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Mr. GRAHAM. Mr. President, the country is debating a lot of issues. We passed the health care bill last year. Now there is an effort in the House to repeal and replace it. I join my House colleagues with the idea that we should start over and come up with some product that is truly bipartisan that will lower costs. All the information we received about this bill since it was passed is showing it is going in the wrong direction. In May 2010, CBO Director Doug Elmendorf stated:
Rising health care costs will put tremendous pressure on the Federal budget during the next few decades. In CBO's judgment, health legislation enacted earlier this year does not substantially diminish that pressure.
We are getting more and more input about the effect this bill has on cost because there are over 700 waivers now in terms of the mandates. Forty percent of all the waivers given are to union health care plans, and the union workforce is 7 percent of the total workforce. The idea that more and more people are asking for waivers indicates that the cost component of this bill is a real problem for the country.
The whole goal of health care reform is lower cost and improved quality. I am afraid what we have done with the health care bill is we have increased costs, consolidated power in the Federal Government, and Medicare and Medicaid already are unsustainable when it comes to Federal financial obligations. The Obama health care bill, if fully enacted by 2014, would extend Medicaid coverage in the State of South Carolina to 29 percent; 29 percent of South Carolinians would be covered by Medicaid. That is a substantial increase over the number of people on Medicaid today. That would require my State to come up with $1 billion more of State matching money, in the next 7 years, to get the Federal Government Medicaid dollars.
The second largest expense in South Carolina today is the State's matching requirement to get existing Medicaid dollars from the Federal Government. If you expand Medicaid, you are going to bankrupt South Carolina.
I think there is a better way to deliver health care to low-income Americans. I was on a bipartisan bill with Senators WYDEN and BENNETT that did cover everyone, but it allowed people to buy health care in the private sector with tax credits that took deductions away from employers. That is a lot of money. It took that pool of money and allowed individuals to buy their own health care in a more competitive environment.
At the end of the day, it looks like we are going to be taking a vote here soon in the Senate, I hope, to repeal and replace the health care law that was passed last year. If it is repealed, it should be replaced. The way you replace something this complicated, that affects one-fifth of the economy, is you do it deliberately, you do it in a bipartisan manner. Let's remember how this bill became law. It got exactly 60 votes, a party-line vote in the Senate. It was passed on Christmas Eve more than a year ago.
At the end of the day, the process I thought was not befitting of the Senate. There were a lot of provisions given to Senators in particular States. Such as in Florida, the Medicare Advantage participants had a lot more Medicare Advantage availability than other States. Ohio, Michigan--some health care companies in those States got special deals.
At the end of the day, it was done in a backroom, partisan fashion, not transparent, not negotiated before C-SPAN, as President Obama promised. It reinforced the worst of politics, and it is no surprise to me that something that came out of that process is not going down well.
What I say today with Mr. Barrasso, a physician, a Senator from Wyoming, is allow States to opt out if they choose to. If this is such a good deal, let the State legislatures throughout the country decide whether they want to be covered by the individual mandate, the employer mandate or Medicaid expansion. I know the answer in South Carolina. My Governor, my legislators, want to opt out of expanded Medicaid because it will bankrupt the State, and they do not want any part of the employer mandates. I will challenge the Congress, if repeal and replace doesn't work, let the individual States have a say about whether they want to be in the system.
I do hope we can repeal it and replace it. That vote is coming up soon. But the amount of tax increases in this bill--$17 billion in individual penalties, $52 billion in employer penalties, $500 billion taken out of Medicare to help pay for the uninsured--at the end of the day, the formula, the construct of this bill I think is going to grow the size and scope of the Federal Government when it comes to health care at a time we need more private sector competition in medicine. It is going to increase taxes on businesses at a time when we should lower their taxes. It is going to make it very hard in the future for senior citizens to find doctors to take Medicare because, at the end of the day, the more you consolidate power in the Federal Government, the more obligations the Federal Government has when it comes to health care, the less we can pay because we are so broke.
I hope this vote will happen soon. To my colleagues who want to keep this bill, I respectfully disagree, but that is what debate is all about. We can have a civil debate about the future of health care. I think the Congress would be wise to start over and come up with a new product. It does put pressure on Republicans, if we do repeal this bill, to replace it with something that makes sense. What makes sense to me is to lower cost and make sure people have access to health care and that the uninsured are taken care of. But one size does not fit all.
I look forward to casting my vote to repeal and replace. If that does not work, I look forward to having my amendment, along with Senator Barrasso, on the floor of the Senate, allowing States to opt out if they choose.
My guess will be that a majority of the States would opt out of the individual mandate, the employer-mandated Medicaid expansion, and some Democratic Governors are going to be talking to the Members of this body about how their States will be devastated by Medicare expansion. I think you are going to have some big States in the hands of Democratic Governors that are going to feel the impact of this Medicaid expansion. They are going to petition this Congress to do something about it, and I hope we listen to them.
This vote should happen soon. We are in a new Congress. There are new people here with new ideas and now is the time to allow the American people to participate because most of this bill was passed in secret, without a whole lot of bipartisan give and take. Now is the time to start over, take the idea of health care reform, a blank sheet of paper, and see what we come up with in a bipartisan, incremental fashion. The only way we can do that is to replace the bill we have before us.
I look forward to this debate. I look forward to the vote. This issue is not going away. Between now and 2012 we are going to have a very serious debate about the future of health care in America. I would argue that anybody running for Governor between now and 2012 should be asked the question: If you could, would you opt your State out of the provisions I just described, the individual mandate, employer mandate, and Medicaid expansion? Those are good questions to ask and answer and maybe they would have a good answer why they would say no. But anybody running for the statehouse throughout the country should have a genuine debate about whether their State should be included in Obama health care. That is why I hope, if we do not repeal and replace the bill with the current amendment that will be offered by Senator McConnell, that we not abandon this debate.
Debating policy in a civil way is the essence of democracy. At the end of the day, I do believe there is a better way to come up with health care reform than that chosen by our Democratic colleagues in the last couple years.
Having said that, the status quo is unacceptable. I am very much for eliminating the preexisting illness exclusion that denies Americans the ability to buy health care when they get sick. I am very much for shopping around and buying a plan that is best for you and your family and, if you are a low-income person, helping you make that purchase but I don't want to consolidate any more power in the Federal Government when it comes to health care because the health care obligations of the Federal Government, Medicare and Medicaid alone, in 20 years, are going to cost as much as the entire Federal Government does today. This is an unsustainable course. Entitlement reform has to be embraced. But until we get to that day, I would like to restart the debate, have a new dialog with new Members of Congress who heard, loudly and clearly in the last election, the displeasure the American people have for the process--a bill that was passed in the dead of night on Christmas Eve, with a lot of chicanery, replace it with a new process that leads to a better bill.
That puts us all on the hook to try to find middle ground. There was no middle ground found last time. Frankly, I don't think a lot of people looked for middle ground. Those days are behind us. There is a new Congress. If this election said anything to us in Washington, it ought to be that the country does not like what we are doing--Republicans or Democrats--and the health care bill, the way it was passed, is the worst of Washington, not the best. I look for better days.
I know the Senate president tonight has genuinely tried to reform this institution to make it more reflective of the American people's hopes and dreams. The health care bill was passed in a way that none of us, quite frankly, should be proud of. If we start over, the obligation exists for all of us to find some middle ground to move the debate forward.
The vote will be soon. It will probably be less than 60, but that doesn't mean the debate ends. There are other ways to address this issue. I can assure the people in South Carolina that this fight will continue, that I will do the best I can as a Senator from South Carolina to make sure the Obama health care bill, President Obama's plan that was passed by the Democratic Congress, is dramatically changed and altered before it takes hold and becomes irreversible.
We have a chance, in the next year or so, to fix this before it gets out of control. I hope we will take advantage of it. I look forward to the debate. I look forward to offering solutions. I look forward to more than just saying no, but I do look forward to a genuine debate, where I do have a say and hopefully people on the other side will listen.
With that, I yield. The Senator from Pennsylvania is next.
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