Department Of Defense Appropriations Act, 2010
Thank you, Mr. President. I have been coming to the floor to remind my colleagues and the American people about the fiscal realities our Nation faces and to explain how this health reform legislation would make our fiscal situation worse…
Thank you, Mr. President. I have been coming to the floor to remind my colleagues and the American people about the fiscal realities our Nation faces and to explain how this health reform legislation would make our fiscal situation worse and our economy suffer even more. I have been here before to highlight how this health care bill is chock-full of budget gimmicks to hide its true unmanageable costs.
As I have said before on the floor of the Senate, as a former mayor and a former Governor, many people have come to me over the years and said: Mayor, you have to do this; Governor, you have to do this. The plea they had was genuine, and the need they expressed was genuine, but the fact is we couldn't afford what they were asking us to do, and I had to say no. Unfortunately, this legislation, in my opinion, will increase the cost of health care, drive up our national debt, and contribute to unbalanced budgets as far as the eye can see in the United States.
As a former Governor and chairman of the National Governors Association, the past chairman of the National League of Cities, one gimmick I am particularly concerned about is the one that puts 14 million additional individuals into the Medicaid Program and then asks the States to pick up a portion of the tab. I am very familiar with what unfunded mandates can do to State and local governments, and I wish to highlight some of the potential consequences of the Medicaid expansion for my colleagues.
At a $374 billion cost to Federal taxpayers, the health care bill before us would expand Medicaid coverage to all people under 133 percent of the Federal poverty level. Because Medicaid costs are shared by the Federal and State governments, the States will be on the hook for $25 billion of this expansion during the first 10 years.
To put the $25 billion into perspective, let me spend a minute explaining the current fiscal situation of most States in this country. Most States such as my State--and I am sure the same is true in the Presiding Officer's State--are struggling to make ends meet. I have never seen anything like it in my entire life.
According to the National Governors Association, the States are in the deepest and longest economic downturn since the Great Depression. In the first two quarters of 2009, State revenues were down 11.7 and 16.6 percent, respectively. At the same time, Medicaid spending is growing, which already makes up, on average, approximately 22 percent of States' budgets, and enrollment in the program is skyrocketing at the levels it is today because more and more people are becoming eligible for Medicaid under the current Federal law.
In Ohio, for example, where the unemployment rate is hovering around 10.5 percent, 154,000 Ohioans enrolled in the Medicaid Program in the last year alone, an 8-percent increase over last year. This is hard to believe, but Medicaid now provides health coverage to nearly 2 million Ohioans, almost one out of five residents. Unbelievable.
Recognizing this increased demand, States have had some help from the Federal Government. Earlier this year,
Congress provided $87 billion in Federal aid to States in the so-called stimulus bill to help States deal with Medicaid costs. Yet this money was not intended to last forever. As it stands right now, in December 2010, States will face--that is next December--States will face a steep budget cliff when the temporary Medicaid payments coming from the stimulus package expire. In facing these realities, Governors across the country are already wondering how they will cover the cost of their existing programs.
I recently met with Ray Scheppach, who is the executive director of the National Governors Association. He said: Senator, Governor, Mayor, we are going to need some help when the money runs out or we will not be able to handle the Medicaid challenges we have.
Not surprisingly, my State's current Governor, Ted Strickland, a Democrat, has told me if Medicaid is expanded, he hopes the Federal Government will assume most, if not all, the costs. In fact, he told the Columbus Dispatch that he has warned officials in Washington that ``with our financial challenges right now, we are not in a position to accept additional Medicaid responsibilities.''
I suspect that almost every Governor in the country would make that same statement to us in the Senate. By the way, this is both Republican and Democratic Governors.
I ask: How can we in good conscience move forward with this bill and the new mandate it places on States? How can we force the States to make the difficult choices that we are unwilling or unable to make in Washington? Pass it on to them, we will pay for it a while, and then you guys pick up the cost.
I served the people of Ohio as Governor for 8 years, and I was forced to cut my budget in the beginning four times. I will never forget it. There were about 5,000 people outside my office screaming because we had made it more difficult or increased the cost of tuition for our colleges. I had to make countless difficult decisions across the board to be fiscally responsible. I understand the demands of soaring health care costs, and as I called that program then, it devoured--Medicaid devoured up to 30 percent of our State budget, and I referred to it as the Medicaid Pac-Man. I think some people remember Pac-Man. That was the Pac-Man just eating up money like crazy. It took away money from primary and secondary education, higher education, roads, bridges, county and local government projects, and safety service programs that we wanted to provide for the citizens of Ohio. We had to do it. It was a mandate. It just sucked up that money, and that meant we didn't have money for higher education, secondary and primary education, and some of the other responsibilities of the State.
With this experience, I became particularly concerned with the cost of Federal mandates, and I worked tirelessly with State and local governments to help pass the Unfunded Mandates Reform Act. In fact, the first time I ever set foot on the floor of the Senate is the day the unfunded mandates bill passed the Senate. It was a wonderful day for Ohio and for this country. I was in the Rose Garden representing State and local governments when President Clinton signed the legislation into law in 1995.
After that experience, you can imagine how it pains me to be standing here today debating legislation that provides for the largest single expansion of the Medicaid Program in our country's history and a brandnew fiscal liability for States at a time when the States can least afford it. I have serious concerns if this bill becomes law and States are required to take on more just as the extra stimulus funds disappear--which they are going to have to do or we will have to come up with the money--Congress will be forced to spend billions more to keep the Medicaid safety net from failing completely in the not too distant future.
So what I am basically saying is that when the stimulus money ends in December of next year, the Governors are going to be down here with a bathtub asking us to fill it because if we don't do it, they are going to have to knock off thousands of people, millions in the country, because they don't have the money to provide for the program.
Now, providing extra dollars to States--and I predict it is going to happen. It will become an annual ritual for Congress, just as the doctors fix has become an annual ritual for doctors. Every year they come in. We are not going to cut the annual reimbursement. Next year it is 23 percent, I think. We are not going to fill the hole, and the Governors are going to be asking for the same kind of help. It is not only a mandate for them, it is going to become a mandate for us at a time when we are least able to handle anything like that.
So as a former Governor and a former mayor, a former county commissioner, I urge my colleagues to consider the impact this bill will have on their respective States. Think about it. Talk to your Governors. See what it is going to do to your States. I hope each of my colleagues will give careful thought to the potentially devastating effects it could have on each of their State budgets and to consult, as I said, with their Governors and to talk about the fact that if this happens, what is going to happen in terms of the Pac-Man eating up more money in their State and their inability to take care of primary and secondary education, higher education, and all of the other responsibilities State governments have.
Mr. President, I yield the floor.