Mr. President, I rise to express my opposition to the conference report that has been granted and put together accompanying the American recovery and Reinvestment Act of 2009, more commonly known as…
Mr. President, I rise to express my opposition to the conference report that has been granted and put together accompanying the American recovery and Reinvestment Act of 2009, more commonly known as the stimulus package.
When I spoke on the floor last week about my disappointments in the Senate version of the stimulus bill, I did not think the bill would get much worse in conference. In fact, I harbored some hope it would actually improve. Unfortunately, I was wrong.
What we have seen emerge from the conference weakens the stronger provisions of the Senate bill and worsens the less effective provisions.
Many Utahans have called and written me to express their concerns about this stimulus package and the process by which it has been legislated. They are rightly worried about the consequences of an economic stimulus package that, with interest, will cost taxpayers well over $1 trillion. That is just the beginning, by the way. They are particularly worried it will be ineffective in saving or creating jobs.
Last year, President Obama's campaign was based on ``hope not fear.'' That is until he needs fear to help him pass a bill, as Charles Krauthammer of the Washington Post points out. The pressure is on the majority to convince the American people this is the right economic package.
On Tuesday, President Obama spoke to the American people, not about the audacity of hope but rather to instill fear into Americans. He said at that time:
A failure to act will only deepen the crisis as well as the
pain of Americans.
He also said:
The Federal Government is the only entity left with the
resources to jolt our economy.
While I do not disagree with these statements, it is wrong to use fear to force the completion of an unbalanced, largely partisan package that the Congressional Budget Office estimates will create at most 1.9 million jobs by the end of 2011 and leave us with a lower gross domestic product in 10 years than if we do nothing at all.
Keep in mind, the head of the Congressional Budget Office is a Democratic appointee.
It is clear we are in an economic recession and that action is needed to stimulate the Government. I think every one of our colleagues agrees with this. What troubles me is the misperception about why most Republicans are opposed to this bill. The President and many of our Democratic colleagues have unfairly implied that Republicans prefer to do nothing. That is absolutely not true. Yes, we are opposed to this bill, but we are not opposed to stimulating the economy. We simply want to do it in the most effective and least wasteful way as possible. We do not want to see us make a $1 trillion mistake, and this is a $1 trillion-plus mistake.
Yet we Republicans were shut out of negotiating the final conference report, which is something President Obama vowed to the American people he would change. According to President Obama's Presidential campaign Web site, change.gov, he vowed to ``end the practice of writing legislation behind closed doors.''
Specifically he said he would `` . . . work to reform congressional rules to require all legislative sessions, including committee mark- ups, and conference committees, to be conducted in public.''
That certainly did not happen here. I believe this bill could be much more effective and so does President Obama. At his Tuesday press conference, he admitted as much when he said:
I cannot tell you for sure that everything in this plan
will work exactly as we hope.
That concerns me. If we plan to spend an amount equal to the 15th
largest economy in the world, we ought to make sure the stimulus plan is drafted in the most effective way possible.
For example, many economists say the make work pay tax credit provision in the plan, which will give workers roughly $15 more a week in each paycheck, will largely be ineffective in stimulating the economy. It is not going to help the economy. Yet it is a tremendous cost, around $150 billion, that could have easily been spent on something that would help the economy, create jobs. I suggested the research and development tax credit by making that permanent. I cannot begin to tell you how that would keep our unqualified lead in the high- tech world.
My objection to this bill is not based on the fact it includes spending, it is because it lacks an effective balance of spending and tax relief.
If we look closely at the bill, we will see that much of what the majority lists as tax relief is actually spending. In other words, those who do not pay any income taxes, as well as State and local governments, are receiving money through the Tax Code. How can there be tax relief to those who do not pay taxes? That is more taxes for those who do. Tax relief from what? I am not saying those who do not pay income taxes should not benefit from this stimulus package. I am saying if you are going to give money to people who do not pay taxes, call it what it is--it is spending, it is not tax relief.
Like I say, I would far rather would have had a permanent research and development tax credit, which would cost about only two-thirds of what they are going to spend on this so-called make work pay provision that would create millions of jobs in America and throughout the world.
In fact, when one adds up all the provisions in the bill, more than 70 percent is spending and less than 30 percent is real tax relief. Where is the balance? Even worse, only one-half of 1 percent of this bill--one-half of 1 percent of this bill--is devoted to tax relief to help struggling businesses keep their doors open. One-half of 1 percent--that is pathetic. We know small business produces most of the jobs. Yet this is what we are doing. Moreover, the bill fails to adequately address the housing crisis. Unfortunately, the $15,000 tax credit for home buyers, which is one of the few bipartisan amendments accepted into the Senate bill during the Senate debate, has now been watered down drastically. So has the other major bipartisan amendment added on the Senate floor--the deduction for interest on a new auto loan. And one of the few provisions to help struggling companies keep their doors open--the expanded period for carryback net operating losses--has been erased from the conference report, except for small businesses.
Now, I have some news for my Democratic colleagues. Small businesses are not the only companies that are laying off workers. Allowing companies to get quick refunds of taxes previously paid was one of the few smart and efficient provisions in the Senate bill, designed to directly save jobs. Now that has been whittled down to a mere shadow of what it was.
I worry that my friends on the other side of the aisle are looking through rose-colored glasses, spectacles tinted by spending priorities, such as expanding Government programs, which they hope will stimulate the economy. They are trying to convince America that spending millions on Government vehicles will somehow stimulate the economy. They refuse to listen to even the President's Chair of the Council of Economic Advisers, Christina Romer, who in a study determined that every dollar of Government spending increases the gross domestic product by $1.40, while every dollar of tax relief increases the gross domestic product by $3. That is what the study says. The President's own Chair of the Council of Economic Advisers says that $1 of Government spending equals a $1.40 increase in GDP, but if you do it in tax relief, $1 will give you a $3 increase in GDP. Doesn't take too many brains to figure out it is far better to do it the second way.
The Congressional Budget Office recently estimated that the Senate version of this so-called stimulus package would only save or create between 600,000 and 1.9 million jobs by the end of 2011. At a cost of $1.2 trillion, including interest, the cost to the taxpayer for each job saved or created under the plan is at least $632,000 and as much as $2 million if that goes up. We are spending taxpayer money to create one job at the rate of $632,000 per job.
Now that the Senate bill has been scaled back significantly, this job-creation estimate is almost sure to go down significantly. We can do better than this, Mr. President. This is not good enough for Government work. With the amount of money spent in this bill, you could give every man, woman, and child in America $4,000. I think Utahns and all Americans would put $1.2 trillion to better use than what this bill does.
A large share of this stimulus bill will go to States to implement temporary programs. When that funding runs out, what do we tell all of those employees who were hired and now have to be let go? Will we say: Sorry, this is just a temporary job. Who are we kidding? This makes about as much sense as denying an undefeated football team the chance to play in the national championship game. I know that sounds a little bit like sour grapes since the University of Utah was the only undefeated team this last year but had absolutely zero chance to play in the national championship game.
The majority knows the American people want to see more tax relief in this stimulus bill. A February 9 poll conducted by the Rasmussen Report found that 62 percent of U.S. voters want the plan to include more tax relief and less Government spending. It appears as if the more time Americans have to review this bill, the less they like it. That is certainly the case for me.
While time is of the essence, we cannot afford to get this wrong. The stakes are too high. Yet President Obama has chosen to break the theme of his Presidential campaign and use fear to hurriedly pass this flawed economic stimulus package. Now, I am not sure I can blame him for that because he is stuck with what the people up here have done to him and to what he said he would do. So I suppose he was limited to using fear to get this package passed. I have a lot of respect for him. I personally have helped him, and I intend to help him more. But, gee whiz, this is pathetic.
Mr. President, we Republicans realize the severity of this economic situation. We recognize the need to stimulate the economy with a balanced stimulus package that has an appropriate mix of spending and real tax relief. We want to create jobs and spur economic growth. But haste makes waste, and, like many of my constituents, I believe our efforts are about to be wasted--squandered on a stimulus bill that will stimulate more criticism and feeling of futility than the economy.
The great American poet and abolitionist John Greenleaf Whittier wrote:
For of all sad words of tongue or pen, the saddest are
these: ``It might have been!''
And while those words were written more than a century ago, they can certainly be applied now to Congress. Faced with serious recession, we need to do our very best to get the economy moving again. Instead, it looks as if this body will settle for a partisan bill that could well fail to do the job our Nation requires. We should do better. We could do much better. The American people need us to do much better. And if this legislation passes, many of us will one day shake our heads at the opportunity lost and wonder aloud about what might have been.
I have told a few people over the last number of weeks who have blamed both parties for what has gone on here over the last number of years that I have been here 33 years and there hasn't been 1 day in the Senate that I can point to where a fiscal conservative majority has been in control of the Senate--not 1 day in 33 years--because there are always enough liberal Republicans, combined with the mostly all liberal Democrats, to do just about anything they want to in spending. It is discouraging, I have to admit. We have won some battles because we have outworked the other side or we have had a President who has made a difference on some issues, no question about it. But not 1 day that I can recall where, if you count the liberals on our side and the liberals on the Democratic side and you put them together--it is usually only five or six, really, on our side--we always have the majority on
the other side. That is why President Bush was hammered all the time for his spending programs when, in fact, his budgets were at all times less than what we ultimately passed here in both Houses.
Mr. President, I would like to now take a few minutes to talk about the health care provisions in this so-called stimulus package or, more appropriately, the next installment of the ``Socialized Health Care for All Act of 2009.'' Democrats hate to hear that. They think it is terrible to hear the word ``socialism.''
President Obama recently made the media rounds stating that any delay in passing this Government spending package would be inexcusable and irresponsible. Well, today I am going to highlight certain health care provisions in this Trojan horse legislation that, in the President's own words, should be classified as inexcusable and irresponsible.
First and foremost, let me make this point again, even though I am starting to sound like a broken record. Reforming our health care system to ensure that every American has access to quality, affordable, and portable health care is not a Republican or Democratic issue, it is an American issue. When we are dealing with 17 percent of our total economy, it is absolutely imperative that we address this challenge in an open and bipartisan process.
Think about it. We are going to talk about this for just a minute. Just like the partisan SCHIP exercise preceding this bill, this stimulus legislation is another example of the Democrats justifying the current economic turmoil to simply expand our entitlement programs and make the Federal Government bigger. More and more Americans are being pushed into Government-run health care programs. Special interests have taken priority over families; politics, of course, over policy.
In this time of national crisis, we should have come together as one group to write a responsible bill for the American families who are faced with rising unemployment and dropping home values. Instead, the other side has simply chosen to turn this into a government-expansion exercise and a grab-bag of favors for the liberal special interests.
I continue to hope that the other side's promise of change was more than a campaign slogan that did not expire on November 4, 2008. Let's all remember: Actions speak louder than words.
Let me start with the COBRA provisions in this package. The Senate version of the stimulus includes more than $20 billion in subsidies for health insurance premiums for those who have lost their jobs in these tough economic conditions. However, this subsidy will only go to those Americans who had access to COBRA coverage through their employers.
Now, let me put this inequity into perspective. If you worked for a large employer, such as Lehman Brothers or Bear Stearns in New York City, which had access to a COBRA qualified group health plan, you will get help under this bill. But mom-and-pop stores in Salt Lake City that could not afford a group health plan for their hard-working employees, they get nothing. Not a thing. Now, let me repeat again--nothing. This is not only unfair, it is unconscionable.
That is not all. It gets worse. Both the Senate- and the House-passed language gave the same COBRA subsidy--50 percent and 65 percent respectively--regardless of one's income threshold. Look at this chart. You probably recognize the fellow on the left. This is Richard Fuld, the former CEO of the now-bankrupt Lehman Brothers, who made almost half a billion dollars in salary, bonuses, and stock options since the year 2000. He is going to get the same level of subsidy for his health insurance premiums as the laid-off construction worker on the right here in Utah.
I worked with Senator Grassley to write an amendment that would have applied income testing to this provision to target this taxpayer-funded help to those who needed it the most. We income test Medicare Part B for our seniors, so why not do the same for these subsidies? Unfortunately, it was not included in the Senate package.
Another concern Americans need to be mindful about is the impact of this massive COBRA subsidy on our Nation's employers, who are already struggling to meet their payroll needs.
By the way, just so everybody understands what COBRA means, if you get fired or the business ends or you have to leave the business, you have a right under COBRA to continue the insurance, but you have to pay for it rather than your employer.
Even though employers are not explicitly liable for the COBRA subsidies in this legislation, they will suffer from this phenomenon of adverse selection. A number of COBRA-eligible individuals have premiums that exceed those of active workers. Studies have shown that the average COBRA premiums are at 145 percent of active worker premium payments. According to a study by PricewaterhouseCoopers, the 10-year impact of this provision on employers, even when limited to those in the 55-to-64 age group, could be up to $65 billion. Economics 101 dictates that these additional costs will simply be passed on to employers, which in return will result in lower wages and more layoffs. This is not exactly what would qualify as ``stimulus'' in my book-- spending, sure, but definitely not stimulus.
Let me shift my attention to the comparative effectiveness provision. The idea behind this concept is simple: Compare the effectiveness of medical treatments and procedures so payers, providers, and patients can make smart choices. Sounds good. However, the difficulty arises when you decide to compare on the basis of what is cheaper rather than what works well. Both the House- and the Senate-passed versions provided $1.1 billion for comparative effectiveness, including a $400 million slush fund to be used by the Secretary at his or her discretion. Once again, this is a topic of bipartisan interest and concern that should have been discussed in the context of comprehensive reform.
We can all agree that a one-size-fits-all approach is the wrong approach for the American health care system. Based on our own personal experiences, we know that what works best for one does not always work the same for the other. Allowing comparative effectiveness on the basis of cost can have disastrous consequences not only on innovation of lifesaving treatments but also in the delivery of quality care.
On this chart, for example, we see Jack Tagg, a former World War II pilot, who in 2006 suffered from a severe case of macular degeneration. The regional health board that utilized cost-based comparative effectiveness rejected his request for treatment citing high cost, unless the disease hit his other eye also.
It took 3 years to overturn that decision. Now let's just all remember that a family member with cancer in an intensive care unit would probably neither have the time nor the resources to appeal such an egregious decision. We need to remember the real implications of these provisions--not simply in terms of political spin and special interests--but in terms of its impact on real people who are our mothers, fathers, husbands, wives, brother and sisters--children.
During the Finance Committee consideration of the stimulus legislation, Senators Baucus, Enzi, Conrad, and I discussed the importance of getting the comparative effectiveness provision right.
I believe that comparative effectiveness must focus on clinical effectiveness, not cost, and it should maintain patient choice and innovation. Failure to do so could have disastrous consequences.
As I have already said multiple times, I am disappointed that Democrats have decided to use the stimulus legislation to address health care reform in a partisan and piecemeal manner. Health IT-- information technology--is another perfect example. It is an area of consensus that should have been part of a comprehensive and bipartisan health care reform dialogue.
It is my hope that the Health Information Technology Standards Committee that is created in this legislation will take into account the work of States like Utah that already have adopted statewide HIT. standards for the exchange of clinical data. Utah is much further down the road than other States in this area. Therefore, when the committee is making recommendations for HIT standards, it is my hope that the work of States like Utah will be taken into account and seriously
considered by the HIT Standards Committee members. Utah has been a national leader in this area and I believe that its work in this area should be used as a template when national HIT standards are developed.
In addition, as we incentivize physicians, hospitals and other health care providers to use electronic health records--EHR, it is important that we provide assistance for them with both the purchase and maintenance of EHR systems. I have heard from one Utah physician in Ogden who paid over $8,000 for software only to discover that the software simply does not work. This is unacceptable. Therefore, if we are going to incentivize health providers to use electronic health records, we need to make sure that providers will have assistance in choosing, implementing and using electronic health records.
Utah has been a leader in physician EHR implementation as a result of its participation in the Centers for Medicare and Medicaid Services-- CMS--Medicare Care Management Performance--MCMP demonstration project which was created through the Medicare Modernization Act. The demonstration provided incentive funding to Utah physicians for adopting EHRs and offered these doctors support and assistance with their EHRs systems. In the bill we are considering, I included language to ensure that health providers in Utah and across the country will continue to receive that assistance. Without such assistance, many practices will move forward with a commitment to adopt EHRs, but will not choose the right product for their needs or could have difficulty using the system.
Another concern that has been brought to my attention by Utah health care providers is that the maintenance of effort provision in this legislation only applies to eligible State and local governments and not to State and local health care providers. This is a real concern in Utah. My State, like others across the Nation, is experiencing economic difficulties and, as a result, is contemplating reducing provider payments. I am deeply concerned about the impact this provision could have not only on providers but patient access to quality health care.
Finally, I would like to briefly address the enforcement provisions contained in section 13410 of this legislation relating to the State attorneys general. When adopting rules to implement the health information technology provisions in this act, I would urge Secretary of HHS to include rules to require the States to notify the HHS Secretary as to any outside groups that will have contracts to assist with the enforcement of these provisions. I appreciate the opportunity to work with my colleagues on this important issue.
I look forward to working together to transform our sick-care system into a true health care system. However, the other side at this time seems focused on transforming it into a socialized welfare system through this Government-spending bill. I continue to hold deep hope in my heart that we will soon move beyond these beltway games and work together to fix Main Street and make sure that our Nation continues to be the shining city on the hill.
Let me just make one other comment. When our bill went over to the House--the House bill was passed too--I happened to notice that the welfare reform program that we worked so hard on in the mid-1990s, that President Clinton vetoed twice until he finally decided that it was worthwhile and signed it, has been greatly modified in this bill. I may be wrong in this because I have not read that section, but I have had indications that that section basically has changed our welfare reform law. It basically put, within a short time thereafter, two-thirds of the people who had been on welfare to work, many of those people second and third generations on welfare. They found out that they could work and get the self-esteem that comes from being able to work, while still having a welfare system to care for those who can't care for themselves but would if they could.
My understanding is they have changed the rules now where people can stay on welfare their whole lifetime. I hope that has been changed. I have not looked at this final version, but I hope that has been changed. If not, let me make a prediction. For most all of my time in the Senate, the percentage of GDP that our Federal Government has required is somewhere between 18 and 20 percent. If this bill goes through and there is another $2 or $3 trillion in spending, without being done right, we are talking about Europeanizing America. We are talking about the percentage of GDP going up as high as 39 percent-- according to the economists I talked to. That would be disastrous.
Some are so crude that they suggest that is the plan of our more liberal friends on the other side because the more they get people dependent on the Federal Government, the more they think the Democratic Party is the only one that is going to take care of them.
We prefer a little different approach to it. We prefer to help those who can't take care of themselves but would if they could, to help them in every way we possibly can. We have difficulty--at least I do-- helping those who can help themselves but will not.
I hope that provision is no longer in this bill, but I strongly suspect it is. If that is so, we will have done the American economy tremendous harm.
I am concerned about this. I can't vote for this bill, but I would have liked to have voted for a really good bill that really provided appropriate tax relief and made it possible to expand jobs in such a way as to bring this economy back to the greatest economy in the world, bar none, without question, and without question of its future greatness.
Mr. President, I suggest the absence of a quorum.