Veterans Jobs Corps Act of 2012--Motion to Proceed--Continued

Floor Speech

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Mr. DURBIN. I was trying to understand this Republican position. It used to be crystal clear. In 23 debates we heard Republican candidates say, one after another after another: First day in office ObamaCare is gone. But I heard the same thing the Senator did, and I have tried to understand it.

I do give Governor Romney some credence in this regard. I have said, when asked, he is the baby daddy of ObamaCare because it was Governor Romney who created the first version of ObamaCare in the Commonwealth of Massachusetts, and he understood--I hope the Senator from Iowa can help me to understand, and those listening--he understood the concept of insurance. If everyone who bought an insurance policy wrecked their car or got sick the next day, insurance would not work. The only way it works is most people are safe drivers. They buy insurance and a small percentage use it. So there is a pool of money collected from premiums creating a reserve for accidents.

Here we have a situation where Governor Romney has agreed with us--I commend him--that people with preexisting conditions when it comes to health care should not be discriminated against. But the Senator from Iowa, as chair of the committee that dealt with ObamaCare, knows what adverse selection means. It means if people wait until they are sick to buy health insurance the whole system falls apart. So in Massachusetts they required everybody to buy health insurance.

Mr. HARKIN. I think that is called an individual mandate?

Mr. DURBIN. An individual mandate, some critics might say. Some of us call it individual responsibility. And we did the same, when it came to health care reform, keeping in mind if people currently have health insurance and like their doctor, like their hospital, we are not going to change their lives one bit. But for those who are out in the marketplace, the availability of health insurance would be there, but everyone has the responsibility to buy it.

We don't think twice when we have a closing on a home. We need fire insurance on this home. My home has never burned down, thank goodness, but I buy fire insurance. That is individual responsibility so there is something to pay the mortgage off if the house burns down.

But in this circumstance what I understand Governor Romney to say is we don't think insurance companies should discriminate against people with preexisting conditions. OK, I am with him. But then he goes on to say--I think the point the Senator made--let's kind of bear on this for a minute--what he goes on to say is so long as people have had continuous insurance.

What if a person was unlucky enough to lose a job? Out of luck. Their preexisting conditions just disqualified them from health insurance. They are stuck, under the Romney approach. What if they had any kind of interruption whatsoever in their insurance coverage? They are dead in the water. So when we talk about taking uninsured people, bringing them into insurance that has quality to it, quality coverage where they cannot discriminate against people, we are saying whatever their previous insurance experience we are all going to get into this together. We are all coming into the tent together and they cannot be discriminated against because they are a woman, had a baby--all the different things they have used.

So when we listen closely to it, here was Governor Romney basically saying he is against the discrimination on preexisting conditions, but then footnoted down at the bottom of the page--as long as people have had continuous coverage. It is an empty promise. It doesn't give people anywhere near the protection and insurance that ObamaCare gives. That is what I understand to be the difference.

Is that the way the Senator understands Governor Romney's clarification of his statement of yesterday?

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Mr. DURBIN. I say to the Senator from Iowa that I met so many people in my State of Illinois who said, I cannot leave my job because I don't know if I can ever find health insurance again. I am stuck because I have a child or a spouse with a problem. The real world of human experience tells us this happens all the time. It makes me wonder sometimes. There are 8 or 9 million Americans--almost one out of three Americans--not covered by this Romney plan. How does this solve any problems? If we are not going to have health insurance we can count on when we need it, it is worthless. It is a subsidy the insurance company doesn't pay off when the family needs it.

I didn't mean to interrupt the Senator from Iowa, but I wanted to make that point very strongly.

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Mr. DURBIN. Mr. President, most commissions appointed in Washington--at least in my experience--hardly make a ripple, people hardly notice them. After a lot of hard work, a report is published and that is about it. Some historian at a later date may look at the work they have done and the research they have done and that is about it, that is the extent of it.

There are a few exceptions. I was fortunate enough almost 2 years ago to be appointed to one of those exceptions and that was President Obama's deficit reduction commission, the Simpson-Bowles Commission. I was appointed because I am a member of the Appropriations Committee and Senator Reid said we should have someone from Finance, Appropriations, and Budget. I took the assignment of one of the three Democratic Senators. There were three Republican Senators, three Republican House Members, three Democratic House Members, and an additional six public members. The public members consisted of a number of people, including Alice Rivlin, respected in Washington, as well as a number of business and community leaders.

We met for about a year and considered the budget deficit and all of the Federal spending and came to know one another a little bit during that period of time. One of the members of that commission was Paul Ryan, a Congressman from Janesville, WI, just over the border from my State of Illinois. I knew Paul before and got to know him a little better during the course of that commission. He is a very bright person. We have some common friends in the Janesville area, and I know he worked with Senator Feingold, a Democrat from Wisconsin, on some issues before.

What surprised me at the end of the day was despite his obvious training and knowledge on the budget deficit, when it came time for a vote on this bipartisan deficit commission report, all three House Republican Members, including Congressman Paul Ryan, voted no. I voted yes. Two out of the three Democratic Senators voted yes. I was surprised, in a way, because I thought that although the Simpson-Bowles plan had its shortcomings--things I disagreed with and said so--it was a dramatic step forward to try to deal with our deficit in a fair fashion.

Jeb Hensarling of Texas was another Republican Congressman, along with Dave Camp of Michigan, the chair of the House Finance Committee, and Congressman Paul Ryan, who all voted no.

I was surprised that at the Republican convention in Tampa, FL, Congressman Ryan, the Republican Vice Presidential nominee, criticized President Obama over the Simpson-Bowles Commission report, saying he had worked hard to implement. I thought that was a curious position for Congressman Ryan to take, because he had voted against it. Now he was criticizing President Obama for not working hard enough on the commission report. But I came to understand that a little more when I took a closer look at Congressman

Paul Ryan's budget plan for America.

Before he was chosen to run as Governor Romney's running mate, 5Paul Ryan, the Congressman and chairman of the House Budget Committee, issued his vision of what America should be doing over the next several years. One of the most controversial sections relates to Medicare. Medicare, of course, is the insurance policy for the elderly and many disabled in our country. It is a lifeline for 40 million-plus Americans. It means even in their old age they will have good protection for health insurance because they have paid into it during all of their working years. Paul Ryan observed that the Medicare Program would come to an end if it weren't changed. We know it has about 12 years of solvency left and change will be needed. His proposal, though, would do more than change Medicare; it would end it as we know it. The RYAN approach would create vouchers--coupons--for senior citizens to buy health insurance. It would force them to pay more out of pocket for Medicare. According to the CBO--the Congressional Budget Office--the Romney-Ryan plan would force Medicare beneficiaries to pay up to $1,200 more by 2030 and almost $6,000 by 2050. That is about $500 a month, ultimately.

Congressman Ryan said seniors could choose to stay in traditional Medicare or they could basically go into a private health insurance market. A senior who is both healthy and wealthy would have an option. Those not so healthy or wealthy would find the only option traditional Medicare, and more and more people with a history of illness would be forced into traditional Medicare, making it a very expensive insurance program and difficult to maintain.

The Paul Ryan voucher plan puts Medicare in competition with private insurance companies and, as I said, many seniors would find that the competition wouldn't want them and they would be stuck with traditional Medicare, much different than it is today.

Medicare would be taking care of the seniors whose care costs more, so Medicare premiums would increase. As they go up and seniors begin to leave Medicare, it causes premiums to rise further, which would cripple the program.

The Paul Ryan program eliminates all the consumer protections in the Affordable Care Act, putting insurance companies back in the driver's seat. I don't think most Americans believes that is a good place to be, at the mercy of an insurance company, an adjuster who will decide what they are covering and how much one will pay.

Young adults would no longer stay on their parents' insurance plan under the Romney-Ryan proposal to eliminate ObamaCare. People with preexisting conditions would be denied coverage--going back to the conversation I had earlier, my dialog with Senator Harkin on the floor. Families would once again face lifetime limits on coverage, and seniors would be forced back into the doughnut hole, meaning paying more out-of-pocket expenses for their Medicare prescription drugs.

I don't think this is a good plan for America and I don't think Americans, once they hear the details, are going to like it.

The ObamaCare program has already helped a lot of people. A report today said there was a 16-percent increase in coverage of younger Americans because of ObamaCare. These are younger Americans up to the age of 26 who now can stay on their family plans. And 1.6 million Americans have been added into coverage under their parents' plan because of this change in the law.

Now, those who say ``I will repeal ObamaCare'' would repeal that protection, forcing 1.6 million young people, without jobs or coverage, out of the protection they have today. I cannot imagine 125,000 young adults in Illinois who have benefited from ObamaCare would believe that is a good idea, nor would their families.

Since the Affordable Care Act was signed into law, Medicare beneficiaries in Illinois have saved over $171 million on their prescription drugs.

There was a discussion earlier about the Medicaid Program. Medicaid is an important program in Illinois and most States. I asked Julie Hamos, who administers our program in Illinois, to explain it in a few words. Here is what she said: One out of three children in Illinois is covered by Medicaid. That is their health insurance--one out of three. In Illinois, Medicaid pays for 52 percent of the births; that is, prenatal care and the delivery of the child--52 percent paid for by Medicaid. But those two things--child coverage and coverage for new moms and their babies--do not even represent half the cost of Medicaid in Illinois.

Sixty percent of the cost of Medicaid in Illinois is for the elderly and disabled, many of whom are completely out of luck and out of money. They live on Social Security, Medicare, and Medicaid. They are in nursing homes and convalescent centers. They do not have anyplace to turn. So Medicaid is a critical insurance program for some of the most vulnerable people in America.

Many seniors and disabled people on Medicare also receive State Medicaid. The ``dual-eligibles'' they are called. That is 15 percent of Medicaid enrollees, but 39 percent of Medicaid spending--low-income elderly people who have no place else to turn.

So when Paul Ryan, in his budget, suggests he is going to cut back on Medicaid payments each year, giving a smaller amount of money to States, saying: Make do, who is at risk? Children: one out of three in Illinois is on Medicaid; moms having babies: over half of the moms having babies in our State; and the elderly folks who have no place to turn.

Think about what that means. A child without basic health insurance, Medicaid, in my State or anywhere, is less likely to have a doctor, immunizations when needed, and an office visit to avoid a trip to an emergency room. A mother without prenatal care is, unfortunately, more likely to give birth to a child with a problem. And we do not want to see that for the sake of the child first, certainly for the mom, for the family, or for taxpayers, for goodness' sake. There is no money saved by scrimping on Medicare for new moms. The Ryan plan would force that kind of scrimping.

The Ryan plan converts Medicaid into a block grant and cuts Federal funding for the program by 34 percent over the next 10 years--34 percent.

So I would ask Congressman Ryan: Which of those groups do you want to cut back on in terms of coverage? According to CBO, cuts at the level the Ryan plan calls for would mean States would have to reduce eligibility for Medicaid and children's health insurance or cover fewer services.

I might add--I am sure it is true in the State of Oregon; it is certainly true in Illinois--one of the most critical areas of medical need is dental care. I talk to doctors every time I go back home in emergency rooms at hospitals who have people coming in to see them in pain because of problems with their teeth, and they end up getting pain medication but nothing is taken care of.

So when we talk about restricting care, as Paul Ryan has suggested in his budget, I have to tell you, I think it is extremely shortsighted. A tooth ache can turn into a life-threatening situation for some people, not to mention the pain and discomfort they are going through. So if anything, we ought to review basic Medicaid services to expand at least into dental care. I would support that. I think it is extremely shortsighted for us not to include it.

This Paul Ryan budget would not expand Medicaid. It would cut it back dramatically. States would lower payments to doctors and nurses by one-third. Can you imagine what that would do? It would reduce the number of providers, which makes it more difficult.

Just to give you an example, in the Quad Cities in Illinois, there is a great clinic put together by a friend of mine in the Hispanic section of Moline. They provide basic, basic primary health care. If you need a specialist, you are referred, with at least an hour-and-a-half drive, to Peoria or with an almost 3-hour drive to Chicago. Remember, these are the poorest people living in our towns. Do they make it to the specialist? Usually not. The Paul Ryan approach, reducing the amount of money that is paid to providers, would mean even fewer specialists would be willing to help those who are poor.

But the thing that troubles me the most about Congressman Ryan is--at least in his budget views and his deficit views--as he talks a good game about reducing the deficit and voted against the Simpson-Bowles Commission report, he comes up with a budget that he produces in the House and says he and Governor Romney are going to protect the Bush tax cuts for the wealthiest people in America and increase defense spending. This does not work. It does not add up. It does not pass what President Clinton called the arithmetic test. You cannot increase tax cuts and increase spending on defense without, as President Clinton said, digging the hole deeper and deeper.

So they sound pretty good when they give the speeches about fiscal conservatism and that we have to be serious about the deficit, but their proposals just do not match. The idea of lowering tax rates, as they proposed, even below the Bush tax cuts--they said: Well, we will use tax reform to get to it. The estimates suggest that the middle-income families will end up losing in that. As a result of tax reform as proposed by Romney-Ryan, they think middle-income families face a higher tax of $2,000 a year to protect tax cuts for the wealthiest people. That certainly is not a positive thing in terms of deficit reduction or helping a lot of working families living paycheck to paycheck.

We have debated Congressman Ryan's plan for 2 years now. The only people who seem to like it are some Republicans serving in Congress. The majority of Americans would oppose the Paul Ryan budget plan to end Medicare as we know it. The majority of Americans certainly oppose his idea of raising taxes on middle-income families to pay for tax breaks for the wealthiest. Congressman Ryan has had his chance to make his case to the American people for his view of where we are going, and it will not work. I wish he had joined us in the bipartisan effort of Simpson-Bowles. His vote in favor of that would have given him more credibility and maybe a better understanding of the reality of budget deficit reduction.

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