Floor Statements

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I come to the floor today to discuss the pain ObamaCare continues to inflict on Americans. It seems like every week brings more ObamaCare bad news for somebody--families, businesses, middle-income Americans, lower income Americans. This past week the bad news was for seniors.

On Friday the Obama administration announced its planned 2015 cuts to Medicare Advantage--cuts that were dictated by ObamaCare and will result in higher prices and fewer choices for millions of American seniors. More than 15 million seniors--close to 30 percent of all Medicare recipients--are enrolled in Medicare Advantage plans. The Wall Street Journal reports that approximately one out of every two new Medicare enrollees chooses Medicare Advantage.

Medicare Advantage offers seniors a chance to pick a plan that is right for them instead of a one-size-fits-all approach. Advantage plans also frequently offer important health supplements, such as dental, vision, hearing, and wellness benefits, as well as smaller copays or deductibles. Studies also show that Medicare Advantage Program enrollees receive better care and experience better health outcomes than seniors enrolled in traditional fee-for-service Medicare.

Despite the benefits these plans offer to seniors, Democrats and the President supported Medicare Advantage cuts in the President's health care law. In 2010, the President and Democrats paid--or I should say tried to pay--for ObamaCare by, among other things, cutting more than $700 billion from Medicare--already, I might add, on its way to bankruptcy--to pay for yet a new entitlement for nonseniors. More than $300 billion of those cuts were targeted specifically at the Medicare Advantage Program.

Those cuts are kicking in this year, hitting Medicare Advantage beneficiaries with cost increases and benefit cuts of up to $70 per month--no small amount for a senior on a fixed income. Friday's announcement of further steep cuts for 2015 could mean up to an additional $75 per month in increased cost next year.

But that is not all. Cost hikes are bad enough, but this year's cuts and the 2015 cuts announced Friday will result in a host of other problems for seniors who participate in Medicare Advantage. First and foremost, some seniors will lose their plans entirely as a result of ObamaCare's cuts, breaking the President's promise that if you like your plan you can keep it.

The Kaiser Family Foundation estimates that more than one-half million seniors will lose their current plans in 2014. If the 2015 cuts go into effect, even more seniors will lose their plans next year. Seniors will also have fewer plan choices as a result of ObamaCare's raiding Medicare Advantage to pay for a new health care entitlement program. If next year's cuts go into effect, we can expect to see even more reductions.

These higher costs and reductions in available Medicare Advantage plans will disproportionately impact low-income seniors in rural areas, areas such as those I represent in South Dakota. Forty-one percent of those seniors in Medicare Advantage plans have annual incomes of less than $20,000 and are least able to bear the higher costs forced on them by ObamaCare. Yet it is precisely those seniors who are bearing the greatest burden when it comes to paying for ObamaCare.

On top of that, reports indicate that plans are responding to the cuts by reducing their footprint in rural markets, giving these seniors fewer options when it comes to choosing a health care plan.

Finally, similar to so many other Americans suffering under ObamaCare, seniors on a Medicare Advantage plan may no longer be able to keep the doctors they have and like thanks to these cuts. Between Medicare cuts and the new ObamaCare tax insurance companies are facing this year, companies are scrambling for ways to be able to afford to continue their plans. Frequently their only option is to narrow their networks of doctors and hospitals or raise their copayments and deductibles, thus reducing seniors' choices and increasing their health care costs.

Republicans have long touted the quality care and patient choice offered by Medicare Advantage plans. When the health care bill was being considered in 2010, we warned at the time that Medicare cuts being proposed in the bill would hurt seniors, damage Medicare Advantage, and weaken a program already hastening toward bankruptcy. Despite this, Democrats not only supported the health care bill, they also voted twice against measures to repeal the law's cuts to Medicare Advantage.

Now it seems many Democrats have changed their minds. Earlier this month, 19 Democratic Senators, most of whom voted for ObamaCare in 2010, joined a number of Republicans in sending a letter to Marilyn Tavenner, Administrator of the Centers for Medicare & Medicaid Services, urging her not to cut Medicare Advantage. Let's hope it is not too little too late.

Democrats' support for the Medicare Advantage letter to the CMS Administrator reflects their increasing unease with their support for ObamaCare. Once they planned to tout ObamaCare to voters as a legislative triumph, but Democrats up for reelection now can't run away from the law fast enough.

In fact, the President has repeatedly delayed parts of the health care law to give Democrats political cover. Each delay is a tacit admission that, yes, this law will hurt jobs and the economy because, after all, if this law is not going to hurt jobs and the economy, why do we have to continually delay it? The latest number is somewhere in the twenties. I have heard 24, 27, and 28 different delays of the harmful effects and impacts of ObamaCare.

If the health care law is the panacea the American people were promised, Democrats and the President would be working to implement the law faster, not slow it down.

The only possible reason to delay the law is because its implementation is going to hurt. It is a little awkward when your signature legislation has to be repeatedly delayed to give the folks who voted for it a better chance of keeping their jobs.

Unfortunately, the President doesn't seem to have learned his lesson. Not content with the damage his health care law is doing to an already struggling economy--a recent CBO report warned that the health care law may result in up to 2.5 million fewer full-time workers--he continues to push policies that will further weaken an already sluggish economy, such as a minimum wage bill that CBO reports would result in up to 1 million fewer jobs.

At a time when our labor force participation rate is at Jimmy Carter- era lows, a law that would further reduce the number of full-time workers is one of the worst possible things we could do for our economy. People working produces economic growth. The fewer people working, the less likely we are to produce the kind of growth we need to pull our economy out of the slump it has been in throughout the President's administration. What we need right now are policies that will create jobs and encourage businesses to expand and invest in our economy and in our workers.

If the President were really serious about reversing the economic stagnation of the past 5 years, he wouldn't be pushing his health care bill or a minimum wage hike. Instead, he would be calling the Senate majority leader and urging him to take up and pass trade promotion authority, which will create thousands of jobs for American workers. He would sign off on the Keystone Pipeline and the 42,000-plus jobs it would support. He would join bipartisan majorities in both Houses of Congress to support a repeal of the job-destroying medical device tax in his health care law, a tax that has already cost more than 33,000 jobs.

American families and workers are hurting. They have been hit hard by ObamaCare and the Obama economy. It is time for the President to give them some help.

I would argue there are bipartisan issues out there. The trade promotion authority, repealing the medical device tax, and the Keystone Pipeline have broad bipartisan majorities here in the Senate. We had a vote a year ago on the budget on repealing the medical device tax, and 79 Senators, including 30 Democrats, voted for that. The last time we had a vote here on the Keystone Pipeline, 62 voted in support of it, again representing broad bipartisan support for that initiative. We know the trade promotion authority is something that enjoys support from both Republicans and Democrats. All of these initiatives enjoy broad bipartisan support and are known job creators. Those are the types of things we ought to be focused on, not things that, according to the Congressional Budget Office, are going to cost more jobs.

Implementation of ObamaCare, according to the CBO report a couple weeks ago, will reduce the number of workers in this country by 2.5 million over the next decade. It also said it would reduce overall wages by about 1 percent. So that is fewer jobs and lower take-home pay.

Last week we had the report come out from the Congressional Budget Office that raising the minimum wage could cost up to 1 million jobs at the same time it is raising prices. So the very people we are trying to help are going to have fewer jobs and higher costs. How does that solve the problems our economy faces? How does that get people in this country back to work? How does that grow and expand our economy in a way that creates greater opportunity for middle-class families?

There are things we can do on which there is broad bipartisan support that are known job creators, that are known to expand and grow our economy. I would add to that list as well reforming our Tax Code. We have lost so much in terms of economic growth in the past few years since the recession and coming out of that recession because we have had subpar growth. We haven't seen the type of growth rates we normally see and experience coming out of a recession during a recovery. As a consequence, we have much larger deficits because when the economy is growing at a sluggish, anemic, slow rate, it means there are fewer people working, fewer people investing, fewer

people making money, and therefore fewer people paying taxes. We need the opposite. We need a growing, expanding, vibrant, dynamic economy fueled by policies in Washington, DC, that make it less expensive and less difficult to create jobs rather than more expensive and more difficult, which is what we see coming out of the Obama administration and the Democratic majority here in the Senate.

We can do better. We must do better for the American people, for middle-class families who have been hit hard by the effects and the impacts of this economy with fewer jobs, lower take-home pay, higher premiums, higher deductibles, and fewer choices of doctors and hospitals under ObamaCare. These policies are hurting the American people. We need to put policies in place that will help the American people by growing our economy and creating more jobs for middle-class Americans.

I yield the floor.

The following Senators are necessarily absent: the Senator from Missouri (Mr. Blunt), the Senator from Texas (Mr. Cornyn), the Senator from South Carolina (Mr. Graham), the Senator from Alaska (Ms. Murkowski), the Senator from Idaho (Mr. Risch), and the Senator from Pennsylvania (Mr. Toomey).

Further, if present and voting, the Senator from Texas (Mr. Cornyn) would have voted ``yea.''

The following Senators are necessarily absent: the Senator from Missouri (Mr. Blunt), the Senator from Texas (Mr. Cornyn), the Senator from South Carolina (Mr. Graham), the Senator from Alaska (Mrs. Murkowski), the Senator from Idaho (Mr. Risch), and the Senator from Pennsylvania (Mr. Toomey).

Further, if present and voting, the Senator from Texas (Mr. Cornyn) would have voted ``nay.''

Madam President, I come to the floor today to discuss the stagnant Obama economy and how ObamaCare is making it worse. This Monday marks the fifth anniversary of the day the President signed his trillion-dollar stimulus bill into law. In remarks he gave in Denver that very day he signed the bill, the President stated that the legislation marked ``the beginning of the end'' of the Nation's ``economic troubles.''

Five years later, however, the end of the Nation's economic troubles is nowhere in sight. The headlines of the jobs report released Friday say it all. The headlines from the Associated Press said, ``U.S. Economy May Be Stuck in Slow Lane for Long Run.''

The New York Times headline: ``Weakness Continues as 113,000 Jobs Are Added in January.''

From CBS News: ``Another month of weak job growth raises slowdown fears.''

From the Wall Street Journal: ``U.S. Adds 113,000 Jobs, in Latest Worrying Sign on Growth.''

From Reuters: ``U.S. employment fails to rebound strongly from winter chill.''

Well before passage of the stimulus, Presidential adviser Christina Romer predicted that the stimulus bill would reduce the unemployment rate to 5 percent by the year 2014. In fact, over the

past 5 years, the unemployment rate has never come close to falling that low. Last month's unemployment rate was 6.6 percent. If so many people had not dropped out of the labor force over the past several years, that number would be even higher.

If the labor force participation rate were the same as it was when President Obama took office, our current unemployment rate would be a staggering 10.5 percent. Despite the fact that the recession technically ended 55 months ago, we are still nowhere near where we need to be in terms of economic recovery.

CBS News reported on Friday that the economy would have to gain an average of 285,000 jobs per month for the next 3 years just to get us back to where we were before the recession. Yet job creation for the past year has not even come close to that. In fact, our economy has added just 180,000 new jobs per month, approximately, over the past year. If we continue at that same rate, it will take us over 5 years to return to where we were before the recession.

President Obama's economic policies have left our economy mired in stagnation. His health care law is making things even worse. Last week the nonpartisan Congressional Budget Office released a new report on ObamaCare. It found that ObamaCare will result in the equivalent of 2.5 million fewer full-time jobs over the next 10 years--2.5 million fewer jobs. Our economy is millions of jobs away from where it needs to be.

Our labor force participation rate is near a 35-year low. The President's health care law is going to result in 2.5 million fewer full-time jobs. How will that work? Well, the CBO report made it clear that ObamaCare provides disincentives to work, particularly for those at the low income end of the spectrum.

An individual receiving ObamaCare subsidies to pay for his or her health insurance may decide not to accept more hours or a higher paying job so that she or he does not exceed the income caps for receiving subsidies. At the higher end of the wage spectrum, workers may decide not to rise too far up the ladder so their income does not reach the point at which it would be subject to ObamaCare taxes. Thus, ObamaCare essentially traps workers in lower paying jobs, putting a de facto limit on the prosperity of literally millions of Americans.

The CBO reinforces that notion, not just by projecting that 2.5 million people will drop out of the workforce but also by projecting that those who stay in the workforce will earn less.

According to one analysis of the CBO report, ObamaCare will reduce total wages by an estimated $70 billion per year. Without question, most of this burden will be placed on lower and middle-income families who already are struggling to make ends meet. Furthermore, by providing Americans with disincentives to work, ObamaCare will limit our economic growth.

As the editors of the National Review put it, ``The depth of the Obamacare crater in the labor force isn't some abstract unemployment rate, but the lost value of the work those Americans would have done.''

Americans working creates economic growth. It is as simple as that. Encouraging Americans to work less or quit work altogether will undermine American prosperity and American families' security. Those who find work and are willing and able to fulfill their jobs deserve wages that are unhindered by a government takeover of health care.

Combine the CBO report with our experience of ObamaCare so far and the future does not look promising: lower income Americans living off meager salaries and government health care subsidies just to get by; middle-income Americans struggling to pay higher health insurance premiums and deductibles; and upper income Americans and small business owners too reluctant to create jobs and wealth for fear that they will be subjected to ObamaCare's burdensome taxes and regulations.

That is not the kind of future any American desires, but that is exactly the future ObamaCare is bringing us. In fact, for too many Americans, that future is already here. With ObamaCare's full implementation this year, Americans are facing huge premium increases and steep hikes in their out-of-pocket costs. They are losing access to their doctors and hospitals. All too often they are facing fewer hours with fewer benefits at their jobs as their employers struggle to comply with ObamaCare's taxes and mandates.

Even the President has tacitly acknowledged the burdens his health care law places on employers by once again delaying one of the law's job-destroying mandates. While I am glad some businesses will get relief until 2016, Congress should go further, much further, and ensure that every single American is protected from this disastrous law.

We can do better than ObamaCare and the President's economic policies. The President has called for 2014 to be a year of action. Republicans could not agree more. It is past time to take action to start reversing ObamaCare's damage and finally get our economic recovery off the ground.

Almost 2 weeks ago, the Obama State Department released its fifth environmental review showing that the Keystone XL Pipeline would have no significant impact on global carbon emissions. There is strong bipartisan support in both Houses of Congress for approving that pipeline and the 42,000 jobs it will support. The President needs to stop pandering to far-left environmentalists and immediately approve the pipeline and the good-paying jobs it will open for Americans.

Next, the President should pick up that phone he keeps talking about to call the Senate majority leader and tell him to bring the bipartisan trade promotion authority legislation to the floor. Passing trade promotion authority will help U.S. farmers, ranchers, entrepreneurs, and job creators gain access to 1 billion consumers around the globe. The majority leader needs to stop obstructing the jobs this bill would create and join Members of both parties to pass this important legislation.

Finally, the President should throw his support behind a repeal of the medical device tax in his health care law. This tax on lifesaving medical technology such as pacemakers and insulin pumps is forcing medical device companies to send American jobs overseas. There is strong bipartisan support for repealing the tax, and the President should add his.

Far too many Americans have spent the past 5\1/2\ years of the Obama Presidency struggling to get by. Household income has fallen. Health care costs have risen. Jobs and opportunity have been few and far between. For many Americans, the possibility of a secure economic future seems further and further out of reach. It does not have to be this way. We can turn our economy around by abandoning the President's failed economic proposals and embracing the kind of legislation that will open up new jobs and opportunities for the American people.

The three proposals I have outlined above are a good place to start. I hope the President will join Republicans and Democrats to get these priorities done.

I yield the floor, and I suggest the absence of a quorum.

Mr. President, I come to the floor today to discuss the many ways ObamaCare continues to negatively affect Americans.

Yesterday, the Washington Post published an article exposing yet another problem with healthcare.gov. I would like to share a couple of excerpts from that article. The article begins:

Tens of thousands of people who discovered that

HealthCare.gov made mistakes as they were signing up for a

health plan are confronting a new roadblock: The government

cannot yet fix the errors. Roughly 22,000 Americans have

filed appeals with the government to try to get mistakes

corrected. . . .

Those mistakes, according to the Post, include being overcharged for health insurance, being directed to the wrong insurance program or being wrongly denied coverage.

So what is the status of those appeals?

The Post reports:

For now, the appeals are sitting, untouched, inside a

government computer. And an unknown number of consumers who

are trying to get help through less formal means--by calling

the health-care marketplace directly--are told that

HealthCare.gov's computer system is not yet allowing federal

workers to go into enrollment records and change them. . . .

So let me summarize here. Mr. President, 22,000 Americans are either without insurance or are paying too much for insurance as a result of mistakes made by the Federal health exchange.

Healthcare.gov contains no appeals process. Attempts to find recourse by other means have been unsuccessful, and the administration's response is basically: Tough luck.

President Obama was interviewed by FOX News' Bill O'Reilly this weekend. One of the topics they covered was healthcare.gov's problems.

The President said:

The goods news is that right away we decided how we're

going to fix it. It got fixed within a month and a half. It

was up and running, and now it's working the way it's

supposed to. . . .

Let me repeat that The President of the United States said: `` . . . now it's working the way it's supposed to. . . .''

Well, tell that to the 22,000 people wondering why there is no appeals process on the Web site or why their paper appeals are stuck in a computer system at the Centers for Medicare and Medicaid Services, where, the Post says, the appeals process is currently stopped because ``the part of the computer system that would allow agency workers to read and handle appeals has not been built.''

When Bill O'Reilly asked President Obama about the Web site problems, the President responded by saying that--and I quote again--``I don't think anybody anticipated the degree of problems that you had on healthcare.gov.''

That is not an excuse. It was the President's job to ensure that people in the administration were anticipating the problems that would occur, and the President owes the American people an explanation of why he did not because this is not just a story of bureaucratic incompetence. It is the stories of the tens of thousands of individual Americans who are suffering as a result of the Web site glitches and who are wondering how they will afford their health care under ObamaCare--Americans like Addie Wilson, whose story is highlighted in the Post article.

Addie is a 27-year-old who makes just $22,000 a year. She was sure she would

qualify for a subsidy on the exchanges, and she was absolutely right. She did--only healthcare.gov did not tell her that.

So Addie phoned one of the call centers, which told her to sign up at the more expensive price she was quoted and to appeal the decision later.

Since her old insurance plan was on its way out and she needed surgery in January, that is what she did. Now she is stuck paying $100 more a month than she should be paying, along with a deductible that is $4,000 higher than it should be. That too-high of a deductible is of particular concern since she incurred huge hospital bills in January when she was forced to have surgery. If she does not get relief from the appeals process, she could end up paying $4,000 in medical bills that she should not have to pay and cannot afford.

But it is not just the Web site that is driving up Americans' medical bills--it is the law itself. As awful as Addie's situation is, at least maybe she will get help eventually. For millions of other Americans, their high deductibles are no mistake.

For too many Americans on and off the exchanges, the reality of the so-called Affordable Care Act has been a staggering increase in health care costs.

Some family plans on the exchanges carry deductibles of almost $13,000. That is more than some families will spend this year on their mortgage.

Upper-income families may be able to absorb these costs--and some limited help is available for lower-income families--but what middle- class family can afford $13,000 a year in medical costs?

Too many families around the country will be putting on hold their plans to buy a home or send their kids to college because they have to devote every spare dollar to paying their health care bills.

On top of crippling cost hikes, many of these same families are facing the loss of doctors and hospitals, as insurance companies narrow their networks in response to ObamaCare's mandates.

So far I have only mentioned the personal devastation ObamaCare is causing. But ObamaCare is not just affecting families' pocketbooks; it is affecting the economy as a whole.

In response to ObamaCare's burdensome mandates and new taxes, businesses are cutting employees' hours, declining to hire new employees, and abandoning their plans to expand. That means fewer jobs available for the millions of Americans looking for work and fewer opportunities for career growth and advancement.

In fact, just this morning, there was a story in the Wall Street Journal, and it references the Congressional Budget Office report that estimates now that the impact of this law through the year 2024 will mean 2.5 million fewer jobs--2.5 million in job losses as a result of ObamaCare. It is so much so that you see many of the very labor unions that supported and wholeheartedly endorsed ObamaCare when it passed coming out now and saying ``[i]t would be a sad irony''--and I am quoting from a letter that went out from several of the labor unions-- ``[i]t would be a sad irony indeed if the signature legislative accomplishment of an Administration committed to reducing income inequality cut living standards for middle income and low wage workers.'' The letter also says that the ObamaCare law ``undermines fair marketplace competition'' and that they are ``bitterly disappointed.'' This comes from labor unions in this country that wholeheartedly endorsed this law when it passed several years ago.

The American people have endured 5 years of economic stagnation, and ObamaCare has been making things worse.

The President has called for 2014 to be a year of action, but I have seen no evidence that he plans to address the causes of our sluggish growth or provide relief for the millions of Americans struggling with crippling health care costs.

Republicans have a number of health care proposals, from comprehensive plans like that proposed by Senators Coburn, Hatch, and Burr, to commonsense ideas to lower costs by allowing businesses to pool together to negotiate lower rates, and by allowing insurance companies to sell health care plans across State lines to promote more competition and give people more choices.

If the President really wanted to make health care more affordable and accessible, he would abandon this government takeover of one-sixth of our economy and work with Republicans to pass real health care reform. But given the President's record, I am not holding my breath that is going to happen.

But at the very least--the very least--I hope the President will see his way to supporting bipartisan proposals to improve the economy and to open new jobs and opportunities to struggling Americans.

Just last Friday, the Obama State Department released its fifth environmental impact study on the Keystone XL Pipeline. Once again, the review found that the pipeline would have no significant impact on global carbon emissions. Senators and Representatives of both parties support this job-creating measure. It is high time for the President to approve the pipeline and open the 42,000 shovel-ready jobs it will support.

He should also pick up the phone that he keeps talking about to call the Senate majority leader to tell him to stop obstructing bipartisan trade promotion authority legislation that would help American farmers, ranchers, entrepreneurs, and job creators gain access to a billion new consumers around the globe.

The President and the majority leader held a White House meeting yesterday, we are told, yet an aide reported that there was no discussion of the majority leader's antitrade comments last week.

Given this legislation's importance for increasing American jobs, it is difficult to understand why the President would not bring this bill up at that meeting.

Finally, the President of the United States also should join the vast bipartisan majority in the Senate that supports repeal of the job- killing ObamaCare medical device tax, which is forcing American companies to send jobs overseas.

The President will be visiting the Democrats' retreat tomorrow, which would be a prime opportunity for him to get on the same page with his party in support of these bipartisan measures.

Republicans are ready and willing to work with the President and with Democrats, and we hope we will have willing partners to do the things that are necessary to get people back to work, to create jobs, to grow our economy, and to help provide and build a better future for middle class families in this country.

The American people should not have to wait any longer.

I yield the floor.

Mr. President, I appreciate the comments of my colleague from Arkansas and prior to him those of my colleagues from Missouri and Wyoming--we will be hearing in a minute from my colleague from Nebraska--all of whom are expressing sentiments that are conveyed to them by their constituents in their individual States about the very real and very personal impacts ObamaCare is having on them.

Last night, in the President's State of the Union speech, he sort of glanced over that issue. It is kind of the equivalent of a driveby. He sort of acknowledged the law. He said it is not going to change and if Republicans have better ideas, then come forward with them.

We just heard the Senator from Missouri, Mr. Blunt, list 10 or 12 things that we think could be done that would be dramatically different and would be a dramatic improvement in a very different approach from what is included in ObamaCare, which is a heavyhanded, government- driven solution to health care, which essentially puts the health care in this country, which is one-sixth of our economy, under political control here in Washington, DC.

As a consequence, what we are seeing out there are higher premiums, higher out-of-pocket costs in the form of deductibles and copays, canceled coverages, and fewer choices when it comes to doctors and hospitals. That has been the real-world impact of the passage of ObamaCare. The President said when he was running for office he was going to reduce health care costs by $2,500 per family. We now know they have gone up, since he has taken office, by about $2,500 per family, and they continue to go up all the time.

We hear consistently from our constituents in our individual States, and those stories that are being shared this morning are good examples again of the real-world impact of this law and why it is so important we go back, start over, and do this the right way, with reforms that actually address the issue of creating more competition, more choice for individuals, allowing market forces in the world of health care as opposed to having this overreaching government approach, which clearly has not worked.

The one thing I and many of us got up and talked about when ObamaCare was being debated was the fact that there was not anything in there that constrained utilization or that put downward pressure on costs. So costs keep going up. That keeps getting passed on. Taxes keep going up. They keep getting passed on. What does that mean? For middle-class families it means higher premiums and higher deductibles, higher copays, and in many cases fewer jobs because that is the impact it is having on the economy, and it worsens the very thing the President says he is most concerned about; that is, the issue of income inequality. Because when you are driving up the cost for consumers in their daily lives--and I would say health care for most people is a very significant cost and I would add energy to that--but those are a couple of things where we have seen policies that have made it more expensive for middle-class Americans to make ends meet. Health care is certainly an example of that.

I would like to share a couple examples from my State. Of course, as has been mentioned earlier by my colleagues, we hear these stories in the form of emails, letters, phone calls coming into our offices. Lest anybody think what we do is done in a vacuum, these are not abstract issues. These are very real personal experiences that people across this country are having.

This is a letter from a constituent in Harrisburg, SD, which is a growing community near Sioux Falls, SD. It is a growing, vibrant community. The letter says:

My wife and I have been fortunate to have become small

business owners and entrepreneurs. So far, we have been

successful of living the American dream for the last 3 years

and have seen great success at what we do.

Unfortunately, with ObamaCare, we are needing to make

choices I never thought we would have to make.

Based upon the rates for health insurance, we would be

paying approximately $800 out of pocket per month.

Essentially, we are thrown in to make an additional house

payment per month, or face a penalty at the end of the year

and not have health insurance.

This constituent goes on to say:

Needless to say, I am very disappointed and upset right

now. I feel I am being taken advantage of because I am a

small business owner and wanted to live the ``American

Dream.''

This next statement is from another constituent who is from Rapid City, and this is in the form of a letter regarding the President's broken promises. He says:

Bottom line is the president lied to us. He said if we like

our policy we can keep it. He said we would be saving around

$2,500 a year. Wrong on both Accounts.

He then concludes:

When our policy expires it will be cancelled and we will

have to pay almost triple what we're paying now.

Those are examples from my State of South Dakota, and my colleague from Arkansas shared some examples from his State. I know my colleague, my neighbor from Nebraska, Senator Johanns, hears many of those same stories coming from his State. He represents people very much like those I represent in South Dakota who in many cases make their living the same way and are experiencing the economic consequences of a bad policy, a failed policy, a bad law that was rushed through here, and they now--the American people--unfortunately, are experiencing the adverse impacts of that in their own personal economic lives and, in a broader sense, on our economy nationally. Higher costs, canceled coverages, fewer choices in the form of doctors and hospitals, and fewer jobs for American workers whom we want to get back to work, that is the real-world experience.

There is a better way. The Senator from Missouri talked about many of those ideas. I hope the President would work with us to repeal this bad law and start over in a way that makes sense for the American people and for our health care economy in this country.

I yield the floor.

Madam President, I ask unanimous consent to speak for no longer than 15 minutes.

Madam President, tonight the President of the United States will come before the Congress and make his State of the Union Address. That is an annual ritual we go through around here every year, and I have been through State of the Union speeches through multiple administrations. I sort of liken them to somebody making New Year's resolutions at the beginning of the new year, filled with lots of rhetoric and promises, most of which get left on the cutting-room floor when the speech concludes. But that being said, it is something that gives the President an opportunity to lay out his agenda for the coming year.

Rumor has it that this year the President's speech is going to focus on income inequality and economic opportunity. Well, that is good to hear because these last 5 years of the Obama administration have been devastating to Americans who are trying to advance economically.

Nobody can deny that the President inherited a difficult economic situation. I think we would all concede that at the very outset. But he has had now 5 years, going on 6, to make things better. Unfortunately, he has not made much progress.

For the majority of Americans, things do not look much better today than they did 5 years ago. The economy still is not working; unemployment remains at historic recession-level highs; income inequality is at the highest point literally in 86 years; household income has dropped by nearly $4,000 since the President took office.

I would like to quote from a piece that was published on Sunday. It said this:

The last five years have been cataclysmic. . . . The

average income of the top 1 percent of earners increased

about 31.4 percent from 2009 to 2012, while wages for the

other 99 percent essentially stood still. The proportion of

economic gains going to the very wealthy under the Obama

administration is greater than it was under Mr. Bush.

Those are not Republican talking points. That is from a column published in the New York Times. The column goes on to state:

The rich-poor gap in the United States is now greater than

in any other industrialized country. Upward mobility, a

staple of the American Dream, is eroding compared with more

than a few nations.

That again is from the New York Times.

Whether the author intended it that way, it is a pretty damning indictment of the economic policies of the past 5 years.

So I am glad to hear that the President is planning to focus on income inequality and economic opportunity tonight. These statistics make it very clear just how important it is we have that discussion right now. And they also make it clear we cannot continue the economic policies of the past 5 years because these policies have clearly failed.

The President has tried throwing taxpayer money at the problem-- witness the failed trillion-dollar stimulus bill. He has tried economic bandaids that attempt to alleviate some of the symptoms of economic stagnation without doing anything to address the cause. Neither of those strategies has been successful in doing the one thing that will turn our economy around; that is, creating full-time, well-paying jobs for the American people.

Extending unemployment benefits or offering food stamps may provide short-term relief, but no government assistance is going to provide a stable, secure, prosperous future like a good job will. Real long-term economic security and prosperity comes when families have access to stable well-paying jobs, with the potential for advancement.

If we really want to help Americans, if we really want to get our economy growing, that is where our focus needs to be: creating the kind of environment where job creation can flourish. That means making it easier and less expensive for businesses--particularly small businesses, which create a majority of the jobs in this country--to expand and hire new workers.

Unfortunately, the President has spent much of his Presidency making it more difficult. ObamaCare, for example, saddled businesses with a host of new taxes and regulations that have

made it difficult or in some cases impossible for businesses to hire new employees.

CBS reported in December that--and I quote--``Nearly half of U.S. companies said they are reluctant to hire full-time employees because of the [ObamaCare] law.'' That is not how you want businesses to feel if you are looking to encourage them to grow and create jobs.

So I am hoping that this evening the President will turn away from the policies that have made nearly half of U.S. companies too worried to hire new full-time employees and turn toward policies that will enable real job creation in our economy.

According to his advisors, the President wants 2014 to be a year of action. Republicans could not agree more, and there are a number of actions we think the President can take, and I hope he will announce them tonight.

One thing Republicans and Democrats agree on, and would like the President to do, is grant immediate approval of the Keystone pipeline. According to the President's own State Department, the Keystone pipeline would support 42,000 jobs that would provide $2 billion--$2 billion--in wages and earnings without taxpayers having to spend a dime. All that is required for the creation of these jobs is the President's approval, which he has inexplicably delayed now for 5 years, despite numerous reports testifying to the benefits of the project and its low environmental impact.

The President's staff has spent a lot of time over the last week talking about the President's intention of acting without Congress when Congress disagrees with him. Well, here is something the President can legitimately do unilaterally. He has the authority to open the door to these 42,000 jobs, and I hope this evening he will announce his intention of acting on approval of the Keystone pipeline.

Another thing I hope the President will do tonight is encourage the majority leader to take up dozens of jobs bills that have been passed by the House of Representatives. Many of these bills passed the House with bipartisan support and could pass the Senate the same way. There is no good reason why the majority leader has decided to let them languish. Surely we could take up a few of those bills. The President ought to call on his party to pass these bills to get Americans back to work.

In the same spirit, I hope the President will call on his party in the Senate to approve trade promotion authority legislation, which would help create U.S. jobs by giving farmers, ranchers, entrepreneurs, and job creators in this country access to 1 billion new consumers around the globe.

Republicans hope the President will use that phone of his that he keeps talking about to call the majority leader here in the Senate and encourage him to pass trade promotion authority as soon as possible.

Of course, no discussion of relief for middle-class Americans and job creators is complete without discussing ObamaCare, which is putting an intolerable burden on middle-class families and small businesses.

I am not very hopeful that the President is going to announce his intention tonight of working with Congress to repair some of the worst parts of his signature law, but for all Americans' sake, I hope he does.

Around the country, families are reeling under the impact of ObamaCare: higher insurance premiums, higher out-of-pocket costs, reduced access to doctors and hospitals. Meanwhile, businesses are cutting workers' hours, eliminating health care plans, or declining to expand their businesses to protect themselves from ObamaCare's burdensome taxes and regulations.

There is bipartisan support for more than one change to ObamaCare, and there is particularly strong support for repealing the job-killing medical device tax, which is forcing medical device companies to send American jobs overseas.

In March of last year, the Senate voted 79 to 20--79 to 20--against the tax. More than 30 Democrats voted for repeal. If the President is really serious about putting Americans back to work, he will announce his intention of working with Congress to repeal this job-destroying portion of his legislation.

Last month almost 350,000 Americans gave up looking for jobs and dropped out of the labor force altogether. That is 350,000 Americans in 1 month--1 month--who gave up looking for a job.

The labor force participation rate is at its lowest level in 36 years. More than 10 million Americans are looking for work, and nearly 4 million of them have been unemployed for more than 6 months. In fact, if you had the labor participation rate today that we had when the President took office, the unemployment rate today would be about 11 percent.

It is definitely--it is definitely--time for a year of action. It is time to leave behind the economic bandaids of the past 5 years and focus on policies that will not address just the symptoms but the cause of our weak economic growth.

We need to remove the obstacles facing our Nation's job creators so that struggling Americans can finally get back to work. We need to help create a future where every American has the opportunity for a well- paying, full-time job, with the possibility of advancement. You are not going to see that as long as the policies coming out of Washington, DC, and this administration make it more expensive and more difficult to create jobs for the American people.

And you are not going to do anything about income inequality if you drive people's cost of living higher, which is what ObamaCare's premium increases, higher out-of-pocket increases, energy-cost increases--there are new regulations coming out today that are going to put new requirements and regulations on existing coal-fired powerplants that are going to drive electricity costs through the roof for people whom I represent in South Dakota.

Fifty percent of the electricity in South Dakota comes from coal- fired power. We are told the administration is coming out with regulations that are going to apply those same things that apply to new plants to existing coal-fired power. So you are going to have not only new plants that are going to be prevented from being constructed but those that are existing that are going to have to modify their plants at enormous cost, in many cases with technologies that do not exist. All that does is put people out of work and makes it more expensive for middle-class Americans to make ends meet.

If you want to do something about income inequality, provide good- paying jobs for middle-class families in this country. Put policies in place that make it less expensive, less difficult to create those jobs, and then drive down the cost for middle-class Americans rather than raising them--rather than having higher energy costs, higher health care costs, higher this, higher that, all because of policies coming out of Washington.

We can do better. The President has not always shown his eagerness to work with Congress in the past. I am told that tonight he is going to talk about all the things he can do unilaterally. I hope that tonight's State of the Union Address will mark a new start. Republicans are ready to get to work. I hope the President is too. I yield the floor.

Recess

Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Madam President, I come to the floor today to talk about the damage ObamaCare is doing to our struggling economy.

After months of unrelenting coverage of ObamaCare's many problems and after Friday's release of December's dismal job report, I am sure Democrats in the Senate would prefer we talk about almost anything else. After all, when you have held most of the power here in Washington for the last 5 years, you don't want to mention the fact that your main legacy is a sluggish economy and a disastrous train wreck of a health care program.

This past Friday we found out December marked the weakest month of job growth since January 2011. The economy added just 74,000 jobs in December--less than half of the monthly job growth needed for a real recovery.

Some are saying perhaps this is an aberration, and perhaps it was for a 1-month period. But the one thing we can't get away from is that December's drop in the unemployment rate--the slight drop that we saw as a percentage--was driven by nearly 350,000 Americans dropping out of the workforce altogether, driving the labor participation rate to its lowest level in 36 years. We haven't seen the labor participation rate this low since the Carter administration.

Had millions of Americans not stopped looking for work since January of 2009, the unemployment rate would be a staggering 10.8 percent. What I mean is if the labor participation rate were today what it was in 2009--in other words, the number of Americans actually in the labor force looking for jobs--the unemployment rate would be almost 11 percent, a significantly higher number than what we use as the official unemployment rate today. Even without that, the Wall Street Journal points out that ``the unemployment rate remains near levels previously seen only during recessions.''

Let me repeat that: The Wall Street Journal states that ``the unemployment rate remains near levels previously seen only during recessions.'' That is a pretty damning statement.

The President and his advisers would like us to believe that President Obama's policies are growing our economy and putting Americans back to work. But in the 5 years of his Presidency, all Democrats have been able to accomplish is a recovery that looks a lot like other Presidents' recessions.

In his weekly address on Saturday, the President said he would do ``everything I can to create new jobs and new opportunities for American families.''

How does he propose to do that? By treating the symptoms, not the causes, of economic stagnation. Economic bandaids like the President proposes may temporarily help a few Americans, but they will do nothing to bring about the real long-term job growth our country needs. Unfortunately, the President's policies are actually hurting already struggling middle-class families and making it more difficult for businesses to grow and create jobs.

Chief among the President's failed policies is the massive boondoggle known as the Affordable Care Act. If there is one thing you don't want in an economy where businesses are already struggling, it is legislation that places everything from new taxes to burdensome new regulations on businesses, and yet that is exactly what ObamaCare does.

There is a tax on medical devices, like pacemakers and prosthetics, which is driving medical device jobs overseas and driving medical bills up for American patients. There is a pill tax, which is a tax on prescription drugs. There is a tax on businesses that do not provide a government-approved health care. There are multiple taxes on health insurance companies, and more.

Then there are the scores of new regulations which raise the cost of doing business--regulations like the requirement that any business with 50 or more workers provide ObamaCare-approved health insurance benefits to its full-time employees, which the health care law defines as 30 hours or more per week. That is all very well for some employers, but for many employers in industries with small profit margins, providing Obama-approved health care to full-time workers is the difference

between making a profit and making none at all. For employers in nonprofit fields like education, it can be the difference between staying in operation or closing.

Around the country, school systems, community colleges and universities, restaurants, and other small businesses are being forced to cut workers' hours to avoid the full burden of ObamaCare's mandate. It is no wonder the health care law is so unpopular with the owners of businesses, both large and small.

CBS News reported in December:

Nearly half of U.S. companies said they are reluctant to

hire full-time employees because of the law.

A survey from the National Association of Manufacturers found that more than 75 percent of manufacturers cite soaring health care costs as the biggest issue facing their businesses.

I ask unanimous consent for an additional 5 minutes.

In addition to being bad for business's bottom line, ObamaCare is placing a tremendous financial burden on American families.

The President claimed his health care law would reduce the cost of health care, but the average family has seen a $2,500 premium increase since the law's passage--and now that the law is being fully implemented, that number is set to soar even higher.

One of my constituents, Carrie, emailed me to tell me she may have to take a part-time job to afford the health care premium she was quoted for a family of 6. That is a part-time job on top of the two part-time jobs she already works and the full-time job her husband works.

Another constituent, Matt from Rapid City, SD, emailed to tell me his insurance has gone up 60 percent. Meanwhile, his wife's hours at work have been reduced below the ObamaCare full-time threshold of 30 hours. ``We have had to cut back on basic needs,'' he told me.

Terry contacted me to tell me his insurance policy was cancelled, and that he was offered a replacement policy for twice the cost of his original policy. ``Now \1/4\ of my salary will go to my insurance.'' That is a quarter of his salary.

Is this the affordable care Americans were promised?

Democrats claim they want to grow the economy, but what do they think happens to the economy when businesses aren't growing and people aren't spending? When Americans have to devote more of their income to paying their health care bills, they cut back on other spending, they go out to fewer restaurants, they keep their old car for a few more years, and they put a bucket under the leak instead of paying for a new roof. That is a lot of money not going to local businesses.

Similarly, when businesses are hit with burdensome taxes and regulations, they cut back on hiring and investment, they cut workers' hours, and they move jobs overseas. That means fewer jobs for the millions of Americans looking for work and lower wages for families already struggling to get by.

If Democrats were really serious about growing the economy and creating jobs, they would stop focusing on economic bandaids and start a long, hard look at the damage ObamaCare is doing to our economy.

As Members of Congress, we need to make it easier to create jobs, not harder. We should be repealing burdensome mandates, not creating them. We should be reducing the tax burden, not increasing it, and we should be creating incentives for businesses to expand, not eliminating them.

Millions of Americans spend too much time wondering how they are going to afford their health care premiums or buy a house or send their kids to college. We need to give them the economic opportunities they need.

Over the past few weeks Republicans in the House and in the Senate have introduced plan after plan to get our economy moving again and help struggling families find better jobs and increased wages.

I recently introduced a plan to exempt long-term unemployed workers from the ObamaCare mandate, an onerous and unpopular provision which will destroy jobs and reduce hours for hardworking Americans. In fact, this mandate is so unpopular and so unworkable that the administration unilaterally delayed it past the next election.

Since even the administration doesn't want to enforce it, I think we can all agree that exempting the long-term unemployed will help break the cycle of extended unemployment that plagues the Obama economy.

We hope Democrats will abandon their short-term cosmetic fixes and join us in talking about the kind of long-term reform which will truly grow the economy and offer economic opportunity to every American. We have lived in the Obama economy long enough.

I yield the floor.

Mr. President, I rise today to discuss amendment No. 2622 I have filed, the Solutions to Long-Term Unemployment Act, that will be before the Senate today.

The bill before the Senate today would extend emergency unemployment benefits for the 13th time since 2008. Let me repeat that. Congress has enacted or extended emergency unemployment benefits 13 times over the past 5 years. At some point you have to start asking yourself: At what point does this no longer become an emergency but it becomes permanent? We have been doing this now for 5 years. This will be the 13th time.

Obviously, there are lots of people in a tough economy who are still hurting. But what this should say to us is that it is time we started not just treating the symptom but fixing the problem we have in America today. And the problem we have is a sluggish economy that continues to sort of stumble along. We have a chronically high unemployment rate with lots of people who have been unemployed for a very long period of time. Over that same period, Congress has pushed through ObamaCare, raised taxes on job creators, while the administration has pursued aggressive regulations that have done little more than drive up costs for many of our small businesses.

So after 13 extensions of unemployment benefits, expensive new regulations, and higher taxes, what is the result? Well, today over 37 percent of unemployed Americans have been out of work for 27 weeks or longer. That represents over 4 million men and women who have been most impacted by President Obama's failed economic policies.

I applaud my colleagues on the Republican side of the aisle who have offered up commonsense, even bipartisan, ideas to pay for the extension of emergency unemployment benefits. If we extend these benefits once again, I am hopeful we can find an appropriate way to pay for this extension and not pass the bill on to our children and grandchildren. However, I also have to come to the floor today to challenge all of my colleagues to look at solutions to the underlying problem rather than simply treating the symptoms of long-term unemployment for yet the 13th time.

The underlying problem is we have 4 million Americans who have not been able to find jobs for more than 6 months on account of the stagnant Obama economy. That is almost double--double--the amount of long-term unemployed Americans relative to prerecession levels. So my amendment addresses the underlying problem of long-term unemployment by reducing labor costs, increasing worker mobility, and strengthening Federal worker training programs.

First, my amendment would provide much-needed relief from ObamaCare for any employer who hires an individual who has been unemployed for 27 weeks or longer. As we all know, ObamaCare is full of additional costs and mandates that are stifling economic growth. The ObamaCare employer mandate arguably has the greatest impact on an already weak labor market. The impact of this mandate is so great the administration has unilaterally delayed it until after the next election. Under this mandate, a business with 50 or more employees must provide government- approved insurance or pay an annual penalty of $2,000 to $3,000 per employee. For a smaller or medium-sized business, that is a significant deterrent to expanding and hiring more workers.

Under my amendment, if a business decides to hire someone who has been out of work for 27 weeks or longer, that person would be exempt from the ObamaCare mandate for as long as he or she works at that business.

Second, my amendment would further reduce labor costs by providing a 6-month payroll tax holiday for any employer who hires a long-term unemployed worker. Employers currently pay a payroll tax of 6.2 percent of an employee's wages up to a capped amount known as the Social Security wage base. Waiving this tax is an incentive for employers to hire those employees often considered to be a higher risk by virtue of the fact they have been out of the labor force for an extended period of time.

Consider a job that is paying an annual wage of $40,000. The employer payroll tax holiday in my amendment represents a $1,240 incentive for the employer to hire a long-term unemployed individual. Or take a higher skilled job paying $80,000 annually. A payroll tax holiday represents a $2,480 incentive for the employer to hire someone who has been unemployed for 27 weeks or longer. When coupled with the ObamaCare exemption in my amendment, that is an incentive of roughly $5,000 to hire an individual who has been unemployed for an extended period of time.

Third, my amendment addresses a fundamental problem facing the long- term unemployed by providing relocation assistance to start a job or find better opportunities.

While the national labor market remains weak, there are pockets of prosperity across the country. In my home State of South Dakota, we have an unemployment rate of 3.6 percent. That is second only to our neighbors in North Dakota who are fully embracing the energy renaissance which is occurring in the Upper Great Plains and other parts of the country. Because of South Dakota's low tax and regulatory framework, it consistently makes us one of the best places in the United States to start and grow a business. In fact, one of the biggest issues we hear from prospective business investors is a concern they are not going to have enough workers if they decide to move to my State.

Meanwhile, we have other parts of the Nation that continue to struggle with persistently high unemployment rates. Virginia has an unemployment rate of 8\1/2\ percent, and Rhode Island has 9 percent. The number of job openings and hire rates varies from region to region as well. This past summer the rate of job openings in the South was 20 percent greater than in the Northeast. The same trend exists for hiring rates between those two regions.

Part of a dynamic 21st economy is ensuring a mobile workforce that can meet regional demands for good-paying jobs. However, if you have someone who has been living off of unemployment benefits for the past 6 months, that person likely does not have the resources to move to a new State for a new job.

My amendment would provide a low-interest loan of up to $10,000 for anyone willing to relocate to a new job or move to a new State with better employment opportunities. These loans would have to be repaid within 10 years, but no payments would be required for 1 year while that individual or family gets back on their feet. Additionally, if the new job is eliminated within that first year, through no fault of the employee, the loan could be forgiven.

Finally, my amendment would strengthen and streamline Federal worker training programs. We currently have over 50--50--Federal training programs across 9 Federal bureaucracies. It is a broken morass of programs that isn't helping employers or employees, and it certainly isn't an efficient use of taxpayer dollars. Even President Obama, in his 2012 State of the Union speech, said he wanted to ``cut through the maze of confusing [job] training programs'' and create ``one program'' for workers to find the help they need. Unfortunately, like many of the President's promises, that turned out to be more talk than action.

While the President has failed to put forward a real plan to reform our worker training programs, the Republican-led House of Representatives has acted on a plan to accomplish just that. The House- passed SKILLS Act includes several critical reforms that ensure workers receive the training they need for positions that businesses need filled today.

The SKILLS Act would consolidate 35 redundant and ineffective Federal worker programs into a single workforce investment fund that would serve as a single source of support for workers, employers, and job seekers at the State level. This legislation creates much-needed flexibility at the State level and it empowers Governors and local employers to train workers for today's in-demand jobs.

The SKILLS Act cuts through redtape and eliminates barriers that oftentimes keep workers from receiving the training they need when they need it. For too long we have been throwing taxpayer dollars at a maze of overlapping bureaucracies when we should be providing more targeted assistance directly to job seekers. We need to be training our workers for the high-tech jobs of today and the jobs that will continue to be in demand in the future.

The SKILLS Act accomplishes these goals, which is why I included it in my amendment as a commonsense way to help the long-term unemployed try to find work in today's economy.

There is no one solution to helping the unemployed. However, one thing is clear: We need to find ways to make it more attractive for employers to invest in and hire workers rather than constantly pushing legislation that will raise the cost of doing business in America.

Let's think for a second about the bills the Democratic majority supports or supported in the past. ObamaCare raised the cost of labor, it drove up premiums for millions of Americans and made it more expensive for employers to hire new employees.

Raising the minimum wage will raise the cost of hiring new employees and only worsen the job prospects for the long-term unemployed.

The tax increases pushed by Democrats here in the Senate and the White House apply to millions of small business owners which discourages investment and job growth.

New environmental regulations are driving up the cost of energy and, therefore, the cost of doing business in this country.

I am not suggesting the provisions in my amendment are the only way to make it more economical for employers to hire more workers, but I am suggesting if we want more employment, we need to make it less costly, not more costly, to hire each additional employee. It seems that nearly every policy pursued by the Democratic majority and the White House would raise costs on businesses, especially those small businesses which create the majority of jobs in this country.

We have tried the approach of bigger government, higher taxes, and more regulations for the last 5 years and it has not worked. Let's try something different. Let's have a real debate about how we lower cost and make it easier for employers to go out and hire new employees. Let's focus our efforts on those who need the most help, such as those Americans who have been out of work the longest on account of the lagging Obama economy.

I hope this amendment as well as others that my colleagues will offer will have an opportunity to be heard here on the floor of the Senate and voted on. What we have going on here now in terms of a process doesn't resemble anything like an open process that should allow us to openly debate the big issues that affect the American people. This is a pocketbook issue. This strikes at the very heart of the quality of life, the standard of living, the future economic well-being of Americans all across this country.

I certainly hope the majority leader will allow for an open process which will enable us to enter into that debate, to put forward proposals--mine, among many others--which could be considered and voted on that would actually improve the overall situation of middle-class Americans. It is high time we had that debate. I hope we can, and I hope the majority will give us that opportunity.

Mr. President, I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, we just heard a very eloquent speech given by

the Republican leader on the Senate floor about the history of the Senate and the role it has played in our democracy, its past, and what could be its future if we can restore it to where it once was.

The leader talked a lot about what used to be taken for granted around here, such as the committee process working and functioning where committees reported legislation out, worked on it, and brought it to the floor.

We had an amendment process. When legislation got to the floor, it could actually be debated. We would have amendments offered and amendments would be voted on. Individual Senators had an opportunity to offer amendments and could thereby be the voice our people who elected us to be here in the Senate.

Unfortunately, in many respects with this current Senate, the wheels have come off. We find ourselves with a process where typically the amendment tree is filled, which blocks amendments from being offered. Perhaps the best factoid with regard to that is that there have only been four Republican amendments voted on since July--half a year. Over the course of half a year, we have had four Republican amendments that were voted on in the Senate. In any institution where there is any form of open debate and open amendment process, there is going to be a lot more votes than that, and I think that is very telling about where we are.

I was here as a young staffer back in 1985 and 1986. At that time Senator Bob Dole was the majority leader in the Senate. It was a very different place. I worked on some issues for my boss, and he had his opportunity, as did other Senators at that time, to come to the Senate floor, offer amendments, and speak out on behalf of his constituents on issues that were important to them and important to him, and that is something that has become a bygone era.

I also had the opportunity--prior to being elected to the Senate--to serve in the other body, the House of Representatives, where things are very structured. There is a rules committee there that basically regulates what legislation comes to the floor, what amendments will be made in order, and how much time is allowed for debate on each amendment. That is how that institution was structured.

The Senate, as Senator McConnell the Republican leader pointed out earlier, is a very different institution by design. Our Founders wanted it to be different. Senator Alexander, in his remarks, talked about an author who described the Senate as a touch of authentic genius. We have gotten very far away from that in terms of its historic role and certainly what should be its role today as we debate major policy and major legislation that impacts over 300 million Americans.

Today I come to the floor to discuss an issue that was debated here a few years ago, which is an example--a byproduct, if you will--of one- party rule, where a big piece of legislation is jammed through in a partisan way; that is, ObamaCare.

My colleagues on the Democratic side recently spent a lot of time talking about income inequality. After 5 years of stagnation in the Obama economy and an ever-growing gap between the rich and poor, I say it is high time for us to talk about that. But a critical part of that discussion that Democrats don't want to have has to be the ways in which ObamaCare is contributing to the problem.

As the last few months have made clear, ObamaCare is making it worse for millions of Americans. Huge premium increases and soaring out-of- pocket costs mean that families will have to take money that they would have used to buy their first home or pay for a child's college education and use it instead to pay for health care. Crippling mandates on employers mean that fewer jobs are available for the unemployed and hours are reduced for workers. As if the economic problems caused by the law aren't enough, recent weeks have made clear that the quality of care is likely to diminish thanks to the President's health care law.

Contrary to the President's promise that you could keep the doctor you had and liked, millions of Americans are discovering they will be losing their doctors this year and their choice of replacement is limited. Why? Because ObamaCare provides an incentive for insurers to limit the pool of doctors--and I might add hospitals as well--that you can visit. The President's health care law placed a number of new burdens on insurers, from new taxes to a requirement that everyone with preexisting conditions be covered at the same rate as healthy individuals.

On top of that, the law gave States the authority to tell insurance companies how much they are allowed to charge for their health plans. As a result, insurance companies are facing huge new cost increases with very few ways to cover those costs. Many companies have chosen the one cost control measure still available to them; that is, limiting their networks of doctors and hospitals.

In California, for example, as a Time magazine article recently reported, Blue Shield offered doctors a choice--be reimbursed up to 30 percent less for medical care or be excluded from the network. The Time article was entitled ``Keeping Your Doctor Under ObamaCare Is No Easy Feat'' and goes on to report that ``among the providers who declined to accept the lower rates were some of the state's most prestigious--and expensive--hospitals, including Cedars-Sinai Medical Center in Los Angeles and hospitals affiliated with the University of California.''

There is a reason these hospitals are prestigious and expensive. They are on the cutting edge of medical research and offer breakthrough treatments that are unavailable at many other hospitals. People come to these hospitals when other treatments have failed, and they often find hope. But these kinds of hospitals--world-class, cutting-edge facilities--are the hospitals most likely to be excluded from exchange plans.

Time reports that ``a December 13 McKinsey study of 20 U.S. Metropolitan areas found that two-thirds of ACA plans analyzed had `narrow' or `ultra' narrow networks, with at least 30 percent of top 20 hospitals excluded for coverage.''

The consequences of these narrow or ultranarrow networks are many. First, of course, these networks might not include your doctor. If you have been forced off your health plan into a new private plan or exchange plan, your new plan may not cover the doctor you have been seeing for years--the doctor you like and who knows your medical history. This is detrimental to any patient, but for someone who is being treated for a serious illness, this could be devastating.

Switching doctors midstream while being treated for cancer or another serious illness could have a disastrous impact on the quality of the care the patient receives.

In addition to losing the doctor you have and like, these narrow networks also mean your choice of a replacement will be limited--at times severely limited--and that the same quality of care may simply not be available in the new network.

Still another consequence, as Time points out, is the distance people may have to travel to get to their doctor or hospital. Excluding hospitals from an insurance network may not present a huge travel problem for urban residents--the article notes--but residents in rural areas may be forced to drive a long way to reach a hospital in their network.

Time quotes Kaiser Family Foundation senior fellow Karen Pollitz, who notes that exchange customers in central Maine have to travel as far as Portland to reach a covered hospital. That could be a 2\1/2\-hour drive. That is not exactly ideal if someone is, say, having a baby or a serious health crisis.

Let's suppose that you do somehow find an affordable plan on the exchanges that does cover your doctor. You still may not be able to get care. A recent FOX News article focused on expert warnings that the health exchange system may start to look a lot like Medicaid, the Federal health insurance program for the poor. Similar to the exchanges, Medicaid features narrow provider networks, as many doctors either refuse Medicaid patients all together or limit the number they see because of Medicaid's lower reimbursements.

So what is the result? Medicaid patients generally face worse outcomes than patients with private insurance.

They wait longer for doctors if they can get in to see them at all. The survey published in the New England Journal of Medicine found that 66 percent of children on Medicaid were denied appointments with specialists compared to just 11 percent of children covered by private insurance. Patients on Medicaid are more likely to suffer complications and spend longer in the hospital, and they are more likely to die from cancer, surgical complications, and other problems.

Unfortunately, this could soon be the future of those forced into narrow networks on the exchanges. Patients will be denied access to top doctors and hospitals and will be forced to compete with other patients for access to a limited number of health care providers. Even those Americans whose plans cover their preferred doctors will not necessarily be able to get in to see their doctor if he is forced to start limiting the number of exchange patients he takes.

Analysts, Fox News warns, ``emphasize . . . that having health insurance won't necessarily translate into access to health care.''

Let me repeat that: Analysts emphasize that having health insurance won't necessarily translate into access to health care.

This is what the grand promise of ObamaCare has come to: Even those who have managed to make their way through the broken exchange Web sites and find an affordable plan still may not be able to get health care.

Is this the rosy future we were promised? ObamaCare was supposed to fix our health care system. The President promised it would reduce costs and expand access to care. Every American was supposed to benefit. Instead, millions of Americans have lost their plans. Health insurance costs have soared. There are parents who now can't afford to insure their children and cancer patients who are losing their doctors and hospitals. Those few who have gained coverage are facing a system well on its way to becoming a copy of Medicaid.

Surely we can do better. We have to do better. It is time to abandon the failed ObamaCare experiment and move on to real health care reform. We can do that and we should do that.

I yield the floor.

Madam President, last night, due to airline flight delays in South Dakota and Minneapolis, I missed the roll call vote on the confirmation of Executive Calendar No. 452, Janet L. Yellen, of California, to be Chairman of the Board of Governors of the Federal Reserve System for a term of 4 years. Had I been present for this vote, I would have voted no.

Madam President, last night, due to airline flight delays in South Dakota and Minneapolis, I missed the roll call cloture vote on the motion to proceed to S. 1845. Had I been present for this vote, I would have voted no.

Mr. President, this week the Senate is considering a couple of fairly big items. We had a vote earlier this week on a budget proposal to fund the government for the next couple of years, and we also are going to be voting on a defense authorization bill that is very important to America's national security interests.

As we brought this legislation to the floor, there has been something conspicuously and noticeably absent; that is, open debate--something that used to be taken for granted in the Senate, a right that was accorded to Senators.

The nice thing about getting to the Senate, when you come from the House of Representatives, is that when you get to the Senate, one person can actually have the opportunity to get amendments voted on and have those amendments debated. In the House of Representatives, those of us who have served there, know there is a rules committee, and the rules committee decides what comes to the floor, what amendments are made in order, and how much time is allowed for debate on each amendment. It is a very structured process.

What the Founders conceived for the Senate was something different. They wanted us to have an opportunity to openly debate the big issues of the day. And there are no bigger issues, I would argue, than the budget proposal which will fund the government for the next 2 years and spend literally billions and trillions of dollars of the American people's tax money; and the Defense authorization bill, which will authorize in this case over half a trillion dollars of spending of the American taxpayers' money.

So these are big, consequential pieces of legislation brought to the floor of the Senate but not open to the debate, not open to the amendment process.

We just heard the Senator from Maryland talk about amendments which, if he had the chance to offer, he would have offered. That applies to a lot of us.

The Defense bill, when it comes to the floor here, will have probably gone through a fairly good vetting process. I served on the Armed Services Committee for 6 years. I think they did then and do now a good job of prioritizing when they come to the floor. But we have to remember, there are only probably 25 or so members of the Armed Services Committee, which means there are 75 Senators who haven't had an opportunity to have their voices heard on such a big piece of legislation.

The same thing with the budget. The budget conference really consisted of a couple people. In fact, I am told by conferees who were members of the Budget Committee and were supposed to be members of that conference, they really didn't vote on it. There was no vote on it when it left the conference. It was negotiated by a couple of people and brought to the floor to be voted on--something that is pretty darned important to the future of this country but not open to amendment, no opportunity for Senators here to have the opportunity to improve upon. Perhaps we could improve upon it; maybe we couldn't. But we at least should have had the opportunity to bring issues to the forefront that rightly should be debated when we are talking about something like a 2- year budget and a defense bill which spends enormous amounts of the American people's tax dollars.

So no debate. Shut down here in the Senate by the majority leader. Why? I guess because it is really critically important we get to some of these nominations that need to be voted on--voted on before the Christmas holiday. Why? Well, because, Lord knows, we couldn't vote on them next year. I guess we can vote on them next year. Now that the majority has broken the rules here in the Senate, changed the rules, they can approve those with 51 votes.

So I don't know what the big sense of urgency is on these nominations that would prevent us from having a full and open debate on something as consequential as the Defense authorization bill or the budget just being voted on here in the Senate. I don't know why these nominations would take precedence over that.

It seems to me that if there was any sense of urgency attached to this, most Members on both sides I think would acknowledge that we need to do that. But clearly these are all nominees who could be voted on next year, and now approved with 51 votes, thanks to the majority breaking the rules in the Senate and making it possible to approve nominees with 51 votes.

So the very notion, as the majority leader came out here and said repeatedly now, that we would be here next week on one of the most important Christian holidays of the year voting on nominees that can be voted on a week later after the first of the year when Congress comes back into session--it seems to me to be really sort of stunning in terms of its audacity.

I think the American people would conclude the same thing; that we would take a defense authorization bill, that we would take a huge budget bill and actually sort of just try and sweep them under the carpet, fill the tree so we don't have an opportunity to debate amendments or vote on amendments, but then have to rush to get these nominations through, nominations which can be considered early next year and approved now with a 51-vote majority.

So think about that. We have had these threats here on the floor. The majority leader has come to the floor and said: We are going to be here Christmas Eve because we have got to do these nominations. Yet we don't have any time to do the important work, such as having a chance to debate and vote on amendments to bills such as the Defense authorization bill.

So that is where we are. Again, I think it is pretty stunning that this is what the Senate has deteriorated into. And it is regrettable. But hopefully--hopefully--at some point people will come to their senses that: Yes, this is an important week next week for a lot of people around this country; that perhaps being able to do the nominations a week later, after the first of the year, when they can be approved with 51 votes, that might make sense and might be a reasonable approach to take with all this.

I hope most Members here, like most Americans, next week at least have an opportunity to celebrate the Christmas holiday with their families. And as they do, a lot of Americans will use that opportunity to reflect upon the past year. In many cases that will mean life changes which occurred in the last year. For many Americans it might be a marriage in the family, it might be a graduation, events that we celebrate. It might be something we look on with reflection and mourn the loss of a loved one. But this is a time when normally people around this country reflect on significant changes in their lives in the last year and start thinking in anticipation about what the next year might bring.

Some things people can't control in their lives. Some changes people don't like and they can do nothing to control. And as they start thinking about last year and start thinking about next year, for a lot of people it is going to be the impact that ObamaCare is going to have on their lives. People are thinking about the fact that they have these skyrocketing premiums that are now coupled with these outrageous deductibles. The sticker shock is forcing millions of Americans to pay more for health care.

President Obama promised the American people:

ObamaCare will cut costs and make coverage more affordable

for families and small businesses.

Well, the reality is that family premiums have already skyrocketed since ObamaCare became law. American approval of this law is now in the tank.

According to a recent CBS/New York Times poll:

Most uninsured (57 percent) think the cost of their health

care will increase, and just 23 percent expect the quality to

get better.

Think about that. Fifty-seven percent of the people who have no insurance--people who are uninsured--think the cost of their health care is going to increase. And a majority in that same poll are opposed to the health care plan. Those are people who don't have health care insurance today, and a majority of them are opposed to this plan.

For many Americans, the holiday season is going to be filled with angst and uncertainty as they look at facing a coverage gap on January 1. More than 10,000 Iowans were told by healthcare.gov that they should qualify for Federal health coverage, but Federal officials have not yet sent complete information on those people to State administrators, who are supposed to then review the applications and enroll people in the program.

My colleague from Iowa Senator Grassley is on the floor. Constituents he represents are going to be filled with a lot of uncertainty as they face the future. According to the Des Moines Register, Percy Smith of Des Moines is concerned about a coverage gap:

I'm losing my optimism, because we're getting close to

January, and I don't know if I'm going to be covered or not.

But this problem will affect more than Iowans. According to the Washington Post:

Those facing a potential coverage gap include an estimated

15 million people.

The law's insurance cancellations mixed with the Web site's

problems might leave some people who have coverage now

uninsured in the new year. These are Obamacare's biggest

losers.

Today, George Will has an article in the Washington Post that explores this administration's abuse of executive discretion. The article effectively summarizes the exact abuses of executive power that my colleagues and I have been vocally opposed to.

Under this administration, if they don't like what the law says, even if they wrote that law, they simply ignore it. Example after example exists of how this President believes he is above the law. Look no further than their delay of the employer mandate or their rewrite of the laws governing the work requirements as a condition of receiving welfare. As Mr. Will says in his article:

In 1998, the Supreme Court held that ``there is no

provision in the Constitution that authorizes the president

to enact, to amend, or to repeal statutes.''

Yet, as Mr. Will further points out, this President often claims:

. . . he can't wait for our system of separated powers to

ratify his policy preferences.

Unfortunately, that is not how our country was founded and not what our forefathers established in our system of governance.

As the Federalist Paper No. 47, authored by James Madison, says:

The accumulation of all powers, legislative, executive, and

judiciary, in the same hands, whether of one, a few, or many,

and whether hereditary, self-appointed, or elective, may

justly be pronounced the very definition of tyranny.

The American people are wising up to this abuse of power, and I believe this President must respect the rule of law, despite his clear self-interest to act otherwise.

I believe it is only a matter of time before the President continues to abuse executive discretion to correct problems with his law. Instead of being forthcoming with the American people and Congress and explaining why parts of this law won't work, he relies on his administrative agencies to issue 11-hour blog posts or leaks to the media to announce delays in portions of his signature law.

Another way this administration is trying to fix problems is to put the burden of fixing problems on others. Last month the President tried to fix the problem of cancelled plans by kicking the can to State insurance regulators to determine whether, in 48 days from the date of his announcement in November, they can change their State insurance regulation policies quickly enough to permit plans to continue to offer those plans available in 2013 and 2014. He expected State insurance commissioners to bail him out to allow Americans to keep the plans they were promised they could keep. He is also expecting insurance companies to bail the administration out of problems as well.

The insurance industry will now extend the deadline until January 10 for Americans to pay for coverage that starts on New Year's Day. This doesn't fix the problem of coverage gaps, but it is a convenient talking point for the administration.

While 2013 was filled with one unbroken ObamaCare promise after another, the President's inability to follow through on making coverage more affordable for families and small businesses was one of the biggest. In a rare moment of candor, Secretary Sebelius was forced to admit:

[t]here are some individuals who may be looking at

increases [in health care costs].

A recent Associated Press/GfK poll confirms that more than ``some'' individuals will be facing sticker shock thanks to ObamaCare: Sixty- nine percent say their premiums will be going up, while 59 percent say annual deductibles or copayments are increasing.

A separate poll by the Washington Post and ABC found that just 5 percent of Americans believe that ObamaCare will actually reduce their health care costs.

The reality for many Americans is that dramatically higher premiums, deductibles, and copayments mean they are going to have less money in their wallets to spend on rent, pay for college, or to invest in a small business.

As a result, 67 percent of respondents in a recent Fox News poll say ObamaCare should be delayed and 53 percent of respondents would vote to repeal the law.

This holiday season Democrats should give the American people what they were promised all along: lower costs, while keeping the doctor and plan they have and like.

As we begin 2014, this President and administration should commit to abandoning their power grabs and complete disregard for the rule of law. This law was passed, hurriedly rushed through here on a partisan vote. Not a single Republican Senator here voted for it. We are now seeing the effects of that: one-party rule, one party running roughshod over the other to try to get something enacted into law--which now, as the American people are finding out, they are the ones impacted.

We are seeing all the adverse, harmful impacts which come with it: higher premiums, cancelled coverage, lower take-home pay, higher deductibles, and a less promising future for the American people. We can and we should do better.

I hope that as Americans this Christmas season reflect on the past and think to the future, we will resolve to do what is necessary to give them a brighter future by putting in place policies which will grow the economy,

create jobs, increase the take-home pay of middle-class Americans, rather than give them another gut punch which makes it that much harder for them to provide for themselves and their families.

I yield the floor.

Madam President, a number of my colleagues have come down here, and we have done so on a number of occasions because most of us

are getting emails and phone calls and letters in our offices of real- world, real-life experiences that people are having with ObamaCare. It is a reminder that the things we do here have real-world impacts across the country.

As someone who represents the State of South Dakota, I came down here and shared a number of stories of constituents of mine who have been adversely impacted in the form of higher premiums, canceled coverages, higher deductibles--all doing great economic harm to the people in our respective States.

I will quickly share a note I received from a constituent in Rapid City, SD.

As my Congressional representative, you need to know how

ObamaCare is harming my life and health care. My insurance

company cancelled my policy. I am currently paying over $800

a month for a family of 4. To upgrade my policy I will be

over $900 a month. If I sign up for ObamaCare, I would be

paying over $2500 a month. I cannot think of any way this is

considered affordable health care!

This is just another of many examples that I have from my State of South Dakota and that my colleagues have to point out how this is flawed and the economic harm it is doing to the American people and why it is so important that we here in the Senate take steps to change it and do it soon, before it is too late.

Madam President, I listened to the Senator from Alabama talk about the current budget debate we are having on the floor, and I couldn't help but think of the discussion we had when we were debating the ObamaCare legislation a few years ago and how many of us at the time were making the argument that this is the biggest expansion of government in literally half a century. I think that it is becoming increasingly clear that was, in fact, the case.

We are seeing dramatically more levels of spending. I think we are going to see dramatically higher levels of debt over time. But you would think that with $\1/2\ trillion in cuts to Medicare, $\1/2\ trillion in tax increases--and when it is fully implemented, it will be much bigger than that. The overall cost of the bill, when it is fully implemented, goes to about $2.5 trillion. The expansion of government that occurred as a result of the passage of ObamaCare was, frankly, stunning relative to anything we have seen in recent history. You would think with that you would see some relief, if you will, in terms of the burdens being placed upon middle-class Americans, but we are seeing the opposite.

Many Americans are already feeling the effects of ObamaCare, whether it is higher insurance premiums, canceled health plans, or the loss of a doctor they like. Middle-class Americans are going to be hit the hardest.

Lower income families will face steep premiums and deductibles under ObamaCare, but they will get some help in the form of subsidies from the government to pay for some of their health care costs.

Upper income families are also going to face higher health care costs. In fact, the majority leader told a Nevada newspaper that his premiums under ObamaCare will rise by $4,500 next year. Affluent Americans will be able to absorb those increases. What about a middle- class family facing a $4,500 increase in health care costs, a family whose budget is already at its limit between housing costs, school expenses, and grocery bills? That family won't be able to absorb those costs. That family doesn't have a spare $4,500 anywhere in its budget. For that family, the $4,500 will have to come from money that was allocated for orthodontic payments or college tuition bills or money for a new car.

Back when the President was trying to sell his health care proposal to the American people, he promised that ObamaCare would ``cut costs and make coverage more affordable for families and small businesses.'' Unfortunately, the last few months have made it abundantly clear that this promise is not being kept.

Instead of seeing reduced costs and more affordable coverage, middle- class Americans are seeing steep premium hikes and soaring out-of- pocket costs. Those Americans who have been lucky enough not to have their plans canceled have been receiving insurance plan renewal letters with staggering premium increases. In some cases it has doubled or even tripled what they have been paying before. One constituent emailed me to tell me that thanks to ObamaCare her premiums will increase more than 100 percent, which she goes on to say is equal to 45

percent of her monthly income--45 percent just for health care. That is more than most Americans pay for their mortgage.

Americans whose health care plans have been canceled as a result of ObamaCare and who are being forced to shop on the exchanges are frequently facing higher premiums and drastically increased out-of- pocket costs.

A couple of days ago an article in Chicago Business reported that an average Chicago family with a midlevel health plan in the individual market would go from a $3,500 deductible to a $10,000 deductible if they obtained a similar plan in the exchange. That is $10,000 on top of the $9,000 a year that family would already be paying in premiums.

In Federal exchanges, many families are facing deductibles as high as $12,700. Barring catastrophic illness or injury, in many cases a family with a deductible that high might as well not have insurance at all.

Of course, a family could buy a more expensive plan and greatly reduce those out-of-pocket costs. Many of the platinum plans, which are the high-end plans, have no deductible at all. As CBS News points out-- and this was for a Houston, TX, family--``that means shelling out almost $12,400 per year in monthly premiums, or about the same as the deductible for the bronze plans. Either way, families and individuals who don't qualify for tax credits may find ObamaCare failing to deliver on its promise of affordable health care.''

That is from CBS News when talking about a specific family in Houston, TX.

What makes it even worse--and this is what the Associated Press reported--many families don't fully understand the expenses they are taking on when they sign up for plans with high out-of-pocket costs. The Associated Press notes that ``only 14 percent of American adults with insurance understand deductibles and other key concepts of insurance plans, according to a study published this year in the Journal of Health Economics. If people with insurance don't understand it, it's likely that uninsured Americans' grasp is even fuzzier.''

A family shopping on the exchanges may snap up plans with relatively low premiums without realizing that they are, in effect, purchasing nothing more than catastrophic coverage that may leave them on the hook for thousands of dollars in medical costs each year.

So far, I have talked about the direct financial consequences of the President's health care law, but its effects don't end with higher premiums and skyrocketing out-of-pocket costs. Middle-class families will also take a financial hit thanks to the damage ObamaCare does to businesses.

ObamaCare puts in place a slew of new regulations, new taxes, and new fees on businesses large and small. When faced with that, businesses will have two choices: They can absorb the costs of new taxes and fees, thereby reducing the amount of capital they have to expand their businesses, hire new workers, or promote existing ones, or they can pass on these costs directly to their workers, further burdening families already facing steep health care costs. It is a lose-lose situation.

Small businesses are being hit particularly hard. Susan Gabay, cofounder and managing director of a small business investment banking firm, published a column on Saturday in the Washington Times in which she discussed the effect the President's health care law is having on her business. Thanks to ObamaCare, the health plan she offered to her employees was canceled. The new coverage she was offered contains a 48- percent premium increase, which she says ``translates into approximately $1,676 in added costs per year for every individual covered on our plan.'' That is a $6,704 premium increase for a family of four. She says that is approximately $44,000 in added annual costs for her business that otherwise could be used to hire a college graduate.

Maybe her employees are getting better coverage thanks to ObamaCare's regulations, right? Well, actually, the answer is no. Let me read her answer to that observation. She says:

The response to our plight is that we are getting much

better coverage. But that isn't true, either. We have

historically provided our employees with a generous plan with

100% coverage for in-network preventative care and low out of

pocket maximums. Conversely, our new ``great alternative''

plan offers comparable benefits with much higher out of

pocket maximums.

So thanks to ObamaCare, Ms. Gabay's business will pay more for health care and so will her employees without receiving any meaningful increase in benefits.

As every middle-class parent--wondering where money for the next dentist bill or tuition payment will come from--knows, America's economy is still struggling to recover from the last recession. Burdening any business--particularly our Nation's small businesses, which are responsible for a majority of the new job creation in this country--is the worst possible thing we could do for our economic recovery and for the millions of middle-class Americans searching for better jobs and opportunities.

Democrats and the President made the American people a promise. They said: We will make health care more affordable. As long as ObamaCare is in place, that promise will continue to be broken, and middle-class families will suffer as a result. In fact, just recently, when asked a question in an interview about the health care plan, Secretary Sebelius said:

There are some individuals who may be looking at increases.

I think you cannot make a statement based on cost unless you

compare what they had to what they are going into.

That was Secretary Sebelius saying there are some individuals who may be looking at increases. I think that is the understatement of the year based upon the experience of literally millions of Americans, some of whom have lost coverage entirely, but millions of Americans who are suffering with the sticker shock of dramatic increases in the premiums they pay for their health insurance coverage, dramatic increases in the deductibles now available under their policies, and dramatic decreases in the take-home pay they have to meet the other obligations they have for their families. This is a direct hit to the pocketbooks and the future economic vitality of middle-class Americans.

I yield the floor and suggest the absence of a quorum.

Thank you, Madam President. I thank my colleague from North Dakota--both colleagues from North Dakota who are here in the Chamber--and I appreciate his leadership as a former Governor, understanding these issues such as health care, which do profoundly impact the people whom we all represent in the Dakotas. There are some unique challenges, obviously, of meeting the health care needs of people in our States because we have a big geography, lots of wide open space. We do not have the big population centers that are in other places in the country, and so health care delivery and coverage of health care, health care insurance and access to it are enormously important to the people we all represent.

I would say it has become abundantly clear that the American people are rejecting ObamaCare, which is the law that was passed several years ago in the Senate, in the house, signed into law by the President. I remember being here at the time and voting on that on Christmas Eve. We were actually here. It was December 24, 4 years ago, I think now, in 2009. We were right up here until the end, and this was, I would say, jammed through the Senate.

The majority had the votes. They were not all that concerned about having participation or input from those of us who served in the other party--as a consequence of that just shoved this thing through right on Christmas Eve. I think that was an unfortunate way in which to conduct the business of the Senate, to enact major legislation. It is very rare around here that legislation of that consequence that literally impacts one-sixth of the American economy is shoved through on a partisan party-line basis.

So that is the way it was done. We said at the time--many of us were down here on the floor over and over predicting that because of the way this was structured it was going to lead to higher insurance premiums, it was going to lead to fewer jobs in our economy, a lot of stress on employers that were trying to create those jobs. All of that is coming to fruition as we hear now reports day after day after day across this country--from my State of South Dakota, other States across the country--from people who are feeling the very real and harmful impacts of the ObamaCare legislation, both in terms of higher premiums but also canceled coverages, higher deductibles, things that affect the pocketbooks of millions of Americans and issues that are discussed and debated at kitchen tables, but they are profoundly important to the economic well-being of people in this country.

When you are seeing the dramatic increases in premiums, the dramatic increases in deductibles, the loss of coverage, the canceled coverages we are seeing across the country right now, it is very disturbing to people. That is why I think you have seen this widespread rejection of ObamaCare.

Interestingly enough, yesterday Health and Human Services released new enrollment numbers for the exchanges for October and November. Over the course of those 2 months, in my State of South Dakota, just 372 South Dakotans--or less than one-half of one-tenth of 1 percent of my State's residents--signed up for health care on the exchanges.

Ten other States also had fewer than 1,000 people sign up.

Oregon, which embraced ObamaCare very early on, had just 44 enrollments. Think about that--44 enrollments to show for 2 months thanks to their Web site, which suffered an even more catastrophic failure than the Federal Web site.

In all, there were 364,682 enrolled in the exchanges during the months of October and November--not even one-quarter of the number the administration had projected after 2 months. To meet its goal of 3.3 million signups by December 31, the administration would have to sign up almost 3 million people in the next 3 weeks or more than 145,000 every single day.

Considering that the administration has averaged fewer than 6,000 enrollments a day over the past 2 months, I would not want to put a lot of money on them being able to meet that goal. It is obvious from the sluggish enrollment numbers that the American people are rejecting ObamaCare. But if anyone needs more proof, three new polls came out last week, all reporting strong opposition to the law among the American people.

The Pew Research Center poll reports that 54 percent of the American people disapprove of the President's health care law.

According to Pew's most recent survey, the percentage of Americans who think the health care law has ``had a negative effect on the country'' rose 11 percent just since September of this year.

In the Wall Street Journal/NBC News poll released yesterday, the President's disapproval rating reached an alltime high of 54 percent. When asked what issue shaped their view of the President this year, 60 percent cited ObamaCare.

The same Wall Street Journal poll also found the number of Americans who think the President's health care law was ``a bad idea'' reached an alltime high.

Quinnipiac University also released a poll yesterday that found that 57 percent of the American people oppose ObamaCare.

The President's health care law has never enjoyed strong popular support. But Democrats and the President argued that public support for the law should not be judged until the law's benefits were in effect.

The law is now in effect. People can buy insurance on the exchanges. Yet opposition to the law is not declining; it is the opposite that is happening. It is actually rising. Opposition to the law is increasing over time as more and more people become aware of the impact on their personal economic well-being.

Quinnipiac reported a 10-point jump in opposition to the law between October 1 of this year and December 11.

Meanwhile, support for the law, already low, dropped a further six points over the same time period.

Even worse for the President, it is not just Republicans and Independents who are fleeing the President's signature law. Many of the President's strongest supporters, those who initially supported his health care law and helped reelect him last year, are deserting the President.

The Pew Research Center found a 10-point drop in support among African Americans since September and a 9-point drop in support among Hispanic Americans--both groups who strongly supported the President in the last election.

The Wall Street Journal/NBC News poll also found ``faith in Mr. Obama has dropped noticeably in recent months among young voters and Hispanics, two groups that had been among his steadiest supporters.''

So the question, I guess, is why are the American people and even the President's strongest supporters rejecting ObamaCare? Why, now that the law is mostly in effect, is opposition growing rather than declining?

Well, I think the answer is very simple. It is because the law has failed to deliver on the President's promises. From rising premiums, to canceled health plans, to lost doctors, ObamaCare is doing the exact opposite of what the President promised it would do. The President said his new law would reduce the cost of health care. In fact, he claimed families would see their premiums fall by an average of $2,500 a year. But that promise fell apart almost immediately after ObamaCare was enacted. In fact, what we are seeing out there is that the average family has seen its health care premiums rise by more than $2,500 since the law's passage. Now that the law is being implemented, those numbers are only going higher. Those families who are lucky enough to keep their plans have been receiving insurance renewal notices with staggering premium increases. Premiums are doubling or

even tripling for many families, and deductibles are increasing as well. Imagine getting a $600-a-month increase in premiums. That is $7,200 a year. How on Earth is a working family, a middle-class family in this country supposed to be able to afford that?

The President would like you to believe that these Americans' updated, more expensive health plans are far superior to what they had before. But, in fact, many of these plans were as good or better than what these families are getting now. Many of these plans are falling short of people's expectations because they have higher deductibles. Of course, with all of the mandated coverages that are in many of these plans, there are all kinds of things that people who are subscribing, trying to get on the exchanges, are finding they do not need. I have had people in my State of South Dakota who are in their fifties and sixties who are asking why they need to have things such as maternity coverage.

You see that as these letters and emails and phone calls are coming into your office and people are finding out about the specifics--the details, if you will--of these various plans, they are rejecting them not only because they have higher premiums, but they are also plans that are not sufficient or adequate compared to what they are currently experiencing with the plans they had before. Now thousands of families around the country are going to be struggling to pay huge premium increases without receiving any additional benefit.

The situation is no better on the exchanges. While there are certainly plans with low premiums on the exchanges, many of those plans have deductibles that are so high that, barring some catastrophic illness or injury, the family might as well not have insurance at all. A family without insurance who typically pays $8,000 a year in health care costs may see no benefit at all from an insurance plan with a $12,000 deductible. In fact, they may spend more on health care because now they have to pay high insurance premiums as well. So you have higher insurance premiums, higher deductibles, meaning in many cases that they are not going to reach the threshold that would trigger a payment from their plan, and so they are getting no additional benefit, but they are paying way more for the same or worse coverage.

In addition to promising a new era of affordable health care, the President also promised that nothing would change for people who liked the health care they had. He repeated many times--we have all seen the videos of this--that if you like your health care plan, you can keep it. He even went so far as to say ``You can keep it, period'' to make it even more emphatic. ``If you like your doctors, you can keep your doctor, period.'' But Americans are now finding out that was not even close to being true. Millions of Americans have seen the health care plans that they liked canceled by insurance companies in response to new ObamaCare regulations. So far, more than 5 million Americans have lost their health care plans as a direct result of ObamaCare. In fact, today, millions more Americans have lost health care than have gained it under the President's signature law.

Millions of Americans are also realizing that they cannot keep their doctors or their hospitals. ObamaCare put in place scores of new regulations on insurance companies and the plans they offer. To meet all of the ObamaCare requirements while still getting their plans approved, insurance companies have been forced to drastically shrink their networks of doctors and hospitals. As a consequence, many families are finding that their new health care plans force them to give up doctors they have been seeing literally for years.

That may not sound so terrible to some of us if we do not have a close relationship with our doctors, but what if you are a cancer patient who relies on your network of doctors and oncologists to coordinate your lifesaving care?

More than one cancer patient has spoken openly in the press about the struggle to find a replacement health care plan after having their original plan canceled as a result of ObamaCare, a plan that covers all of the doctors and the medicines they are currently using.

Joan Carrico, a nurse from Michigan and a cancer patient, published a heartbreaking column on CNBC yesterday updating readers on her struggles to find a health care plan that covers all of her care. I will let her words speak for her and the other Americans in her position:

I can't begin to describe how devastated I am. Many people

like me, who are in a difficult health crisis and fighting to

regain good health, are finding it very difficult--if not

impossible--to make sure that we can keep our doctors and

receive the chemotherapy and other treatments and medicines

that are keeping us alive. . . . I'm scared and wondering

what surprises are around the corner.

Well, Ms. Carrico brings up another thing people may lose under ObamaCare besides their doctors and their health care plans; that is, their medications.

Forbes published an article this week outlining the reasons ObamaCare may cause millions of Americans to lose access to the medications they are currently taking. The author points out that many exchange plans have steep cost-sharing requirements for prescription drugs. Purchasing a bronze plan, for example, the article points out, means you will likely be responsible for 40 percent of a drug's cost. That may not be so bad if we are talking about a common antibiotic, but that gets very expensive when we are talking about more sophisticated drugs, such as cancer drugs and other lifesaving treatments.

The second reason patients may lose access to their medications, according to Forbes, is that some plans simply may not cover the prescription drugs that person has been taking. Out-of-pocket limits, the article notes, do not apply if the drug you are taking is not on your new insurance company's ``approved'' list of drugs. You may find yourself paying for a very expensive drug without any benefit at all from your new insurance plan.

In addition to higher costs and the loss of their doctor and health care plans, there is another reason Americans are rejecting ObamaCare. ObamaCare is not just bad for health care, it is bad for the economy. New health care regulations are discouraging businesses from hiring and expanding their businesses.

Earlier this week a CBS News article reported that ``nearly half of U.S. companies said they are reluctant to hire full-time employees because of the law.'' The Hill reported on a recent survey by the National Association of Manufacturers that found that 77 percent of manufacturers cite soaring health care costs as the biggest issue facing their business. The title of the Washington Post article on the health care law's impact on small businesses says it all: ``Health care law's aggregation rules pose a compliance nightmare for small businesses.'' That is the headline of the Washington Post.

Small businesses are responsible for a majority of the job creation in this country. If we look at some States around the country, my State of South Dakota being a good example, most of the jobs, a huge proportion of the jobs created in States like mine are created by small businesses, but the health care law is discouraging them from hiring, drowning them in regulations, and promising stiff new requirements if they have 50 or more employees. I can't tell you how many times, when I am traveling in my State of South Dakota--or, for that matter, traveling outside my State but specifically in my State of South Dakota--when I am talking to businesses, to people who are creating jobs, investors, the uncertainty associated with this health care law and the new costs because of its mandates and its requirements are making it more difficult and more expensive for them to create jobs.

So what are we seeing as a result of that? We are seeing a slower, much more sluggish economy; chronic high unemployment; and fewer jobs, particularly for people who are coming out of college. Younger Americans in particular are paying a dear price because of the slow economy. When businesses do not hire, the economy suffers. Every American who has spent weeks, months, or years struggling to find a job suffers too.

I know my Democratic colleagues here in the Senate know all of this. That is why some of them are starting to run away from ObamaCare too. Democrats in Congress may have supported the law, but now that they have

seen how it looks in reality, some of them--particularly those running for reelection--are eager to distance themselves from it. No one running for reelection wants to be too closely associated with the law that is raising Americans' health care costs, taking away their health care choices, and hurting an already struggling economy.

The American people have spoken. They do not like ObamaCare. They do not want ObamaCare. They cannot afford ObamaCare. It is time for Democrats in Congress to start listening. I always think it is never too late to do the right thing. I hope that as more Americans start to weigh in and start to engage in the discussion about how this is impacting them personally, that will have such a profound impact on Members of Congress here in Washington, DC, that they will come to the conclusion that many of us reached a long time ago; that is, this is a bad, flawed bill, built upon a faulty foundation that is destined to fail, and that the best thing we can do is pull it out by the roots and start over in a way that makes sense for the American people, that addresses the challenges we have in our health care system in America today but does it in a way that does not require the government to take over literally one-sixth of the American economy and create political control--command and control from here in Washington, DC, over literally one-sixth of the American economy.

One out of every six dollars in our economy today is spent on health care. Think about that. There are very few areas where you can say that complete, total government intervention impacts that big of a swath of our economy. Unfortunately, government intervention is impacting way too much of our economy. As a consequence, we are paying a price in the form of fewer jobs, chronic high unemployment, and a slower, sluggish, anemic economy, which is making it more difficult for people to find jobs and more difficult for us to get ourselves out of what is a very difficult economy.

My hope would be that before this is all said and done--and I do not know when this will happen; hopefully sooner rather than later because I think the sooner we make that adjustment and decide this was the wrong course and reverse course and go in a different direction, the less damage we will do to people's livelihoods, to their personal economic circumstances, and the less damage we will do to the overall economy in this country. I hope that realization comes sooner rather than later. But I think what will drive it--I have maintained all along that ultimately the only thing that can really change this is the American people because clearly we have a President of the United States for whom this is his signature achievement. Unless he starts hearing from the American people, he is unlikely to change.

We have a lot of people here in the Senate--every Democrat here today who was here in 2009 voted for this. Not a single Republican who was here in 2009 voted for it. That is probably one of the reasons this is such a failed policy. It did not have input or buy-in from the other side. It did not get some of the best ideas coming to the forefront.

There was a much better way to do this. Many of us who have been around here for very long have been proposing solutions to address health care challenges that have been rejected by Democrats here in Congress.

We have talked a lot over the years about allowing people to buy insurance across State lines. Why wouldn't we create interstate competition? Competition in a free market economy generally, as a matter of principle and as a matter of practice, drives down price. If we create more competition and give people more choices, that tends to drive down prices. That is a fairly basic economic principle.

Why wouldn't we allow small businesses to join larger groups where they can get the benefit of group purchasing power and thereby put downward pressure on the cost of health care in this country?

Why wouldn't we allow for expanded opportunities for people to take care of their own health care circumstances by allowing for expanded, larger health savings accounts, opportunities for people to put money aside in an account, perhaps buy a catastrophic policy with a high deductible but tax free. They can put money aside that allows them to cover some of those health care costs that don't reach that catastrophic level.

What about finally doing something to reduce the cost of defensive medicine, which means we would have to reform our medical malpractice laws in this country and weed out a lot of the junk lawsuits that clog our legal system and make it so much more expensive to deliver health care. I talk to physicians all the time for whom concern about liability is a major issue. It creates overutilization. You take all this great technology we have in America today, and you have physicians who are worried about being sued. Of course, they are probably going to run duplicative tests. Anybody who is involved in the delivery of health care in this country knows very well about the cost of practicing defensive medicine. There have been many studies done on it, all of which conclude that it adds significantly to the cost of delivering health care in this country. There are differences of opinion about how much that is, but there is no question that it is a factor in the high cost of health care.

There have been proposals. There are a number of my colleagues on this side of the aisle who have suggested allowing people to have their own personal, refundable tax credit for the purchase of health insurance and to create equity between the tax treatment of health care that people can get through their employer with that which they would be able to get in the individual marketplace.

Again, the principle is greater choice, greater competition, and therefore lower prices. It is a fairly straightforward and simple formula when it comes to a market-based approach to how we deal with the health care crisis we have in this country.

Clearly, we have programs such as Medicare and Medicaid where the government is fairly heavily involved in the delivery of health care in this country. That too is an area where we need to be looking at how we can reform and make those programs work more efficiently, more effectively, in a way that hopefully maximizes the return the taxpayers get on those particular programs.

If we look at programs such as Medicare, there was a good example a few years ago, which was Medicare Part D, which is the only program I can think of since I have been here--or, for that matter, since I have been following policies that have been put in place over time--that has actually cost less than what it was projected to cost. Why? Because it allowed for competition. It created a private component where private insurance companies would vie for, would bid for the business of senior citizens across this country when it comes to their medications. As a consequence of that, we have seen those costs come down to a reasonable level. It actually has cost less than what was anticipated.

That is a principle we could start to apply in other areas. There are a number of things that could be done to reduce the cost of delivery of health care when it comes to the component of it that the government is heavily involved with.

But the point, very simply, is that whenever we create more choices, when we create more competition, it has a downward impact on costs. It drives costs down. So why weren't a lot of these things considered or incorporated into ObamaCare when it was passed? Well, we all know the answer to that. It is because the majority party, which had the votes, decided to do it their way. They decided to go their own way, and as a consequence we ended up with a bill, a piece of legislation, and now a huge new program that has been an utter disaster.

I think any objective observer would come to that conclusion based upon the rollout of the Web site and everything subsequent to that that impacts costs; that impacts people's ability to keep the plan they have and the doctor they have; that impacts to the economy, which is overburdened with the cost of regulation in the new law; as well as the many--and I say ``many''--taxes that were included in the new law. There were many new taxes included, not to mention lots of cuts to Medicare, which, interestingly enough, were double-counted. That was allowed to be used as ``savings'' put in the Medicare

trust fund, therefore extending the lifespan of Medicare. At the same time, that was going to be spent on the new health care proposal.

Only in Washington, DC, could someone get away with an accounting convention that would allow someone to double-count revenue, which is essentially what happened. We raised that question many times, and eventually we had a letter from the Congressional Budget Office that said: Yes, this is double-counting revenue. You are spending the same money twice.

Yet the majority party had the votes. Around here, it is a function of math: If you have the votes, you can do pretty much whatever you want. And that is what they did. We are paying a dear price for that, but the people who are really paying the biggest price are the American people, who are seeing these increased premium costs, increased deductibles, fewer jobs, slower economy, and lower take-home pay. That is the bottom line.

It boils down to basic economic terms. What we are talking about is a slower, more sluggish, anemic economy, chronic high unemployment, and lower take-home pay for middle-class America. In fact, if we look at average household income, which is something we use as a metric to measure people's overall economic situations, the average household income in this country, since 2009 when the President took office, has decreased by about $3,700 per family. There are a lot of things, obviously, that contribute to that, but I don't think it is any surprise that when you drive up the costs of something that everybody needs in this country--and by that, I mean health care--in the form of higher premiums and higher deductibles, it is inevitable that you are going to see a lot of people's household incomes impacted by that. Then you couple and layer on top of that the impact it has on the economy. When you have a sluggish economy creating fewer jobs, that, too, has a very devastating impact on people's personal economic circumstances and livelihood. So average household income, since the President took office, has gone down by about $3,700--lower take-home pay. That is another of the results and the outcomes and the ultimate impacts, if you will, of policies created in Washington, DC, that make it more expensive and more difficult to create jobs in this country.

As I said earlier, I think ultimately what will get us to where we really can change this, change course, change direction, take this thing which is headed for the cliff and turn it around and move it in the other direction, is going to be the American people. If every Senator, every Member of Congress, if the White House is hearing what I am hearing from people in South Dakota, perhaps there is some hope that we can persuade enough people in Congress that we have to change the direction we are heading.

I would like to share a few things that I heard from people in my State of South Dakota.

A male constituent from Sioux Falls, SD, wrote and said:

I just received notice that our health insurance will go up

almost 60 percent due to the ACA, from $718 per month to

$1146 per month. We will also lose our prescription drug

benefit and office co-pay benefit until each of us reaches a

$5,000 deductible. We have maternity benefits now and

pediatric dental and vision care, although I am 64 and my

wife is 59. This will cost us an additional $5,000 per year.

For somebody who is trying to make ends meet in this country, trying to get the mortgage paid, trying to put a little aside for their kids' education, $5,000 is real money. That is a tangible impact of this law on the economic circumstances, the standard of living, the quality of life this particular couple is experiencing in America today.

ObamaCare is sticking hard-working Americans with higher costs for unnecessary coverage. Families were denied the ability to keep their plans--the plans that best fit their needs, lifestyles, and budgets.

The following is a letter we received from a female constituent from Wilmot, SD:

My husband and I have four small children and purchase our

own health care. My husband runs his own small business and I

am privileged to stay at home. We are very healthy, so we

have always purchased a plan with a large deductible, so we

can afford a reasonable premium.

Today we received our letter from our health insurance

provider letting us know that next month our premium will be

jumping 232 percent! That's over $500 more a month--and we

barely use our health insurance.

We currently live in an 1,800 square foot house and have

been trying to find something bigger. This jump in our

monthly health care premium could prevent us from being able

to afford any kind of monthly house payment.

ObamaCare is cutting into the carefully planned budgets of American families, holding them back from the futures for which they have carefully budgeted. This is an example of a family who is trying to get by--four small kids--and they buy their own health care in the individual marketplace. The husband is self-employed, runs his own business, and the mom has been able to stay home and care for those four kids. They work very hard staying healthy and very rarely use their health insurance policy. They are going to see a 232-percent increase, over $500 more a month. They live in a 1,800-square-foot house. They had hoped to be able to find something a little bit bigger, and they aren't going to be able to because of the consequences of ObamaCare.

A female constituent from Spencer, SD, writes:

Thanks to ObamaCare, my monthly premium will increase over

100 percent, which equals 45 percent of my monthly income. My

daughter lost her insurance, as well. The ACA is not

affordable, and if I could tell the President so, I would. My

private insurance did change.

The Obama administration has broken its promise that Americans who wanted to keep their plans could. We are also learning that this law simply isn't affordable for many middle-class families, such as this lady from Spencer, SD, whom the Obama administration said it would protect when they said: ``If you like your insurance plan, you can keep it, period.'' A lot of Americans took that to the bank. Clearly, they should have known better. The double talk coming out of Washington, DC, is not only frustrating a lot of Americans, it is creating cynicism and a lack of trust and confidence, which is going to make it difficult to do big things in the future.

A male constituent from Rapid City, SD, wrote:

I know you did not vote for this--

Thank you--

but I wanted to tell you. My health care premium went from

$640 a month to $1080 a month. My deductible went from $3600

to $5000. I feel like the federal government has stolen over

$5000 a year from me.

Americans feel betrayed by this law, likening the increased rates to theft by their own government. That is the level of frustration people across this country are feeling. They are frustrated, they are discouraged, they are despondent, and they want something to give. They want something to change. They know we can't continue down this path and expect that any of these families are going to be able to provide a better standard of living and a better quality of life for their children and grandchildren. The family has over a $400 increase in their monthly premium and a $l,400 increase in their deductible. That is the effect on this constituent in Rapid City, SD.

A constituent family from Watertown, SD, writes:

You need to know how ObamaCare is harming my life and

health care. We were one of the families that lost their

health care plan. We heard President Obama say, ``if you

like your health care, you can keep it.'' That was a lie.

Our new health care plan is going to cost our family

$21,600 a year compared to the health care plan of 2013

which cost us $7,335.96. That is a 300-plus percent

increase. We are a healthy family of six people. We are

outraged and upset.

Madam President, these letters and calls to my office echo similar complaints from American families back home in my State of South Dakota and all across the country. ObamaCare is costing this family more money and denying them the plan they want. That is the real life, real world impact.

If you think about it, this is really pretty staggering. This new health care plan is going to cost this family over $21,000 a year compared to $7,335 today. A 300-plus percent increase for a healthy family of six. You can't blame them when they say they are upset and outraged. Who wouldn't be. Who wouldn't be.

This is from a small business owner from Brookings, SD, who writes:

In the mail today was a letter from my health care

insurance provider . . . and, well,

guess what? Thanks to the great ObamaCare plan, my monthly

premium almost doubled, and my deductible doubled. I'm a

small business owner, and I would like to hire an employee

next spring. . . . Well, that's not going to happen. When

will those we elect to Washington ever do something to help

people and small businesses?

Madam President, ObamaCare is not only slamming individuals, it is hitting the small businesses, the job creators that Washington needs to be protecting. ObamaCare is stopping employers from expanding their workforce.

In a bigger place, in a big city, this may not have the same domino effect or the ripple effect that it does in a small State such as South Dakota where you have a small business owner, such as this gentleman from Brookings, SD, who wants to expand his business, wants to hire another employee but is saying that is not going to happen, and the reason it is not going to happen is because of this huge increase in their monthly premiums--almost doubling the monthly premium, and doubling the deductible.

I don't know how an employer in this country today, who is trying to grow a business, expand the business and provide for themselves and their families, perhaps put a little aside to use for the kids' college education or perhaps put a little aside for retirement, deals with the doubling of probably one of their biggest costs of doing business, and that is the cost of health care. You double your premiums; you double your deductible.

This is from a mother in Garretson, SD, who writes:

Next year, our insurance is changing, and I will lose my

family practice doctor of 22 years--the doctor that delivered

all my children and that has cared for our teenage children

all their lives. We will also lose all the backup doctors our

family has seen when we couldn't see our regular doctor. I

was happy with my insurance, and now I have to lose my

doctor.

This is more testimony from people losing their plans and doctors, which the Obama administration--President Obama himself--repeatedly, over and over, told the American people they could keep. Families are losing their trusted doctors.

Whether it is a doctor, a hospital, or prescription drug coverage, these are all real life examples, real world examples of the impacts of ObamaCare that point to just one thing, and that is this law, No. 1, doesn't work, and No. 2, it can't be fixed. There is no way we will be able to address what most people care about when it comes to their health care--and that is the cost--when we require the people who provide that health care coverage to deal with more mandates, more requirements, higher taxes, all of which are going to get passed on and paid for by the very people in this country who are just trying to make ends meet and make a living and provide for their families.

Those are seven examples from my State of South Dakota. I could go on, because there are many more examples. There are examples from people all across the country. But I think the point that needs to be made here--and can't be made often enough--is that these are real world economic impacts that are affecting every day Americans in a way that is making it more difficult for them, making their economic circumstances more complicated and more difficult.

What, if anything, should we here in Washington take away from this? First off, as I said earlier, this doesn't work. Let's start over. Let's do this the right way. It is not too late to do that. It is never too late to do the right thing. We could, if we decided to pull this thing out by the roots and start over, come up with a whole series of reforms that would move us in a step-by-step direction toward the ultimate goal, and that is to address the health care challenge we face in America today; that is, the cost.

I don't think there is any American family, any individual, as they think about having to purchase health care--and particularly if you are a young healthy person, obviously, you don't want to pay a lot for it because you are probably not going to use a lot. Yet those are the people who will get hit the hardest. I can't tell you, if you are in your 20s, how much more you are going to have to pay to get health care coverage in this country, simply because the law requires what they call the community rating band be narrow so that people who are healthier and younger are going to pay much more to cover people who are less healthy. That is a reality in the legislation and it is a reality now in terms of the way it is being applied and being implemented.

So we are looking at a lot of people in this country--for sure younger Americans, but Americans of all ages as well--who are looking at higher cost because of these regulations and mandates and requirements that are being imposed upon the insurance companies and health care providers in this country. The new taxes, which I mentioned a little bit earlier, are also something that ultimately get passed on.

When we were debating this, the Democrats argued that we would have $\1/2\ trillion in tax increases and $\1/2\ trillion in Medicare cuts and that was how this was to be financed. It turns out when it is fully implemented the cost is much higher. What they did is they front-end loaded some of the revenues and back-end loaded the costs. When the Congressional Budget Office looked at it, in a 10-year window, they said there will be about a $1 trillion cost.

When it is fully implemented, and we see the full impact of the cost and the revenues together, the 10-year cost is more like $2\1/2\ trillion. So it was a massive expansion of the Federal Government-- literally the largest expansion of the government in 50 years. It was literally a takeover of one-sixth of the American economy. That is what health care represents in this country.

So if we think about that in those terms, how much this thing is going to cost--and at the time they said: Don't worry, it is all paid for. It will not add to the deficit--we are finding out now more and more information, with more and more analysis being done, and it is coming to light that, in fact, it is going to cost way more than what was initially expected. I think this is the tip of the iceberg, the tip of the iceberg in terms of the cost to the American taxpayers. Again, this is financed by higher taxes, all of which get passed on to the very people in this country this is supposed to help.

The Medicare cuts that were proposed to help pay for this, many of us said at the time were cutting hospitals, cutting home health agencies, cutting nursing homes, cutting hospices--which is what this did. This was all designed to take $\1/2\ trillion. But again, when it is fully implemented, it isn't $\1/2\ trillion, it is $1 trillion, when you look at the full 10-year implementation. But taking this out of Medicare was, No. 1, going to help pay for all the new benefits that would happen under ObamaCare; and No. 2, somehow--somehow, don't ask me how-- it was going to be credited to the Medicare trust fund, thereby extending the life of Medicare.

How do you do that? How do you, with a straight face, say we are going to take--let's just use the conservative number used by the Democrats on the floor--$\1/2\ trillion out of Medicare, use it to finance a new entitlement benefit and somehow be able to say we are going to credit the Medicare trust fund and that this is actually going to prolong the lifespan of Medicare? It was absolutely stunning at the time that we were having this debate and we raised these issues. But people would say: The CBO says this, the CBO says this. That is because CBO uses some pretty strange accounting conventions that aren't used anywhere else in the world. Anyplace else in the world you would be in jail for doing something like that, for double counting revenue-- spending the same money twice. But that is essentially what happened.

Many of us at the time, as I said, raised this issue on the floor and tried to point out we are spending the same money twice. At that time it fell on deaf ears. To me, that is again a symptom of a process that is geared to get a result with a majority vote driven through here, jammed through here, forced through here on Christmas Eve. We all had that vote Christmas Eve morning, and all I can say, as someone who was here and observed that entire process, we tried our best to warn the American people about what was going to happen.

It is too bad we didn't at the time decide, as we usually do when we do major legislation--major legislation that has enormous consequence for the American people--to do it in a bipartisan way that incorporates the best

ideas of both sides of the aisle and perhaps gets a big bipartisan vote. Usually, when you pass major legislation around here, you are sort of hoping for 70 to 75 votes, perhaps even more, because you have the buy-in, everybody has been involved in helping shape and formulate that legislation. But that wasn't the case when this passed.

Again, I understand. This becomes a function of math. You have the votes or you don't. That is the way this place operates. At that particular time, 60 votes was something the majority had the luxury of and didn't seem to care a whole lot about what Republicans had to say. The President was bent on getting his initiative through and getting it his way. Today, that is the reason, in my view at least, we are where we are, with a piece of legislation the impacts of which are now being fully felt by the American people, and their conclusion is what I think their conclusion should be: This is a really raw deal.

I can't tell you, as I think about the broader context, beyond just the world and the space of health care when it comes to public policy, how these decisions that are made here, major policy decisions, impact the broader economy. There is no question, there is no debate about the impact this is having on the economy.

If you talk to any small business person in this country, anybody who has the responsibility of providing health insurance for their employees, who has the responsibility for hiring and employing people and, hopefully, paying them a living wage and benefits that go with it, there is no question this is having a detrimental impact on the overall economy, which continues to sputter along at a 1 to 2 percent growth rate. The best thing we could do, if we want to really help the American people and really improve the standard of living and the quality of life for people in this country, is to first get people unemployed back to work; but, secondly, get the economy expanding at a faster rate.

We are growing at 1 to 2 percent a year instead of 3 to 4 percent, and that has a profound impact in not only the number of jobs created but also the wealth that is created. When we think about an economy that is growing at 3 to 4 percent versus an economy that is growing at 1 to 2 percent, the difference in the gross domestic product, the difference in the total economic output is substantial. In fact, it is dramatic.

What does that mean? It means a lot, not the least of which is that government revenues are a lot lower than they otherwise would be. If you had a more robust economy, growing at a faster rate, people are working, people are investing, they are making money and they are paying taxes.

We have this debate around here like it occurs in some sort of vacuum or static environment. Republicans come in here, those of us who believe in limited government, and we talk about doing what we can to make government more efficient and make it cost less.

Democrats believe that we ought to have more revenue, more taxes; and the problem isn't that we spend too much, it is that we tax too little. That is a fundamental philosophical debate that we have here on a regular basis. One of the reasons, by the way, why it is so hard to reach a significant budget agreement: There is a profound difference in the way we view the world and how we get our country on a more sustainable fiscal path.

There are those of us who believe in spending reforms, lower spending, a more limited role for the government and think that is what we ought to be doing. Democrats by and large believe that we just need a little more tax revenue. If we just raise taxes a little bit more, we could do more here in Washington for the American people. I happen to be of the view that the American people can do just fine for themselves if you allow them to keep more of what they earn.

The reality is that there is a third way, and that is to grow the economy. We can reduce spending, we can raise taxes. We ought to reduce spending. We ought to reform spending in a way that changes this fiscal trajectory which we are on today, which becomes increasingly problematic the farther we get down the road in the future.

But in addition to reducing and reforming our spending programs in this country, we also ought to be looking at growing the economy and actually making the pie bigger. Because that is a surefire way, a certain way of getting the kind of growth in the economy which would allow Federal revenues to go up rather than down.

We have seen this over time historically. If history is any sort of guide and we go back to the 1920s under Coolidge or to the 1960s under Kennedy, a Democratic President who understood the importance of reducing marginal income tax rates or Reagan in the 1980s or more recently in the last decade President George W. Bush, when you reduce taxes on income and investment, you don't get less revenue. You get more because it changes the behavior of the American people. People have an incentive then to invest, to go to work. That generates not less revenue but more and puts us in a situation where we are much better off, not only in terms of our economy and the opportunities it provides the American people but also to the fiscal track we are on as a Nation.

I see my colleague from Kentucky is here. I know he has some observations on this issue of ObamaCare, the economy generally, and other matters before us. But certainly one of the reasons we are here is because we have this rush to approve all of these nominees to these various agencies of government--many agencies which are guilty of the very overreach which has contributed to where we are with regard to ObamaCare. We have too many regulatory agencies with way too much power and are circumventing the will in many cases of the Congress to accomplish an agenda that is very contrary to the very things I just talked about, which are economic growth and job creation.

But through the Chair, I yield the floor for the Senator from Kentucky. I believe Senator Paul is here to take up the measure.

Mr. President, as we consider some of the nominations before us, we are reminded that one of the reasons we have all these problems around the country associated with ObamaCare and all our constituents are being impacted in such a negative way by higher premiums, higher deductibles, higher taxes, and fewer jobs is because of the overreach of government.

This is a perfect opportunity for us to discuss the fact that overreaching government--in this case, government which has literally taken over one-sixth of our economy--is causing great harm to the American people and that there is a much better approach most of us here advocated when this was debated. Of course, at the time we didn't have the votes. This was passed in a party-line, partisan way and, as a consequence, we are seeing now the results and the impact on the American people, all of which are very harmful to their own economic circumstances.

I have a personal example from the emails and letters coming into my office of the adverse impact of ObamaCare. This comes from a female constituent of mine in Wilmot, SD. She writes:

My husband and I have four small children and purchase our

own health care.

My husband runs his own business and I am privileged to

stay at home.

We are very healthy, so we have always purchased a plan

with a large deductible, so we can afford a reasonable

premium.

Today we received our letter from our health insurance

provider letting us know that next month our premium will be

jumping 232 percent! That's over $500 more a month--and we

barely use our health insurance.

We currently live in an 1,800 square foot house and have

been trying to find something bigger. This jump in our

monthly health care premium could prevent us from being able

to afford any kind of monthly house payment.

. . . ObamaCare is cutting into the carefully-planned

budgets of American families, holding them back from the

futures for which they have carefully budgeted.

This is just one example of the harmful economic impact ObamaCare is having on countless Americans from my State of South Dakota.

Mr. President, today I recognize Joseph Bliss, an intern in my Sioux Falls, SD, office, for all of the hard work he has done for me, my staff, and the State of South Dakota.

Joseph is a graduate of Roosevelt High School in Sioux Falls, SD. Currently, he is attending University of South Dakota, where he is majoring in political science and criminal justice. He is a hard worker who has been dedicated to getting the most out of his internship experience.

I extend my sincere thanks and appreciation to Joseph for all of the fine work he has done and wish him continued success in the years to come.