Patent Reform Act of 2011
Floor Speech
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Mr. President, I come to the floor today as someone who has practiced medicine in Wyoming, taken care of families there for a quarter of a century, working with people all across our great State, as a physician who has also served in our State senate.
Both in my practice, as well as in my service in the State senate, I have dealt with the issue of Medicaid, a program that was set up to help low-income Americans obtain health care. So I came today with a doctor's second opinion about recent developments and findings with regard to the health care law because, day after day, we see news reports showing States all across the country facing extreme financial budget pressures, even bankruptcy. One of the key factors exacerbating State fiscal troubles is the Medicaid Program. Over the next 10 years, Washington will spend about $4.4 trillion on Medicaid. At the State level, Medicaid spending now consumes roughly one-quarter of the budgets of each of the States.
Increases in Medicaid costs often force Governors and State legislators to make drastic cuts to local priorities, such as education, law enforcement, public safety. As I mentioned, I did serve in the Wyoming State Legislature--5 years in the Wyoming State Senate--and was there last week to address the legislatures, the Wyoming State Senate and House, to talk with them, listen to them about their concerns.
In the State of Wyoming, we are required, on an annual basis, to balance our budget. We do it every year. So I know from a firsthand experience that tough choices need to be made. That is why I can tell you this current health care law, President Obama's health care law, is not going to make it any easier for our States to close the budget gaps they are facing, and, as a matter of fact, it is going to make the situation worse.
The President's health care law created the biggest Medicaid expansion in history. The law says every State must provide Medicaid for every one of their citizens who earns up to 133 percent of the Federal poverty limit. This does not work for the States, and it does not work for the people who will be forced onto Medicaid.
The health care law does not provide additional resources to States that are already strapped for cash in order to try to deal with paying for this incredible expansion of Medicaid, and it certainly does not give States additional financial help so they can pay health care providers enough to participate in Medicaid--because about 40 percent of physicians across the country refuse to see Medicaid patients. My partners and I took care of everyone in Wyoming who would call or come to our office, regardless of ability to pay, but across the country about 40 percent of physicians refuse to see Medicaid patients.
So I have said, over and over throughout this health care reform debate over the last year or so, that having a health care government insurance card does not mean someone will automatically have access to medical care. The President frequently talks about making sure people have coverage, but that does not necessarily mean they will have access to care.
So I wish to be very clear. The States, especially my home State of Wyoming, do an incredible job of running the Medicaid programs. They do it with limited resources. But a weak economy, combined with a high unemployment rate, drove Medicaid enrollment to record levels. So it is not a surprise that Medicaid is quickly consuming greater and greater portions of State budgets, cutting into money that is being used to pay for teachers, for police, and for firefighters.
Former Governor Phil Bredesen of Tennessee, a Democrat, said it best when he called the health care law's Medicaid expansion ``the mother of all unfunded mandates.'' Governor Bredesen went on to say that ``Medicaid is a poor vehicle for expanding coverage.'' Let me repeat that. Medicaid, which the President has used as the approach to expand coverage, the Governor, the Democratic Governor, says Medicaid is a poor vehicle for expanding coverage. He want to say:
It's a 45-year-old system originally designed for poor women and their children. It's not health care reform to dump more money into Medicaid.
Well, the former Governor of Tennessee is not alone. On November 9, 2010, Governor Brian Schweitzer, of my neighboring State of Montana, also a Democrat, met with his State's health industry leaders to talk about Medicaid, the challenges they are facing.
What he said was: ``As the manager of Montana's budget, I am worried because there are only three states that will increase the number of people on Medicaid at a faster rate than Montana, thanks to the new health care bill.''
He said: ``My job is to try and find ways to go forward that Montana can continue to fund Medicaid and not be like 48 other States ..... broke.''
So, in January, 33 Governors and Governors-elect sent a letter to President Obama, to Congressional leadership, and to Health and Human Services Secretary Sebelius. What did they say? Well, the letter asks Federal lawmakers to lift the constraints placed on them by the health care law's mandates. The Governors are begging Congress for help.
They each have very unique Medicaid Programs across the country, the different States, and they want, they asked, they need the flexibility to manage their programs, their individual programs as effectively and efficiently as possible.
Well, they all need to make tough but necessary budget decisions, and they cannot do it when Washington bureaucrats and the enduring wisdom of those in Washington will not allow it. You want to add insult to injury? This week, the President claimed, as he was addressing Governors at the National Governors Association, that the health care law offers States flexibility to create their own health care plans.
This was Monday in an address to the National Governors Association. The President made an announcement. He announced: ``If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does--without increasing the deficit--you can implement that plan.''
Well, that is quite a tall and almost impossible order. The American people and certainly the Governors who were listening to him in the audience on Monday saw right through the President's PR stunt. The President's plan requires States to create health care plans that imitate his health care law, rather than actually offering States true freedom to innovate better solutions. There are better solutions out there than what this body and the House of Representatives passed and the President signed into law almost 1 year ago.
It seems to me the President wants to have his cake and eat it too. He tells the States they already have the ability to craft a different health care plan, but, of course, there is a catch. What the President does not say, what he would not tell the Governors, is that States can only design different health care plans if--if, and only if--they meet the health care law's litany of Washington mandates.
States still must pass legislation mandating all its citizens buy health insurance. States must still provide Washington-approved insurance coverage--Washington levels, Washington approved--limiting use of innovative health care products such as health savings accounts. Oh, no, that is not allowed by the President. States are still locked into the law's Medicaid expansion spending requirements. During these tough economic times, the States need certainty, they need consistency, not more Washington doublespeak.
Last month, I introduced, along with Senator Lindsey Graham, a bill giving the States exactly what they need: flexibility, freedom, and choice. The bill is called the State Health Care Choice Act. This legislation is simple, it is straightforward, and it protects States rights by allowing them to voluntarily opt out of portions of the health care law.
Specifically, our bill offers States the chance to opt out of the law's individual mandate, to opt out of the law's employer mandate and penalties, to opt out of the Medicaid expansion, and to opt out of the insurance benefit mandates.
Why should the Federal Government, why should Washington, force the States to adopt a one-size-fits-all health care plan? States can decide what works best for them. They need to be able to act on those decisions. They do not need Washington to tell them what to do.
Well, some of the most innovative health care policy ideas truly do originate at the State and local levels. Governors, State legislators, State insurance commissioners, each have much greater insight into what works for their citizens and what does not. States are feeling trapped by the new health care law's mandates.
My bill, the one along with Senator Graham, gives the States the sovereignty to pursue their own reform ideas and approaches. Each State deserves the right--let me repeat that: each State deserves the right--to pursue health care reforms they think actually help the citizens of their State.
The States have always been the laboratories of democracy, the laboratories to test good ideas. Unfortunately, this health care law locks them into a one-size-fits-all approach. The States want their freedom. The States deserve their freedom. Our bill gives it to them, offering the flexibility needed to generate better health care reform solutions, solutions that do not require the States to follow a Washington plan that may ultimately leave them broke.
In writing the State Health Care Choice Act, I started with the assumption that people generally can be trusted to do the right thing, and society prospers when government has less to say about how people run their lives. Others, many in this body, start by assuming Washington knows best and should take more authority over everyone else.
Well, the States, the American people are telling us they want health care reform. But they are telling us loudly and clearly that they do not want this health care law. So it is time to give the States the autonomy to create health care systems that work best for them, and we do not have to dismantle the Nation's current health care system, build it up in the image of big government, shift costs to the States, add billions to our national debt, and then try to sell it as reform.
There are better ideas, and I have put forward mine. I ask all Senators to join me in cosponsoring the State Health Care Choice Act.
I yield the floor.
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