Transcript of Sen. Alexander's Appearance on CBS "Face the Nation" from
Author: Face the Nation
Publication: CBS "Face the Nation"
December 21st, 2009 - BOB SCHIEEFER: And good morning again from snow-bound Washington where we got nearly two feet of snow yesterday. As the Senate Democratic leaders were claiming that they finally had the vote of Senator Ben Nelson of Nebraska, and that gave them the 60 votes they need to pass health care reform in the Senate. Final vote now scheduled to come at 7:00 p.m. on Christmas Eve.
The bill is massive, more than 2,000 pages. Basically it extends insurance coverage to 31 million Americans who are not now covered. It creates nonprofit insurance exchanges where people can purchase insurance. It does not include the so-called public option that is a government-run plan similar to Medicare.
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The cost, an estimated $871 billion over the next decade. This bill also tightens restrictions on funding for abortion. It has many other provisions, including barring insurance companies from denying coverage to people with pre-existing conditions. It will be paid for by new taxes on employers who provide health care by various fees on medical services and procedures, and taxes on some high-cost plans themselves.
All our guests are in the studio with us this morning. We begin with Republican senator and appropriately enough Senator Olympia Snowe who is with us this morning. She was believed to be the most likely Republican to vote for this bill. In the end, senator, you decided not to vote for it. Thank you for joining us this morning.
SNOWE: Thank you, Bob.
SCHIEFFER: Why in the end did you decide you couldn't do it?
SNOWE: Well Bob, at this point anyways, I deeply regret that because I frankly I have been fully immersed in this process for a better part of the year, both my staff and myself because I'm committed to health care reform.
I believe that the current situation is unacceptable and unconscionable when you think about rising health care costs. That's why the only Republican on the Finance Committee, I voted for legislation. I did have some problems with that particular legislation. But at the time the credibility of the process going forward would determine the credibility of the outcome.
So here we are today with a bill that's dramatically different, more expansive than the Finance Committee. In fact it's 1,200 pages more than the Finance Committee legislation. It was placed on the floor just short of three weeks ago. Four hundred amendments and two dozen have been considered voted upon.
As 400 members are not unusual since each of the committees that considered the legislation have had more than 500 amendments. Then less than 24 hours yesterday, we get a 400-page amendment that was filed by the Senate majority leader. We are scheduled to vote on that major amendment 15 hours from now at 1:00 in the morning with no opportunity to amend it. All to get done the entire bill with no opportunity to amend it, to change it by Christmas, so that we can adjourn for a three-week recess for a bill that doesn't become implemented until 2014.
SCHIEFFER: What was the tipping point for you? What was it that happened that made you say I just can't do it?
SNOWE: Well it was a number of issues. I have been in countless meetings, meetings and telephone calls, meetings with the president, meetings with the majority leader, a number of people across the aisle without question. The problem is the bill became bigger. It has the class act which is a whole new entitlement that frankly will turn in the red five years after the benefits begin.
SCHIEFFER: What is that?
SNOWE: It's a long-term care insurance. And it's a whole new entitlement. In fact, half of those revenues that will be set aside for a vesting period will be used to calculate the deficit reduction over the next 10 years. That's where they derive half of their deficit reduction. Then you have a whole new layer of taxes. The Medicare payroll tax. We have good tax subsidies. And I applaud Senator Landrieu that you'll be hearing from in a moment on those tax subsidies for small businesses.
SNOWE: But on the other hand, you have a 1 percent Medicare payroll tax on small businesses, affecting them disproportionately at a time we're depending on them to create jobs to lead us out of this recession.
It is not indexed for inflation. It's a 62 percent increase. So this will be devastating for small business as well.
I had submitted a CBO letter on December 3rd with substantial questions on what is the premium cost for every American who will be participating in the exchange? What can they expect?
As they're sitting around their kitchen table, they expect certain answers to certain questions. We don't have those answers to those questions. And that's why I indicated to hold off. I said to the president and I said to the Senate majority leader and others, please, give us the time; come back after the new year; get together. This is a generational issue that has substantial effects with -- in fact, I would say sweeping effects because you're recalculating one- sixth of our economy.
And, frankly, we're treating it as if it's the legislative appropriations at the end of the year. It's like the last train leaving the station; we're going to dump everything in there.
SCHIEFFER: Let me ask you this. It's my understanding that, even after Leader Reid announced that he had the 60th vote, the 60 votes he needs, you met again with President Obama. What was -- what was that about?
SNOWE: Correct. The president, you know, and I have -- have worked together on this issue. And I applaud him for, you know, his knowledge, his grasp of the issue. It's his major and highest domestic initiative, on this issue, and he wants to get it done this year, and encouraging me to support the legislation.
And as I indicated to him, I'll continue to work through, our House and Senate conference, but the legislation that is pending -- this process denies us the ability to thoroughly and carefully and deliberately evaluate what is at stake. I mean, we're talking about reordering $33 trillion over the next 10 years.
SCHIEFFER: Well, do you -- was the reason for this meeting -- was he asking you to vote for this thing when it comes out of conference? Is that what it was?
SNOWE: No, it was the pending legislation.
SCHIEFFER: But you told him you couldn't?
SNOWE: That I had -- yes, that I had problems, because the process is denying me and others, for that matter, the opportunity to amend it, on a big bill.
Why Christmas? There's no magic deadline. This "beat the clock" is really overruling legislative sanity.
SCHIEFFER: Let me ask you -- let me ask you about the abortion language in here. Senator Nelson insisted that the abortion language be tightened on what money could be spent on abortions in these insurance policies.
But now he's satisfied, but now the right-to-life folks, the anti-abortion people say they're not satisfied with it. But the people who favor abortion say they're not satisfied with it, either. Are you...
... how do you feel about that part of it?
SNOWE: Well, I helped to -- to work on the underlying legislation and the provision that basically, you know, embraced the status quo, making sure that we're not using any federal funds to finance abortion, using a precedent that already exists in domestic family programs and in national family planning programs, as well as Medicaid.
And I think there's 17 states that separate their funds. They're not commingled. That is a process that's worked time and again.
And I think it's regrettable that it's reached this point with respect to this issue because, clearly, what is in the current legislation should have satisfied those concerns. It was every attempt to write it as it is in existing law that would not use any federal funds to finance abortion.
SCHIEFFER: All right. Senator, so thank you very much for coming in on a very snowy day here in Washington.
SNOWE: Thank you.
SCHIEFFER: We'll be right back.
SNOWE: Thank you, Bob.
SCHIEFFER: And we're back now with Democratic Senator Mary Landrieu from Louisiana, Ohio Senator Sherrod Brown and Republican Lamar Alexander from Tennessee. Well, you heard Senator Snowe. She was one of those, Senator Brown, who was very much -- almost really wanted to vote for something here and in the end just couldn't bring herself to do it. You were one of those who very much wanted a lot more than what's in this bill. In a sense you wanted a public option. You said you're going to vote for it. But are you happy with it?
BROWN: I'm disappointed. I think it could be a better bill. But we're making major progress in this bill. First of all, for those people who have insurance in this country, right now you're paying $100 a month more than $1,000 a year of hidden tax for basically for care for people who don't have insurance that go to emergency rooms and all that.
This bill has got good insurance reform. It says that no more pre-existing condition. No more exclusions for that. No more discrimination. Women paying more for health insurance than men. It strengthens Medicare. It provides free screenings for Medicare, for every Medicare beneficiary. It lengthens the life expectancy of Medicare. And it gives tax breaks for small business. And those start immediately so small companies can begin to ensure their employees.
Most companies in Cincinnati and Cleveland and Columbus that I talk to want to insure their employees. They simply can't afford it. If they have 20 employees and one of them gets cancer, it makes their premiums unaffordable. So this bill moves absolutely in the right direction.
SCHIEFFER: Are you convinced people are going to pay less, that this is going to reduce costs? I keep hearing people saying it's going to cost a lot more.
BROWN: This bill -- if we do nothing, insurance premiums are going to double. You know, I'm amazed as I hear Republican after Republican take to the Senate floor and defend the insurance companies, practices worthy of Ebenezer Scrooge. And the way they'd have it is that the insurance companies would cancel Tiny Tim for pre- existing condition. I mean it's clearly not sustainable what we're doing now. We clearly need to go on a different path.
SCHIEFFER: So Senator Alexander, as a Republican, I take it you don't quite agree with that. Let me ask you this. Republicans have done everything they can and openly. They're not making any secret of it to slow this process down as much as they can. Is it now done or will you continue to try to slow this vote down?
ALEXANDER: Well no, it's never done in the Senate until it's done. And I thought Senator Snowe pretty eloquently explained why we want to know more about the bill. There's a reason why we're voting on it in the middle of the night. We just learned about it yesterday. They're trying to push it through before Christmas. There's a lot of explaining to do.
I mean, how are you going to help Medicare by taking a trillion dollars out of Medicare over a 10-year period at a time when Medicare is going broke in five years according to its trustees?
How will taxes help create new jobs when we've got 10 percent unemployment? How are governors going to pay for the Medicaid expansion? Almost all of them are saying they'll have to raise state taxes. They'll have to raise college tuitions. Then what about the $16 million Americans low-income, who are getting dumped into Medicare, Medicaid, excuse me, the program for low-income Americans, where 50 percent of the doctors won't even see new Medicaid patients? There's a lot of explaining to do.
SCHIEFFER: Let me get back to the question I asked you. Are you going to continue to try to slow this process down or are you going to let it come to a vote?
ALEXANDER: Well, we want to take the time to let the American people know what it costs, what it is, how it affects them because we believe when they find out, they won't like it any better than they do now and they won't allow Congress to pass it.
SCHIEFFER: Do you believe it is possible to keep this from coming to a vote before Christmas?
ALEXANDER: I'm not sure. We'll have to see. But it is outrageous in the middle of a snowstorm to give us a 2,700-page bill yesterday, start voting in the literally in the middle of the night and say let's pass it before we go home for Christmas.
SCHIEFFER: Senator Landrieu, you were one of those like Senator Snowe who was very much on the fence but then somehow in what people are calling the Louisiana purchase, $300 million in Medicaid help for your state came your way and you suddenly were able to vote for that.
LANDRIEU: Bob, let me be very clear. Nothing could make me vote for a bill if I didn't think it was the right thing to do for my state and for the nation. Nothing, no amount of money.
That was one of about 12 things that I fought very hard for. And I'm pleased to say in the final bill, many of them have presented themselves. One, Sherrod mentioned tax credits for small businesses. I'm the chair of the Small Business Committee. I was not going to support a bill that didn't have robust help for small business. I was not going to support a bill that had a small business mandate. So there were a number of things. That was just one.
LANDRIEU: And it was a very worthy request in the sense that, after Katrina, our calculation for Medicaid put us in the same category as Connecticut. People know that Connecticut is a much richer state than Louisiana.
But having said that, I'd like to answer the question you asked Lamar. There's only one reason we're going to be here until Christmas, and that's Senator Tom Coburn . We don't have to vote in the middle of the night. But he's the one making us do it, not Harry Reid , not the Democrats. It is a Republican obstructionist that is making us vote in the middle of the night.
Number two, we've been discussing this issue for 40 years, not four months, not four weeks, 40 years we've debated this. And since last March, this discussion has been public. So this business about they don't know what's in the bill, it has been widely, widely distributed. The language has been on the Internet. We are going to get this done before Christmas.
And it's extraordinary that Democrats, Sherrod, who started out for a robust public option, I was not necessarily for that much government involvement, have come together to write what we think is a great, very good, great bill for the American people.
ALEXANDER: The assistant Democratic leader, Dick Durbin, said on the floor last week he didn't know what was in the bill. We got a 400-page amendment yesterday. The reason they're rushing it is because they don't want people to know about the Medicare cuts, the tax increases, and the chief actuary...
LANDRIEU: That is not true.
ALEXANDER: ... of government has said that rather than decreasing costs, it will raise costs over the next 20 years. That's the chief actuary of government in the Obama administration said that.
LANDRIEU: That is not true.
BROWN: Let me put a human face on this. In Toledo, in Dayton, in Piqua, Ohio, 390 people every single day are losing their health insurance, 390 people a day. Across this country, a thousand people a week die because they don't have health insurance.
A woman with breast cancer is 40 percent more likely to die if she doesn't have insurance than if she does have insurance, 40 percent more likely. So this kind of obstruction -- I mean, this "gang of six" started meeting in -- formally in June, but much before that as they started negotiating this bill.
Everybody knows the great majority of what's in this. Everybody has debated it. Everybody is -- and it is just a question of delay. I mean, and in the end -- and you know, I like Lamar and I like most of my colleagues on the other side of the aisle, but it's so much what the insurance industry wants.
The insurance industry stands to lose a lot. CEO of Aetna made $24 million last year. Under this bill, because we've got a provision in this bill that no more than 15 or 20 percent of every premium dollar can go to the insurance companies, the rest have to go to hospitals and doctors in Knoxville and in Baton Rouge and in Columbus. And so that...
ALEXANDER: The fact of the matter is...
BROWN: That means that insurance companies are going to come to the table and going to have to give a little bit up.
ALEXANDER: I would like to hear Sherrod Brown or any other person explain to me how you're going to take a trillion dollars out of the Medicare program on which 40 million seniors depend, which is precisely the amount when the program is fully implemented, and not spend it on Medicare, not spend it on grandma, but spend it on somebody else.
ALEXANDER: ... at a time when the program is going broke in five years.
LANDRIEU: First of all, we don't take a trillion dollars out of Medicare. We take a couple of hundred million by streamlining the program.
ALEXANDER: Now, Mary...
LANDRIEU: We streamline the program.
ALEXANDER: ... if the CBO said it's a trillion dollars...
ALEXANDER: ... over 10 years when fully implemented.
LANDRIEU: It is not a trillion dollars over time. And Republicans like John McCain and Lamar Alexander have supported many of those same ways to streamline Medicare in the past. John McCain actually ran on some of this. So to claim that we're doing something that Republicans and Democrats haven't tried to do for Medicare, we're strengthening Medicare. That's the bottom line.
Seven years expanding that trust fund. And we're taking some of that money and providing tax cuts and tax credits to small business. And for the first time in America, Americans will have an opportunity to have the same kind of insurance that federal employees have, including members of Congress. That's a promise the president made. And we're keeping it.
BROWN: And the AARP and the American Medical Association wouldn't be supporting this bill if it were substantially cutting Medicare. Most of the cuts, the reason -- you know, when you throw a rock into a pack of dogs, the one that howls is the one you hit. And most of the people, the reason that the Republicans are howling on the Medicare, quote-unquote, "cuts" is because we're cutting insurance company subsidies that have gone to Medicare.
So you take those subsidies out, of course they're unhappy with that because the insurance companies are their biggest supporters in election after election.
ALEXANDER: This is exactly why we shouldn't be voting in the middle of the night and passing at Christmas. They are saying that tax cuts -- that tax increases aren't tax increases. They're saying that a trillion-dollar cut in Medicare spent on a new program isn't a $1 trillion cut in Medicare.
They're ignoring the fact that they're dumping on states new expenses for Medicaid that, in my state, our Democratic governor has said is the mother of all unfunded mandates, will cause tax increases and increases in college tuitions, and they're dumping $16 million low-income Americans into a Medicaid program which 50 percent of the doctors won't -- in which they won't see new patients.
LANDRIEU: Bob, let me just add this. They're going to -- 94 percent of all Americans are now going to have health care. This is being done through a private-public partnership, not a government takeover but reform of the insurance industry that people even who have insurance are desperate for.
And it is not being done, you know, in a -- in a very quick way. As I said, we've been debating this all year. So we're ready to come to this great compromise that we believe -- that brought the Democratic Party together.
We wish the Republicans would have joined us. But it's easy to be unified when the only word in your vocabulary is no. That's all they've been able to say to the American people. It's time to say yes to them and get on with the job of governing.
BROWN: Let me tell you why this is no longer business as usual.
SCHIEFFER: We have about 10 seconds.
BROWN: OK. OK, in 2003, when the insurance companies and the drug companies and President Bush pushed through the Medicare privatization bill, they had no -- they were not paying for it in any way. We are paying for this bill. The Congressional Budget Office says it will over -- in the next 20 years, it will be a $1.4 trillion paydown of the national debt. LANDRIEU: Savings.
BROWN: This is the Congressional Budget Office saying that.
SCHIEFFER: All right. One -- 10 seconds, Senator Alexander?
ALEXANDER: Medicare cuts, tax increases, big new taxes on states and dumping low-income Americans into a Medicaid program where half the doctors won't see new patients.
SCHIEFFER: We will continue this conversation...
... but we're out of time. Back with some closing thoughts in a minute.