Republican Health Care Solutions

Floor Speech

Republican Health Care Solutions

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Mrs. LUMMIS. Thank you, Mr. Speaker.

I am going to be joined this evening by Republican freshman colleagues of mine, and this session will be cochaired by my fellow freshman from the great State of Minnesota, Erik Paulsen.

Erik, thank you for joining me this evening, and our other freshman colleagues will be joining us shortly.

We're going to be talking about health care from the perspective of freshmen. We're going to be talking about some Republican alternatives to the large bill that the Speaker introduced last week and unveiled and that we're discussing this week. We'll be doing some comparisons between bills that Republicans have to provide better solutions, to take incremental approaches, to address the most important concerns that the American people have about their health care system first, and about the need to take a very deliberate, careful approach to changing an American health care system that needs tweaking rather than throwing out and replacing.

I yield to my colleague from Minnesota, Mr. Paulsen.

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Mrs. LUMMIS. I look forward to having our colleagues join us so we can discuss some of those. We have been maligned as a party for not having a health care solution to counter the Pelosi approach and the Obama approach to health care; but in fact, we have over 53 bills that you can read online which will address health care reform. We offer and challenge the Democrat leadership, who controls this Congress, to pick and choose from among the better ideas that Republicans have and to bring some of those bills through committees and to the floor so we can debate them openly in a transparent manner.

They were not crafted behind closed doors as was the Democratic bill. They were crafted in the traditional manner with the help of legislative draftsmen and -women to address specific components of our health care system in a way that they can be aggregated into a larger reform package or addressed individually if we prefer. So we can have a healthy debate on a variety of subjects.

Even the Chicago Tribune noted recently that Republicans have a number of great ideas. Here is an excerpt from a recent editorial in the Chicago Tribune:

GOP proposals contain smart ideas to increase choice and competition in the health insurance market. These excellent ideas could expand coverage for the uninsured without cratering the Federal budget or curbing the competition and innovation that drive the U.S. health care system.

My colleague Mr. Paulsen is on the Financial Services Committee, and I am on the Budget Committee. Among the things that he and I have seen in our committee work in the last 10 months is that we are aggregating more debt than George Washington through George W. Bush combined and that, while our colleagues on the Democratic side of the aisle criticize Republicans for spending too much and criticize their inheriting a deficit, in fact, since we arrived in Washington--we freshmen along with the Pelosi Congress--they have increased the deficit, doubling it in 5 years and tripling it in 10. So it is not an excuse that they inherited a deficit.

Indeed, they did, and indeed, Republicans predating Mr. Paulsen and I did overspend, but you don't solve an overspending problem by making it two times worse in 5 years and three times worse in 10 years. Our approaches to the health care bill are to advance solutions that will not add a dime to the deficit.

How many people believe that the $1 trillion-plus Democratic health care bill is not going to add a dime to the deficit? In fact, a poll recently showed that more people believe we'll discover life on other planets than the Democrats' health care bill will not add to the deficit.

The Republican bills, however, do not add a dime to the deficit. Here are three of them that I'd like to highlight this evening. As I said, there are 53 on a Web site that I'll provide to you later in this discussion.

One of them is H.R. 3400, Empowering Patients First Act. The prime sponsor is Representative Tom Price, a physician from Georgia. It is the product of the Republican Study Committee.

The bill uses a mix of new tax credits and deductions to make the purchase of health care feasible for all Americans. The bill expands the individual health insurance market, using association health plans and interstate health insurance shopping to give people more choices. The bill encourages the creation of State-based portals so people can compare plan prices and benefits. For those with preexisting conditions, the bill redirects unspent stimulus funds towards State-based high-risk pools. Importantly, this bill is fully offset through redirecting stimulus funds, stepping up efforts to root out waste, fraud and abuse in our entitlement programs, reducing defensive medicine through medical liability reform, and capping discretionary spending.

This bill scores in the favorable column.

Another bill, sponsored by Representative John Shadegg of Arizona, entitled Improving Health Care for All Americans Act, has many of the taxation provisions incorporated into it that were eventually added into H.R. 3400. Then the Patients' Choice Act, which is a fun one to highlight, because it takes a little bit different tack, is sponsored by Representative Paul Ryan. The bill provisions include some reforms that are badly needed to Medicare and Medicaid without decreasing benefits.

I yield to the gentleman from Minnesota.

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Mrs. LUMMIS. The gentleman from Minnesota has four really cute little girls, and I carried one of their Scooby-Doo backpacks through the Minnesota airport while we were transferring planes trying to get back to Washington for votes. A lot of us have kids or grandchildren that will be affected by this legislation because they will be paying for it for years to come.

One of the things we all learned from our parents in this baby boom generation is the importance of handing a better America to your children, and that is something that I don't want to be responsible for being the first generation to renege on. That's why I am so much more supportive of these Republican bills than of the Speaker's bill.

Among the things that are in the Republican bills that are so important are meaningful tort reform. I say this with a caveat; I am one of those Republicans who would rather see tort reform done at the State level. I think we see more innovation and creativity. We see some States that want to have caps on noneconomic damages. We see some States that want health care panels, States that want to make sure that expert witnesses, within the certain specialty that is charged with malpractice, are the ones that are designated as witnesses. There are a whole variety of ways to address tort reform.

I prefer that it be handled at the State level, but I have signed on to several of these bills that have State tort reform provisions even at this Federal level because I think they take a much better approach to the overall subject of health care reform. In other words, the Republican plan has meaningful tort reform. Oddly, the Speaker's bill contains a provision that says they will give out grants for innovations in tort reform but not to States that have placed a cap on noneconomic damages.

If you talk to some of the former legislators, now Members of Congress, who are from States that enacted caps on noneconomic damages and medical malpractice cases, you will learn that their medical malpractice premiums for their physicians dropped, thereby allowing their physicians to either charge their patients less or stay in practice in small communities where they don't have as many patients to spread out the costs of that extremely expensive malpractice insurance premium.

Then we have interstate health insurance shopping. This is really what I think is going to be one of the most exciting keys to reducing the costs of health insurance, because it's going to create more competition. Coming from the smallest population State in the Nation, Wyoming, and not being able to buy insurance across State lines for health care the way I can for automobile insurance, I don't have the options, because of our little small pool of citizens, to spread the costs.

It's going to be very important that we have the ability to shop for health insurance across State lines and that we do it in a transparent way. I see these ads on TV for car insurance. Well, there is a little sign that you look at that compares one company's premium to another, to another. You can go online and shop and compare and put in the kinds of factors that you want in your automobile insurance.

We should be able to do that for health insurance. We should be able to buy our health insurance premiums that way, and the Republicans' bills will allow that to happen.

Then, further, association health plans, the Republican plans have it; the Democrat plan does not have it. Association health plans, once again, would allow groups with some common interest to pool, to create a larger pool, whether it's your church denomination, your Rotary Club, your alumni association or any other group that wanted to form an insurance pool for purposes of providing health insurance to their member participants.

This I call kind of an equivalent to what's available in the banking community. You have commercial Main Street banks, and then you have some credit unions. I kind of associated this kind of association health care plan with the notion of a credit union.

These are things that we have that would increase and stimulate competition in the private sector, and these are in the Republican plans. They are not in our colleagues', who are members of the Democratic Party, plans.

Now I would like to call on one of our colleagues who is from the State of Colorado. Mike Coffman is here this evening from my neighboring State of Colorado.

I yield to you and thank you for attending this evening's discussion.

Mr. COFFMAN of Colorado. Thank you, Representative Lummis.

What I think is of concern to those of us from Colorado, and I think many people across the country, is what is the impact upon jobs and employers. There is a

concern about small business in particular.

There is a provision in the Pelosi bill, the Pelosi health care reform bill, that has a surcharge on small businesses and employers. Now, granted, it has moved up to where it was in the first version, H.R. 3200, where it was if somebody had the average annual payroll between $250,000, and then it started as a surcharge at 2 percent up to $400,000 on an average annual payroll, with an 8 percent surcharge, that number has been moved up a little bit; but I think it's still going to be devastating to the economy. With $750,000 and above it's an 8 percent surcharge, and then it's graduated a little bit down below that.

To put a surcharge on employers, a payroll tax, if you will, on employers that are just trying to keep their doors open, to keep making, to be able to make the payroll that they have, I think, is going to be a devastating job killer to this economy. I think we ought to focus on job creation and not job killers.

Mrs. LUMMIS. The gentleman is correct. In fact, we have found that studies determined that 5.5 million more jobs will be lost as a result of the taxes placed on small businesses under the Democrat version of the bill. Furthermore, there is a double whammy for small business. For businesses under 500,000 in payroll, there is not a big hit. But, of course, a lot of businesses in my State of Wyoming, there are 1,400 in my State of Wyoming that will be hit because they pay these taxes at the individual tax return, but they are small businesses that pay payrolls of more than $500,000. That means 1,400 businesses in Wyoming are going to be slapped with that tax.

I yield to the gentleman from Minnesota.

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Mr. PAULSEN. Just to mention, I mean, it sounds like it just defies common sense. With unemployment at near 10 percent--I know there are going to be some new job figures that will be released in the very near future--but it defies common sense of why we would really hit the small business community even harder and make it tougher for them to raise jobs.

As the gentlewoman mentioned earlier, the Republicans have a proposal to allow small business to pool together through these associated health care plans to actually help small businesses provide health insurance for their employees.

Mrs. LUMMIS. That will do wonders in my State of Wyoming where a lot of people are small business people, in fact, mom and pop sole proprietors, ranchers, that are just the mom and the dad in the family, and they have individual insurance policies that they purchased as an individual because they are it, they are the business. Under the Democrats' bill, those are the very people who are going to be completely foreclosed from being able to purchase individual health insurance plans after 2013.

We have been joined by our colleague from the State of Pennsylvania. Glenn Thompson has with him a very large stack of paper. Representative Thompson, what is that?

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Mrs. LUMMIS. Reclaiming my time, I would echo some of your concerns in saying that in rural areas Medicare is not reimbursed at the same rates as it is in urban areas. So hospitals and physicians in rural areas receive less compensation for Medicare patients than they do in urban areas; so much less that in Casper, Wyoming, a town in central Wyoming, only about one-third of their actual out-of-pocket expenses are reimbursed from the Federal Government when they treat a Medicare patient.

Well, the hospital, because it is a quasi-public hospital, is going to keep taking those patients. But private physicians don't have to keep taking those patients, and when they are undercompensated, some of them choose to no longer take Medicare patients. And in a State that has a dearth of physicians anyway because we have such a small pool of patients, we are losing more and more access to doctors, even today.

My concern under the Democrats' bill is that we will be worse off as a State in terms of the number of physicians who will take Medicare patients and the hospitals that will take Medicare patients because of the poor reimbursement levels and decisions that are being made by the majority party in Congress to make further cuts in Medicare.

I yield to the gentleman from Colorado.

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Mrs. LUMMIS. One of the math items in this bill that just doesn't add up is the fact that they are going to be paying for 6 years of benefits under this bill with 10 years of revenue collections. And yet when we get, then, to that magical 11th year where we need to be able to pay for it as we go, obviously we won't be able to just stop providing benefits and have the taxes run for 4 years where we don't tap into them before we involve ourselves in the benefit component of the program again.

So that is a one-time in the first 10 years type of financial balancing act or financial gimmick that is being used in this bill to make it sound like it is in some way financially balanced. It is not, and it will suck more out of this economy in the second and ensuing 10 years and in decades when once again our children are going to be paying for it.

So, this bill really does defer to our children and grandchildren huge financial obligations that the people in this room feel is not only unnecessary, but highly inappropriate.

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Mrs. LUMMIS. We are all freshmen who have been talking here. Many of us served in some capacity either in our State legislature, in your case as a mayor, a couple of State treasurers; so we know how State government works. And what we see, as States could not print money, we had to live within our means. So when the Federal Government places an unfunded mandate, meaning they require States to provide a service and then don't provide the money for the State to provide the service, the State has to come up with the bucks. And this has been called the ``mother of all unfunded mandates'' by the Democrat Governor of your home State of
Tennessee.

And those of us who are here--I know that you were leader in your Minnesota legislature--tried to find good legislation that was sitting around and had been introduced by Members of either party. And in honesty, in my legislature, if a Democrat had a great idea, and we were Republican legislators, we'd go steal their ideas and put Republican names on it and sponsor it. It was the best form of flattery. The ideas were coming up.

And you know who did that maybe better than anybody I have ever seen on a national scale was Bill Clinton. He took what was cultivated in the States and nurtured in the States a plan to reform welfare, and he slapped his name on it and he made it his. And he worked with Republican Members of this Congress to reform welfare.

We could do that today. We have 53 bills out there that our Democratic colleagues could say, hey, this is a good idea or I like the idea of letting young people stay on their parents' insurance until they're 26 years old. That helps them out, especially in these tough economic times when it's hard to find a job. There are ideas out there that would solve these problems.

Yet we are faced with a bill that is almost 2,000 pages long that we're expecting a big additional amendment to, that was drafted behind closed doors, that has some nonsensical language in it that people can't understand that we only get 72 hours to read. It all seems like a bad dream. But it's the American Congress. And there are so many better options out there. I just am so frustrated with the majority party that they won't look through our 53 bills that they could read online and say that's a good idea, let's put a Democrat's name on it and make it our idea. We'd be delighted.

I yield to the gentleman from Tennessee.

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