Health Care Reform
Floor Speech
HEALTH CARE REFORM -- (Senate - November 17, 2009)
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Mr. THUNE. Mr. President, I wish to say to my colleague from Nebraska, former Governor and now Senator from that State, that I am one of the signatories on the letter he has sent requesting we get cost data before we move forward with this and what the impact is going to be, because that is the issue.
I have listened to some of the discussion that has occurred on the floor this morning. The Senator from Illinois was down here earlier, Mr. Durbin, saying that the Republicans are attacking the House bill. Why are they attacking the House bill? Why aren't they talking about the Senate bill? Well, it is very simple. There is no Senate bill. It is being written behind closed doors. We have not been included in any of that. We have not been privy to any of the discussions that are occurring behind closed doors. So when we come down here and talk about health care reform, we are confined to talking about the House-passed bill because there isn't a Senate bill.
There are two Senate versions that have passed Senate committees. The Finance Committee has passed a bill. The Health, Education, Labor and Pensions Committee has passed a bill. But the merger of those bills is occurring behind closed doors in direct contradiction of what was promised earlier about health care reform. President Obama said when we do health care reform, it is going to be an open, transparent process. The American people are going to be able to observe this. In fact, it is going to be done on C-SPAN. Well, nothing could be further from the truth, because it is all happening behind closed doors.
So when we come out here and talk about health care reform, we are left with talking about a House bill because there is no Senate bill. We are told that this week we are going to see it, and I hope that is the case, because we would love to be able to react to the Senate bill and we would love to know what it is going to cost, and the American people would love to know what it is going to cost. We would also love to have some time to look at it before we start voting on it in the Senate.
My understanding is this is going to be a compressed schedule. They are going to try to get a vote this week on a motion to proceed to this bill, and come back after Thanksgiving and try to rush this through the Senate before the Christmas holiday, a bill that represents one-sixth of the American economy. The House bill was 2,200 pages long and the Republicans were allowed 1 amendment, 1 amendment in the House.
I think we are going to have to make sure, in the Senate, this gets done right. That will take some time.
When the No Child Left Behind legislation was debated in the Senate, it took 7 weeks on the floor. We had a comprehensive energy bill a few years ago that took 8 weeks on the floor of the Senate. The farm bill that passed in the last session took 4 weeks on the floor of the Senate. We need to make sure this gets done in the right way for the American people. We don't even have a bill yet. That is why we are down here talking about the bills that were so far out there.
The Senator from Illinois also said the main concern the American people have is cost--costs keep going up. I had a roundtable in my State, in Sioux Falls, last week. The Governor, Governor Rounds, participated, as did several small business owners, including a restaurant owner, a retail pharmacy, a chain drugstore manager, and a small business owner who manufactures wood products.
They were all concerned about the same thing--costs. They said: How are we going to provide good coverage to our employees? What are we going to do if this massive expansion of the Federal Government--$3 trillion, when it is fully implemented--passes and when all the costs are going to be passed on to business? How are we going to be able to continue to cover our employees? What will that mean for people in terms of coverage?
I agree with the Senator from Illinois, who said cost is the issue. That is what I care about, and that is what the people in South Dakota care about. How do we get the cost for health care and health care coverage down?
The ironic thing we have seen about all these bills so far is none of them does anything to get costs down. All of them increase costs. So the so-called curve we talk about--bending the cost curve down--isn't happening under any of these bills. We have not seen the Senate bill because it is still being written behind closed doors. The House-passed bill--the 2,200-page monstrosity that passed the House of Representatives earlier--and the Senate bills we have seen so far that have been produced by committees all have the same basic characteristics about them. The first one is, they raise taxes substantially. They raise taxes--in a contradiction of promises made by the President--on people making less than $200,000 and those making less than $100,000. In fact, because of the individual mandate in the House-passed bill, people making $22,800 a year and up to $68,400 a year will see a huge tax increase that will hit them. Small businesses, because of the pay-or-play mandate, which under the House bill supposedly raises $135 billion, are going to see their taxes go up. The high-income earners making $500,000 and above will see their taxes go up because there will be a surtax applied to the high-income earners.
The problem with that is, this doesn't just hit high-income earners, it hits small businesses because of the way they are organized, as subchapter S corporations or LLCs, to file on their individual tax returns. CBO has said one-third of the tax increases targeted at the so-called rich will hit small businesses, which are the job creators in our economy, the engine of economic recovery in America. They say three-quarters to two-thirds of our jobs are created by small businesses. We are going to raise taxes on them. In fact, the highest marginal income tax rate, if this passes, next year, with the expiration of tax cuts that were enacted in 2001 and 2003, will go from 35 percent to 46.4 percent. That is the highest marginal income tax rate we have seen in 25 years. It is going to hit squarely small businesses that we are relying on to try to get us out of this recession and create jobs. This health care reform is all financed with higher taxes, with Medicare cuts.
I talked about the characteristics consistent with regard to all these proposals: You have higher taxes, and you have Medicare cuts to the tune of one-half trillion dollars a year, which, as my colleagues already pointed out this morning, are going to hit not only providers but also seniors. Medicare Advantage Program seniors will see benefits cut. So you have the individuals impacted, the providers impacted, and, of course, you have most Americans impacted in one way or another by the tax increases.
The final point is the most important; that is, the other characteristics these plans have in common, in addition to higher taxes and Medicare cuts, are higher health care costs and higher premiums. The CMS actuary came out last week with a report describing the House-passed bill, and it says it is going to increase the cost of health care in this country by $289 billion. We spend 17 percent of our GDP on health care today. Under that bill, it would go up to 21.1 percent, if we did nothing. We would be better off in terms of the costs that will be passed on to people in the form of higher health care expenses. It said we are going to see increased costs and that we are going to see, the chief actuary concluded, 12 million people lose their employer-sponsored coverage because small employers would be inclined to terminate coverage so workers would qualify for heavy subsidies through the exchange.
The biggest number of people who will be covered will be those who are pushed into Medicaid, which, under this proposal, does expand significantly. The problem with that is, it passes on enormous costs to the States. You heard the former Governor of Nebraska and the former Governor of Tennessee talk about that. My Governor, Governor Rounds, in South Dakota, said we are going to be faced with $134 million in increased costs to the States to pay for this because Medicare is a partnership between the States and the Federal Government. So any benefit we get--about 60 percent of the people who will get coverage because of the bill will get it through Medicaid at an enormous additional cost to the States, which will be passed on to the taxpayers in the individual States.
So you will have higher taxes on small businesses, higher taxes on individuals, and you will have Medicare cuts that will impact seniors and providers. The amazing thing about all this is you are going to have higher health care costs when it is all said and done. It is remarkable that anything could be called health care reform that raises costs the way these proposals would do.
Finally, in response to what the other side has said, which is that Republicans don't have alternatives, that is wrong again. Republicans have proposed step-by-step solutions that would do this right, so it would drive down the costs, such as interstate competition, allowing people to buy insurance across State lines; small business group health plans, which would give businesses the advantage of group purchasing power, tort reform. We have a range of things we hope we have an opportunity to get to. We have to defeat this $3 trillion monstrosity.
I yield the floor.
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