Speeches & Floor Statements

Floor Remarks of U.S. Senator Lamar Alexander (R-Tenn.) -- A 2,000-Page Health Care Bill

Posted on October 29, 2009

Madam President, I have an important announcement to make on another subject which is of interest to the American people. The era of the thousand-page bill is over. We now have a 2,000-page bill, a new health care bill introduced in the House of Representatives today by Speaker Pelosi. What we will do on the Republican side, and what I hope our friends on the Democratic side will do as well, and what every American expects us to do, is read all 2,000 pages and know exactly what it costs before we begin to vote on the congressional Democrats' health care bill. For example, while we know just a few things about the bill, we know the price tag is likely to be more $1 trillion. So it is 2,000 pages, more than $1 trillion. We know the physicians Medicare reimbursement rate, which is important to all of us to be included, is scheduled to be treated separately there. Well, it wasn't treated separately here. On what was the first vote on health care a week ago, 13 Democrats joined with 40 Republicans to say we are not going to begin the health care debate by increasing the deficit by $1/4 trillion. That was an important statement to the American people. One of the questions we will be asking is how is the physician Medicare reimbursement plan, which is an essential part of any plan for health care over the next 10 years, how is it paid for? Does it add to the debt? We will be looking -- and I know the distinguished Senator from New Hampshire who is the ranking Republican on the Budget Committee already is looking -- at not just what happens in the first 5 years of this proposed bill but in the second 5 years and the 10 years after that, because our goal is to reduce the cost of health care, the cost of premiums to each of us and to our government. A preliminary look suggests that while the cost may go down to the government in the first 5 years, it might go up in the second 5 years as the plan is implemented. Third, we want to look at the new taxes on small businesses we have been told about. Next, we want to look at the provision in the bill which seems to say that an employer might have to pay 8 percent of his payroll as a penalty if the employer does not provide health care to his employees. Does that mean all employees? Does that mean full-time employees? Does that mean part-time employees? We want to read the bill. We want to know exactly what it says. We want to see a Congressional Budget Office estimate -- a formal estimate -- of what it costs. There is in the bill a new government-run insurance plan. We have said before that our view on the Republican side -- and I know some Democrats have concern about this as well -- is the effect of a government-run insurance company -- some call it the government option -- is no option because if you are one of the 170 million or 180 million Americans who have health insurance through your employer, the combination of a bill such as this is you are more likely to lose your insurance and the government option is likely to be your only option. We will be asking that question and see what it costs. There is a provision in the bill that expands Medicaid. This is the government-run program for the low-income we already have that has 60 million Americans in it. The State and the Federal Government share the cost of it. My preliminary understanding of this provision is, it increases the cost of the Medicaid expansion, which Governors all across the country are deeply concerned about, and it adds a provision to require that physicians be reimbursed for Medicaid services at the same level as Medicare, which would basically double the cost of the Medicaid expansion. How much of this will the States pay? There are a number of questions to be asked, but the news of the day is this: The era of the 1,000-page bill is over. We have a new 2,000-page health care bill. We will be reading the bill, and we will be trying to understand exactly what it costs. Mr. GREGG. Will the Senator from Tennessee yield for a question, Madam President? Mr. ALEXANDER. I will be glad to yield. Mr. GREGG. A 1,000-page bill is pretty big. It is about this big, and a 2,000-page bill is about this big. We are going to find out when we see it printed. That probably weighs a lot, 4 or 5 bricks, 10 bricks maybe? Mr. ALEXANDER. I don't know. The Senator from New Hampshire has a wide variety of experiences and may understand the weight of bricks better than I do. I just know the era of the 1,000-page bill is over. We have a 2,000-page bill, and we will need to read it. I ask the Senator from New Hampshire how long should it take the Congressional Budget Office to provide a formal estimate of a 2,000-page bill, based upon his experience -- I ask through the Chair -- as former chairman of the Budget Committee and the ranking Republican member. Mr. GREGG. Madam President, I say to the Senator from Tennessee, I presume it would be at least a week or maybe 10 days. I understand they are going to do an informal sort of "on the back of an envelope" estimate quickly. But the implications of this bill, 2,000 pages -- it is akin to dropping 10 bricks on our seniors, isn't it? Doesn't this basically wipe out Medicare Advantage and massively impact Medicare benefits and move those savings over to fund a brandnew entitlement? Mr. ALEXANDER. I thank the Senator from New Hampshire. Our concern has been, with the bills we have seen so far, that a bill that is supposed to reduce costs actually raises the cost of premiums, cuts Medicare, and raises taxes. The new government insurance plan will cause millions to lose their employer-based insurance and become a part of the government option and, unless the physicians Medicare reimbursement payment is a part of the plan, it also adds to the debt. Mr. GREGG. If the Senator will entertain one other question. The Senator, in his comments on this new 2,000-page piece of legislation, which started out at significantly less, made a point that I believe the last 5 years of this bill -- it is a 10-year bill and, of course, it is going to go on forever -- they basically start the taxes at day one, but they don't start the expenditures until year five. It turns out, as I believe the Senator said, the expenditures in the last 5 years exceed the income. So if you were to logically put this bill in a 10-year timeframe, where you had all the expenditures and income matched up, this bill is going to add a lot to the deficit. This is a $1 trillion to $2 trillion bill, and the deficit is going to go up a lot. That is common sense; is it not? Mr. DURBIN. Will the Senator yield for a question? Mr. ALEXANDER. It seems to me it will. Mr. DURBIN. Will the Senator yield for a question? Mr. ALEXANDER. I am always glad to yield for a question by the assistant Democratic leader. Mr. DURBIN. Since we are dealing with health care reform that addresses one-sixth of the American economy, does the Senator from Tennessee believe there should be a maximum number of pages the bill would entail? Mr. ALEXANDER. That is a very good question. I saw the Senator from Illinois on the floor the other day saying: A 1,000-page bill, who cares about a 1,000-page bill? I don't think Americans like the idea of a 1,000-page bill. I think they will like even less a 2,000-page bill. I don't think we do comprehensive very well here. I think what the American people want us to do, if I can say to the Senator from Illinois, is not have a comprehensive bill full of higher premiums, taxes, and surprises but to focus on reducing the cost of health care premiums and reducing the cost to the government and go step by step on things -- Mr. DURBIN. Will the Senator yield for a question? Mr. ALEXANDER. I am trying to answer his excellent question. -- go step by step to meet that goal, such as a provision that would allow small businesses to combine resources and offer their employees insurance, such as provisions that would get rid of junk lawsuits against doctors, which virtually everyone agrees drives up the costs. Mr. McCAIN. Will the Senator yield for a question? Mr. DURBIN. Will the Senator yield for one more question? Mr. McCAIN. Will the Senator yield for an additional question? Mr. ALEXANDER. Yes. Mr. McCAIN. Does the Senator recall -- and perhaps the Senator from Illinois recalls -- does the Senator recall, during the last Presidential campaign, when the President of the United States said there will be Republicans and Democrats sitting down together and there will be C-SPAN cameras? I wonder if the Senator knows the C-SPAN cameras are still waiting outside this room over there. Does the Senator recall that commitment? I wonder -- I wonder -- whatever happened to that campaign promise that the American people would know who is on the side of the pharmaceutical companies and who is on the side of the American people. If they came in now, it would be too late because they already cut a deal with the pharmaceutical companies in return for $80 billion. They got $100 million in positive ads for reform. I wonder if the Senator from Tennessee recalls that commitment on the part of the President of the United States. I wonder if he might urge his colleague, the other Senator from Illinois, to get the C-SPAN cameras in there while these negotiations are going on. Mr. ALEXANDER. I thank the Senator from Arizona for his excellent question. I am sure there is no one in this Chamber who more vividly remembers that promise than the Senator from Arizona. We all would like to know what is in this bill and what is going on behind closed doors. Mr. DURBIN. Will the Senator yield for one more question, a very short question? Mr. ALEXANDER. Only if -- Mrs. FEINSTEIN. Before he does, Madam President -- The PRESIDING OFFICER (Mrs. SHAHEEN). The Senator from Tennessee has the floor. Mr. ALEXANDER. Without yielding the floor, I certainly would be glad, if I may reclaim the floor -- I have the floor -- I will be glad to allow the Senator from California to say whatever she would like, if I can have consent to have the floor back. Mrs. FEINSTEIN. I appreciate that. The Senator from Tennessee is the ranking member of the Interior Appropriations Subcommittee. I alert the Senate that time is running on the bill. It is 2 hours, equally divided. Let me ask the Parliamentarian this question: How much time remains on the Interior appropriations bill, and how much time has the Republican side used to this moment? The PRESIDING OFFICER. The majority still has 1 hour, and the minority has used 12 minutes. Mrs. FEINSTEIN. Just so you know. Mr. ALEXANDER. I thank the chairman. I look forward to moving over there and working on the Interior appropriations bill. I think Senator McCain is here to speak about it. I was only, in an extravagant gesture of courtesy, trying to answer the question of the distinguished assistant Democratic leader from Illinois. Mr. DURBIN. Will the Senator yield for one more question? Will the Senator yield for one short question? Mr. ALEXANDER. Knowing the Senator is a very able trial lawyer, it is only because I am courteous that I will do that. Of course I do. Mr. DURBIN. Very good. Can the Senator from Tennessee tell me how many pages the Republican health care reform bill is? Mr. ALEXANDER. The Republican health care reform bill, Madam President, if I may talk about it, has been offered in a series of proposals. The proposal for a small business health insurance program is less than 1,000 pages, by several hundred pages. What I think I will do is not take so much more of the Senator's time, but I will enumerate the proposals and give him the number of pages. While he is reading our proposals, I will read his, and we will see who gets through first. Of course, we will have to wait until they come out from behind closed doors with their bill. I will get the small business proposal. I will get the proposal to end junk lawsuits against doctors. I will get the proposal to allow people to buy insurance across State lines, which will reduce the cost of insurance. I will get the proposal that would adjust tax incentives. There is a proposal that would also expand technology on which we have proposals on both sides of the aisle. So I will get five or six of the Republican proposals, most of which we hope will gain bipartisan support. I see the assistant Democratic leader every day at the beginning of the day. Maybe we can even read them together, and then whenever his bill comes out from behind closed doors and we get the House bill, we can all read that 2,000-page bill. I am going to accede to the wishes of the chairman of the Interior Appropriations Subcommittee, because I am her ranking minority member, and cease talking about the end of the era of the 1,000-page bill and let us get to Interior appropriations.