Department of Defense, Military Construction and Veterans Affairs, and Full-Year Continuing Appropriations Act, 2013

Floor Speech

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Mr. RUBIO. Madam President, I rise to speak on the pending question, which is the Cruz amendment, to defund ObamaCare. I appreciate him offering the amendment on this very relevant issue. I am glad we are talking again about it.

When I ran for office 2 years ago, this was one of the central issues. There has been a court decision since then. We need to understand, court decisions are about the constitutionality of something. They do not speak to its policy wisdom. That is what this debate is about today. I think it is important because since the election--and even going into the election--we had lost some view on this.

But let me begin by saying health insurance is a problem in the United States. There is no doubt about it. I think that to be in opposition to the health care bill is not to say that we think nothing should happen. On the contrary, I know health insurance is a major problem for millions of Americans. Its affordability is a problem. Its access is a problem, the ability of people to get the kind of health coverage they want.

In fact, when I was speaker of the Florida House--I had the honor of being that for 2 years in Florida--we actually worked on some ideas that created a marketplace where the private insurers and others could come together and create creative packages for people. That is the kind of insurance you need. Not everybody needs the same health insurance. Let me give you an example.

A family of four with two children--I have four children--I promise you, you are going to wind up in the pediatrician's office quite a bit, for everything and all kinds of stuff. We are very blessed. My children, thank God, are very healthy. And even then, there are issues where you need to bring them, whether it is primary care, whether it is vaccinations, whether it is a cold that does not go away--whatever it may be. I think it is so critically important to have that. So families in that circumstance need a certain type of coverage.

Then there are other people, people I know who are in their mid to late twenties. They never go to the doctor. But if they ever get sick, it is probably going to be, unfortunately, something very bad. So those folks maybe would rather have a plan that covers them upfront with some primary care coverage--maybe a higher deductible that you could pay with a health savings account--but on the back end some catastrophic hospitalization costs so if you truly get sick, God forbid, you have the opportunity to have the kind of coverage you need.

The point is everybody needs different kinds of health care coverage. My hope is that this country and the Federal Government--to the extent it has a role to play in all this--would help incentivize the creation of marketplaces for those sorts of innovative health ideas.

As I said, not everybody needs the same health insurance. That is why there are some principles that should have guided us when this was debated before I got here and should guide us going forward.

For example, I think one of our guiding principles should be that Americans should be able to buy health insurance from any company in the country that is willing to sell it to them. Right now, health insurance is regulated at the State level. In essence, these States have mandates as to what insurance companies must offer in order to sell insurance in that State, and you cannot buy insurance if it does not have all of those. The equivalent would be of saying: You either have to buy a Cadillac Escalade or you have to buy nothing. Some people do not want a car that is that big and that fancy. They need something that is a little different.

The point is those choices are not available to consumers. We should start with an organizing principle by saying every American should be able to buy health insurance they want from any company in America that is willing to sell it to them.

Another part of that is you should be able to buy health insurance for yourself. Let me tell you why that is problematic. If your employer buys the health insurance for you, they do not have to pay taxes on the money. Taxes are not paid on the money that is used to buy that health insurance. But if you buy it for yourself, it is income, it is treated as income. You have to pay tax on it. That is problematic for a couple reasons. No. 1, some businesses and some employers would rather give them the health care money so they can go out and buy the plan they want. Others would want to buy you plans or give you options among different plans.

Federal employees know very well what that is like. Let me tell you what a Federal employee gets. A Federal employee gets a book. In that book you get to choose between--depending on where you live--a bunch of different plans. You go right down the graph, and it tells you: This is how much this plan offers, this is how much you have to pay in premiums per month, this is how much you are going to owe in copayments if you go to a doctor, if you go to a specialist, if you go to a hospital.

How many people in America get that choice? How many people in America get the same choices on buying health care that their Congressmen and their Senators get? Very few. To me, that is a serious problem.

The good news about this--imagine now, for a moment, a country where people control their health care dollars, where you got to buy the insurance you wanted from the company you wanted. Let me tell you what the market is going to do. It is going to react to that. What the market is going to do--when there are people out there who are going to have choices over how they spend their health care dollars--they are going to start creating insurance packages that people want to buy. They are going to realize: We have a bunch of 25, 27, 29-year-olds in the United States who do not get sick. We should create special packages of insurance for them. They are going to realize: We have a lot of families out there who can afford to pay ``X'' amount of money for a family coverage plan.

We should go out and create a special plan for families like them.

By the way, along the lines of this level of flexibility, you could see where small businesses all of a sudden can get together with other small businesses. As an example, a small chamber of commerce in a midsize city somewhere can decide to bring all of those companies together. Together they can buy health insurance for their employees. It is hard to buy group coverage if you only have four or five employees. But if you can get together with a bunch of other companies that have three, four, five employees, all of a sudden you have a buying pool. That buying pool gives you leverage and power to go out and create plans for all of your employees.

There is no one size fits all. We should have that kind of flexibility in our insurance marketplace. We do not. These are not going to cure everything, but these are important steps forward.

By the way, I would be remiss in talking about medicine to not talk about the malpractice insurance rates, especially for specialties. Do not underestimate what a significant impediment that is for some people to go into the medical profession or to stay in the medical profession.

Right up front, let me tell you, if a doctor is negligent, if a doctor commits malpractice, you should have a right to recover your economic damages, and there should be some level of punitive damages to encourage people not to do that in the future and to be careful. The problem is it has gone beyond that. In many States we have a crisis when it comes to litigation and medicine. People are not just suing because, unfortunately, something went wrong. They are suing on outcomes. They are not just suing because the treatment was bad. The result is that doctors practice defensive medicine.

You go to a doctor, you go to a hospital, they order a slew of tests. It is not because you need them, but because they want to make sure they are covered; that if they ever wind up in a court they can be able to say to the jury: Look at all of those tests I ordered--even though most of them might not have been necessary. Who do you think pays for that? We do.

It is worse than that. There are places like in Florida where obstetricians do not even have coverage at all. They go bare. They hire lawyers to protect their assets so they cannot be sued. I know true stories of obstetricians who will not see certain patients anymore because they are afraid of the outcome of what may happen.

So I think we need to look at, perhaps, not as a part of the insurance situation but in health care across the States, a way to incentivize States to pass medical malpractice reform that protects patients. People should always have the right to access the court system for wrongdoing, and especially to be compensated for their economic damages. If a doctor commits malpractice and you cannot work anymore, all of those lost wages that you are not going to be able to work for in the future, you should be able to be rewarded for that.

If we allow doctors to continue to be sued in this country as an industry, which is what it has become, people are not going to go to medical school.

Here is another problem we are starting to see. A lot of young people in medical school do not want to go into the complex issues anymore. They do not want to become brain surgeons. They do not want to become OB-GYNs. They want to go into some other specialty that in addition to offering better hours--your beeper does not go off if you are a plastic surgeon at 3:00 in the morning. In addition to that, they do not have to worry about liability. Let me tell you, that is a problem. In Florida, most of our cardiologists are over the age of 50. What does that mean 10 years from now? That means we are not going to have enough cardiologists. It is discouraging people from going into very important professions in medicine because they are afraid they are going to get sued--not for doing something wrong but because things did not turn out well in treatment.

Let me put on the record that I am not against people being able to sue a negligent doctor. In fact, I think negligent doctors should not only be sued, they should lose their license. I am just saying, if we go too far, like anything else in the world, you are going to lose people from medicine. They are going to decide not to go in it.

Let's talk about this issue for a moment and the amendment that is before us. The problem with ObamaCare is that it is a one-size-fits-all approach to the entire country. The health care needs of Americans are very different. No. 1, they are very different geographically depending on where you live; No. 2, they are very different depending on your family situation, your health situation, et cetera.

Now, some people are very sick. They are chronically ill. That is where we can have a conversation about high-risk pools because these people are very difficult to insure. If someone is sure to get sick, it is hard to find an insurance for them because you are guaranteed to be sick. So we have to find a solution for that problem. That is where conversations about high-risk pools at the State level are a valid thing to talk about. But beyond that, I think people should have flexibility. That is not what ObamaCare does.

I understand that people read the newspapers and say: This is good. We are going to get a health care plan. We are going to be able to buy insurance. My boss is going to be forced to give me health insurance.

That is not how it is going to work out, guys. That is not how things work out in the real world. We are already starting to see the impacts of it. What is amazing to me is as this law begins to develop, as people start to see the true impact and the unintended or maybe even the intended consequences of this law, I predict right now that the number of people who were excited about ObamaCare is going to dwindle dramatically.

The proof is how many groups have come here already and asked to be exempted. How many unions, how many other groups have raised their hands and said: Please do not make us live under the laws that we supported. Do not make us live under their laws that we held rallies for. Do not make us live under these laws that we bragged about because it has a negative impact on us. And some of them are coming to bear right now.

No. 1 is the cost. When this bill was passed, they said it would be about $1 trillion--$940 billion to be exact. Now we know it is $1.7 trillion in gross cost over the next few years.

How about tax hikes? Absolutely, because starting in

2014, the IRS is going to create a problem for millions of Americans and small businesses. Basically, if you are not buying health insurance of the kind they want, of the kind the law requires--not just health insurance, a specific kind of health insurance--you are going to owe the IRS a fine. Think about that for a moment. If you are a small business owner or an individual, and you are not buying the health insurance the government says you must have, you now are going to have to pay a fine every year to the IRS.

Some people are going to do the math. They are going to say it is cheaper to pay the fine than it is to buy the health insurance. That is problematic, but it is a cost.

We are trying to grow our economy. That is the only solution to our problems. Over the next couple of weeks, we are going to debate budgets, we are going to debate continuing resolutions, and the word ``debt'' is going to come up. We cannot tax our way out of this debt. There is no tax increase that gets us out of this debt. To my own party, I say while we always have to have fiscal discipline, you cannot cut your way out of this debt alone either. The only real solution to our debt problems--and the debt matters because it is killing jobs in America--the only real solution to our debt problems is a combination of two things: rapid, robust economic growth.

If we can grow our economy at 4 percent a year, we could generate $3 trillion for debt reduction over the next decade, and we would create millions of jobs and pull people out of poverty and strengthen our middle class, which is the source of our exceptionalism as a country.

The second thing we need is fiscal discipline on future spending. This bill violates both. This bill violates both. It hurts economic growth because the only way you are going to grow your economy is if you make America a better place to create jobs and start businesses. That is how economic growth is created. When someone takes money they have or money they borrowed or money someone invested in them, and they use it, they risk it to open a new business or to grow an existing one, as the idea works, they start hiring people, and those people now are making a middle-class salary. Those people are now buying things and spending money, creating jobs and opportunity for others.

That is the formula for growth and prosperity. This hurts that because what you are now saying is, in addition to everything else you have to put up with in America--all the State and local regulations, all the complicated Tax Code stuff, the natural downturn in the economy, globalism and the changes that it has brought--in addition to all of that, here is one more thing you are going to have to do: You are either going to have to offer health insurance of a certain kind or you are going to owe the IRS a fine.

I promise you that is not the kind of thing chambers of commerce put on their pamphlets when they try to attract businesses to their communities or their States. This is not going to help in job creation. The tax hikes are a big problem. It is especially bad for small businesses because they have this arbitrary number of people--50 employees or more--who have to do certain things. OK. So what do you think a lot of businesses are going to do? I know people. They have already told me about this.

If you have 51 employees, this is a huge incentive to only have 49 employees. So you think about that for a moment. If you own a small road-paving company with 50 full-time employees or 51 full-time employees, you sit down with your accountant to do your math for next year. Your accountant will tell you: By the way, if you get rid of a couple of employees, this is how much money this is going to save you because of ObamaCare.

So do we want to have an incentive in our laws to have businesses get rid of workers because it helps them avoid certain costs mandated by government? This is happening. This is not pie in the sky, this is going to happen. There are people planning to do that already. It is happening right now.

Here is another thing. How about part-time workers versus full-time workers. We have already seen evidence of this across the board. But I will tell you where you are seeing it already is in people who own a bunch of franchises. So you own a chain of Kentucky Fried Chickens or a chain of McDonalds, and all of a sudden you have incentive to move as many of those people as you can to part time because they do not trigger the ObamaCare mandates either. So now you have all of these businesses across America that have an incentive that we have created in this law--I say ``we,'' the people who were here when this passed--a perverse incentive to cut people's hours so they do not trigger the mandate. These are horrible consequences that are going to have an impact on our country at a time when we should be growing our economy and creating middle-class prosperity, not working against it.

So my prediction is that when they start to fully implement this over the next 12 to 18 months, it is going to be an epic disaster. Not because it was ill-intentioned, per se. I think the goal of providing an environment where everybody can buy affordable health insurance is something we should take very seriously and something we have to work on. You cannot have a strong, stable middle class if people cannot afford the cost of living. You cannot have a strong and stable middle class if people do not have access to quality health care at an affordable price. We should work on that. We should work on that very hard. But we have to do that with balance.

This is not balanced. This is an across-the-board application to the entire country that is going to hurt a lot of people. There are people in America who are going to lose hours at work because of this bill. There are people in America who are going to lose the health insurance they have which they are happy with because of this bill. There are people in America who are going to have to lay off people, and therefore there are people in America who are going to lose their jobs because of this bill. Our debt is going to grow.

I hope we will pass this amendment. I hope we will defund this program. It was ill-designed. As the true ramifications of this bill begin to apply over the next few months and the next couple of years, we are going to be right here on this floor trying to fix it because this country cannot be what it is meant to be if it has to deal with something like this hanging around its neck.

I yield the floor.

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Mr. RUBIO. Let me say a couple of things--actually, a true world example. Here is the startling thing about it. A lot of people are not fully aware of what this means yet. This may surprise some of us who are here every day or the people who cover politics on a daily basis, but most Americans are not tuned into C-SPAN 24 hours a day. They get their news in tidbits in the morning when they are making their coffee. They have the radio on. They hear some stuff on the radio on the way to work. Then they go to work for 10, 12, 14 hours to run a business. They get home, they have to do homework with the kids, make dinner, put them to bed. Maybe they get to watch an hour or two of TV. They wake up tomorrow morning and they do it all over again. They are not in touch with all of this on a daily basis. They have lives to lead.

You will be surprised how many small business men and women and how many employees around the country are not even aware of this yet, do not even realize the decisions they are going to have to make next year. So if you are in a business that has anywhere between 45, 55, 60 employees, when you sit down at the end of this year with your planner--be it your accountant, your lawyer, whatever it is you use, your human resources people--and do next year's planning, they are going to tell you: OK, next year we have this new law. This new law says we have to offer this kind of insurance. Here are your choices: Option No. 1 is you can offer the insurance, and this is how much more it is going to cost than what you are paying right now. Option No. 2 is do not offer any insurance and pay a fine to the IRS every year from now on. Here is how much that is going to be. Option No. 3 is to let some people go so you do not have to do any of this.

I am telling you, a lot of these people are going to say: You know what. It breaks our heart; we do not want to do it; it is not good for our business, but of the three options, the only one that is going to allow us to survive is to let some people go. That is not good for us. That is not good for us.

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