, more spending, higher premiums, fewer choices, a government-run plan, the biggest Medicaid expansion in history, unsustainable new entitlement programs, and 2,000 pages.
Despite all the promises, the facts don't lie. The House bill and the HELP Committee bill I referred to during these remarks represent an unprecedented government takeover of our Nation's health care system--a takeover that this country cannot afford, and a takeover that the American people don't want.
I thank my colleagues for giving me this time beyond the hour of 4, when the unemployment compensation bill was to be taken up, so I could keep another obligation.
I yield the floor.
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