SGR Legislation

Floor Speech

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Mr. CORNYN. Mr. President, hopefully this afternoon we will take up a very important piece of legislation coming over from the House of Representatives that received an overwhelming vote of Republicans and Democrats alike--a package negotiated at the highest levels of the House leadership between Speaker Boehner and his staff and Nancy Pelosi and her staff.

What could it be that brings the political parties and the leaders of the parties in the House together to try to build a consensus and come up with a solution? Well, it is really to right a wrong or remedy a mistake Congress made back in 1997. Basically, at that time, Congress decided, in order to save money on health care costs, it would begin periodically to cut the amount of money that was reimbursed to health care providers--primarily doctors and hospitals. That is how Congress thought way back then we were going to save money.

What has happened in 17 of the 18 times these cuts will have been implemented? Well, Congress has realized it was a mistake. Here is the problem. When you tell doctors in rural parts of Texas ``You are going to earn 20 percent less to treat a Medicare patient tomorrow than you did today,'' well, what they are going to decide is ``Can I afford to keep my doors open? Can I afford to pay the bills? And maybe I can't afford to see any more Medicare patients.'' When doctors simply refuse or are unable to afford to see Medicare patients, then our seniors lack access to health care they need and they deserve.

So in very difficult, contentious times politically, I think this so-called sustainable growth rate--or doc fix--bill I am alluding to which is over here from the House and which I hope we will vote on this afternoon actually represents a commonsense solution to one of our big challenges and certainly will get Congress out of this embarrassing position of every 6 months to a year or so having to come back and backfill and fix a problem we ourselves created back in 1997.

Hopefully, we will be able to pass this legislation and get it done and give physicians and health care providers the certainty they need about the reimbursement rates under Medicare and thus will allow more of them to see more seniors and provide them health care benefits under Medicare.

Now, some people may say: Well, this bill is not perfect. They would be right. It is not perfect. But actually there is no such thing as a perfect piece of legislation, particularly when it is the product of bipartisan negotiations where both sides had to give in a little in order to get to an agreement. But I do commend Speaker Boehner and Leader Pelosi for working in a bipartisan way and producing something that has received resounding support from the House of Representatives.

As I said, this legislation provides our health care professionals with a predictable expectation for reimbursement rates--an idea that has, sadly, only been a dream for many physicians in Texas and across the country and one that Congress can now and should make a reality.

But this legislation also does something else very significant. It not only addresses the reimbursement rate of doctors, it also introduces other changes to Medicare that will help reduce the deficit over the long term--not just for the next 10 years but 20 years out and beyond.

Now some people might say: Well, if Congress passes this legislation now, can't they come back and undo it next year? The pattern has actually been when there have been negotiated bipartisan agreements on things as important as Medicare and Social Security that they tend to stick and they tend to stay in place. So I believe that while this negotiation certainly was no easy task and while it is a modest first step, the good news is it does represent real meaningful entitlement reform--something the President of the United States said he supports and something now that both parties here in Washington and Congress have been able to support.

This bill does make important strides on a difficult issue. When I said a moment ago it is not perfect, let me explain exactly what I mean by that. Not all of this bill is paid for. Today I plan on offering an amendment that would keep our country from growing into greater debt by offering a pay-for for this piece of legislation.

How would we do that? Well, my amendment--which I hope, again, we will vote on this afternoon in a series of as many as eight votes and final passage of the bill--would repeal the individual mandate from ObamaCare. That would, according to the Congressional Budget Office, free up literally close to $400 billion that could then be used to satisfy the deficit for this so-called doc fix.

Many have rightly demanded an offset for the bill. I am very sympathetic to that, and my amendment is designed to address it, because--as the Presiding Officer knows, given his long service not only in the Bush administration, at OMB, and in the Congress as well as the Senate--we have to do something about the long-term debt and unfunded liabilities of the Federal Government. I am amazed almost daily about the lack of urgency. Perhaps that is because interest rates are relatively low and we are not feeling the drain of debt service payments to our country's creditors because they buy our debt and they demand to be paid interest or debt service on that debt. When interest rates begin to creep back up again, as they invariably will, that is going to put a real dent in everything from national security to the safety net programs that we all believe are important. So my amendment will repeal the individual mandate in ObamaCare and help pay for this appropriate fix in doctor reimbursement rates in Medicare.

You may ask, well, isn't that a pretty dramatic or controversial thing to do, to repeal the individual mandate in ObamaCare? I asked my staff to go back and get some quotes from a candidate running for President in 2008, who happens to be the current occupant of the White House. Here is what then-Senator Obama said on February 28, 2008, on one TV show:

Here's the concern. If you haven't made it affordable, how are you going to enforce a mandate. I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house.

Well, as the Presiding Officer knows, the President actually said when we passed ObamaCare--frankly, without my support and the support of this side of the aisle--the President claimed it would lower health care premiums by $2,500 a year for a family of four. That has proven not to be the case. But quite clearly, the President himself, when he was running for office in 2008, opposed the individual mandate.

Here is another quote from CNN in 2008. This is Senator Obama running for President. He said:

In some cases there are people who are paying fines and they still can't afford it, so now they are worse off than they were. They don't have health insurance and they are paying a fine.

That is what the individual mandate is all about, as you know. I will go on with the quote. ``And in order for you to force people to get health insurance, you've got to have a very harsh, stiff penalty.''

So President Obama, back when he was candidate Obama, back when he was Senator Obama, opposed the individual mandate. All my amendment would do would be to repeal the individual mandate and allow us to obtain a savings to pay for this legislation.

I will read one more quote, because I find the irony pretty rich. Senator Obama said--and this was when he was running against then-Senator Clinton, who apparently is now again running for President. Senator Obama said in 2008:

She believes that we have to force people who don't have health insurance to buy it, otherwise there will be a lot of people who don't get it. I don't see those folks, and I think that it is important for us to recognize that if you're going to mandate the purchase of insurance and it's not affordable, then there's going to have to be some enforcement mechanism that government uses. And they may charge people who already don't have healthcare fines or have to take it out of their paychecks. And that I don't think is helping those without health insurance.

So my amendment that would offer to pay for this bill would repeal the mandate that then-Senator Obama, candidate for President, was so critical of. It would repeal a tax on the American people that coerces our citizens into purchasing health care they apparently don't want or they wouldn't otherwise buy but for the threat of government coercion.

The better way to do it, in my view, is to make health care more affordable, not to make it more expensive and say if you don't buy the government-approved care--even if you don't want what it provides--then we are going to coerce you to do it. We are going to penalize you for it. This is bad for America and hurts people instead of giving them the helping hand they need when it comes to health care.

We are going to have a lot more to say about how we need to repeal and replace ObamaCare with more affordable health insurance that gives people access to the doctors and services they want and need. But on the present bill, no one denies the need for a long-term permanent solution to the way we pay health care providers under Medicare. So for the benefit of physicians, our seniors, and the American people, we need to do this, but we also need to find a way to pay for it.

I am hoping we pass this legislation today. I believe the current provision expires at midnight tonight. It is important that we stop kicking the can down the road and we allow our family doctors to do what we want them to do most, which is to focus on what they do best and what our families need the most. At the same time, it will ensure seniors access to the care they need. Such a meaningful solution is long overdue.

Mr. President, I yield the floor.

I suggest the absence of a quorum.

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