Health Care And Education Reconciliation Act Of 2010

Floor Speech

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Mr. BARRASSO. I would absolutely like to do that because Wyoming clearly is a rural State, long distances between patients and the hospitals.

This Sunday, just 2 days ago, I was visiting the Elk Horn Valley Rehab Hospital in Casper, WY, down the road from the Wyoming Medical Center, to see a friend of mine, Ted Lee. Ted is now in his eighties. Ted is a veteran of World War II. Ted actually drove a Jeep for Eisenhower, who was a general at the time, and Ted has been back to Washington as part of the Honor Flights, as we honor our World War II veterans.

Ted had fallen at home on the Wyoming ice and snow and had broken his hip. His wife Jackie called my wife Bobbi and me at home over the weekend to say: Ted is in the hospital. Would you stop by?

Ted is a terrific guy. I repaired his shoulder. I operated on his leg, when, at the age of 70, he jumped from an airplane to show he could still jump out of a plane with a parachute. And I replaced both of Jackie's knees. I know these people like family.

I went to the hospital to see Ted, and he said: What are those people in Washington thinking? What are they thinking?

Ted is very sharp. He said: I paid in. I fought for my country. I put my money into Medicare. Why are they taking my Medicare money, not to save Medicare but to start a whole new government program--a whole new government program for people who did not pay into the system, did not fight for their country, on and on. What is wrong with the people in Washington? What are they thinking? Don't they realize that it is our money, we paid in, we are expecting care, and now all of a sudden they are going to take Medicare money and start a new government program.

Ted said--and he knows; this is a guy who follows us--they are going to take it from the hospitals, and he had just been in the hospital; they are going to take it from Medicare Advantage, $120 billion, because there are a lot of people in Wyoming who see the advantages of signing up for Medicare Advantage; they are taking it from the home health care agency, and Ted is likely to need home health care help when he gets home. It is a lifeline to allow him to stay out of the hospital and at home. He also knows it is going to cut a lot of money from nursing homes. We are trying to keep Ted out of a nursing home. But he understands clearly that these Medicare cuts are going to affect doctors, hospitals, nursing homes, home health agencies, even hospice providers, and all of that money is going to be taken away not to save Medicare, which he knows is going to be broke in 2017, but to start a whole new government program.

When we get to the specifics of rural hospitals and rural health--and I see my colleague from Nebraska, who is a former Governor of Nebraska.

There was a front-page story in the New York Times a few months back: ``For Elderly in Rural Areas, Times Are Distinctly Harder.'' Times are distinctly harder. And they quote a woman from Oshkosh, NE, who says: ``One foot in the grave, the other sliding.'' One foot in the grave, the other sliding.

So I ask my colleague and friend from Nebraska, who has served as Governor--lots of rural areas in Nebraska--in Nebraska does the Senator see these same concerns where folks here in Washington are taking money away from our seniors on Medicare, money they depend on for their health care, to start a whole new government program? And it is fundamentally not right, and that is why we are bringing this amendment.

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Mr. BARRASSO. Madam President, it is a privilege to be here on the floor with my colleague from Arizona because he talks so well on this topic and he knows it so very well. He knows how to read this legislation and look through the nooks and the crannies.

I will tell all of you and my colleagues that I spent some time Sunday visiting my friend, a veteran from World War II, in the hospital. He broke his hip and he is recovering and he is bothered by a lot of things. He said what are the people in Washington thinking? He is recovering from his surgery and he said why are they taking my Medicare money to start a new government program and how in the heck did they get all of those votes that they needed to get this bill passed? He said has it been vote buying, sweetheart deals, a culture of corruption in Washington?

Those are the questions being asked by people all around this country which is why this bill, when it was brought to the floor in the House, what we have seen is that half of the people of America are vehemently opposed, strongly opposed to the bill and fewer than one in four supports it.

The thing that touched the nerve of the American people before Christmas was the ``Cornhusker kickback.'' That actually has not been taken out of the bill. What they have done is said let's spend more money and give that same special sweetheart deal to other States around the rest of the country. So that actually is still in there. Yet the President said we are not going to have any special deals. It happened when Senator McCain and I were at the White House for this summit and Senator McCain asked the specific question of the President, he said, What about all these deals.

He said they should come out.

Yet we see today that not only have many of those deals not come out, there is a whole list of additional sweetheart deals put in to get this bill through the House of Representatives. The people of Wyoming are asking why.

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Mr. BARRASSO. So here we are. We are looking at a bill, in my opinion, having practiced medicine for 25 years, taking care of families all across the State of Wyoming, that is fundamentally going to be bad for patients, bad for providers, our nurses and our doctors, and bad for payers, the people who are going to pay the bill, the American taxpayers. That is why Warren Buffett, when he looked at this whole piece of legislation, said it is time to eliminate about 2,500 pages of the nonsense and focus on cutting costs.

In my opinion, having looked at this and visiting with other physicians and hospital administrators, it looks to me that with the bill the President signed into law today, which cuts Medicare by $500 billion, not to save Medicare but to start a whole new government program, which raises taxes by another $500 billion on American families, I believe this bill, still loaded with sweetheart deals, is going to cause people to see that their own insurance premiums are going to go up, their taxes are going to go up, and they are going to find out that the quality of their medical care is going to go down.

We saw it in Massachusetts where, with the result of this program, a program very similar, it is now the most expensive State in the country for health insurance. It is breaking the budget of the State and people have to wait 42 days to get a physician. Yet the President says we are going to cover more people and he is going to do it by cramming 16 million more Americans onto Medicaid, a program in which many doctors will not even see those patients because the reimbursement is so low.

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Mr. BARRASSO. Thank you, Mr. President.

I come to discuss an amendment that has to do with the fact that--as I read this bill, as I talk to my colleagues who are physicians, as I talk to Senators--I believe this bill that was signed into law, as well as the reconciliation bill that is before this body right now, is going to significantly increase the cost of health insurance premiums paid by American citizens.

I am bringing up an amendment tonight that says if the Department of Health and Human Services certifies that premiums will rise faster under this Democratic health care bill signed into law, and the reconciliation bill, than they would under current law, then the provisions of the bill will sunset. Because we have been promised--the American people have been promised--that by passing this law, what would happen is that the cost of their own health insurance premiums would go down.

The President of the United States promised it. The President of the United States, while campaigning, talked about that, made that promise, and then early in his term said he would actually lower the premiums for families by an average of $2,500 per family for the cost of their health care insurance. That is what the President said.

So then the bill is written behind closed doors. People had very little input. That bill came out, and then Senator RICHARD DURBIN, the Democrat from Illinois, the majority whip, comes to the floor on March 10 and says: Anyone who would stand before you and say, Well, if we pass health care reform, next year's health care premiums are going down--which is what the President has said--anyone who says that I don't think is telling the truth. He went on to say: I think it is likely they would go up--they would go up. What we are trying to do, he said, is slow the rate of increase.

Well, only 2 days before Senator Durbin said that on this floor, the President was in Glenside, PA, and he said: Our cost cutting measures mirror most of the proposals in the current Senate bill which reduces--he said--reduces most people's premiums.

Mr. McCAIN. Mr. President, may I ask my colleague whether he recalls when at Blair House our colleague from Tennessee began the discussion with the President and our Democratic colleagues, and he said at that time that the Congressional Budget Office said premiums would increase from 10 percent to 13 percent for individuals purchasing health insurance? That comes out to $2,100 more for a typical family. The President challenged that, as you may recall, and said: Well, we are going to settle this before the end of this--what later turned out to be 7 hours of fun.

So what was the answer to that, I ask Dr. Barrasso. What was the answer? Was Senator Alexander correct when he quoted the Congressional Budget Office that premiums would increase by 10 percent to 13 percent for individuals purchasing health insurance or was the President correct by saying that was not true?

Mr. BARRASSO. Well, Senator Enzi, who has joined us on the floor, was also sitting with us that day at Blair House, and my recollection and from doing the research afterward and the press reported that Senator Alexander was correct. Individuals buying health insurance in the individual market would see their health insurance premiums go up by 10 percent to 13 percent if this bill becomes law, and the President signed it into law today.

So the American public needs to know that their insurance premiums are going to go up as a result of what the President signed today, and I am bringing up an amendment opposed to that.

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Mr. BARRASSO. That is absolutely correct. The nonpartisan Congressional Budget Office says it is going to go up. The Joint Committee on Taxation says people are going to have to end up paying more in health care premiums than if there was no bill at all. The Chief Actuary for the Centers for Medicare and Medicaid Services said the same, as did eight additional private sector studies. They all confirm that the health care reform bill signed into law today will drive insurance costs up greater than if there was no bill at all signed into law.

There are mandates we are putting on young people who are going to be forced, many of whom are going to be forced to buy insurance, forced by this law--all of them are going to be forced to buy insurance that many of them don't need, many of them don't want, and many of them can't afford, because they are going to have to buy levels that are far in excess of what they might want. It is going to be very expensive, as many of them are going to be subsidizing others because of what is called the community rating and the way this whole program has been set up.

Mr. McCAIN. May I ask the Senator from New Hampshire--just a personal point. Suppose we had decided to do away with the tax benefit for employer-provided health insurance and given every American family a $5,000 refundable tax credit. Would we have then been able to provide the ability to acquire insurance to some 30 million Americans?

Mr. GREGG. Yes, I think the Senator is right, and the type of insurance they would have gotten would have been the type of insurance they wanted. If you are a young person today and you are not buying health insurance, it is probably in many instances not because you can't afford it. In fact, it is estimated that of the uninsured population, of the 47 million uninsured, approximately 20 million have incomes over $70,000, and they can afford insurance. They just simply decided they are not going to buy it.

If you gave them this refundable tax credit, what they could buy is a catastrophic plan so they could assure themselves of coverage in the case of that accident or that catastrophic disease that might wipe them out financially, and it would probably be more tailored to what they want as opposed to what some bureaucrat here in Washington wants or what the President of the United States wants or what somebody here on the other side of the aisle decided they should have.

Mr. LeMIEUX. If my colleague will yield, this is really a bait-and-switch. During the campaign, President Obama said this is about lowering the cost of health insurance. We know the cost of health insurance has gone up 130 percent in the past 10 years. The debate was: Don't you want your health insurance to be lower? And the American people said: Sure, yes. Of course they did. The switch is what this is all about, which is putting more people into Medicaid. It will put 15 million more people into a program that is failing; a program where Walgreens in Washington State is no longer taking Medicaid; a program where doctors are no longer taking Medicaid. It is not health care reform if the doctor is not in. But for the rest of Americans, the 159 million people who have health insurance, their costs aren't going to go down. In fact, their costs are going to go up.

I ask my friend, the Senator from Arizona, who comes from a State where there is a population just like Florida with a lot of seniors, what do we say to our seniors, our seniors who are now going to have a cut in Medicare of $500 billion-plus to finance this big expansion in Medicaid? How do we justify that to them?

Mr. McCAIN. And the program, I am sure Dr. Barrasso and Senator Enzi would agree, that is going to be cut the most is a program called Medicare Advantage where seniors do have some relative choice as to what type of care they wish to receive. Fortunately, the 800,000 enrollee carve-out has been removed because of the national attention it got.

Mr. BARRASSO. There is an advantage to Medicare Advantage. That is why people signed up for it, as 11 million Americans have. The advantage works with coordinating care, prevention of illness and disease. That is why people want to be in that program. But now the President is eliminating it.

My colleague from Florida talked about the 15 million people dumped onto Medicaid, and the New York Times reports that as Medicaid payments shrink, patients and doctors drop out. The President is not only dumping on 15 million through the health care bill, with the bill we are discussing right now, the reconciliation bill, it also adds another million people to those rolls dumped into Medicaid.

Mr. McCAIN. So perhaps the worst fraud being perpetrated in this entire legislation is the doc fix. No one who is an expert on health care believes we are going to cut physicians' payments for treatment of Medicare enrollees by 21 percent. No one. Yet that is calculated in so there can be this phony actual reduction in the deficit.

Mr. BARRASSO. And for the ginned-up numbers we have been presented by the Democrats to work where they say we have actually helped lower the deficit, for it to work, in the next couple of months they would have to cut doctors' fees for all of the Medicare patients they take care of by 21 percent and then keep those fees frozen at that low level for the next 10 years. Now, is that going to happen? But if it doesn't happen--and I ask the accountant from Wyoming as opposed to the surgeon from Wyoming--from an accounting standpoint, can you do that?

Mr. ENZI. The Senator from Wyoming not only is correct that we are going to have a huge problem, but something that is new in the reconciliation bill besides this 21 percent that, of course, we are going to have to fix and that is going to cost us $300 billion--and all of the proposals so far have not paid for that proposal--they slipped in a little cliff in there for Medicaid this time, too, and in 2 years we are going to drop off a cliff with Medicaid just the same way as Medicare. Does anybody believe we won't fix that? That is going to drive up the deficits too.

Wasn't everybody promised catastrophic care as one of the Presidential promises? It kind of fascinates me that Medicare doesn't have catastrophic care unless you buy Medicare Advantage, and then you can have the catastrophic care. But we are trying to get rid of Medicare Advantage now and force all of those people into a different kind of insurance.

I appreciate the Senator from New Hampshire mentioning mandates. Yes,
they are going to require you to have a lot more different kinds of insurance than you might want to have. We are going to say: The Federal Government knows best, and this is the minimum insurance you can have, and you are going to have to buy it or we are going to put a mandate on you--another mandate.

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Mr. BARRASSO. Mr. President, we have a number of colleagues on the floor, and we believe absolutely this amendment is critical because it goes specifically to the heart of the promises that have been made to the people of our home States and the people of the country.

The promise made to the 85 percent of Americans who have coverage they like is that their costs would actually go down. But yet as I travel around my State and around the country, I see people are very worried that this bill that cuts Medicare for our seniors, raises taxes on all is loaded with sweetheart deals, is going to cause their health insurance premiums to go up at a time when they believe the quality of their care will go down.

Mr. GREGG. Will the Senator yield?

Mr. BARRASSO. Yes.

Mr. GREGG. I wish to make one point I hope is obvious to everyone. This amendment simply says that if the premiums rise faster than what they would under current law, then the bill will not go into effect. Isn't that what it says?

Mr. BARRASSO. That is exactly what it says.

Mr. GREGG. It is basically reinforcing what the other side of the aisle claims and what the President claims. Why should there be any opposition to something that basically puts into place the language which enforces what the President has claimed he is doing and what the other side of the aisle is claiming they are doing? Can the Senator from Wyoming think of why there would be opposition to this amendment?

Mr. BARRASSO. It should be unanimously accepted, with all sides agreeing because that is what the promise was to the American people when this bill was brought forth and when the President first addressed the Nation, that he wants to get the cost curve down, the cost of insurance down to $2,500 per American family. We just want to hold folks to the promises that have been made to the American people.

The American people have spoken overwhelmingly and loudly in opposition to the bill that has come out from behind closed doors for them to finally see and try to understand all the machinations and maneuvers. They ultimately looked at it and in overwhelming numbers said: We don't want this for ourselves, for our families, for our neighbors or for our country. Yet it was crammed down the throats of the American people.

I bring up this amendment tonight to say that I wish to hold those who voted for this bill to the promises they made to the American people. If, in fact, insurance premiums go up faster because this bill has become law than they would have gone up without this bill, then the law is no longer in effect.

As I look to colleagues from other States, I imagine this is what you hear in Florida when you head home for the weekend: What have we been promised? What are we going to get? How are we going to hold people to the promises made?

Mr. LeMIEUX. I thank my good friend and doctor for bringing up that point. My constituents in Florida say we care about the rising cost of health insurance, so I think the Senator's amendment is exactly on point.

If this bill makes the situation worse, it should not go into effect. Why would any of the 100 of us not support the Senator's amendment if we are not going to control the cost of health insurance? That is what we are supposed to be about. That was supposed to be the No. 1 goal.

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Mr. BARRASSO. Mr. President, we continue tonight to bring forth to the American people our concerns about a bill that I believe from my years of practice in medicine, taking care of families in Wyoming, and now as a Senator for the last several years, is going to be bad for patients, it is going to be bad for providers, the nurses and the physicians who take care of those patients, and it is going to be bad for payers, people who pay for their health insurance, people who pay taxes in this country, the taxpayers of this country as a bill continues down the road which is going to contribute to the debt, contribute to the deficit and, as I hear, week after week at home in telephone and townhall meetings, the debt is the threat.

Our spending at this point is unsustainable. It is irreversible. It is irresponsible. I bring this up to say we cannot pass bills in the Senate and have them signed into law which promise one thing and do something very different--promises to help people and ends up hurting our Nation, hurting our economy, hurting our jobs, hurting the opportunity to hire more people with mandates, hurt young people who are trying to buy insurance because their rates are going to go up.

This is a bill that is going to cost all of America in ways in the decades to come that, from a financial standpoint as well as a health standpoint, are going to be detrimental to our Nation.

I say with my colleagues on the floor, please, take a very serious and close look at this amendment because the American people should not be promised one thing during a campaign and during a bill being written and then when it comes into law, they are going to see something very different, which is going to be detrimental to them, much more expensive for them, for their families, and impact on the kind of care they want for themselves and their families. That is why when I have townhall meetings in Wyoming and other States and people raise their hand, they think the cost of their own care is going to go up and the quality of the care is going to go down.

I yield the floor.

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