Madam Chairman, I yield myself such time as I may consume. I hope everybody's been listening to this. What has become clear is this: the Republicans have a 3-act play. First, repeal IPAB; next, repeal the rest of health care reform; and,…
Madam Chairman, I yield myself such time as I may consume.
I hope everybody's been listening to this. What has become clear is this: the Republicans have a 3-act play. First, repeal IPAB; next, repeal the rest of health care reform; and, finally, repeal Medicare.
It is so hypocritical to come forth and say that the efforts of Republicans is to protect Medicare when the purpose of it is to destroy it. That's what would happen if they had prevailed before. That's what would happen if they prevail today with their voucher plan.
So the third act really came forth before the first act. They rolled out, yesterday, their budget plan that essentially would repeal Medicare, would destroy it. There would be a voucher and, over time, the end of Medicare.
It's an essential commitment to the seniors of this country, and we Democrats are determined to thwart every effort to destroy it.
Now, as to the first act, repeal IPAB. You know, it's interesting that Medicare is a major instrumentality for ensuring that over time the costs of Medicare are brought under control, protecting the health care opportunities of seniors. Indeed, there have been efforts already under the Affordable Care Act to bring under control the costs of Medicare, to make sure it survives.
So being an essential part of controlling health care costs over the long term, the Republican proposal, essentially, would go in the opposite direction. And that's why the CBO, last year projected--and I want everybody to listen to this--that health care costs would jump by 39 percent under the Republican plan to end the Medicare guarantee. That's why 300 economists have said that health reform puts into place, essentially, every cost-containment provision policy that analysts have considered. It's because of those policies that CBO has given this estimate that IPAB isn't going to be triggered until some time after 2022.
So what happens is, the Republicans come forth with the repeal of IPAB as a first step towards repealing Medicare when they have never presented an alternative in terms of the Affordable Care Act. So, today, we hear all the scare tactics about a board whose operation effectively won't be triggered for a decade. That's a scare tactic that is not worthy of this floor, so I urge very much that we oppose.
It's interesting that the Republican budget has a cap that is more severe, if you want to put it that way, more strenuous than the provision that relates to IPAB. And so they come forth, and they say that IPAB, which won't be triggered until 2022, is something that they should oppose, while they want to put in place a budget this year that would have a more severe cap than is in IPAB. Let me also say the notion that there is some agency here that could act without any role for Congress is simply untrue. It's not true. You shouldn't say it.
We have an opportunity, once IPAB goes into operation, to review any recommendation that comes forth, and to replace it, as long as the various targets are met. So I urge very much that we reject this proposal in part because the repeal, in and of itself, I think, is a mistake but mainly because of what the aim is here, and that has been so clear from the debate, because people who come here on the Republican side, some of them talk about IPAB; some don't even discuss IPAB. They talk about the Affordable Care Act.
The polling data we have is essentially relating to the Affordable Care Act as well as to IPAB. I think the more people understand what has been going on, the more they see the benefits of health care reform, the more they will be supportive of it. We're going to take that case to the American people.
Let me just give you a few numbers that everyone should know about
I now yield 3 minutes to the distinguished member of our committee, Mr. Blumenauer, from the proud State of Oregon.
I yield the gentleman an additional 2 minutes.
I yield 4 minutes to a member of our Ways and Means Committee, the gentleman from Wisconsin (Mr. Kind).
I yield to the gentleman 2 additional minutes.
I now yield 4 minutes to the gentleman from Texas, a member of our committee, Mr. Doggett.
It's curious. You're talking about, according to CBO, a board whose operation would be triggered in 2022. You come here and scare people. It doesn't work. You talk about rationing. You're talking about an operation 10 years from now.
Right now, health care is being rationed. You have 50-plus million people who have no insurance, 50-plus million people who have no insurance at all, and you haven't come up with a bill that would address that.
I am proud to yield 4 minutes to the gentleman from New Jersey (Mr. Andrews), who has been so key in the health care debates.
(Mr. ANDREWS asked and was given permission to revise and extend his remarks.)
I yield the gentleman 2 additional minutes.
Let me just say it is strange to say you save something by destroying it. That is 1984 in 2012.
I now yield 2 minutes to the gentleman from New Jersey.
(Mr. ANDREWS asked and was given permission to revise and extend his remarks.)
It is now my privilege to yield 3 minutes to the distinguished gentleman from Missouri (Mr. Clay).
I yield myself such time as I may consume.
We're talking about a board whose operations trigger, according to CBO, 10 years from now.
I just want to say to those who say it's unaccountable: Every one of their recommendations will come before the Congress of the United States, every single one. What's unaccountable are the statements that are made on this floor that are not true.
I reserve the balance of my time.
No. What the Republicans would do would be to send the decisions already there in large measure to insurance companies.
I reserve the balance of my time.
I reserve the balance of my time.
I yield myself 1 minute.
The present system doesn't have enough primary care. I know from my own experience that there's a lack of family physicians and primary care physicians. The Affordable Care Act strengthens that program, will strengthen the relationship between the physician and the patient. And for anybody to come here and scare patients and seniors into thinking that there is some kind of a wall that will be replaced is really not true.
I yield to the gentleman.
I yield myself an additional 1 minute.
Look, I respect that. But the primary fact, the basic fact is that the Affordable Care Act addresses this issue more effectively than has been addressed before. There is more money for primary care physicians, for family physicians. That's what we need. That's what we need.
And to come here and raise the specter that this bill is going to diminish it, when its major purpose, among others, is to increase the availability, to have a linkage between the patient and the specialty care--
I yield to the gentleman.
I yield myself an additional 30 seconds.
Look, we need to address it, but destroying Medicare is not the way to address it. That's what you do. You destroy it. You destroy it when you say you're saving it.
I reserve the balance of my time.
I yield myself the balance of my time.
Look, the Supreme Court will be hearing the case about the individual mandate next week, and I don't think we want to argue this now. We don't have any judges here.
But let me say, on the individual mandate, it really is ironical that the more conservative, apparently, you are, the more you dislike the individual mandate, when the individual mandate was the central point within the health care reform proposal of conservatives in this country several decades ago. It was their central point in the eighties and in the nineties. And now they've reversed course and claim, I guess, what they proposed in the seventies and eighties was constitutional then is unconstitutional today. Talk about a flip-flop. That is, I think, maybe an unconstitutional flip-flop, but the Court will decide that.
Let me just say a word about cost containment and the importance of our addressing that and the importance of our reforming the present system, how we reimburse the fee-for-service system. I don't think it's been noticed that, in addition to IPAB, ACA has a number of provisions that will go into effect long before IPAB could become operational. Those systems are beginning to work.
For conservatives who talk about the importance of cost containment, they want to repeal an act that has within it not only the seeds of cost containment, but the instrumentalities of it. In fact, they're beginning to work well enough. That's why CBO says that it's going to be 10 years before IPAB is triggered.
So, those who come here who claim to be concerned about cost containment essentially are undermining their own position.
Well, this is act one of the Republican three-act play.
The second is to eliminate health care reform altogether, and the third is to take away Medicare.
I want to close reporting the views of AARP in terms of the Ryan budget proposal. It says:
It lacks balance, jeopardizes the health and economic
security of older Americans. A number of proposals in this
budget put at risk millions of individuals by prioritizing
budget caps and cuts over the impact on people.
Those who talk about the cap that would essentially be within the structure of IPAB's operation, that proposed cut is less than in the Ryan budget, which would be more severe, and essentially the implementation would be by insurance companies who are nameless, who are unaccountable.
So let me continue with another quote from the AARP:
By creating the premium support system for Medicare
beneficiaries, the proposal is likely to simply increase
costs for beneficiaries while removing Medicare's promise of
secure health coverage--a guarantee the future seniors have
contributed to through a lifetime of hard work.
The premium support method described in the proposal,
unlike private plan options that currently exist in Medicare,
would likely `price out' traditional Medicare as a viable
option, thus rendering the choice of traditional Medicare as
a false promise.
So this is what I think we should do in terms of this three-act play of the House Republicans. That is to start by rejecting act one, this repeal of IPAB.
This may be a vote, but it's not going to be an act.
I finish with this. In a sense, you are acting because this isn't going to become law. You have not come up in all of these months with a comprehensive alternative to the Affordable Care Act. There's not been a comprehensive bill put forth. We haven't voted on a comprehensive bill in these days on the Ways and Means Committee. Instead, there has a piece-by-piece effort to dismantle what was health care reform to address a serious situation, including over 50 million people who go to sleep every night without health care coverage in the United States of America.
We should be ashamed of that. We should be ashamed. A couple years ago, we acted to lift that shame off of the shoulders of all of us in the United States of America.
I urge we vote ``no'' on this bill.
I yield back the balance of my time.