Mr. President, I ask unanimous consent to speak as in morning business for such time as I might consume. Mr. President, many of my colleagues have called me an ``eternal Optimist.'' Since I entered the Senate more than 12 years ago, I have…
Mr. President, I ask unanimous consent to speak as in morning business for such time as I might consume.
Mr. President, many of my colleagues have called me an ``eternal Optimist.'' Since I entered the Senate more than 12 years ago, I have consistently worked across party lines to find new solutions and broker bills that then become law. I have a long and consistent track record of working in good faith with my colleagues from both sides of the aisle. I had hoped, and still hope, to do that on the complex issue of health care reform.
Last Congress, I proposed Ten Steps to Transform Health Care in America. I traveled 1,200 miles across my home State last March to bring my message of reform directly to the people of Wyoming. My message was built on the belief that the American people needed more choice and more control over their health care. I put it together by working with people on both sides of the aisle. I found a way to get coverage for everybody if we did all 10 steps, and any one of them would increase access and cut costs.
Among other things, my plan attempted to level the playing field in the tax treatment of health insurance and also provide a helping hand to low-income Americans in the form of subsidies to ensure access to quality, affordable health insurance. My plan also provided greater equity and ease to our Nation's small business owners by allowing cross-State pooling. Each of my proposals targeted three fundamental goals: Increasing access to health care, reducing costs within our health care delivery system, and improving the quality of care.
As the only accountant in the Senate, I was and remain very concerned about the effect of any health reform proposal on our Federal budget, as well as personal and family budgets. We all want coverage for everyone, including preexisting and chronic conditions. We want portability. We want health care, not sick care.
I have continued my work on health care reform this Congress. As the ranking member on the Committee on Health, Education, Labor, and Pensions, a member of the Finance Committee, and a member of the Budget Committee, I assumed a unique role in the health reform debate this year. I worked hard to foster a constructive dialogue with the members of all three committees, and I have met with the President and administration officials to share ideas on how to best craft a strong bipartisan bill. As the debate on health care reform progresses in the Senate, I continue to stand ready to work on this critical issue. As I have noted many times before, this is likely to be the most important piece of legislation that we will work on as Members of the Senate. It touches the life of every single American in a very real way.
Our health care system is approximately one-sixth of our Nation's economy, and the changes we make in it will ultimately affect the lives of every single American. I have never worked on a bill that was that extensive. It is a sacred trust we have, and we must not be moved by artificial deadlines and short-term political considerations.
I do not think a good bill and a bipartisan bill are mutually exclusive. To the contrary, I believe a health care reform bill will need strong support from
both sides of the aisle to gain the credibility and the support of our constituents. It is still my hope we can produce a strong bipartisan health care bill that upwards of 80 Members of the Senate could support. I see that as a possibility.
I remain eternally hopeful we will deliver the American people the strong bipartisan health care bill they deserve. But I have to tell you I am disappointed by the recent developments of the House of Representatives and, more particularly, in the Committee of the Senate on Health, Education, Labor and Pensions.
Yesterday, on a party-line vote, 13 to 10, the committee passed the Affordable Health Choices Act. But don't let the name fool you because, with a $1 trillion pricetag, the bill is anything but affordable.
Unfortunately, the HELP Committee chose to gallop down a path of partisanship. Despite my strong urging that we start with a blank piece of paper, HELP Committee Republicans were presented with roughly 600 pages of longstanding Democratic policies. It seems not a single Democratic member of the committee was told no, as every pet project was included in this bill. Because Republicans were shut out of the drafting process, we were forced to file hundreds of amendments. Unfortunately, of the 45 committee rollcall votes on Republican amendments, 2 were successful. There were a number of amendments that were accepted, but they fall more in the category of proofreading amendments and some slight changes.
President Obama has repeatedly called for a health care bill that will reduce costs. He has called for a bill that will help every American get access to quality health care, a bill that allows people who like the care they have to keep it, a bill that will not increase the deficit. Republicans strongly support those goals. Unfortunately, the HELP bill does not meet any of them.
In my view, and graded on the criteria specified by the President, the bill voted out of the HELP Committee fails on all counts. The bill breaks the President's promises and falls short on achieving the commonsense goals the Republicans and President share. Instead, the partisan HELP bill adds $1 trillion to the deficit, despite the President's promise that health care reform must and will be deficit neutral. The bill increases that deficit by more than $1 trillion over 10 years. It is not as bad as the House bill. It is my understanding that increases it by $4 trillion over 10 years. Maybe it is just more honest, because there are ways to avoid a cost by phasing in authorizations and by using such sums in authorizations--little tricks of budgeting that avoid the score. But this is on the heels of news last week from official scorekeepers that the Federal budget deficit was $1.1 trillion for the first 9 months of fiscal year 2009.
According to scorekeepers, this bill will bend the cost curve the wrong way, driving up the cost of health insurance for most Americans and increasing total spending on health care.
I refer people to an article by Lori Montgomery in the Washington Post today, ``CBO Chief Criticizes Democrats' Health Reform Measures.''
Instead of saving the Federal Government from fiscal
catastrophe, the health reform measures being drafted by
congressional Democrats would worsen an already bleak budget
outlook, increasing deficit projections and driving the
nation more deeply into debt, the director of the nonpartisan
Congressional Budget Office said this morning.
Under questioning by members of the Senate Budget
Committee, CBO director Douglas Elmendorf said bills crafted
by House leaders and the Senate health committee do not
propose ``the sort of fundamental changes that would be
necessary to reduce the trajectory of federal health spending
by a significant amount.''
``On the contrary,'' Elmendorf said, ``the legislation
significantly expands the federal responsibility for health
care costs.''
Though President Obama and Democratic leaders have said
repeatedly that reining in the skyrocketing growth in
spending on government health programs such as Medicaid and
Medicare is their top priority, the reform measures put forth
so far would not fulfill their pledge to ``bend the cost
curve'' downward, Elmendorf said. Instead, he said, ``The
curve is being raised.''
The CBO is the official arbiter of the costs of
legislation, and Elmendorf's stark testimony is certain to
undermine support for the measures even as three House panels
begin debate and aim to put a bill on the House floor before
the August recess. Fiscal conservatives in the House, known
as the Blue Dogs, were already threatening to block passage
of legislation in the Energy and Commerce Committee,
primarily due to concerns about the long-term costs of the
House bill.
Cost is also a major issue in the Senate, where some
moderate Democrats have joined Republicans in calling on
Obama to drop his demand that both chambers approve a bill
before the August recess. While the Senate health committee
approved its bill on Wednesday with no Republican votes,
members of the Senate Finance Committee were still struggling
to craft a bipartisan measure that does more to restrain
costs.
The chairman of the Senate Budget Committee, Kent Conrad
(D-ND), has taken a leading role in that effort. This
morning, after receiving Elmendorf's testimony on the
nation's long-term budget outlook, Conrad turned immediately
to questions about the emerging health care measures.
``I'm going to really put you on the spot,'' Conrad told
Elmendorf. ``From what you have seen from the products of the
committees that have reported, do you see a successful effort
being mounted to bend the long-term cost curve?''
Elmendorf responded: ``No, Mr. Chairman.''
Asked what provisions would be needed to slow the growth in
federal health spending, Elmendorf urged lawmakers to end or
limit the tax-free treatment of employer-provided health
benefits, calling it a federal ``subsidy'' that encourages
spending on ever more expensive health packages. Key
senators, including Conrad, have been pressing to tax
employer-provided benefits, but Senate leaders last week
objected, saying the idea does not have enough support among
Senate Democrats to win passage.
Elmendorf also suggested changing the way Medicare
reimburses providers to create incentives for reducing costs.
``Certain reforms of that sort are included in some of the
packages,'' Elmendorf said. ``But the changes that we have
looked at so far do not represent the sort of fundamental
change, the order of magnitude that would be necessary to
offset the direct increase in federal health costs that would
result from the insurance coverage proposals.''
Senate Majority Leader Harry Reid dismissed Elmendorf's
push for the benefits tax. ``What he should do is maybe run
for Congress,'' Reid said.
But Senate Finance Chairman Max Baucus expressed
frustration that the tax on employer-funded benefits had
fallen out of favor, in part because the White House opposes
the idea. Critics of the proposal say it would target police
and firefighters who receive generous benefits packages. And
if the tax is trimmed to apply only to upper income
beneficiaries, it would lose its effectiveness as a cost-
containment measure.
``Basically the president is not helping,'' said Baucus.
``He does not want the exclusion, and that's making it
difficult.''
But he added, ``We are clearly going to find ways to bend
the cost curve in the right direction, including provisions
that will actually lower the rate of increase in health care
costs.''
Ideas under consideration include health-care delivery
system reform; health insurance market reform; and empowering
an independent agency to set Medicare reimbursement rates, an
idea the White House is shopping aggressively on Capitol
Hill.
But Baucus is not giving up on the benefits tax. ``It is
not off the table, there's still a lot of interest in it,''
Baucus said.
I would mention the members of the committee are still working to find that bipartisan match, but it does take time. There are so many moving parts to this bill. But the partisan HELP bill breaks the President's promise, ``if you like what you have, you can keep it.'' The scorekeepers report the bill would force millions of Americans to lose their health care plan they have and like. Several Republican members offered amendments that aimed at ensuring Americans who like the coverage they have they can keep it, but they all suffered the same failing fate.
The partisan HELP bill kills jobs and cuts wages. The nonpartisan Congressional Budget Office concludes the bill will result in lower wages and higher unemployment. These jobs and wage cuts would hit low- income workers, women, and minorities the hardest. It is hard to believe that with unemployment at a generational high, Democrats on the committee will even consider putting more jobs on the chopping block.
Despite passage of the so-called stimulus bill earlier this year, Americans are facing the highest unemployment rate in 26 years. At the same time, the HELP Committee and the House Democrats are attempting to impose new taxes on small employers that will eliminate jobs for low- income minority workers.
The partisan HELP bill raises taxes at the worst possible time. Despite several amendments offered by Republican members, which the Democrats defeated on party-line votes, the bill breaks President Obama's promise not to raise taxes on individuals earning less than $250,000 per year. The bill would impose a new tax on people without health insurance. The partisan
HELP bill allows Washington bureaucrats to ration health care. The bill lays the groundwork for a government takeover of health care, giving Washington bureaucrats the power to prevent patients from seeing the doctor they choose and obtaining new and innovative medical therapies.
I could go into the cost effectiveness--the clinical effectiveness research, but I will not go into the details of that at this time. But that is a way that care could be rationed. How do we know? We tried a bunch of amendments that would specify what could not be rationed, and every one of those was defeated.
The partisan HELP bill traps low-income Americans in a second-tier health care program. Despite several amendments, the other side refused to give Medicaid patients the choice to access higher quality care.
The other side claims to support giving patients choices but when the choice is a new government-run health plan. However, they refuse to give low-income Americans the chance to get out of the worst health care programs in the country.
I would mention government-run programs, instead of giving the lowest income Americans a choice to enroll in private insurance with subsidies, the HELP Committee bill forces them to stay in a program where 40 percent of the physicians will refuse to see them and the care they receive will be worse than what is available through private health insurance.
I have to remind you, if you cannot see a doctor, you don't have health care.
Instead of reducing health care costs, the partisan bill will spend billions of taxpayer dollars on new porkbarrel spending. The bill would build new sidewalks, jungle gyms, and farmers markets through a mandatory spending $80 billion slush fund. That is just the first 10 years, which is delayed 2 years; otherwise, it would be $100 billion. That is for additional porkbarrel projects.
Talk about a rating system. A rating system is how much difference you have between the low age and the high age, the more well and the sicker people. That is being compressed dramatically, which will raise the rates for virtually everybody in America.
The partisan HELP bill preserves the costly, dangerous, medical malpractice system. Again, despite several blocked attempts by multiple Republican committee members, the bill fails to reduce medical lawsuits which drive up the cost of health care and force doctors to order wasteful tests and treatments to cover liabilities.
The bill worsens doctor shortages. According to an analysis by the Department of Health and Human Services, the bill would worsen the Nation's primary care physician shortage by providing fewer medical students with financial assistance in return for work in underserved areas.
In short, the HELP Committee bill costs too much, covers too few, and if you like what you have you can't keep it. Under this bill, if you like your job, you may not be able to keep that either. With all these bad policies comes a $1 trillion pricetag. That is $1 trillion this country cannot afford right now and a trillion reasons why it is a bad bill for America. We have not even talked about clinical effectiveness or some other programs that were not actuarially sound.
As I said at the beginning of the speech, I am an eternal optimist. Despite my comments on the perils and policies in the HELP bill, we still have a chance. We can write a good bill, a bill that ensures every American has quality, affordable health care; a bill that is fully paid for with savings exclusively from health care; a bill that reverses the cost curve; a bill that lets Americans keep what they have if they like it; a bill the American people deserve. We are working on that now. We are trying to put together that bill, but it takes time.
Those are all things that can be done. One way to enact real change is to sit down and work out the details. Health care is complicated. The laws of unintended consequences are severe and unforgiving. We cannot rush into something that will change one-sixth of our Nation's economy and affect 100 percent of Americans. We must take our time and get the policies right.
I have heard reports of White House staff calling the HELP Committee bill a bipartisan bill. I heard White House staff say this bill incorporated Republican ideas. White House staff speak for the President, not for Senate Republicans.
I can tell you as the ranking Republican on the HELP Committee, the partisan vote speaks for itself. Republican ideas were excluded from the process and from this legislation. We have five bills that have ideas that would meet the goals of the President and the ones I have stated. Parts of those were considered; most were rejected.
I passionately want to reform our health care system to improve quality, reduce costs, and increase access. I think the HELP Committee legislation fails to meaningfully address those goals and sticks the American people with a bill we cannot afford. I hope we can get back to work and construct real reform that has the support of the American people.
I appreciate the openness that Senator Baucus has had in dealing with Finance Committee members and am optimistic eternally that something good can come out of it.
I yield the floor.