Affordable Health Care For America Act

Floor Speech

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Mr. PETRI. I thank my colleague from Minnesota.

Madam Speaker, unemployment is 10.2 percent, the highest in 26 years, yet here we are being asked to vote on a bill which will radically alter and disrupt one-sixth of our economy, hit businesses with costly new regulations, ratchet up monstrous Medicaid mandates on the 50 States, raise taxes on job creators, impose skyrocketing insurance premiums on individuals and families, and destroy popular Medicare Advantage plans, all this while failing to bend the cost curve down and providing no real liability reform.

At a time of record deficits, this bill spends over $1 trillion to provide health insurance to less than 15 percent of Americans. To pay for this budgetary train wreck, it imposes $730 billion in new taxes and relies on a series of budget gimmicks in a slippery attempt to claim it won't contribute to our deficit tsunami.

This legislation will bring about a radical intrusion of government into every sector of health care. It puts bureaucrats between patients and their doctors. It doesn't make sense, isn't very smart.

Let's not pass this monstrosity.

I certainly agree that it is time to fix the health care system in the United States so that all Americans have access to quality, affordable health care. In order to achieve this goal, I strongly believe that any bill that is approved by Congress must institute reforms that will address the rising cost of health care.

The majority of Americans have some kind of health insurance they are generally satisfied with. What they really care about is rising costs. Spending on health care services already accounts for about 17 percent of gross domestic product (GDP)--an expected total of about $2.6 trillion in 2009. Health care inflation has outpaced general inflation by approximately 2.5 percent a year. Government spending on health care continues to grow exponentially and without action, spending on Medicare and Medicaid will rise from 4 percent to 19 percent of GDP in 2082.

However, the bill we are considering today takes us in the entirely wrong direction by instituting reforms that will increase health care spending while doing little to bend the cost curve. This legislation is best categorized as an entitlement expansion rather than health care reform. At a time of record deficits, H.R. 3962 spends $1.055 trillion to provide health insurance to less than 15 percent of Americans. Furthermore, almost 15 million of these individuals will receive insurance coverage by expanding the eligibility of Medicaid. This results in the largest expansion of Medicaid since its inception almost forty years ago. In fact, according to the Congressional Budget Office, the bill will increase the federal budgetary commitment to health care by $598 billion in the first ten years alone!

To pay for this budgetary train wreck, H.R. 3962 imposes $729.5 billion in new taxes on small businesses, individuals who cannot afford health insurance, and employers who cannot afford to provide coverage that meets new insurance standards. In Wisconsin, the "surtax'' that provides the largest source of funding for the bill will hit 11,900 small businesses--at a time when unemployment is hovering around nine percent. Individuals who are dependent on medical equipment such as wheelchairs and hearing aids will also face increased costs because of additional taxes in this bill--at a time when many families are struggling to pay their monthly bills.

Furthermore, H.R. 3962 relies on a series of budget gimmicks to make it appear that the bill would not increase the federal deficit. First, the legislation fails to account for this year's projected 21 percent cut to Medicare physician reimbursements, which if allowed to go through would severely threaten seniors' access to physicians. However, preventing this and future cuts will cost over $200 billion. Instead of making this fix in H.R. 3962 and accounting for its cost, the Democratic House leadership introduced it as a stand-alone bill without offsets--despite

the fact that the Senate already rejected this approach. H.R. 3962 also proposes over $400 billion in cuts to Medicare. However, as many acknowledge, Congress has a history of reversing itself on unpopular cuts to Medicare, so it is very questionable as to whether these savings will be realized. The legislation also authorizes a new long-term care program which is funded through a voluntary payroll tax. H.R. 3962 uses these pay roll contributions for other spending priorities in the bill, instead of the benefits that will eventually have to be paid out under the new program. Even the Democratic Chairman of the Senate Budget Committee, Kent Conrad, called the inclusion of this program a ``Ponzi scheme.'' Finally, only 7/10th of a percent of new spending occurs in the first three years, while most of the tax increases begin at enactment, representing a debt and "tax'' time bomb.

Besides increasing taxes and adding to the exploding deficit, this legislation represents a radical intrusion of government into every sector of health care. H.R. 3962 gives the government unprecedented authority over the regulation of health insurance. The top-down bureaucratic model of mandating extensive cost sharing and coverage requirements will do very little to ensure high quality care and will certainly lead to increased costs.

We should be doing the exact opposite and giving consumers, rather than government bureaucrats or insurance companies, more responsibility for decisions regarding their health care. This bill does nothing to incentivize consumer driven health plans which encourage individuals to take care of themselves, save for future medical expenses and comparison shop to find the best health care at the most reasonable cost. Most importantly, consumer driven plans put into motion the incentive structure throughout the health care delivery system that will slow the rising cost of health care.

In fact, many of the reforms and new mandates in H.R. 3962 will actually raise the cost of health insurance for those that are now covered. Multiple studies have demonstrated that younger and healthier Americans could see their health care premiums triple, and a family of four could see its health care premiums more than double. While H.R. 3962 mandates that all citizens purchase "acceptable coverage,'' in reality many young and healthy individuals may find it more economical to forego coverage and pay the penalty which is less expensive than the cost of buying health insurance. Should younger and healthy people forego coverage, premiums for everyone else will increase. In fact, because of the bill's ban on insurance companies discriminating against pre-existing conditions, younger healthier people will have even more of an incentive to wait until they are sick to purchase health insurance.

The legislation also breaks the President's promise that if you like your health insurance you will be able to keep it. The legislation makes significant cuts to Medicare Advantage Plans which will surely eliminate or reduce benefits to the 216,000 beneficiaries in Wisconsin.

Furthermore, the legislation places an 8 percent tax on businesses that don't offer acceptable coverage, as defined by federal bureaucrats. According to the Galen Institute, a non-profit think tank, "data from a 2009 Kaiser Family Foundation survey suggest that at least 30 percent of firms with fewer than 200 employees that now offer insurance would fail the test for family

coverage, and about 20 percent would fail individual coverage.'' However, instead of complying with the new mandates, many employers will likely stop offering health insurance to their employees because the 8 percent payroll tax penalty is less than the cost to provide coverage. Furthermore, the extensive new federal record keeping and audit requirements provide further incentives to stop offering coverage. In fact, a study by Blue Cross and Blue Shield demonstrated that ``complying with the new actuarial standards in the bill would increase average costs by 17 percent for individuals and almost 10 percent for small employers.''

Over 80 percent of the money spent on health care in the United States today is spent on the delivery of health care. Yet, what we see in today's bill is just ``more of the same'' in the delivery of care instead of making fundamental changes to reward high quality, low cost care. The bill authorizes hundreds of Medicare pilot programs to test different ways to pay doctors and hospitals for quality of care. But once again, these pilots are governed from the top-down and typically take years to initiate and rarely result in reforms applied throughout the system. Instead, we should be supporting efforts that are coming out of both the states and multi-collaborative projects between networks of hospitals, businesses and physicians. Wisconsin hospitals such as ThedaCare, Marshfield Clinic, Gunderson Lutheran, and Aurora Health Care have long been engaged in transforming the delivery of care to get rid of the inefficiencies and provide low cost, high quality care. We should be supporting these reforms from the bottom-up, instead of repeating the work that has already been done.

And finally, I have grave concerns that the legislation will allow for government funding of abortions and threaten current conscience protections for health care providers. I strongly believe that the Hyde Amendment should be codified in this legislation.

Today, I will vote in support of Congressman BOEHNER's substitute amendment which is a good step forward in lowering health care premiums for families and small businesses, increasing access to affordable high quality care, and promoting healthier life styles--without adding to the deficit.

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