Further Changes To S. Con. Res. 13 Pursuant

Floor Speech

FURTHER CHANGES TO S. CON. RES. 13 PURSUANT -- (Senate - December 22, 2009)

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Mr. WICKER. Mr. President, I thank my friend from Washington for commending and complimenting the staff. That is a bipartisan sentiment for this Christmas season. I am sure every Senator on the floor feels the same way and expresses that appreciation to the hard-working staff.

I want to start off by saying there is still an opportunity for this bill to be amended to change some of the very harmful ways that this will affect our people back home and, particularly, our State governments.

I was on the Senate floor several days ago pointing out the objections that most of the State Governors have with regard to the Medicaid mandates. I want to read from a letter dated December 10, from my Governor, Haley Barbour of Mississippi, who reminds Senators that:

This bill continues to place a huge unfunded mandate on States, while harming our small businesses and seniors through budget gimmicks and increased taxes.

And he says this:

If the current bill, which would expand Medicaid up to 133 percent of the Federal poverty level, were enacted into law, the number of Mississippians on Medicaid would increase to 1,037,606, or 1 in 3 citizens, in Mississippi. Over 10 years, this bill would cost Mississippi taxpayers $1.3 billion.

I was on the Senate floor a few days ago also with this map, which shows in red the number of States that are facing this unfunded mandate because of the increased Federal mandate for Medicare coverage coming from this bill, should it be enacted into law. I was pointing out that only the two States--Vermont and Massachusetts--because of a formula that has been worked out, would be exempt. Every other State will have to come up with the extra money either through cutting education programs, cutting mental health programs or other vital services or by raising taxes. They will have to come up with the extra money under this legislation so that half of the people covered by this new act will be covered by Medicaid.

I want to make an amendment to that chart today and add one other State. I think it has become quite a well-known fact that we need to put one other State up there in yellow, and that is the State of Nebraska.

We know pursuant to an agreement that was made before Senator Nelson announced his support as the 60th vote for cloture on this very important legislation, a deal was cut--the minority leader said a cheap deal, and I agree--that the State of Nebraska would be exempt in perpetuity from its requirement to pay the State match. The Federal Government, according to this legislation that we will be asked to vote on in the next 2 days, will pick up all of the extra expenditures for the State of Nebraska.

The poverty level in Nebraska is not quite as bad. I don't know how the powers that be felt they should or could justify this expenditure, but I will tell you the people in the State of Mississippi are going to have to come up
with another $1.3 billion over the next 10 years to pay for what we are going to be required to do by Congress--in its wisdom.

How is it fair that one Senator from Nebraska goes behind closed doors with the majority leader and cuts this deal so that his citizens don't have to pay this extra tax, and they don't have to do without services in other State programs to come up with the money? No one in this building--nobody within the sound of my voice--can come in here and explain why that is fair.

The fact is, the majority leader needed that vote, and that was part of the deal that was cut. Now citizens in Arizona, citizens in Wyoming, citizens in Mississippi, in Arkansas, and in Louisiana--we will have to come up with the extra Federal tax money on our part, but the Federal Government can cover all of the additional costs--State and Federal--in Nebraska.

Mr. McCAIN. If the Senator will yield, on that map, I wonder should there not be a sticker for the State of Florida? According to a published report by one of my favorite columnists, Dana Milbank, of the Washington Post:

Gator Aid: Senator Bill Nelson inserted a grandfather clause that would allow Floridians to preserve their pricey Medicare Advantage program.

So maybe we should have one of those stickers for Florida there. By the way, that will cost my constituents more money because they will not have that same deal. Should there be a sticker for Montana?

Again, according to Dana Milbank:

Handout Montana: Senator Max Baucus secured Medicare coverage for anybody exposed to asbestos--as long as they worked in a mine in Libby, Montana.

Should there be a sticker there?

Continuing, Dana Milbank says:

Iowa pork and Omaha Prime Cuts: Senator Tom Harkin won more Medicare money for low-volume hospitals of the sort commonly found in Iowa. .....

Maybe there should be a sticker for that. I don't know if you have North Dakota in there. Dana Milbank says:

Meanwhile, Senators Byron Dorgan and Kent Conrad, both North Dakota Democrats, would enjoy a provision that would bring higher Medicaid payments to hospitals and doctors in ``frontier counties'' of states such as--let's see here--North Dakota!

Should there be one for Hawaii? Mr. Milbank goes on to say:

Hawaii, with two Democratic senators, would get richer payments to hospitals that treat many uninsured people.

Should there be a sticker there for Michigan? Mr. Milbank says:

Michigan, home of two other Democrats, would earn higher Medicare payments for some reduced fees for Blue Cross/Blue Shield. Vermont's Senator Bernie Sanders held out for larger Medicaid payments for his state. (neighboring Massachusetts would get one, too).

I guess there are a number of States that maybe should have stickers on them so that the American people can see where these special deals were cut out, and the majority of the population of this country can see where they were not. They are going to pay while those States pay less because of not just their location but because they happen to have been behind closed doors and cut special deals.

Mr. BAUCUS. I wonder if the Senator would yield briefly.

Mr. McCAIN. Sure. I ask that Senator Baucus be recognized.

Mr. BAUCUS. I am pointing out, as the Senators know, for example, under this legislation, the Federal Government pays all the costs of eligible enrollees through 2016. In this legislation, we are talking about the so-called expansion population. That is those between 100 percent of poverty on Medicaid and 133 percent of poverty, and under the underlying statute----

Mr. McCAIN. Does that mean all these States are being treated the same?

Mr. BAUCUS. In 2016, all States are treated the same.

Mr. McCAIN. This happens to be 2009. What happens between now and 2016?

Mr. BAUCUS. Beginning next year, when this goes into effect, 2010 through 2016, all States will get 100 percent payments for that expansion coverage.

Mr. WICKER. What would happen, then, after 2016 under current legislation?

Mr. BAUCUS. Afterward, under current legislation--one sentence of background. Today, as the Senator well knows, different States receive different Federal contributions to Medicaid. It varies according to States. The average is about 57 percent Federal. The average for all States on average is 57 percent of the cost of Medicaid is paid for----

Mr. McCAIN. If that is the case----

Mr. BAUCUS. Let me finish.

Mr. McCAIN. If that is the case, we will be glad to have the same provision inserted for the State of Arizona that was inserted for the State of Florida. You don't have a problem with that, do you?

Mr. BAUCUS. Let me answer the question.

Mr. McCAIN. Do you have a problem with that?

Mr. BAUCUS. I can answer only one question at a time. The first question is from the Senator from Mississippi. Then, after 2017, all States get 90 percent--we are talking about expansion of population.

Mr. WICKER. The Senator yielded to me the other day, and I appreciate that. We have a number of Republicans who want to speak during our hour.

The fact is, after 2016, every State in red has to tax their own citizens and pay their State share, except Vermont, Massachusetts, and Nebraska. And I still challenge any colleague in this Senate to come before this body and say that is fair. I do not believe they will say that is fair.

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Mr. WICKER. I will say to my friend, I am afraid. I am afraid for my country. We are going to have a vote sometime between now and Christmas Eve on raising the debt limit. It will just be a short-term thing. I doubt if a single Republican will vote for that. Then we will have to come back again in February and do the same thing.

The debt that is piling up on our country is something to be frightened about. It is something we need to fight against and be resolute about. We are not shedding crocodile tears, but I am frightened by this debt, and we should be, if we want our economy to stay strong. The fact we are adding $2.5 trillion in an entitlement program, which apparently the majority has the votes for, is simply going to add to this enormous debt.

So it is no wonder, when you add the Medicare cuts, the taxes that most States are going to have to pay--unless they cut a special deal--on top of the tremendous national debt that we are facing, the American people are frightened. They have a right to be frightened and worried.

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Mr. JOHANNS. It doesn't go over. It just simply doesn't. In every way possible, over the last 4 or 5 days, I have been asked: Do you support this special deal for Nebraska? I don't. I think it is wrong.

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So I appreciate Senator McCain asking me the question. I feel very strongly about this. I wish the other side would consider my request for a unanimous consent agreement that just says: Time out, everybody. Let's pull out the special deals, whether it is Nebraska or Montana or whatever. It doesn't matter to me. Let's pull those out and let's take a step back and let's work for what Senator Risch talks about and the rest of us have talked about. We can get 80 votes on a health care reform bill. I guarantee you. But not on this bill.

Mr. WICKER. I would echo what the Senator from Nebraska has just said. I know my friend from Arizona has been one of the most outspoken critics of special deals and special earmarks. This is not some catchall appropriations bill to get us through the end of the year. This is one of the most major pieces of legislation on which any Member of this Senate currently serving will ever vote. This is one-sixth of the American economy, and the American people are learning about these special carve-outs where the citizens of one State will be treated differently not because of a formula, not because of the poverty level, but because of political power.

It would just seem to me that one Member of the majority party, in these next 2 days, might step forward and say: You are right, and I will not be a party to this.

Mr. McCAIN. Let me make one additional comment. I have seen reform go through the Congress of the United States. The first one I saw was when we saved Social Security--a major reform of Social Security.

There was no backroom dealing. It was a straightforward proposal as to how to fix Social Security. We fixed welfare, it was welfare reform--again, open, honest, bipartisan negotiations and bipartisan agreement. Welfare reform, Social Security reform, the efforts we made at tobacco reform, at campaign finance reform, at immigration reform and many others--the Patients' Bill of Rights. Every reform I have ever been involved in has had two major and sole components: No. 1, it is bipartisan; No. 2, there were no special favors or deals cut, provisions in thousands of pages of legislation.

Again, we know where the train is headed. We know what is going to happen a short time from now, but they will make history. You will make history. You will have rammed through ``reform'' on a strictly partisan basis, without the participation of the other party, over the objections of a majority of the American people, done in closed negotiations, with results that are announced to the American people without debate or discussion and to this side without debate or discussion.

The American people do not like it. They do not like for us to do business that way. I am sure this peaceful revolution that is going on out there already--because as the Senator from Idaho pointed out, because of the involvement of the car companies, the stimulus, the bonus, the generational theft we are committing, this, all on top of that, is going to give great fuel to the fire that is already burning out there, where they want real change, real change which they were promised in the last Presidential campaign and certainly did not get.

Mr. RISCH. I say to Senator McCain, probably one of the great ironies of all this is going to be at 8 o'clock on December 24--when this bill passes with the 60 votes, all Democrats--immediately following that vote is going to be a vote, again all 60 Democrats and only Democrats, raising the national debt. What an irony, to put $2.5 trillion in spending of a new social entitlement program, adding it to the three already huge entitlement programs that are in the process of bankrupting America, adding this to it and then turning right around and increasing the debt ceiling. When they increase it, it is going to be--nobody knows exactly how much it is going to be, hundreds of billions. But that is only in the last 2 months. They are going to have to come back again in February and increase the national debt ceiling again. What irony.

Mr. McCAIN. Of course, this legislation turns everything we know about budgeting on its head, although it has been done before and it has been done by Republicans, to our shame. Today, if you go out and buy an automobile, you can drive it for a year before you have to pay for it. Under this bill, it is the opposite. You pay the taxes, you have the reductions in benefits, and then 4 years later you start having whatever benefits would accrue from this legislation. So for 4 years small businesspeople, people all over America, will see their health care costs increased before there is a single, tangible result from it--remarkable.

Mr. WICKER. The Senator mentioned the Florida carve-out. Perhaps I should have it on my map. The reason I did not is it involves Medicare Advantage and not Medicaid. The map was about Medicaid, but he makes a good point about the Florida carve-out.

I had a discussion with some of the leadership on the Democratic side on the floor of the Senate the other day about Medicare Advantage. The strong assertion over on that side is, Medicare Advantage is not Medicare. As a matter of fact, some of the leadership in this very body said the booklet the Government puts out that says Medicare Advantage is part of Medicare should be changed. Those words should be stricken from the handout because it is not part of Medicare. The Web site the Federal Government has saying Medicare Advantage is part of Medicare, that should be changed because it is just an insurance company masquerading as Medicare.

Let me just take a second. This is Betty. Betty represents--she is from Louisiana. I don't know if she was one of the 60 percent of Louisianans who voted for Senator McCain in Louisiana, but she enjoys Medicare Advantage. She was told during the election that if you like your coverage, under any plan that the Obama administration would approve, you get to keep that coverage. She gets hearing aids, vision coverage, dental care, and she likes her Medicare Advantage.

If Betty is 1 of the 150,000 seniors in the State of Louisiana who enjoy this benefit, she is at risk of losing it. But if she happens to be in the State of Florida, in any of these counties with the $100 million carve-out, she is fortunate enough to be able to keep her Medicare Advantage.

In other words, it may not be guaranteed, but she sure likes it. Obviously, one of the Senators from Florida believes his constituents like it--again, a carve-out so this nonguaranteed, non-Medicare benefit that is not very good, they can keep it in Florida. That is in the bill and no one can deny that special treatment is given to that one State under Medicare Advantage. Again, I challenge any American to come onto the floor of this Senate and tell me how that is fair.

Mr. BARRASSO. It is not. There have been a number of references to our friend and colleague, the late Senator Ted Kennedy. Let's take a look at the book his brother, John Kennedy, wrote, ``Profiles in Courage.'' As we have seen all this, it is time for one courageous Democrat to stand and say: This is about our country. This is about our country, not about a kickback. This is about health care, not about a hand in the cookie jar.

That is what we need. We need one courageous Democrat to stand and say: I don't want to be part of this editorial that talks about the Louisiana Purchase and Omaha Stakes. I don't want to be a part of this that says this, the world's greatest deliberative body, has now become corrupt. I don't want to be a part of this that says this is about bribery.

It needs one courageous Democrat, 1 out of 60, to stand and say: I am going to vote no; we need to back up; we need to think about this. We have 100 Members of the Senate who want to reform health care in this country, who want to get the costs under control, who want to improve quality, who want to improve access--100 Senators want to do that. That is the goal of each and every one of us here.

We need one courageous Senator to say it is time, time now, to take a step back, let us go home over Christmas, let us think about this, let us talk to our constituents at home, let us hear what they have to say about this looking out for No. 1--$100 million. Dana Milbank's column in the Washington Post today, that is what we need now in the Senate. We need the kind of courage John Kennedy wrote about in ``Profiles in Courage.''

Mr. RISCH. I say to Senator Barrasso, you know there are already some courageous Democrats stepping up. I hope every Democrat on the other side calls their Governor and says: Governor, what do you think about this? Help me out here. I am in caucus, they bought enough votes to get to the 60. But I have to tell you I don't like the way they did it, No. 1; and, No. 2, what about the rest of us? We didn't get the $300 million. We didn't get the X number of million. Help me out, Governor. They say they are going to shift $25 billion to the States that you are going to have to come up with. What do you think? Do you think I ought to vote for this--or maybe if one of us steps forward and says I am going to vote no and I want to set the reset button and I want to put people back to the table and say let's do this right, we can do this right.

We are Americans. We know how to do this. We are the most innovative people in the world. All we have to do is get together and do it. But to jam this down the throats of the American people--and make no doubt about it, this is being jammed down the throats of the American people on the eve of Christmas, in the middle of the night, in the face of poll after poll that says don't do this to us.

That is what is happening. There are courageous Democrats out there. Not one of them is sitting here.

Mr. WICKER. Let me tell my friend from Idaho about some courageous Democrats. When the House version of this was being considered at the other end of this building, a number of Democrats stepped forward and said: I can't vote for this. It was very close. They have a huge majority, 40 votes over there. As a matter of fact, one Member of the House today basically said: I can't take any more. He switched parties. A Member from Alabama is now joining the Republican conference. But there are a number of loyal Democrats who have no intention of switching parties and they have stepped forward and said: I can't vote for it. Don't count me in on this.

Bart Stupak is a Representative, a courageous pro-life Representative from Michigan. He did vote for the bill. I do not impugn his motives. He did what he thought was right. But before he voted for it, he made sure legislation was included in the House version to make sure the Hyde language, which
has been the law of the land for almost two decades, was included.

Here is what Representative Stupak said yesterday or the day before yesterday about this so-called pro-life compromise that was included in the version we will have to vote on in the Senate. He said it is ``not acceptable ..... a dramatic shift in Federal policy that would allow the Federal Government to subsidize insurance policies with abortion coverage.''

That is a release actually on December 19.

I appreciate the courage of someone from a Democratic State, from a district that has long been Democratic, who is a member--chairman of a committee and a member of the leadership over there--stepping forward and saying: I can't go this far. Unless this language is changed--and we are told by Members of the Senate there better not be much of a conference. What we vote on, on Christmas Eve, it better sort of stay like it is or it will not be passed by the Senate when it comes out of conference.

Bart Stupak is stepping forward and saying, if that is the case, then I am switching from a yes to a no. I appreciate that kind of courageous Democrat.

Mr. McCAIN. Can I say, I appreciate the Senator from Mississippi bringing this important aspect to this issue and continuing to do so.

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Mr. McCONNELL. If I may say to my friend from Arizona, he is absolutely right. I have had an opportunity to observe Senator Kennedy over the years. That is exactly the way he operated.

If I may, just to make a point with regard to the observation of the Senator from Mississippi about Congressman Stupak, as I understand it, Congressman Stupak was not asking for some special deal for Michigan in return for his vote. He was, rather, trying to establish a principle that would apply to all Americans. Is that not the case?

Mr. WICKER. That is exactly correct. I commend my former House colleague for taking that principled stand.

Mr. McCONNELL. Could not be same thing be said for our colleague, Senator Lieberman from Connecticut? I am sorry he ended up voting for this 2,700-page monstrosity, but you have to stay, as I understood his position--and Senator McCain certainly knows him very well--his position was, if the government goes into the insurance business, I can't support this bill, not: I am open for business and what you can you do for Connecticut.

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Mr. WICKER. Unless my colleagues want to join in, I thank them for joining us and certainly thank Senator McCain, one of the most distinguished public servants, someone who sacrificed for his country and who has been on this floor hour after hour.

The bill we will be asked to vote for on Christmas Eve by the administration's own Chief Actuary increases health care costs, threatens access to care for seniors, forces people off their current coverage, and actually increases the amount of the gross domestic product that will be spent on health care rather than decreasing it. These are not statements I have made; these are assessments made by the Chief Actuary for the Obama administration.

There is still time. Even if this bill passes, we will go home for Christmas, for the holidays. We will hear from our constituents. I hope we listen to that over 60 percent of Americans who say: We advise you not to vote for this legislation.

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Mr. WICKER. Will the Senator yield briefly?

Mr. BAUCUS. Absolutely.

Mr. WICKER. I think the Senator has really answered his own question. As a matter of fact, Senator Grassley and Senator Enzi met for hours and hours, weeks upon weeks with my friend from Montana in good faith, hoping to come up with a program that could get that 80-vote support we usually get on matters of----

Mr. BAUCUS. That is how they started out, that is true.

Mr. WICKER. And then eventually, it dawned on them that my friends on the other side of the aisle wanted to Europeanize the health care system of the United States of America.

Mr. BAUCUS. Reclaiming my time.

The PRESIDING OFFICER. The Senator from Montana has the floor.

Mr. WICKER. I thank the Senator for yielding.

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