Chinese Trade Practices

Floor Speech

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Mr. BARRASSO. Madam President, I come to the floor after having just heard my friend and colleague from Connecticut talk about the health care law. As a doctor, I am always happy to hear about people who are getting better care. My concern is that there are so many people across this country who have been hurt as a result of this health care law that I feel compelled to speak about so many of the side effects of the President's health care law and families who are seeing the government waste massive amounts of money that is not going for care. It is not helping people actually get better. It is not giving them the care they need from a doctor they choose at lower costs, which is what the President promised when he said premiums would drop by $2,500.

I heard the President, as well as my colleague here today, say that this law will help keep people out of emergency rooms and they will go to primary care doctors instead. So I feel compelled to come to the floor to share with my colleagues a study that just came out on Wednesday, and perhaps some Members of the Senate who weren't aware of it will be made aware that the emergency room visits actually have been going up, not down, despite the law. This was the headline in the Wall Street Journal this past Wednesday, May 21: ``ER Visits Rise Despite Law. Health Act Isn't Cutting Volume.''

I will point out a couple of things mentioned in this article. It starts off:

Early evidence suggests that emergency rooms have become busier since the Affordable Care Act expanded insurance coverage this year, despite the law's goal of reducing unnecessary care in ERs.

My colleague said emergency rooms aren't going to be needed as much. Well, despite the law's goal of reducing unnecessary care in ERs, what we see is an expensive side effect of the President's health care law.

It goes on to say:

Democrats who designed the 2010 health law hoped it would do the opposite. They wanted to give the uninsured better access to primary-care doctors who could treat routine ailments and prevent chronic diseases, with the intent of keeping patients out of the ER. The median ER charge was more than $1,200 for the most frequent outpatient diagnoses in a study of over 8,000 ER visits in the years 2006-08, said a 2013 report funded in part by the National Institutes of Health.

This is a report by the NIH.

Instead, the ER doctor group's research and several other recent studies suggest that people who gain private insurance are more likely to seek emergency care.

Not more likely to go to a family physician, not more likely to go to their own internist or pediatrician; more likely to go to the emergency room--the most expensive place for care--despite what the President told the American people.

Among the reasons is that a shortage of primary-care providers in some regions has made it difficult for patients to get appointments.

So why is there a shortage? Well, if the President's health care law actually focused on training physicians, putting money into educating and training more providers, instead of putting all of this money into hiring IRS agents to examine Americans' tax returns to make sure they check the box that says they have insurance and can provide proof of that, perhaps we wouldn't have these problems. But now we are seeing a very expensive side effect of the President's health care law.

While we can celebrate people who are helped by the law, there are so many people being hurt by the law in every State around this great country. We heard about a family from Connecticut who has benefited from the law. There are many who have been hurt.

There is a couple in Sharon, CT, according to NBC Connecticut. They were dropped, according to the headline, from their health care plan. It says:

A Sharon couple says they are running out of options after being dropped from their ObamaCare insurance plan. John and Dawn DiMarco signed up for an Affordable Care Act plan through the state health insurance exchange during open enrollment. They received their insurance card and were covered but their bill was thousands of dollars more than advertised.

What could happen there?

It says:

They spent weeks going back and forth with various State agencies and the insurance company to try to get answers.

This is dated May 13 of this year.

Then, this month, their carrier, Anthem BlueCross BlueShield, sent them a cancellation notice. The DiMarcos have been so frustrated with trying to get answers that they posted a sign outside their home that reads--

This is in Connecticut--

``We have no insurance because Access Health has a computer glitch.''

It's stressful, says Mr. DiMarco. It's overwhelming.

So why did this happen?

Well, NBC Connecticut contacted Access Health Connecticut, and they told them that it had to do with a computer issue

with a vendor, and when this gentleman went back to change information during the enrollment process, a new form was sent to the insurance company, but that form didn't include the couple's subsidy. So the form paperwork was wrong.

How could this happen? Is it just this one DiMarco couple whom this has happened to in Connecticut? Not according to a front-page story in the Washington Post the other day. The headline is ``Federal health-care subsidies may be too high or too low for more than 1 Million Americans''--paying incorrect subsidies to more than 1 million Americans for their health plans, and the government has been unable so far to fix the errors.

The President of the United States goes on TV and says to the Democrats: Forcefully defend and be proud.

Who in America can be proud of the mess the President and his administration have made of the Web site and this health care bill? Once again, we see, as the Washington Post points out, important aspects of the Web site remain defective. They cannot fix this. Actually, I am not even sure how hard they are trying. People have been sending in paperwork. They are expecting, perhaps, by the end of the summer to be able to address the problem that there are 1 million Americans whose Federal health care subsidies may be either too high or too low.

``Forcefully defend and be proud.'' Where are they? Where are these defenders? It is sad because the idea is this is to actually help people get care. What people have gotten is headaches and heartaches and one problem after another.

It is also interesting, as a doctor who has been very involved with preventive care and working on early detection of problems and as somebody who has been the medical director of the Wyoming health fairs--I think it is important to screen people for problems. It is interesting. The New York Times even reported in an article written on April 30 on the problem with the health care law that it favors screening over diagnosis. So here is one of the issues that come into play.

My wife is a breast cancer survivor. She has been through three operations, chemotherapy twice, radiation, the whole thing. She is now cancer free. We are delighted. So I think screening tests are important. But this is the problem with this law that I believe very few Democrats read--very few of the people who voted for it read. I believe that about Members of the House and Members of the Senate. I read it cover to cover, but I believe many Members who voted for it never read it.

They say: Diagnosis is what we offer to those who have no signs or symptoms of disease. Because diagnosis isn't prevention, it is subject to deductibles and copays.

So if somebody actually has a diagnosis of something, there are deductibles and copays, but if it is just a screening test, no signs or symptoms, then it is covered.

The New York Times goes on:

In other words: A woman over 40 can have a free screening mammogram.

She shows up and says: I want a free screening mammogram. But if she notices a breast lump and goes to her doctor to have it evaluated, well, then it is not a screening mammogram. Then it is not a free test. So she will pay for the diagnostic mammogram that costs $300.

This goes on:

So the woman at lower risk for cancer--the one with no signs or symptoms of the disease--has an incentive to be tested, while the woman at higher risk--the one with the lump--faces a disincentive.

So she goes to the doctor. This goes on and says that the problem is they are now pressuring doctors to fraudulently change the paperwork so it complies with the screening test and not a diagnostic test. Doctors don't want to do that because they want to be honest. Yet the incentives set up in this program are to discourage the woman who finds a lump from actually going in to have the test, while encouraging somebody off the street to go in and have a similar test. It is a great concern.

So when I see a colleague come to the floor to say that the health care law, in his opinion, works--I will tell my colleagues, this is an Associated Press story that says: ``Consumers frustrated by new health plans as they find their doctors are not included.'' They can't go to their doctor.

This is a story out of California. Michelle Pool is one of those customers. Before enrolling in a new health plan on California's exchange, she checked whether her longtime primary care doctor was covered. This woman, Michelle Pool--60 years of age, a diabetic; she has had back surgery and a hip replacement--purchased the plan only to find that the insurer was mistaken; the doctor wasn't included. So her $352-a-month gold plan, she said, was cheaper than what she had paid under her husband's insurance and it seemed like a good deal because of her numerous preexisting conditions.

I understand preexisting conditions as the husband of a woman who has been through breast cancer treatment. This goes on to say:

But after her insurance card came in the mail, the Vista, California resident learned her doctor wasn't taking her new insurance.

It goes on to say, quoting this woman:

``It's not fun when you've had a doctor for years and years that you can confide in and he knows you,'' Pool said. ``I'm extremely discouraged. I'm stuck.''

This is an American who is stuck and hurt by the health care law. It goes on to say:

The dilemma undercuts President Obama's--

This is an Associated Press article--

The dilemma undercuts President Obama's 2009 pledge that: ``If you like your doctor, you will be able to keep your doctor, period.''

The President said: ``period.'' But one of the side effects of the President's health care law is that people are continuing to lose their doctors.

It goes on to say:

Consumer frustration over losing doctors comes as the Obama administration is still celebrating a victory with more than 8 million enrollees in its first year.

There are astronomical concerns that people across the country are expressing about this health care law. And yet--and yet--we see one Member of the other party coming to the floor and saying: Oh, it is working.

The American people do not believe it is.

People get insurance through work. The laws are interesting. This is a story from Ohio about the cost because that is what really people were concerned about when we wanted to do health care reform; it was to say let's get the cost down. The President promised families would see a $2,500 reduction in the cost of their insurance policies in a year once all of this was implemented. But one of the side effects is actually higher premiums. This article talks about a man who owns a popular brew pub in Cleveland. He has fewer than 50 full-time employees. So he is classified under the health care law as a small business, which means he does not actually have to provide health insurance to his employees. But he has been doing so. He has been doing so since he opened this pub a number of years ago, and he has done it in spite of some fairly significant jumps in the cost of the insurance.

He said: ``They just seemed to keep going up every year.''

He opened this pub in 2009. One year he got an increase of 38 percent; another it was 11 percent.

The article says: ``This year, under the Affordable Care Act, he saw another hike--this one about 20 percent.'' So he is seeing higher premiums. He said: ``It just seems odd that we get such a drastic price increase when nothing has really changed with us as far as our employees and health issues.''

Most of the workers at [his place] are in their 20s and 30s. They are healthy, enthusiastic about their jobs. .....

They like the fact that they get insurance, but they are getting priced out of the market. That is the concern about this: the health care law is making premiums go up.

From today, Thursday, May 22, The Hill newspaper, right here in Washington, DC: ``Premium hike drumbeat before Nov. Election Day.''

People continue to be shocked by the increases in the cost of their insurance, and they are going to go up again across the country. There are a number of reasons for that. We have seen it in North Carolina, where I expect this is going to be discussed and debated over the next months.

Blue Cross and Blue Shield of North Carolina. .....

This comes from the Herald-Sun in North Carolina: ObamaCare enrollees older, sicker than insurer forecast--older and sicker than what the President told--actually it was not the President; it was Kathleen Sebelius, the Secretary of Health and Human Services, when she described what she thought success would look like in terms of the number of young healthy people who would sign up. It says:

Blue Cross and Blue Shield of North Carolina officials said--

This is dated May 8--

..... that they found that the people who enrolled in the individual Affordable Care Act plans it sold on the online health exchanges were older and sicker than expected.

That may mean higher rates--

Higher premiums--

for Affordable Care Act plans in the future. .....

The insurer's vice president of health policy said: ``[It's] a concern when we think about future premiums.''

They have great concerns about the amount things are going to go up. That is not what people want. People wanted affordable care. They wanted access to care. They wanted to get the care they need from a doctor they choose at lower cost. What they see is waste--money not going to help people get care, but money being wasted.

I found it interesting coming out of Missouri, a story about how an ObamaCare contractor pays employees to spend their days doing nothing--doing nothing--paying their employees to do nothing.

``A billion dollar government contract involving hundreds of local workers at an ObamaCare processing center. ..... ''

So these are people hired by the government or a contractor to work at an ObamaCare processing center--hundreds of local workers.

``But now employees on the inside are stepping forward, asking, Is this why we're broke? Some of them claim to spend most of their day doing nothing,''. .....

This is reported in St. Louis.

The contractor is called Serco and local reporters discovered that, despite there not being any work to be done, the government contractor is still hiring.

Why would they be hiring? Because they get a percent of the action. That is why they are hiring. They are hiring people to not do anything, to take the paycheck. The article continues:

``The company is still hiring,'' says a local reporter. ``A current employee wonders why. ..... After providing proof of employment, this ..... employee agreed to speak through the phone with their voice altered. The employee says hundreds of employees spend much of the day staring at computer screens, with little or no work to do.''

The reporter asks the employee, ``Are there some days where a data entry person may not process a single application?''

Not a single application? The person who works there said: ``There are weeks''--weeks--``when a data entry person would not process an application.''

The anonymous employee says the contract gets paid by the federal government per employee hired.

That is why they are continuing to hire--because the company gets paid by the Federal Government per employee hired, which is why it is in their interest to have a bunch of employees sitting around all day doing nothing.

So I have to feel an obligation, when I hear a statement on the floor being made that says: Well, a lot fewer people are going to go to the emergency room; it is going to save money--that has not happened. Studies from emergency room doctors, work from the NIH said it is not happening. The exact opposite has happened--a side effect of the health care law, when we see that people are not able to keep their doctors, in spite of the President promising people that if you like your doctor, you can keep your doctor. I feel compelled to come to the floor and share that story with those of us who care about care for patients, who care about finding a way to make sure patients get the care they need from a doctor they choose at lower cost. That is what people want. They know what they want. They want access to care. They want affordable care. They want care, they want choices, and they want quality care.

I believe this health care law is turning out to be bad for patients, bad for providers--the doctors, the nurses, the paramedics, the nurse practitioners--who take care of those patients, and terrible for the taxpayers when we hear stories like this one out of Missouri, which says the employees are being paid to sit around and do nothing, when we hear there are a million people who are just waiting to try to get the government to correct something that should have been fixed in the beginning, when the President, 4 days before the Web site opened up in October, said: easier to use than Amazon, cheaper than your cell phone; keep your doctor if you like your doctor--there was so much misleading of the American public--and then when he says stand and forcefully defend and be proud of this health care law.

I think it is very hard to defend what the President and the Democrats have forced down the throats of the American public, and it is very hard to be proud of the kind of abuse and waste in a system that--whatever the intentions--has proven to the American public to be something they do not want, that they want to have replaced with an opportunity to have access, affordability, choice, and quality. By adopting proposals in a step-by-step fashion that Republicans have been promoting--to deal with those sorts of things of access, affordability, choice, and quality--we can try to ultimately get the American public what they need and what they asked for in the beginning: the care they need from a doctor they choose at lower costs.

I yield the floor.

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