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Ms. MURKOWSKI. I rise this evening in support of the Grassley amendment, and I appreciate that my colleague has brought this forward. We had an opportunity to discuss this months ago in the HELP Committee.
The fact is, the health care bill that is now law creates these State exchanges where all non-Medicaid and Medicare individuals will go to purchase their health insurance. And included in the exchanges are Members of Congress and their personal staff, who are required to join these exchanges in order to obtain their health care benefit.
But as the Senator from Iowa has mentioned, the rules that apply here--the rule that came to my mind when we were discussing this is this rule we were all taught as young children: Do unto others as you would do unto yourself. Unfortunately, I think what we see with this new health care law is that it fails to adhere to this rule.
So what you are going to have under this new law is every American will have to be part of this new health care exchange. But who is going to be left out? Who is going to be excluded? Well, the law itself here is pretty clear in terms of the definitions. It says Members of Congress, congressional staff. Congressional staff means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC, or outside of Washington.
But let's think of whom it does not include. It does not include the President, it does not include Cabinet members, it does not include members of the White House senior staff, it does not include committee staff that we may have. As the ranking member on the Energy Committee, I have committee staff for that. As the vice chair of the conference, I have leadership staff. But neither my committee staff nor my leadership staff would be covered under this new law. In other words, many of the chief architects of this health care law were apparently, very conveniently, omitted from any requirement of being within the health exchange.
So, again, whether it is the Cabinet members, the White House senior staff, the committee members, the leadership staff, you have to ask the question, Why have they been left out of this? Why is there a double standard? And if you are not asking that question, is it just a glaring omission or is there something else? Is this yet further evidence of what we are seeing that was done in the back rooms, the outcome of the late nights, the backroom deals that certain staffers who might perhaps work for the majority leader or certain staffers who work for the White House get to be treated differently than every other American out there? I do not think that is what we intended here.
As I mentioned, during the HELP Committee markup, I supported an amendment that was offered by Senator Coburn that most Democrats on the committee did not support. But it would require Members of Congress and their staffs to be included in the health care exchange. And the conversation that was had at the committee at that point in time, certainly by Members on the Republican side, was: Hey, if it is good enough for my constituents, if it is good enough for the people of the State of Alaska, then it ought to be good enough for me, it ought to be good enough for the President. But what we see is the President and the House and the Senate leadership offices who have pulled this bill together have conveniently left themselves out from being subjected to this provision.
So I appreciate Senator Grassley bringing up this issue, pointing it out, pointing out that there are omissions. There are perhaps convenient omissions. I am not one to say whether it has been convenient or not, but it does raise the question, So what else has been left out? What else is contained within this bill that might be viewed by others as a special deal?
Earlier on the floor, Senator McCain came and, along with many of our colleagues, kind of outlined some of those special deals about which I know people in Alaska are quite concerned. They are like, wait a minute, if you are going to move health care reform in the manner you have, make sure it is even, make sure it is equal, make sure people are treated fairly and in a manner that we think and we recognize is consistent.
So I think we need to ask ourselves certain questions about what is in and what is out. We know there is certainly more spending--more spending in terms of the proposal. We know we have gone from $200 billion in spending to now $2.6 trillion in spending. We know there are more entitlements, we see that repeated and repeated, $115 billion in new entitlement spending, bringing the combined new spending in the proposal to $1.2 trillion. We know there are more taxes. We know there are more Medicare cuts. We know there are more gimmicks. You know, these are why the folks back home are saying: Wait a minute, these are the types of things you have promised us, and now you are telling us there are some good provisions in this bill, you are going to like this bill once you get to know it.
Some of my colleagues will tell you Medicare patients will now see free preventive services. I admit that sounds great. I am all for making sure we have screenings, whether they be mammograms or preventive services. But I have to ask the question, in a State such as Alaska where we face such an incredible crisis when it comes to access to care, to primary providers, knowing that we now have this bill before us, this new law of the land, how many of the few primary care doctors in my State are going to be accepting those new Medicare patients to provide them these wonderful preventive services, these free preventive services?
According to experts, not only in Alaska but in many parts of rural America, Medicare patients are not going to have a provider who will be willing to take them on. We have a think tank in the State, the Institute of Socioeconomic Research, that has said that seniors in low-payment Medicare States are going to be forced to wait in line. They have said: Independent of the doc fix, in Alaska, seniors are at risk for long lines to see a primary care doctor and overflowing to community health centers and hospital emergency rooms where existing capacity is highly likely to be quickly overwhelmed and long wait times become increasingly common. They go on to say that additional insured patients are going to hurt the existing Medicare beneficiaries, again, because of the access issue.
What we will have done is, we will have been able to issue that card, we will be able to say, yes, this is now available to you. But if you still can't get in to see the provider, then what have we provided for these seniors other than the card? That is not access. My mom used to tell us: If it sounds too good to be true, it is probably too good to be true. We are going to be spending a fair amount of time in these next few days and in the next many hours going through so many aspects of this reconciliation bill, trying to understand what is in it, what is not in it, who it applies to, and how it applies.
I am hopeful tomorrow I will have an opportunity to talk a little bit more about not necessarily the health care side of this reconciliation bill but one way in which the health care reforms are going to be paid for, and that is on the backs of students; students who have taken out loans, who, as we eliminate the Federal Family Education Loan program, the FEL program, essentially we are going to be helping to pay these young people. These some 19 million young people who take out student loans are going to be paying for the cost of the health care provisions contained within this bill. Is that right? Is that fair?
There is so much that needs to be discussed, that needs to be uncovered. Because what we have before us within this reconciliation bill is more of the same in terms of the bad provision that passed this Senate on December 24--more taxes, more cuts to Medicare, more hits to our seniors and our small business people. It was not good in the Senate bill. It is made worse in the reconciliation provision. Our job tonight and in the intervening hours is to make sure that the American public fully understands that.
I yield the floor.
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