Service Members Home Ownership Tax Act Of 2009

Floor Speech

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Mr. CRAPO. Mr. President, as we approach the vote tomorrow morning, I know a lot of people are calling it a historic vote. In some contexts, I guess it is. However, many of us are concerned it is a historic mistake rather than a history-making opportunity.

We have had a lot of debate about whether this legislation is the right or wrong way to improve health care for all Americans. We have had hours and hours, in fact, days and weeks of committee hearings and meetings with good bipartisan discussion on options and ways to accomplish this. But now, apparently, we have a mandate by the majority demanding we have a final vote in the Senate before Christmas.

While we debate this, let me say I believe we need to hear more from the people who are going to be most affected, the American people, because the final details of this bill were not crafted in front of the American public. I think most people in America know the President pledged that this legislation would be crafted around a table that is public, where, in fact, he said C-SPAN cameras could be present--in his words: So people could see the deals people were making and who was working for the American people and who was cutting deals.

The C-SPAN camera was not present, the table was not open, the room was closed, and the bill was negotiated in secret. But we are starting to find out what the deals were, and the deals are outraging the American people as they see specific exemptions from certain burdens in the bill being given to certain States in order to get the votes from the Senators for those States.

We heard about different proposals dealing with the State of Louisiana, the State of Florida, the State of Connecticut, the State of Nebraska, and the list is growing as we have an opportunity to deeply delve into the bill and determine exactly what is in it.

But we will not have time to know all the details of these deals. We will not have time to even know all the details of how the bill works because this 2,700-page bill, 400 pages of which were only disclosed last Saturday, will be voted on at 7 o'clock in the morning.

Three days ago, I asked Idahoans who, similar to most Americans--in fact, all Americans--want health care reform, to sign a petition on the Internet asking the Senate to:

..... defeat H.R. 3590 ..... because we need reform that will lower costs while increasing quality ..... and keeping health care decisions between a patient and their doctor.

The response to this request has been remarkable. In fact, I suspect that, as I am speaking, we have already gotten over 20,000 signatures on the petition on the Internet. I asked people to go to my Internet site, mikecrapo.com, and simply sign the petition. Here is a partial stack. We are still printing out the rest of the names of the people who signed the petition, but somewhere between 19,000 and 20,000--and growing--people signed the petition.

Here is the remarkable thing about it. When I asked the people of Idaho to sign this petition, I asked them to do two things. I asked them, first, to go to the Web site and sign the petition. Then, second, I asked them to contact everyone within their circle of influence--people on their Christmas card list, people on their e-mail contacts list, people on their Facebook, their Facebook friends, everyone who is within their circle of influence--and ask them to also sign the petition and, if they didn't live in Idaho, to contact their Senator and encourage their Senator to oppose this legislation, if they agreed with me that it is not the path our Nation should follow.

Remarkably, more than half the people who have so far signed the petition did not get that information from me. They got the request or encouragement to sign the petition from the friend or relative. A huge proportion of them do not live in Idaho. In fact, we have had people from all over America, in every one of the 50 States, sign this petition.

Why is this happening? By the way, the number is growing. It is happening because the more Americans know about this bill, the more they know it is not the path they want us to take for health care reform. Health care is personal, private, and a sensitive matter among individuals and their doctors and their family. This bill makes health care a public policy decision controlled by a government bureaucracy. Americans don't want that kind of government control over our health care economy. Yet instead Americans see an administration and a congressional majority forcing this bill down their throats in a rush to pass it before public opposition legitimately overwhelms this wrongheaded monstrosity. Thousands are signing this petition because they desperately want Congress to listen, but they know that their collective voice has been ignored. The petition is one way they can make themselves heard in hopes that this Congress will pass needed and sensible reform but not this bill.

In fact, another point about this petition is in addition to getting on the Web site and signing the petition, I have individuals calling my offices and saying: Thank you for giving us an avenue to try to reach out to the Senate and tell the Senate to stop. I think thousands of Idahoans and people from all over America are eager to have an avenue to speak out, and we need to stop and listen. I thank the thousands of Idahoans and Americans across the country for being willing to get involved as citizens and petition their government to respect our rights and to honor our values and to reform health care sensibly. The national polls indicate people oppose this bill. They want commonsense, lower cost action that will reduce the cost of premiums and doctor visits.

This legislation instead raises taxes on the middle class, increases premium costs for many people now carrying insurance, cuts senior programs, and fails to lower health care costs. Simply put, there has not been a piece of legislation this decade that has come forward to meet more opposition than this health care reform bill. The more Idahoans and Americans know about the bill, the more they dislike it. Health care is a personal, private, and sensitive matter, and this bill goes the opposite direction. But the majority is moving full steam ahead in hope that they can pass it before the public can understand what it is and register their opposition. If we will take the time, we can improve the health care system--without the tax increases, without the massive increase in the growth of government, without the porkbarrel spending and the sweetheart deals, without the Medicare cuts and the unconstitutional burdens on State governments this bill presents.

Among the steps many of us are trying to see enacted are things such as allowing insurance companies to compete across State lines, allowing small businesses to band together to negotiate group rates for insurance, requiring pricing disclosures from health care providers to promote a competitive, consumer-driven health care market, and offering incentives for patients and the private sector to create wellness programs and other efficiencies in health care delivery. In fact, when a bill similar to this was presented as the Republican alternative in the House, with the provisions the House Republicans proposed, it was scored, contrary to the bill we will be voting on, by CBO that it would actually reduce the cost of health care in America by significant percentages. Yet we are now continuing to plow full steam ahead with a vote at 7 o'clock in the morning on a bill that will increase the cost of health care.

The petition I brought forward asks Congress to listen. It registers the fears of many Americans that they are being ignored by the administration and by the majority in Congress. I am going to continue to aggressively push for their wishes on the floor of the Senate.

I wish to take an opportunity now to go ahead and get into a little bit more of the detail we do know about this bill. Why do I say it is the wrong direction for America? To start, let's ask what Americans want in health care reform. If you asked most Americans--and there have actually been a number of polls that have shown this--do they want health care reform, they say yes. When they are asked what they mean by that and what they want, the overwhelming answer is that they want to stop the skyrocketing increases in the cost of their health care insurance, they want to control the skyrocketing increases in the cost of medical care. They also say they want to see increased access for those who don't now have access to quality insurance, both because they are compassionate and want to see that kind of health care for everyone and because they know they are paying for it in their insurance premiums, for those who have insurance, and in their taxes, those who pay taxes. They want to assure that we continue to have the highest quality of health care possible. That is what we are supposed to be doing. That is what this bill should be working on. That is the objective we should be achieving.

Yet what are we achieving? In an earlier discussion of the House bill, I believe the Wall Street Journal said it was the worst bill ever. We now have a different bill in the Senate, but it is still falls into the same category. Why? Because it drives up the cost of health care. It raises taxes by hundreds of billions of dollars. It cuts Medicare by hundreds of billions of dollars. It grows the government by $2.5 trillion. It forces the needy uninsured not into a program where most of them can get insurance but into a failing and less robust medical system, Medicaid. It imposes damaging unfunded mandates on our State governments that are already sharing the burden of Medicaid and facing difficult troubled economic times. It means increased taxes not just at the Federal level but at the State level with unfunded mandates. It leaves millions of Americans uninsured, and it establishes massive government controls over our health care economy.

Let me go through a few of those to give more specifics. First, I don't think most Americans, when they talk about health care reform, think that means we need to grow the size of our government by $2.5 trillion. Although there is some smoke and mirrors in the way this bill is put together, because the first 4 years of its costs are not started until 4 years into the bill, so when you try to count the first 10 years, you only see a smaller number, when you take the first true 10 years of spending in this bill, it increases the cost of this government's health care expenditures by $2.5 trillion. As we can see on this chart, look at the first 4 years. The spending is basically deferred. Why would that happen? I will explain that when I talk about deficit issues. But what it does is hide the true cost of the bill. If you measure the true cost of the bill in the first full 10 years of spending, it is $2.5 trillion rather than the $1.2 trillion it would be if you counted it otherwise.

What we see is a massive growth of the Federal Government. That is not what people were asking for and, frankly, it makes them kind of do a doubletake when you explain to them that we are increasing the size of our government by such massive amounts with health care reform. Those proposing that we adopt this bill often say: Our objective and what the American people want is to drive the cost curve down. I often ask, what cost curve are they talking about? If they are talking about the cost of health care or the cost of health care premiums, they are going up. If they are talking about the size of the Federal Government and the level of Federal Government spending, that is going up.

There is one that they talk about. It is called the deficit. That is whether we are spending more than we are taxing and cutting. They argue that the deficit is going down. There is only one way you can argue that this bill does not increase the deficit, and that is if you assume that we don't have nearly $ 1/2 trillion of Medicare cuts, that we don't have $ 1/2 trillion worth of taxes in the first year and $1.28 trillion of taxes in the first full 10 years of implementation and that we don't have several budget gimmicks.

What are the gimmicks? The first and biggest is the one I showed on the previous chart. They don't count the first 4 years of spending. They stop the spending and don't let it start happening for 4 years so that we have 10 years of taxes, 10 years of Medicare cuts, and 6 years of spending. When you balance that out, you can claim it doesn't increase the deficit because you don't have a full 10 years of spending.

There are other budget gimmicks. We have something called the SGR fix, the adjustments in compensation rates for physicians that we all know on both sides we must do. We must keep the physician compensation comparable and moving up with inflation. That is going to cost $245 billion, approximately, over the next 10 years. That $245 billion cost to reform and adjust the Medicare compensation system is absent from the bill. Why? Because they are going to do it in a separate bill and probably not pay for it; in other words, not have offsets. We will see whether they have offsets, but it is not in this bill. If it were, it would drive the deficit numbers by $245 billion in the wrong direction.

There are other types of gimmicks. For example, there is double counting of the Medicare cuts. The CBO came out with a report today that said that if you cut Medicare by $465 billion, claiming that you are going to use that $465 billion to help make the financial situation for Medicare more stable, you can't then take that same $465 billion and use it to establish a massive new government program, yet a third major government health care entitlement system. You can't spend it on a new one and claim you are saving one that is already facing fiscal collapse. It is these kinds of budget gimmicks that make many of us object to the bill. If you didn't have those budget gimmicks, if you didn't have those tax increases, if you didn't have those Medicare cuts, there is no way you could say this bill is deficit neutral.

One of the things CBO does report--I want to move to the question of the cost of insurance--is that the premiums in the individual market will go up, not down. What does that mean? CBO breaks the insurance market into three categories: the individual market, the small group market, and the large group market. The individual market is the one that is primarily there for small businesses that don't have a large or a small group opportunity or individuals who don't get their insurance through their employer. It represents about 17 percent or almost 1 in 5 of all insured people in the country. Their insurance rates under this bill--17 percent of all Americans--are going to go up. The amount by which they will go up is about 10 to 13 percent, according to CBO.

The next group is the small group market. They represent about another 13 percent. Again, CBO says under this bill their rates are going to go up, not quite as badly, between 1 and 3 percent, but up, not down.

That brings us to the large group market. The large group market actually fares a little better. This is the remaining 70 percent of those insured in the United States. Basically, the CBO report says that for them there is a chance theirs may go down by a percent or two, but basically, it could be stable, a zero-percent change as well. Because individuals in the large group market, those who get their insurance from larger employers, have less liability of a harmful impact because they have that large group that can continue to negotiate to control their health care costs.

So what do we see? Even under the best scenario--and there have been nine or ten studies of this and the CBO report is the one that is the most favorable toward the bill; most of the other reports have said that the rates are going to go up for everybody--but even if we take CBO's numbers, 30 percent of the people will see their insurance rates go up, not down. The other 70 percent can expect basically the status quo; in other words, not any change at all, maybe a slight decrease.

Is that what Americans were asking for robust health care reform system? No. Americans are asking for true, solid, significant control of the cost of their premiums and their health care costs.

I wish to move next to the question of taxes. This bill increases taxes by about $ 1/2 trillion. The President has pledged he wouldn't sign a bill that involved tax increases on the middle class. He defined the middle class to be people who as individuals make less than $200,000 a year or as a family or a couple making less than $250,000 a year. Here is the President's pledge:

I can make a firm pledge. No family making less than $250,000 will see their taxes increase.

He was pushed on this pledge and he clarified it. He said not your income taxes, not your payroll taxes, not your capital gains taxes, not any of your taxes. You will not see any of your taxes increase one single dime.

That is the President's pledge. But what do we have? In the first 10 years, $493 billion in new taxes. The question is: Do those taxes all fall on the so-called wealthy, those making more than $250,000? Well, CBO and the Joint Tax Committee have analyzed it, and the answer is clearly no.

But before I get to that, let's see what the taxes do in the first full 10 years of implementation. Remember, the first 4 years are kind of a slow start with the spending, but if you compare the taxes and the spending, count the total amount of taxes starting on the day when the spending kicks into gear, it is not $493 billion, or whatever the number was, it is $1.28 trillion in new taxes. That is not what the American people are asking for.

The next question you might ask yourself is: OK, how much of those taxes are going to be paid by people who the President pledged would not be hit? Well, the Joint Tax Committee has analyzed the bill, and by 2019--and the reason they use the year 2019 is that is the end of the first full 10 years of implementation--by the year 2019, at least 73 million American households earning below $200,000 will face a tax increase. That is not just people making $200,000, that is everybody who pays taxes who makes any kind of income less than $200,000 in America. Seventy-three million--not individuals--households will pay taxes under this bill.

One of the things that is interesting, in response to this argument, some of my colleagues on the other side have said: Wait a minute. That is not true. This bill is actually a tax cut. Wait a minute, you have me saying this bill increases taxes and someone on the other side saying this bill cuts taxes. How could that be?

Well, there is a subsidy in this bill for those who are at lower income categories and are provided government dollars or subsidies in order to purchase insurance--the ones who are fortunate enough not to have been pushed into the Medicaid system. That subsidy is about $400 billion or $500 billion in the bill, and it is administered by the IRS, so it is claimed to be a tax cut. If you offset that subsidy against tax increases in other parts of the bill, then you can say: Well, there is a tax cut in this bill.

First of all, that is not what the President said. The President did not say: I will not increase your taxes more than I will cut somebody else's taxes. That is not what he said. What he said was: Your taxes will not go up if you are making under $250,000 as a couple or $200,000 as an individual.

But even if you accept that argument, 73 percent or $288 billion of this tax subsidy goes to taxpayers who do not pay any taxes. Their income levels are so low they do not hit the thresholds for incurring a tax liability. They get a pure, straightforward subsidy. The Congressional Budget Office acknowledges this and scores it as Federal spending, not as tax relief.

But either way you want to look at it, let's say you agree it is tax cuts and agree to offset it--which I think is wrong--you still come up with 42 million American households earning less than $200,000 a year who will face a net tax increase, and the tax increases are not small for these families.

The bill grows the Federal Government. It pushes up every cost curve you could think of. It increases taxes. It increases the cost of health insurance. It increases the cost of health care.

What does it do to Medicare? It cuts Medicare by $465 billion in the first
year and, again, if you want to look at the first full 10 years, by $953 billion in Medicare cuts. Basically, what we have here in this part of the bill is an absolute transfer--an absolute transfer--from America's senior citizens right over to the new government entitlement program and a redistribution of that wealth to other people.

Senior citizens who have throughout their life paid the Medicare tax, the Medicare payroll tax, will now see the Medicare they thought they were going to get cut. What kinds of cuts are we talking about that we may be dealing with here? The biggest one is Medicare Advantage--$120 billion of cuts.

About one in four American seniors has Medicare Advantage insurance. This is insurance that was provided in a contract relationship with the private sector. In other words, it was an experiment to see if we could let the private sector deliver Medicare and how they would do at it. They found they can actually, through the Medicare Advantage Program, increase the benefits seniors get.

This is probably the most popular part of the Medicare Program. It is growing rapidly. The reason it is growing rapidly is because it provides better coverage. Those in the Medicare Advantage Program are going to see their benefits cut.

Another pledge the President made was: If you like what you have, you can keep it. Well, not if you have Medicare Advantage. It is also not true about a lot of people who have their insurance through their employers these days because that is going to be lost to millions of Americans too.

But in addition to the Medicare Advantage cuts, you are going to see hospital reimbursements, skilled nursing facilities, home health agencies, hospice, and others cuts to the tune of $465 billion in the first 10 years. The experts have all told us, what that is going to do is to make impossible for many health care providers in these categories to keep their doors open, or it will cause them to reduce the amount and quality of services they provide.

So senior citizens are going to see their Medicare, particularly their Medicare Advantage, benefits cut and their access to care restricted and reduced under this bill.

In summary, there has been a lot of talk again about how Americans want health care reform. But we need to do it in a smart and sensible way. Many have argued there are no alternatives being put forward by our side. As I indicated earlier in my remarks, that is simply not true. In fact, the alternative that was put forward in the House and the alternative many of us have been talking about here have been scored to actually achieve the results Americans are asking for.

We do not need to rush this bill through in a claim that we are making history but in a way that will be a huge historical mistake. The American people, in huge numbers, are asking us to slow down and stop it and start working together in ways that do not create a government takeover of health care, that do not drive up the size and reach of the Federal Government, that do not drive up taxes but instead provide the right kind of approaches to medical savings, that do not slash Medicare benefits to our seniors, that do not put massive burdens on our States, and that do not force the neediest of our uninsured into a failing health care system, Medicaid.

We are simply going to have to be back at this in the future if we do not get it right now. Only then we will be facing much worse fiscal circumstances and very difficult problems with sustaining the fiscal stability of the two programs we are now dealing with trying to sustain: Medicare and Medicaid.

I urge my colleagues to listen to the people who signed this petition--people all across this Nation in every one of the 50 States--who are saying: Wait. Do not do this now. Do some sensible reform, but do not make this mistake.

I encourage all my colleagues, as we are literally on the eve of the vote that will determine whether this bill makes it through the Senate, to step back and take a deep breath and evaluate whether it will not be better for all of America for us to move a little slower and start trying to build a bipartisan solution that can have true benefits for the American people.

With that, Mr. President, I yield the remainder of my time.

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