Madam President, I ask unanimous consent that the order for the quorum call be rescinded. Madam President, a lot of Americans are worried right now about their health insurance. They know what is…
Madam President, I ask unanimous consent that the order for the quorum call be rescinded.
Madam President, a lot of Americans are worried right now about their health insurance. They know what is coming. Seniors have been turned down by their doctors for Medicare treatment because the doctors are not adequately compensated. If they have not been turned down, they know someone who has been turned down.
Medicaid is uncertain and a stigma. On the one hand, advances in medical technology and the capabilities and knowledge of our health care providers mean we are living longer and have more tools at hand than ever before to address diseases and illnesses.
However, on the other hand, this increasing life expectancy, coupled with the aging of our population and the steady increases in health care costs, means our health care system is on the verge of becoming completely unsustainable financially.
All across the country health insurance rates are skyrocketing. Families are struggling to cope with the higher costs and less choice. Employees are losing coverage and they are losing working hours. Businesses are not hiring. At the center of this uncertainty is the President's health care law. A number of provisions have already gone into effect, but we will not experience the full force of the law until 2014; that is, January.
The Democrats' ``go it alone'' health care reform plan in 2009 was the first major piece of legislation to pass Congress without a bipartisan vote. Let me repeat that again. The Democratic ``go it alone'' health care reform plan in 2009 was the first major piece of legislation to pass Congress without a bipartisan vote. When you have a partisan bill you get partisan results.
After 20,000 pages of regulations and still a lot more to come, they are a little behind on those, and after over 150 new bureaucratic boards, agencies, and programs, the Federal Government still cannot figure out how to make the law work and has had to delay it, in part.
What I have seen to date is enough to convince me that we need a different path. I opposed the health care law initially and I support full repeal of the law. Fixing our health care system does not have to be divisive or partisan. There are clear differences in the approach to fixing health care from all across the political ideological spectrum. However, the least we have to do is to dismantle the worst parts of the law and replace them with reforms that actually work, reforms that lower cost and expand choice, reforms that do not bankrupt the country and every taxpayer.
The Federal Government needs to support viable solutions when needed and refrain from handcuffing innovative private designs with the excessive regulations for narrowed political interests. We need more competition, not less.
Unless we take concrete steps now, we will soon be unable to switch off the track toward government-run health care. When I first got here, I was warned that there were people who did not care who ran the train of health as long as it wrecked. Then we could have universal single- pay, government-run health care. I am not sure that is not still the goal.
One clear example of how convoluted this law is comes from the definition of who an employee is. I used to work in the shoe business, so I understand the difference between full-time work, which was 40 hours a week, and part-time work, which was under 40 hours a week.
However, under the health care law, there are now full-time employees and full-time equivalents. What this means is the law requires employers, and particularly small businesses, to determine how many of their part-time employees it takes to equal a full-time employee. They don't come under the full force of the law until they hit 50 employees. There are businesses that understand that, and they are trying to avoid getting to the 50th employee. But there are some catches in this law.
First of all, the health care law sets full time at 30 hours, not 40 hours per week but 30 hours. It was news to me. It always was 40 hours.
Second, the law requires these employers to take everyone working 29 hours a week or less, combine all of their time for a week, and then divide by the number 30 to establish how many full-time equivalents these part-time workers represent. I don't think a lot of people planned on that.
If you are still following along at this point, congratulations. You can see how costly the taxes imposed by this law will be.
What if the rule forces you to add all of your employees' hours and divide by 30 hours to determine your full-time employees? What if you have 10 employees who are working 40 hours? That would be 400 hours. If you divided that by 30 and find out that you are paying 10 people, but you actually have 13\1/3\ employees at the full-time requirement, that could put you over the 50 and put you into a whole different category of costs and penalties.
If you have 10 employees and you watched it so that there are only 29 hours, that comes to 290 hours. If you divided that by 30, you would find out that even though none of these people are full-time employees, you have 9\2/3\ full-time employees. You can see how they could do a little miscalculation, suddenly be at the 50, and be into a whole new series of penalties.
The Obama administration also had to admit recently that the employer mandate, one of the key pieces of the law, isn't ready.
One of the most economically crushing and burdensome regulations will not be implemented until past 2014, past the 2014 election in 2015. I don't think that was a mistake on their part. I think it was intentional--to come after the election.
There is another little complication that gets thrown in here though. If those employers are not providing the health insurance and not being fined for not providing the health insurance, then the people who work for them have to go on the exchange to get their health insurance. If they go on the exchange to get their health insurance, they can't be subsidized by the businesses they worked for. That is going to be a surprise to a lot of employees too.
The delay will force more people to enroll in health care exchanges or face the tax penalty if they don't. A lot of people don't realize if they do go on the exchange, there is also a surcharge on the cost of their health insurance. They are going to be paying a 3.5 percent tax for buying the insurance. Of course, if they don't buy the insurance, then they get a penalty.
The delay was also made for the businesses without congressional approval, done administratively. The Congressional Budget Office and the Joint Committee on Taxation informed Senator Hatch this week that this delay will increase the cost of the new insurance program established by law by $12 billion. It is not as if we had an extra $12 billion laying around here.
In particular, the Congressional Budget Office and the Joint Committee on Taxation estimated that the Federal Government will be required to pay an additional $3 billion in subsidies for people on the exchanges. A lot of extra costs were just kicked in there. This delay not only increases the costs on hard-working Americans, but it fails the original intent of health care reform, and that is to provide Americans with high quality, affordable health care.
In addition, the law requires the administration to set up health insurance exchanges in a number of States, including Wyoming. We are sparsely populated, low numbers. The numbers wouldn't work out to do our own exchange.
One problem is the administration has yet to tell anyone exactly how they are going to do those exchanges or what even a basic plan is. If you are going to have a range of plans that insurance companies can bid on, that you can look up on the computer, doesn't it seem, before you can even start, that you would have to know what the basic plan is?
How the President can argue that everyone will love the health care law once it goes into effect is beyond me. This administration can't even tell anyone where they can buy their insurance, what plan options will be available, and, most importantly, what the costs will be.
Remember what Nancy Pelosi said before they passed the law? They will have to pass the bill before we get to know what is in it. The administration is shopping its own version of that statement.
As the Senate Finance Committee chairman put it recently: this law is a train wreck waiting to happen. That is the Democratic Senate Finance Committee chairman.
Of course, on top of all of this, the law relies in part on new taxes and tax subsidies to support the coverage expansion.
This means the IRS will be involved in implementation. I have significant concerns with the ability of the IRS, particularly in the wake of the current scandal. The fact that this organization, the IRS-- tainted by such political behavior--is involved in implementing the new health care law has increased my belief that the health care law is not something the country wants or needs. Of course, the IRS employees don't want to come under this law either. I don't know of anybody who really wants to come under it.
I will take a close look at proposals to remove the IRS from any implementation activities, but I do think they should be subject to the law too. At the same time, I will continue to work to provide folks with relief from the health care law as a whole.
One of the things they have said if you are going on the exchange is, if you are in certain income categories, then you get a subsidy from the government to help you purchase your insurance. We are told now that will be self-reporting and will not be subject to audit. Doesn't that sound like something that could be fraught with a lot of fraud, where you say you just make enough to get into the biggest subsidies? Everybody wouldn't do that, of course, but I think there are some who would.
How is the government doing on some of the things that they already put into effect? I saw a little article on high-risk pools. When the bill went in, a lot of the States already had high-risk pools, and we worked with States to make those viable, but the Federal Government said we could do it for less. They put in a high-risk pool.
To keep people from jumping from the State ones, which, yes, are more expensive, over into the Federal one, which is less expensive, they said you couldn't make the jump unless you were without insurance for 6 months. People who are in the high-risk pool can't afford to be without insurance for 6 months.
There wasn't a big jump to the high-risk pool. But in spite of the fact that there wasn't a jump to the high-risk pool, the Federal high- risk pool went broke. It ran out of money.
Here is the disturbing part of that article. They said, well, they would just shift that cost over to the States. The States are already doing it, and they are doing the right thing. Now they are going to be asked to pick up the additional costs. How many parts of ObamaCare are going to get shifted over to the States? The States have had a lot of promises. Can any of those promises be met? Will they be met? A lot of decisions are being based on what the Federal Government promised.
Of course, in truth, we are out of money. The new law also tried to address the problem of rising health care costs. I believe the Federal fiscal situation is untenable, and we need to implement significant and far-reaching spending cuts to get our fiscal house in order. We cannot continue on our current path.
The President and his administration will argue that the new law will expand access and lower costs. While the law certainly increases access to insurance, it also moved billions of dollars from the Medicare Program to pay for this new insurance program. That is not exactly saving the government money.
The projections for lower costs also don't add up for the average American either. Insurance premiums and rates are increasing. Small businesses are unable to continue to provide health insurance for their workers.
Businesses in general have delayed hiring or are only hiring people part time--although I hope they listen to the part that I gave about the little part-time catch that is built into the law.
All of these decisions are directly driven by the economic impact of the health care law. My Senate Republican colleagues and I are focused on developing proposals that address the worst aspects of the health care law. The law increases premiums and health care costs, forces employers to stop offering insurance to their employees, and slashes benefits for millions of Medicare beneficiaries.
I support repealing both the cap on health savings accounts, flexible spending accounts, and the prohibition on over-the-counter purchases included in the health care law.
Flexible spending accounts help make consumers more aware and engage in their health care spending.
Health savings accounts are something that young, healthy staffers of the Senate like to do. They can do the math real easy. They can look at the regular program and see how much that would cost or they could take a look at health savings accounts. The difference in the price, in only 3 years they could cover the whole deductible part as long as they were healthy for 3 years. They would be covered for that part until something major happened--and they were covered for catastrophic--so they found that to be a real bargain. But not anymore.
Additionally, a number of other Senators and I have put forward bills to repeal the taxes imposed by the President's health care law. That would be
relief from new taxes on prescription drugs, relief from new taxes on medical devices, and relief from new taxes on health insurance plans. I wish to provide relief to employers from new regulations imposed on them by the law.
These ideas preserve competition in a private market for health care coverage and lower the cost of care for the consumer. All of these steps are commonsense reforms to the health care law that take us off the path toward a national, Federal health care system.
One of the most effective ways Congress can address the rising costs of health care is to focus on the way it is delivered as part of the Nation's current cost-driven and ineffective patient care system. America's broken fee-for-service structure is driving our Nation's health care system further downward.
Today's method of payment encourages providers to see as many patients and prescribe as many treatments as possible, but it does nothing to reward providers who keep patients healthy. Maligned incentives created by the fee-for-service system drive up costs and hurt patient care.
Tackling this issue is a good start to reining in rising health care costs. The health care law championed by President Obama and the majority party in the Senate did little to address these problems because the vast majority of the legislation involved a massive expansion of the government price controls found in the fee-for-service Medicare and Medicaid Programs.
If we wish to address the threat posed by out-of-control entitlement spending, we need to restructure Medicare to better align incentives for providers and beneficiaries. This will not only lower health care costs, it will also improve the quality of care for millions of Americans. It is very important that we protect access to rural health care services too.
There is more that can be done to better align Federal programs to meet the needs of rural and frontier States. The criteria that determine eligibility for Federal funds to support rural health care programs are based on factors that make it difficult to prove the needs of the underserved, rural, and frontier areas.
For example, one provider for 3,500 people in New York City is entirely different than the 3,500 people living in Fremont, Campbell County or, perhaps more so, Niobrara County. I use Niobrara County quite a bit, for example, because Niobrara County is the size of Delaware and has 2,500 people living in it. It is 90 miles tall, 75 miles wide, and near the bottom of the center is a town called Lusk. This is where almost all of the people live. They do have a hospital there.
When they have a doctor or a physician's assistant, the hospital is open. When they do not, they are 104 miles from a trauma center.
You can't apply the same rules to that hospital that you apply to New York City hospitals. In addition, we need to think more creatively about how to use technology services, to improve telemedicine capabilities, particularly for the rural areas so that where a person lives has less impact on the level of care they are able to receive.
The advancement of more powerful, wireless technologies has substantial potential to remotely link individuals across the country to deliver health care in more accessible settings. Our Nation has made great strides in improving the quality of life for all Americans. We need to remember that every major legislative initiative that has helped transform our country has been forged in the spirit of cooperation. These qualities are essential to the success and longevity of crucial programs such as Medicare and Medicaid.
When it comes to health care decisions being made in Washington lately, the only thing the government is doing well is increasing partisanship and legislative gridlock. The President and Democrats need to listen. It is time to admit that this partisan experiment in government-run health care is failing. In order for this to get better, they must acknowledge the problem. Some of the law's authors and biggest supporters admit this law is a mess, and it will only get worse.
However, those in the Democratic leadership continue to support flawed health care laws out of pride, politics, or a belief that the government knows best. It makes no sense to stubbornly cling to a law that is so massive, burdensome, bureaucratic, and confusing that it is collapsing under its own weight.
By focusing on positive changes, Congress can give the failed law's proponents a way out. The key is finding common ground. More often than not, the country hears about what divides Congress instead of what unifies us. We could come together and focus on commonsense solutions with the kinds of step-by-step reforms that would protect Americans. I believe Members of Congress on both sides of the aisle can agree on 80 percent of an issue 100 percent of the time.
I want to be clear that this isn't compromise. When you compromise, each side gives up something they believe in, and in the end they get something no one believes in. I am about agreeing on common ground without compromise, without sacrificing each party's principles, by leaving out parts of the issue to look for a solution later.
Congress also needs to stop deal-making and start legislating. We need to stop developing comprehensive bills and then marketing them as the only option. To me, comprehensive means incomprehensible. The larger a bill is, the harder it is to agree. And, of course, you can tuck some things in there that people never see. This is especially true when we pass a bill that no one has fully read and then afterwards we find out what is in it.
No party has all the good ideas. By working together, the end result should be something that not only works but moves the country forward in a responsible way.
We still need health care reform, but it has to be the right way, with strong bipartisan support on individual health care issues. What happened to individual choice on a policy? What happened to liability reform? What about the sale of insurance across State lines or pooling through an association so they have leverage against the insurance companies? What happened to adequate compensation for providers? All of these have been left out. Providing Americans with access to affordable health care at a high quality is something Republicans and Democrats should be able to agree upon.
The challenges of the American health care system are not going away. If we improve health care in a practical instead of a political way, we can make its better. Good policy is good politics. Why do I have some hope this is going to happen? Congress is more interested now than they have ever been, and the reason is there was a Republican--yes, there was one Republican provision in the bill that forced Congress to go into the exchanges too. We and our staffs have to live under the law we passed. That is how it should be. But the result is hitting everyone in their offices right now. Every Senator and every Representative is looking at what may happen to their staff on January 1, and their staffs are concerned. It has changed the tenor of some of the hearings we are having. It is pretty hard-hitting on both sides. So with that, I do have hope.
Madam President, I yield the floor.