Speeches & Floor Statements

Floor Remarks of U.S. Senator Lamar Alexander (R-Tenn.) -- Health Care Reform

Posted on November 19, 2009

I was listening to my friends on the Democratic side. I wish they could have been in the Senate 4 or 5 years ago. Actually that would have reduced our numbers, so as much as I like them, I would not have wished that. If they had been here, they might have been some help in arguing to the Democrats who blocked Miguel Estrada from even having an up-or-down vote, who blocked Judge Pryor of Alabama from having an up-or-down vote. The Democrats at that time seemed to argue a completely different point of view. What we want on the Republican side is very simple. You see this bill I am leaning against? This is the new bill. This is the Harry Reid -- the distinguished majority leader's health bill. We want to make sure the American people have a chance to read it and they have a chance to know exactly what it costs and they have a chance to know exactly how it affects them. That is not an unreasonable request, we don't think. That is the way the Senate works. That is our job. When it came to the Defense authorization bill, we spent a couple of weeks doing that. When it came to No Child Left Behind, the Education bill, we spent 7 weeks going through it, and neither of those bills was 2,074 pages long. The Homeland Security bill took 7 weeks. The Energy bill in 2002 took 8 weeks. A farm bill last year took 4 weeks. So we have a little reading to do, a little work to do. We have done some preliminary reading, but what we want to make sure of is that the American people read the bill, know what it costs, and know how it affects them because health care is a very personal matter. I have done some reading since the bill came out last night. I was also a little bit amused to hear our friends complaining about how we are slowing things down. Well, this bill has been hidden in the majority leader's office for 6 weeks. He wouldn't let any of us read it. I don't know who he has been in there with writing it, but I guess it takes a long time to write a 2,074-page bill. But he didn't bring it out until last night, and now we have it printed out. Now he wants to vote on Saturday. Well, that is all right with us if he wants to vote on Saturday or Sunday or Monday or Thanksgiving Day. We are going to be here because these are the most important set of votes we are ever likely to take in this body, at least during the time I am here. Let me give a preliminary report to the American people in terms of the Thanksgiving spirit about this bill. It came out with a lot of fanfare. It has been hidden in the majority leader's office for 6 weeks, but here is my early verdict in terms of the Thanksgiving season. This is the same turkey you saw in August, and it is not going to taste any better in November. It is not much different than what worried you in August. In fact, it has gotten a little bit worse. If I may, let me give just a few thoughts about the bill. Why would I say it is the same turkey you saw in August, and you didn't like it in August? Well, it is still going to have higher premiums for you to pay. It is still going to have higher taxes for you to pay. There are still going to be big Medicare cuts for seniors to absorb in their program. And while it is a little too early to tell, there is very likely to be more Federal debt. It is still a big bill -- more than 2,000 pages -- and if you wait until it is fully implemented, it is still somewhere between $2 trillion and $3 trillion over a 10-year period of time. The Republican Budget Committee staff has looked it over carefully since last night and says it is about $2.5 trillion in spending over 10 years. It still starts taxing you and cutting your benefits immediately if you are on Medicare, but the benefits that come to you for the most part don't start until 2014. Let me be a little specific about it. It still leaves 24 million Americans uninsured, although it reduces the number of uninsured Americans by 31 million according to the Congressional Budget Office. It still doesn't take care of the physicians reimbursement. One of the most difficult issues we have is what we should do about the amount of money we allow doctors to make when they see patients who are in the government programs. In the Medicare Program, doctors only make about 83 percent of what they would be paid if they were seeing the 177 million of us who have private insurance. We regulate that. Doctors who see Medicaid patients, about 60 million patients in the low-income government program, only get paid about 63 percent, which is set by the state, of what they would get paid if they saw somebody who has a private policy. In fact, 50 percent of doctors will not see new patients in the biggest government program we have -- Medicaid. So as you can imagine, a lot of doctors can't see the people in the government program. This new bill takes care of the doctors reimbursement for only 1 year. It leaves out about $250 billion over the 10-year period of time, so add that in when you are figuring out whether this adds to the debt. Does it have higher premiums? Yes, it does. The Congressional Budget Office says the new government plan in this bill would have premiums that are higher than private plans. Your common sense would also tell you that, because if we have $800 billion in new taxes somebody is going to have to pay those taxes. If they are on medical devices or insurance policies, do you think the insurance company is just going to pay those taxes? No, they are not. They are going to pass those on to you in the form of premiums. So higher taxes mean higher premiums. There is also $28 billion in new taxes from employers who have to pay a fine when they don't provide employer-based insurance. Under this bill, the chances are very good -- in fact, the Congressional Budget Office says maybe 5 million Americans will lose their insurance. How could they lose their insurance under a bill such as this? The reason would be that the employer will read this big, complicated thing and say: I don't want anything to do with that. I will pay the fine. I will write a check to the government. Then I will write a letter to all of my employees and say: Congratulations, there is a new government plan, and you are in it. That is going to happen to millions of Americans who have private insurance today through their employers. The employer is going to simply say it is cheaper for them to pay the fine. It is easier for them to pay the fine than deal with this 2,074-page bill. According to the Congressional Budget Office, 5 million Americans -- and others think many millions more -- will lose their employer-based insurance, and they will end up in the government plan. I just said in the government plan, the largest one we have, Medicaid for low-income Americans, 50 percent of doctors will not see those patients -- new patients -- because of the low reimbursement rates. The bill still relies on the States to pay for some of Medicaid. That is not new either. That concerns me greatly as a former Governor. Our current Democratic Governor said the bills he had seen so far would add over $1 billion to State taxes or spending over the next 5 years which, in my way of thinking, would require a new State income tax that would seriously damage higher education or both. In other words, we are saying give us a pat on the back. Thank you very much for expanding Medicaid, and I am going to send some of the bill to the States and let the States either raise college tuition or raise taxes or cut spending or put in new taxes to pay for it. There is also a new Medicare tax. The money that is raised from that, the Medicare payroll tax, is not spent on grandma, not spent on Medicare; it is spent on a new program. So we are going to cut Medicare and tax Medicare and not spend it on Medicare, which is going broke in 2015, according to its trustees. We have a new government program. Those are new. But, basically, it is still the same turkey you didn't like in August, and it is not going to taste any better at Thanksgiving dinner on Thursday. We need to start over. We need to go in the right direction. We need to cut costs. Republicans have offered a number of ways to do that: small business health plans, reducing junk lawsuits against doctors, competition across State lines. All of these steps would cut costs. We don't need a 2,074-page bill. We need to take it step by step in the right direction to cut health care costs, and when we take those five or six steps, we can take five or six more. I thank the President and yield the floor.