Service Members Home Ownership Tax Act Of 2009

Floor Speech

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Mr. KAUFMAN. Mr. President, I rise, once again, to express my support for this historic health care legislation before us. After more than a year of debate and months and months of negotiations, I welcome the extraordinary opportunity finally to enact meaningful health care reform. Yes, I mean years and months, since this reform effort has been a long and deliberative process, not the rush job opponents of this effort have been claiming.

I must admit, however, there were times during this debate when I was not sure if we were ever going to reach this point. In fact, I was convinced we were not. But I found in my life that when you think things are never going to happen, as with every important thing I have ever done, you reach a point when you say this is never going to happen, and this is another example. There are many times I never thought this would happen.

From the bogus charge of death panels--which was just named politifact.com's ``Lie of the Year''--to the tension over whether the bill will contain a public option, which I supported, there were some long days where it was hard to see how we were going to get to the end point.

But thanks to the hard work of the majority leader, as well as Senators BAUCUS, DODD and HARKIN and their staffs, we are finally here.

As many of you know, I have worked in and around the Congress for more than 36 years. I have learned quite a bit about how things operate in the Senate.

The Senate is commonly referred to as the most deliberative body in the world. But such deliberations are not always pretty. Sometimes tempers flare, sometimes debate does not reach the level we aspire to or the American people deserve. Sometimes the most important legislation actually fails to get the votes necessary to pass.

We all know what happened to health care reform the last time we attempted a major overhaul 15 years ago when President Clinton tried to pass his version of health care reform. The debate was just as passionate with charges and countercharges on both sides of the aisle. Because of the coarseness of that debate, because of the seemingly intractable opposition to health care reform, Congress has been wary in the intervening 15 years to take up this cause again, and it is understandable.

But over the past 15 years, our health care system has gotten more expensive. Rising medical costs, skyrocketing premiums, increasing numbers of the uninsured and the strain on both business and providers have brought the critical need for health reform back to the Senate this year.

Make no mistake, we need health care reform now. The status quo--what I call the present health care system--is simply unsustainable.

Medical costs account for one-sixth of domestic spending and are headed upward. In 1979, we spent approximately $220 billion as a nation on health care. In 1992, we spent close to $850 billion. In 2009, we will spend $2.5 trillion on health care. Listen to this: $220 billion in 1979, $850 billion in 1992, and $2.5 trillion in 2009. How can anyone argue it is not time to deal with health care reform and that the need is urgent? The trajectory of our national health care expenditures is out of control.

In addition, one of the biggest--if not the biggest--forces behind our Federal deficit, which we hear so much about on this floor, are the skyrocketing costs of Medicare and Medicaid. In 1996, Medicare and Medicaid accounted for only 1 percent of all government expenditures; they now account for 20 percent. If we do nothing to start bending the cost curve down for Medicare and Medicaid, we will eventually spend more on these two programs than on all other Federal programs combined. We must slow the level of growth in the Medicare and Medicaid Programs if we are to ever get our budget situation under control.

In addition to the fiscal pressures crushing our Federal and State governments, the present health care system is also crushing families and workers. Just look at the rise in the insurance premiums in my home State of Delaware. In 2000, the average premium for family health coverage was just over $7,500. That is $7,500. By 2008, the number had jumped to $14,900--that is $14,900--almost doubling in just 8 years. If we fail to enact the pending health care reform legislation, the same premium for family coverage is expected in Delaware to reach $29,000 in 2016.

Let me repeat that: $29,000 for family coverage in Delaware in 2016 if we don't pass health care reform now.

States around the country will see similar increases, which are simply unaffordable. Too many people are going bankrupt paying for their medical care. Today, the inability to pay for skyrocketing medical bills accounts for more than 60 percent of U.S. personal bankruptcies, a rate of 1 1/2 times what it was just 6 years ago. Keep this in mind: More than 75 percent of families entering bankruptcy due to health care costs actually have health insurance.

Let me repeat this because it is a critical point: Three-quarters of all Americans filing for bankruptcy because of medical bills already have insurance. We also need reform to stop the worst abuses in the health insurance industry. In my year as serving as the Senator from Delaware, I have heard from far too many constituents who have been refused an insurance policy because they have a preexisting condition.

I have heard from fathers who were denied family insurance coverage because they were told their children had preexisting conditions too expensive to cover. Much to my shock--and I have talked about this on the Senate floor--I have received letters from women who have been turned down for coverage because their pregnancy was considered a preexisting condition. Pregnancy a preexisting condition? That is simply intolerable. Even worse, however--if that is possible--is the practice of rescission, where insurance companies drop coverage for individuals the moment they get sick and need their insurance the most. Being denied coverage after you have already paid your premiums is just plain cruel.

For all those reasons and more, we must reform the present health care system. Thankfully, we now have the opportunity to bring about meaningful health care reform through the Patient Protection and Affordable Care Act, and I would like to take just a couple more minutes to discuss why this legislation has earned my support.

First off, it is fiscally responsible. President Obama laid down a marker that any health care reform legislation that landed on his desk could not add to our Nation's debt. I am happy to say this legislation passes this test.

According to the Congressional Budget Office, the Patient Protection and Affordable Care Act will reduce the deficit by $132 billion over the first 10 years. This bill is fully paid for.

Second, the bill helps stabilize Medicare and Medicare Programs. In the absence of this legislation, the Medicare trust fund is expected to go bankrupt in 2017. According to the head actuary at the Centers for Medicare and Medicaid Services, passing this bill would extend the solvency of the trust fund for an additional 9 years--9 years. Medicare is a sacred trust with Americans, and this bill ensures this trust is preserved.

In addition to reducing the deficit and shoring up the Medicare Program, this bill contains numerous provisions that will help Americans afford their premiums and prevent them from filing for bankruptcy protection. Starting next year, insurers will no longer be able to place lifetime caps on health care benefits. For the next several years, insurers will also be restricted in the annual limits they can place on benefits, and then these will be eliminated altogether in 2014.

These are huge changes for people with debilitating diseases and those who experience unexpected catastrophic events costing millions of dollars in treatment.

In addition, premium subsidies for families with incomes under 400 percent of the poverty level--or $88,000 for a family of four--will be available to help them afford their premiums once the new insurance exchange is up and running. There will also be annual limits on out-of-pocket costs for individuals, and dependents will be able to be covered under their parents' insurance policies until the age of 26.

All of these are meaningful reforms that will dramatically lower the rate of bankruptcies associated with medical costs.

The bill also contains some other great consumer protections that don't currently exist in our present health care system. I have already highlighted the problems in the current system with insurers denying coverage for people with preexisting conditions and rescinding coverage when people get sick. Under this bill, Americans will finally be freed from the shackles of preexisting clauses that have kept so many from obtaining much needed health insurance.

Starting next year, insurers will no longer be able to deny coverage to children with preexisting medical conditions. This ban on not covering preexisting conditions will be extended to all Americans in 2014.

The bill also forbids insurers from rescinding health insurance after Americans have already paid their premiums. Americans will no longer lose their coverage when they get sick and need it most.

In addition, the bill dramatically expands coverage of prevention and wellness services. It provides incentives for employers to implement wellness programs and offers a new annual wellness checkup for seniors enrolled in Medicare.

These are all good, positive reforms to our health care system.

Now that we are close to finishing this debate, the media has focused its attention on particular deals that benefit certain Senators and specific States, but I want to point out that all the benefits I have talked about--all of them--are available to every American in every State.

Most every Senator has brought something to this debate and to this bill. I am very pleased that the managers' package includes the health care fraud enforcement amendment, which I introduced, along with Senators Leahy, Specter, Klobuchar, and Schumer as cosponsors. Again, this benefits all Americans not just Delawareans.

The National Health Care Anti-Fraud Association conservatively estimates that 3 percent of all health care spending--some $72 billion--is lost to health care fraud in both public and private health care plans. That is $72 billion lost in health care fraud in both public and private health care plans. Other estimates place the figure as high as 10 percent over $220 billion.

Fraud hits every one of us in every corner of our Nation where we can least afford it--our health care premiums--while simultaneously driving down the quality of, and our trust in, the health care system. This amendment increases funding for fighting fraud in public programs.

It improves screening of providers and suppliers and requires implementation of meaningful compliance programs. This section tightens requirements for claims submissions and provides new tools to deter fraud and abuse in the private insurance market.

It also strengthens criminal investigations and prosecution. Today, outdated laws and punishments insufficient to provide effective deterrence hamper prosecutors and agents. This may seem incredible, but many criminals have told law enforcement officers that they switched to health care fraud from the drug trade because the reward-to-risk ratio is so much higher. Can you imagine that? There is actually an incentive for crooks in the present health care system to commit health care fraud.

This antifraud amendment can begin to reverse this trend. Significantly reducing costs attributable to fraud will go a long way toward bending the cost curve down. What this bill does is it increases the sentencing requirements for people who commit health care fraud to make it much less attractive for them to get into the health care fraud business. It gives us the prosecutors and the agents we need--just like we did in the financial regulatory reform--to go after these folks and catch them, then put them in jail. With these new sentencing guidelines, we can put them there for a longer time, discouraging people from getting into the health care fraud business to begin with.

In addition, the package of amendments I cosponsored with my fellow freshman Democrats will also improve the bill and benefit all Americans.

I am lucky to be a member of a dynamic freshman class, including the Presiding Officer, and I have enjoyed teaming up with them in our morning speeches and colloquies to push the health care reform effort forward. I am pleased that our amendment package was accepted by the bill's managers and that it provides commonsense, practical solutions that help further contain costs, improve value, and increase quality.

For example, it quickens the implementation of uniform administrative standards, allowing for more efficient exchange of information among patients, doctors, and insurers. It provides more flexibility in establishing accountable care organizations that realign financial incentives and help ensure that Americans receive high-quality care. It provides greater incentives to insurers in the exchange to reduce health care disparities affecting underserved minority communities.

For all the reasons listed above, from the original text to the additions added to the managers' package, this bill should and must be passed. It brings quality, affordable health care within the reach of all Americans, including more than 30 million Americans who are currently uninsured. It strengthens the Medicare Program, extending its insolvency for 9 years. It helps restore fiscal order by reducing the deficit by approximately $132 billion over 10 years and more than $1 trillion over 20 years. It offers much needed consumer protections that provide stable coverage at an affordable cost.

In closing, I again want to acknowledge the hard work of Senators BAUCUS, REID, DODD, HARKIN, as well as their staffs--especially their staffs--because the staff has done incredible work on this piece of legislation. They have enabled us to reach this historic legislative moment.

I have ended many speeches by noting that it is time to gather our collective will and do the right thing to join this historic opportunity by passing health care reform. I think we may have finally reached that goal. We certainly can't afford to wait any longer. We need to act now. We can do no less. The American people deserve no less.

Mr. President, I yield the floor.

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