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Mr. KYL. Unless my colleague from Arkansas wants to respond, I will proceed.
Let me comment on the suggestion by the Senator from North Dakota that we need to move on with this legislation. I agree. It could be concluded this week. On the other hand, the matter that relates to the perimeter rule and slots at the airport, while every bit as complicated as my colleague suggested, is also very much in need of resolution. One way or another, we will have to get that resolved on this bill. I am hoping that after a meeting we will convene in a little less than an hour, a compromise can be achieved such that we can move forward and get something adopted. But we will not finish that bill until that important issue is dealt with.
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Mr. KYL. I certainly appreciate the sentiment of my colleague. The underlying bill is important to get done. These perimeter rule revisions are important too. Our fear is, unless there is some action, it will not be resolved, as it hasn't been in the past. I don't think it has to be a lot of amendments or a huge amount of debate. I do think we need the opportunity to have a vote or two on a couple of these amendments. If they don't prevail, then so be it. But that is an issue we will have to deal with one way or the other.
What I would like to do is change the subject a little bit and talk about the proposals made by Senators Sessions and Pryor in a different context. We just got the word from the Congressional Budget Office that the new cost of the legislation on health care is going to be over $940 billion. Each iteration of this bill has seen an increase in the cost. This is striking because, as we know, even though the Congressional Budget Office has had to take the legislative language as it has been given to them in providing the pricetag and, therefore, alleges that it will not put us in deficit, the truth is, it will. If you double count savings, if you assume savings that will not exist and so on, then you can project a budget-neutral bill. I think most objective observers have acknowledged that the bill will be far out of balance and that the $940 billion price tag will not be paid for by the various taxes and spending reductions ostensibly a part of the bill.
There is nearly $ 1/2 trillion dollars in Medicare cuts. Most people think that is unrealistic. We have never been able to find that much waste, fraud, and abuse in the past. It is going to be hard to find it in the future. You can't assume we will save all that money.
It is true this new bill will also raise taxes. There are 12 or 13 new taxes in the bill. It supposedly raises about $ 1/2 trillion in taxes. That includes on seniors, the chronically ill, and on the very drugs and devices that help us when we are sick. I wonder how long those taxes are going to last.
The bottom line is, we will be adding to the deficit under this legislation or paying a lot more in taxes than we do today. The irony is, we are not even solving the core problem we started out to try to solve, which was to reduce the cost of health care premiums. CBO confirms over and over again that premiums will continue to rise. They say, in the individual market, this bill will cause premiums to soar by 10 to 13 percent in the year 2016 because the government is going to force patients to buy benefits packages with coverage they may not need or want.
According to Lewin Associates, an objective observer, the premiums will go up even more. A third study, Oliver Wyman & Associates, has projected that prices will exceed a 50-percent increase--in my State of Arizona, a 72-percent increase in premiums--as a result of this legislation. That is almost incomprehensible and it is wrong. The irony is, the increases will be paid by small businesses that we are asking to hire more people. It is going to paid for by young families and individuals forced to buy insurance they don't believe they need right now. Right now they have relatively low premiums because they have relatively low health care needs. The bill will raise the cost of insurance for many Americans and then, through new mandates, force everyone to buy a policy and not just any policy but one that has actually been written in Washington.
It adds a new entitlement we can't afford. There are so many other things wrong with it. My point was not to go through all the things wrong with the health care bill but, because we now know or we believe the bill will be voted on in the House perhaps as early as Sunday and we now have the new score, the biggest score yet of almost $1 trillion, it is worth talking about in the context of the amendments on the floor to try to deal with escalating spending.
During his campaign, President Obama made almost a fetish out of saying he would fix the way Washington works. There would be no more business as usual. But from what we have seen on the health care debate, there has been arm-twisting and backroom deals and sweetheart deals that end up buying the votes they need to pass the legislation but add dramatically to the cost, as well as the unfairness, because certain provisions of the bill are made inapplicable to certain favored constituencies.
I have always thought, if the bill is such a great idea, why would Members exempt their own constituents from the application of the bill. One of the areas in which this is done is the cuts to Medicare. About half of that comes from reducing the benefits under Medicare Advantage. Medicare Advantage is enjoyed by a great many seniors who are on Medicare, about 330,000 in my State of Arizona. Their benefits will be dramatically decreased under the bill. Our colleague from Florida heard an earful from his constituents, senior citizens, who said: Don't cut my benefits under Medicare Advantage. He said OK. We will grandfather you, and we will grandfather some folks from other States. But my constituents in Arizona don't get grandfathered. Their benefits are going to be cut. How is that fair? How is that right?
Let me run through a couple of these other special deals. Unfortunately, not everybody gets the advantage of these special deals. There was the so-called ``Louisiana purchase,'' $300 million. I don't know the page of the new bill, but in the old bill it is section 2006, page 432, line 14. The ``Gator aid,'' which is the thing I was just talking about, grandfathers Medicare Advantage patients to the tune of about $25 to $30 billion from the cost of rather than from the effects of reducing their Medicare Advantage benefit. There are some other States that get specific benefits as a result of Medicaid patients who are added to the rolls:
Vermont, $600 million; Massachusetts, $500 million.
There are three targeted FMAP provisions: bonuses for Vermont, Massachusetts, and Nebraska. Vermont gets a 2.2-percent FMAP increase for 6 years for their entire program. Massachusetts gets a half-a-percent increase for 3 years. Nebraska gets a 100-percent FMAP increase for newly eligibles forever. That was this new particular deal.
Under the disproportionate payment section, Hawaii is alone among the States that get an extension. Michigan and Connecticut get a special benefit under section 508 so that their hospitals have an option to benefit under that section if it means higher payments. This was also done in previous legislation.
Montana, South Dakota, North Dakota, and Wyoming get a special deal: an amendment that adds 1 percent to the hospital wage index for those States. There are other States that would qualify but would not benefit because they are already above the 1-point wage index value. It also establishes a 1.0-practice expense floor for physicians in those particular States.
One of my colleagues got a benefit for his constituents in Libby, MT: Medicare coverage for individuals. The EPA has announced there is a public health emergency at a Superfund site there, so they get a special advantage.
It is interesting that while the Nebraska ``Cornhusker kickback'' got a lot of attention, two other benefits for Nebraska entities did not. Blue Cross and Blue Shield of Nebraska and Michigan Blue Cross Blue Shield and also Mutual of Omaha get special benefits--so two in Nebraska and one in Michigan. They get a carve-out. One of them gets a carve-out from the insurance fee for Medigap policies and the other the insurance fee paid to these two particular companies.
Connecticut hospital--Senator Dodd from Connecticut took credit for getting $100 million for a hospital in his State.
I could go on and on.
The point is, the process by which the legislation has been put together, as well as its substance, is what has caused the American people to have an extraordinarily low opinion of Congress. The latest trick, this so-called scheme to deem the legislation the Senate passed--passed without a vote; in other words, passing a law without ever voting on it--is just the latest of the chicanery that appears to be engaged in, in the House of Representatives now, in order to get around the Senate bill, which, as the Speaker said, her Members do not like and do not want to vote on.
Madam President, I ask unanimous consent to have printed in the Record an editorial from this morning from one of my hometown newspapers, the Arizona Republic, which discusses what they call the end run by Democrats as a travesty, and they discuss this so-called scheme to deem in the editorial.
There being no objection, the material was ordered to be printed in the RECORD,
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Mr. KYL. Yes, I will. I was about to get to the final point, which is the matter on which my colleague from Tennessee is the expert, and that is the latest item to try to flavor the legislation to get more votes; namely, to have the Federal Government take over student loans. But, yes, I will yield.
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Mr. KYL. Madam President, my colleague from Tennessee is exactly correct. Just that one item alone--of course it is part of Medicare; you have to pay doctors to take care of you in Medicare--and if you do not include the cost of that, then obviously you are not identifying the true costs of the legislation, and just that item alone would be enough to knock it out of balance.
I did not even get into all the double counting and the other ways in which they try to game the system so it makes it look like you have saved money, but you have not. One of our friends, Stephen Moore, I heard, had this analogy. He said: This is a great deal: Gee, you cover an additional 30 million people and you save money. Gee, at that rate, we should cover everybody in China. We could really reduce the deficit.
Well, I think it makes the point. The American people have broken the code here. We are not going to save money by adding more people to the rolls. That may be a good idea. It may be that we should subsidize people, but let's acknowledge the true cost, and that gets back to the amendment of our colleague from Alabama, the amendment that is pending on the floor. He says we have to stop spending so much, so let's do something very modest. Let's put a cap using last year's budget. We are not talking about cutting way back. We are not cutting into muscle or bone or anything like that; we are just saying: OK, if it was good enough for 2010, let's stop there. Let's have a little hold, let's have a little pause here before we add a whole lot more money to the deficit.
My State of Arizona has had to cut well over $1 billion out of its budget. I think it is closer to $2 billion. They are cutting significant elements that the State has paid for in the past. The city representatives were in seeing us yesterday and last week the county representatives. They are all having to dramatically cut what they provide in the way of government services.
But we in the Federal Government, we keep right on going as if there were no problem at all. That is why the amendment that is pending--I guess we are going to vote on it in about an hour--the amendment by Senators MCCASKILL and SESSIONS is one we need to support and to vote against any other amendments that appear to try to provide savings but, in fact, do not.
I will close here because I see my colleague on the floor. The last thing I want to mention is the latest gimmick to get support for this health care legislation: adding something that has nothing to do with health. It is the Federal Government takeover of the student loan program. A lot of folks in the country have gotten student loans for their kids to go to college. It is a process that has worked. It is federally guaranteed so banks are able to make those loans at a relatively low rate of interest. It is a good deal for kids who want to go to college.
Well, the Obama administration--which has taken over car companies, taken over other insurance companies, now wants to take over health care and has taken over, partially, banks--now wants to take over student loans. It has made them part of this legislation. We do not know for sure exactly how because we have not seen the bill yet. But allegedly it is made a part of this legislation.
My colleague from Tennessee has been very good at pointing out that actually it is going to cost people more money because the government gets to borrow money at 2.8 percent interest, then it is going to loan it out at 6.8 percent interest, and then take the difference in the two and pay for additional government programs.
To me, though, one of the most pernicious things is that after July, you are not going to be able to pick the lender that best fits your needs or your kids' needs to go to college. You get to go to a Federal bureaucrat who is going to decide that for you. Instead of something like 3,000 different places where you can go to get this, I think there are going to be four call centers. Good luck. If you think it is slow down at the motor vehicle division or the Post Office, good luck trying to get a loan for your kid now to go to college.
As my colleague, Senator Alexander, wrote in the Washington Post:
[Y]ou'll work longer to pay off your student loan to help pay for someone else's education--and to help your U.S. representative's reelection.
This is a bad idea. To try to fold this into the health care legislation is a doubly bad idea. The bottom line is, our House Democratic colleagues who are now being very strongly pressured to vote for this health care legislation are not going to be able to fix any of this. Because when the bill comes over to the Senate, and they supposedly have put the fixes in it, the reality is that every one of those things that is subject to a point of order will be stricken from the bill on a point of order. Some things can be amended, of course. So the House is going to have to deal with the bill at least one more time if, in fact, they pass it this weekend. The Senate is not going to bail them out, as some of them apparently think may be the case.
So I throw that note of caution to my colleagues in the House who may be thinking of supporting this bill on the grounds that the Senate is going to clean it up. In fact, that is not going to happen.
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Mr. KYL. Yes. Madam President, my colleague is exactly correct, and the math is correct as well. It is very disappointing to me because most of the doctors with whom I have spoken are very afraid of this legislation. They are afraid of what it will do in their practices in the way they will be able to deal with their patients. They are also afraid because they can see this continued downward pressure on reimbursements they receive. Frankly, a lot of them are saying: We are not going to be able to take Medicare patients in the future.
In my own State of Arizona, in fact, the Mayo Clinic has already announced that at two or three of its facilities, it is not going to take new Medicare patients. So that is one of the things that should be fixed in the health care bill. It is not fixed.
It disappoints me that even though the medical association has urged they take out a very pernicious amendment that deals with specialty hospitals--basically, it cuts specialty hospitals off in the future; and the AMA has fought very hard to allow specialty hospitals to exist, but that is not going to get fixed in this bill--even though they have sought to be excluded from the Medicare cuts that are in the Medicare Commission here--that is supposedly going to save $250 billion or so; that has not been fixed--and even though they need to have the basic reimbursement section, the so-called SGR, fixed--and as my colleague has just pointed out, it is not fixed in the legislation--what is disappointing to me is--and those are three of the most critical elements of this bill because of the effect it will have on the treatment of their patients--the American Medical Association is still toying with the idea of supporting the legislation, when the vast majority of physicians in the country, in my opinion, do not support the legislation. Again, it is primarily because of the effect they think it will have on their patients.
I would close by saying, all of these----
Mr. SESSIONS. I have one more question of the distinguished Senator.
Mr. KYL. OK.
Mr. SESSIONS. The way this new benefit is funded, as I understand it, is through a $500 billion cut to Medicare and increased Medicare taxes. Wouldn't it be the correct thing for policymakers to take that money first and strengthen Medicare and pay the doctors whom we owe instead of starting an entirely new program, leaving the doctors unpaid, and raiding Medicare benefits?
Mr. KYL. Madam President, I will conclude by saying, absolutely yes. This is one of the good ideas Republicans had. Rather than creating a new entitlement, taking money from Medicare to fund that new entitlement, the savings we believe we can achieve in Medicare should be applied to keeping Medicare solvent for another 17 years or whatever amount of time this money could provide.
Then, if we are going to expend money, let's use it to pay the hard-working physicians and all the other providers, the RNs, the folks in the hospitals, and everybody else whom we want there to take care of us when we get sick. Let's make sure that money is available there and that we have some kind of permanent resolution of this problem so we do not have to come back and try to fix it every year.
Those are just some of the things we believe should be done rather than to scrap the whole system we have, replace it with this new government-operated behemoth that takes over this big section of our economy, pushes government bureaucrats between patients and their physicians and ends up providing enormous new taxes, without cutting the premiums--in fact, allowing premiums to go up even more than they would have otherwise. Other than that, it is a nifty idea. Of course, I am being facetious. The health care bill, in my opinion, is not a good idea.
My last point is simply to urge my colleagues in the House to appreciate the fact that the Senate is not going to bail them out by cleaning up the Senate bill, which we already passed here, and they should not be voting for this legislation under the false assumption that somehow we are going to make all those changes in the Senate bill.
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Mr. KYL. Mr. President, let me echo the comments of all my colleagues who have spoken to the issue. I think the comments Senator Warner just made summarize the issue very well and I will not repeat all those things. The translation of all this for our colleagues is--although I am not making the announcement--that I presume there will be no further formal action in the Senate tonight or tomorrow but that we will be laying down a modification of the amendment that was filed that would include modifications to the perimeter rule and perhaps other matters.
We will have an opportunity to discuss that tomorrow, and there will be some opportunity to discuss that Monday, for those who perhaps have already left. In particular, I know some of my colleagues will not return until around 4:30 in the afternoon. I am not going to propound a unanimous-consent request, but I hope, in consultation with the two leaders, we could work out an arrangement whereby at least some of the time on Monday can be reserved for a debate on the amendment that will be filed by, presumably, Senator Hutchison, myself, Senator Ensign and others and that part of that time will also be in the 4:30 to 5:30 timeframe. That is the time the leader has ordinarily set for the first vote, returning on Monday, and presumably there will be a unanimous-consent agreement with the leaders that will reflect the precise understanding of what vote or votes will occur on Monday night and when, but presumably it would fall within that timeframe that is customary.
Just to conclude by saying I hope that as a result of the conversations we have had and will continue to have Monday and tomorrow, that we can lay the foundation for the establishment of a Senate position in the conference committee that would reflect a consensus and perhaps some compromise that would satisfy the interests of all. We are never going to outdo the fierceness with which both Senator Warners--Senator John Warner, who preceded, and now-Senator Mark Warner--fight for their constituents and for the interests of two national airports--in a sense representing us all. We certainly appreciate the single-mindedness with which now-Senator Mark Warner has pursued those interests but also his recognition that obviously times change, there are some needs for other parts of the country, and that through comity and conversation perhaps things can be worked out without having any detriment to anybody. That is obviously the goal we would seek to accomplish.
In any event, we will have an amendment on the floor that can discuss this. Perhaps we will vote on it. In any event, the object will be to vote on final passage of the bill on Monday evening.
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