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Mr. KYL. Mr. President, I would say, we are fortunate to have a real doctor, a physician, Dr. Tom Coburn of Oklahoma, as one of our colleagues in the Senate to talk about the real impact of legislation like this as he sees it when he treats his patients. I think his words deserve a lot of attention.
I just want to briefly address this morning a couple of the claims my Democratic colleagues are making about this new legislation, claims that are simply false.
The first one: There is a big tax cut. One of my colleagues said this is the biggest tax cut we have ever had. There is no tax cut for taxpayers in this bill. What they are touting as a tax cut is, rather, a direct payment to insurance companies. I find it very odd that is called a tax cut. When I think of a tax cut, I think of money remaining in the pockets of taxpayers so they do not have to pay taxes they have been paying in the past. That is not what is in this bill.
What the bill does is to provide a subsidy to insurance companies to dispense government-mandated insurance. It is not a tax cut for taxpayers. Instead, most of the so-called tax relief goes directly to the insurance companies. It never touches--you never touch the money--it never touches an American family's pocket.
These premium subsidies are delivered straight from the U.S. Treasury to help insurance companies, as I said, to purchase this government-mandated, government-approved insurance. They are not extra dollars in people's pockets, as the chairman of the Finance Committee argued. They are, rather, advanceable, refundable tax credits, which is code for a new tax entitlement. In fact, that is exactly the way it is recorded in the Federal budget. It is recorded as a spending program, the reason being that the people receiving these so-called refundable credits paid very little if any taxes. These are folks who do not pay taxes, so they get what is called a refundable tax credit. But even then the money goes directly to the insurance company, not to them. I always thought you had to pay taxes to get a tax cut, but not in the rubric of this legislation.
According to the Joint Committee on Taxation, only about 8 percent of all taxpayers making under $200,000 a year would actually benefit from this government subsidy for health insurance. The remaining 92 percent would receive no tax benefit under the bill.
I have to say, when we are talking about tax cuts, we have to at least put in a little word about the tax increases in the bill because that is where the bill focuses, on taxes. It taxes many of those who have health insurance and taxes people if they do not have health insurance.
The taxes in the bill hit families. They hit seniors and the chronically ill, small businesses, those who have flexible spending accounts, and those who use medical devices. All of those things create a tax people pay. The vast majority of the people who pay these taxes are not high earners. As the Congressional Budget Office has said, whenever there is a tax on some other entity that delivers health services, that tax flows directly through to the taxpayers in virtually the same amount of money.
In fact, in order to collect all of these taxes, and especially the tax that is imposed on people if they do not buy this insurance, the Internal Revenue Service estimates it is going to have to have between $5 billion and $10 billion more just in order to collect the taxes. It has been estimated this would require 16,500 new IRS agents. Welcome to your friendly new health care bill.
The second aspect my colleagues have been talking a lot about in the last 48 hours: The elimination of the problem of preexisting conditions in acquiring health insurance. The implication is that Republicans have not supported help for people who have preexisting conditions. That is not true. We have made that point clear. We made that point clear in the meeting we had with the President at Blair House. The argument is about the best way to do it.
As you will see in just a moment, it turns out this bill has not done it very well. Republicans have suggested there are a lot of different ways to get to this problem--State reforms, risk pools, more competition, some subsidization. All of these things can help us with this problem. But for all of the Democrats' central planning in this bill, it looks as though the problems are already arising as a result of their specific provision to deal with this problem.
According to a brand new Associated Press story of March 24, President Obama's claims about preexisting coverage for children are not what they seem. The article notes that ``the letter of the law''--which Democrats took upon themselves to write behind closed doors--``provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.''
In your rush to do these things--behind closed doors, without proper vetting, always voting no on any attempts to correct it--you end up with problems like this, and they are going to have to somehow go back and try to fix this. If this blunder is discovered on the first day this law takes effect, how many more errors will be discovered in the next days and weeks, as people pour over the 2,733 pages of this new health care law, and the 150 pages of the reconciliation bill that is on the floor right now?
If you cannot draft a bill properly to protect children with preexisting conditions--which is a centerpiece of the bill's so-called immediate deliverables--then how are you going to be able to successfully make one-sixth of the economy work through this new government-operated system?
Finally, I have talked about two things our Democratic friends are crowing about, neither one of which, it turns out, I think are worth crowing about. How about the things they are not talking about, the things Americans are very concerned about?
Democrats love to talk about people who are allegedly helped by the legislation. How about those who are hurt by the bill? How about talking about seniors whose care is going to be jeopardized as a result of this bill? Seniors in my State of Arizona are very worried about the Medicare cuts. There are over $ 1/2 trillion in Medicare cuts in this bill.
Well, our Democratic friends do not like to talk about that. But it is a reality. It is in the bill. The reconciliation bill slashes more than $ 1/2 trillion from Medicare and contains a whopping $202 billion reduction in Medicare Advantage. That is more than in the bill the Senate passed last December. But you do not hear about that. Medicare Advantage beneficiaries in my State like the health care they have right now, and it is simply not true if they like their health care they get to keep it. It is false. This bill takes health care benefits away from seniors who are on Medicare Advantage. That is the truth. It may be an inconvenient truth for our colleagues who like to stress what they think is good about the bill but conveniently ignore things that are going to hurt their constituents and certainly going to hurt my constituents.
My senior citizens in Arizona do not want the government taking away their health care, and they are very concerned as a result. A constituent from Tucson--I will just close with this--wrote me a very short, a very direct letter, but it summarizes the point a lot of people feel.
I am a senior citizen, age 83. If I lose my Medicare Advantage coverage, I'll also lose my primary care physician of 18 years because he does not accept Medicare Direct. Senator Kyl, do not let them take away my Medicare Advantage.
Well, all of us know physicians who are no longer taking new Medicare patients. They cannot afford to because we do not pay them enough. Mayo Clinic in Arizona has already said it is not going to accept any more Medicare patients at several of its facilities in the Phoenix metropolitan area.
This health care bill is asking a lot of the American people, a lot in terms of tax collection, and a lot in terms of future debt that our children and grandchildren are going to have to pay.
But just one group that ought to be very concerned--and is--are our senior citizens who face nearly $ 1/2 trillion in Medicare cuts. Taxes and premiums are going to be increased on all Americans. Small businesses will be hit with a litany of onerous new taxes and mandates and regulations. Probably worst of all from my perspective, just as these costs inevitably escalate, as time goes on, just as in the European countries that have had to deal with these same kind of health care issues, this legislation will ultimately lead to the rationing of health care.
That is the cruelest result of all.
I ask unanimous consent to have printed in the Record at this point an op-ed piece by Mr. Bob Robb who writes for the Arizona Republic. It is dated March 24. The last two sentences of this op-ed I think summarize the point I made very well. He says:
But it is impossible to treat health care as a public good without rate regulation and rationing. And those are the inevitable next steps down the health care road the Democrats have taken the country.
There being no objection, the material was ordered to be printed in the RECORD,
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