Health Care And Education Reconciliation Act Of 2010

Floor Speech

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Mr. JOHANNS. I so appreciate the opportunity to speak to this issue because this is enormously important for our rural States.

We took a look at this bill. We tried to give it a good, fair look in terms of its impact on Nebraska. If I might, let me cite some statistics, and you can repeat these statistics whether you are in Texas or Tennessee or Wyoming or wherever. Two-thirds of our home health agencies, if this bill--well, this bill became law today--two-thirds will be operating in the red by 2016, home health agencies. So what does that mean? Here is what it means: Back home in Nebraska, if you are in a major city such as Omaha, Lincoln, Kearney, whatever, it appears to me that you are probably going to get through this pretty reasonably. However, if you are in a rural area, you are going to lose service. They are going to pull in on the services to these rural areas. Why? Because they can't afford to send a home health person out 50 or 75 or 100 miles.

We asked ourselves, What would be the impact of this bill on nursing homes? Again, we have rural nursing homes all over our State. This is exactly what has happened in other States. People want to spend their elderly years in their community or near their community. These nursing homes are fighting to stay open today; they will take a $93 million hit. We are going to have nursing homes close in Nebraska.

Hospitals and hospice will also experience major reductions.

To those Nebraskans who are on Medicare Advantage, 35,000 Nebraskans are going to see a cut in the amount of money they receive only exacerbated by what we are talking about today.

If I might, let me anticipate an argument. I know, because you have been watching this, somebody from the other side is going to say: Come on, Mike. This is the way it works. We extend the life of Medicare.

The Actuary in CBO has looked at that, in a rather amazing analysis, and said: Yes; right. What you are doing is double counting the same dollar. This comes from CBO, but I can take the same from CMS. CBO said: The key point is, the savings to the HI trust fund, under the Patient Protection and Affordable Care Act, would be received by the government only once, so they cannot be set aside to pay for future Medicare spending and at the same time pay for current spending.

That is exactly what they have tried to do here.

Mr. GREGG. If the Senator will yield on that point, CBO also says: In effect, the majority of the HI trust fund savings, under the big bill which was signed today and the reconciliation proposal which we are dealing with today, would be used to pay for other spending and, therefore, would not enhance the ability of the government to pay for the future of Medicare benefits.

The amendment we have at the desk does the opposite. It will allow us to use any savings to pay for Medicare benefits and enhance the strength of the trust fund.

Mr. JOHANNS. That is exactly why I stand here today--to bring honesty to the accounting. If you bring honesty to the accounting, you can see what we are doing to the American people.

A former CBO Director recently said: Fantasy in, fantasy out. They will only score what is laid in front of them. They had this gimmick laid in front of them which is what they had to score. I applaud what this amendment does because what it is saying is: Let's cut through all this. Let's score this honestly. If we have savings in Medicare, let's keep that money in Medicare. Believe me, that is the right way to go about this. This idea of double counting the same dollar makes no sense whatsoever.

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