Speeches & Floor Statements

Floor remarks of Senator Lamar Alexander (R-Tenn.) -- Healthcare

Posted on March 17, 2011

Mr. ALEXANDER. Mr. President, this is St. Patrick's Day, as Reverend Austin mentioned, and we celebrate that. We are coming up on another important anniversary, and that is the anniversary of the enactment of the health care law, which the majority regards as a historic achievement, and most Republicans regard as a historic mistake.

I want to talk a little bit about that law, but there is another anniversary I remember very well that came a few days before enactment of the health care law -- the so-called health care summit that was held at the Blair House. It was a remarkable event.

The President of the United States, who is highly intelligent and well-versed on health care, invited a bunch of us down to discuss health care. He stayed and we stayed for 6 or 7 hours. During that discussion, it was a pretty free exchange. I especially remember one of them. I had been asked by Senator McConnell and Representative Boehner to represent Republicans in presenting our side, and the President's invitation gave us a platform we usually don't have. He has a better platform than we do most of the time.

We made our argument that we would prefer an approach on health care that instead of expanding the health care delivery system, which we all know costs too much, we should go step by step to reduce the cost of health care so more people can afford to buy insurance. That was the basic discussion we had. We got down to some facts. I had said that, according to the CBO, the President's plan would raise individual premiums and make insurance cost more for individuals who buy insurance by 10 to 13 percent. The President said, after I finished:

So, Lamar, when you mentioned earlier that you said premiums go up -- that's just not the case, according to the Congressional Budget Office. I said: Mr. President, if you're going to contradict me, I ought to have a chance to respond. The Congressional Budget Office report says that premiums will rise in the individual market as a result of the Senate bill. The President said:

No, no, no, no -- let me -- and this is an example of where we've got to get our facts straight.

I said: That's my point.

And it went on from there. I had to make a decision at that moment whether I should continue to have a public disagreement with the President. I thought I was right, and he thought he was right, so I decided it would be more appropriate for me not to do that in public, to let other Senators and Congressmen have their say. I exchanged a letter with the President that day, and I came to the floor of the Senate later that week to make my argument on why I believed premiums would go up.

Mr. President, I ask unanimous consent to have printed in the Record the transcript of my exchange with the President and that of Senator Kyl and a couple of Members of Congress; the letter I sent to the President that day which made my point rather than publicly argue with him; and, finally, I would like to reference the remarks I made on the floor of the Senate later that day.

Mr. ALEXANDER. We talk a lot about the law of unintended consequences in dealing with legislation. In this case I believe the health care law is a situation where we had a lot of predictable consequences. Republicans were saying, for example, premiums are going to rise. In fact, they have. We were saying specifically that individual premiums will rise. It was predictable they would because, in the first place, the health care law requires that individuals buy a better policy than what they buy today. So if they are going to buy a Cadillac instead of a Chevy, it will cost more and they will get more benefits.

Second, there are some taxes in the health care law, such as with medical devices, that are passed on to the consumer and premiums will go up.

Third, a lot of people who moved into Medicaid are going into a system of government health care where the doctors aren't properly reimbursed. Many of the doctors shift the costs over to the people who buy insurance. That is called cost shifting.

For all those reasons, we have seen stories regularly in California, Nevada, Wisconsin, and Connecticut that individual premiums, over the last year, have gone up at least partially due to mandates included in the new law.

Let's look at some of the other issues we talked about during that time. We said the bill would raise taxes. In fact, it does -- $813 billion. As I mentioned, the tax on medical devices is passed right along to people who buy insurance, and their costs go up.

We said it would cut Medicare, and it has. Eleven million Medicare Advantage recipients -- about one-fourth of everyone who has Medicare -- are seeing or will see their benefits reduced.

We said there would be thousands of pages of new regulations that would hamper small businesses and individuals as they go about their daily lives. We are beginning to see them come. The most notorious is that form 1099 which causes 40 million businesses to file a report every time they buy something that costs more than $600. We hear a lot of talk about repealing that. We have tried to repeal it for some time, but it is still the law.

Something that particularly bothered me about the debate were the unfunded mandates on State governments. We hear about college tuition going up in California 30, 40 percent. People would be surprised to think that the reason may be that the Federal Government is imposing more health care costs on California, and the money that ought to go for the University of California or the University of Tennessee isn't there. Where does the university get the money to keep its excellence? It raises tuition.

Our former Democratic Governor, who just retired, said the health care law imposes on Tennessee more than $1.1 billion in new costs between 2014 and 2019.

That is an unfunded mandate from Washington that will cost the people of Tennessee.

Fewer jobs will be created as a result of this law. Someone might say: How can you say that? I will give an example. I met with a group of leaders of the restaurant industry in America. They are CEOs of all the big restaurant companies. They are the second largest employer in America. They hire a lot of low-income people. One of them said they had been operating their stores with 90 employees on the average, and as a result of the health care law, their goal was to operate with 70 employees. That is fewer jobs. And there were many other examples of that around the room.

Even the student loan takeover has created a problem because students are actually paying more in interest on their student loans to help pay for the new health care law, which I think a lot of students would not appreciate.

The health care law that was passed a year ago, which some believe is a historic achievement, we believe is a historic mistake. We believe it would have been better and will be better to, instead of expanding a health care system that costs too much, go step by step to reduce its costs so more people can afford insurance. We will continue to advocate that position. We voted to repeal the health care law. We lost that vote. But we are continuing to work.

The ACTING PRESIDENT pro tempore. The Senator's 8 minutes has expired.

Mr. ALEXANDER. With Senator Johanns' leadership and others, we will work to repeal the 1099 provision. Senator Hatch and others are working to give Governors more flexibility in the Medicaid Program. And we will continue to advocate solutions such as allowing people to buy insurance across State lines.

Next Wednesday is an important anniversary. Some believe it is a historic achievement. We believe it is a historic mistake and that there is a better solution to health care costs.

I thank the leader for his courtesy in giving me a chance to go ahead. I yield the floor.