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Public Statements

Health Care

Floor Speech

Location: Washington, DC


Mr. COATS. Mr. President, this past Friday marked the 2-year anniversary of when the president's health care law, the affordable care act, otherwise known as ObamaCare, was signed in to law. I wasn't in the Senate at the time; I was actually in the State of Indiana campaigning to be in the Senate as a representative of that State. As such, I had spent a considerable amount of time crisscrossing the State and talking to Hoosiers about the health care plan. From diners and restaurants all across Indiana to small businesses, large businesses, medium-size businesses, big industrial giants, small mom-and-pop operations, medical providers, and ordinary citizens, we in Indiana join the nearly two-thirds--or perhaps even more than two-thirds--of the country that oppose this law.

Hoosiers didn't then, and they don't now, want to have a one-size-fits-all nationalized health care system. They want a healthier health care system. They want reforms to the current problems and excessive rising costs of health care. This is the first of many attempts I will make to discuss why we need to address this law, which is moving toward ever and ever greater implementation and particularly kicks in over the next two years. Hoosiers, as I said, did not want the plan then and they don't want it now. They don't want to have Federal bureaucrats making their health care decisions for them. They want less government intervention and higher quality of care, and they don't want a health care system that increases costs and premiums while hurting job creators with fines and penalties. They want affordable care and good job opportunities.

Two years after passage of that act, I continue to hear these messages from the people of Indiana and from others as we discover more and more information about what is contained in this massive 2,700-page bill that was passed in early 2010. I wish to discuss a few of the impacts of the ObamaCare law today. The first is the individual mandate, and of course that is one of the issues the Supreme Court is hearing right now and will be making a determination on.

ObamaCare is the biggest example of government intrusion in the everyday lives of Americans, whether by forcing individuals to buy health insurance, enacting onerous regulations on small businesses, or by raising taxes and imposing penalties. The health care law forces every American to purchase a health insurance plan or, if they choose not to do so, to pay the government a fine. This is unprecedented in American history. It is the first time the Federal Government is forcing citizens to purchase a product or a service they may or may not want or pay a fine for their decision to say no.

This administration basically is saying to Americans: We know what is better for you than you know for yourself. We know what is better for you than what your doctor suggests is needed, and if you don't get a government-approved health care plan, we are going to assess you a fine.

That is a basic, fundamental principle of constitutional law and the Supreme Court will be making that determination. But I suggest that this Congress needs to continue to debate this and be prepared to act depending on what the Supreme Court decision is, which will come down several months from now.

The second thing I wish to talk about briefly is the higher costs that emanate from this particular piece of legislation. In addition to mandating that all Americans have health insurance, ObamaCare hits individuals and families with increased costs at higher premiums. The Nation's nonpartisan budget experts at the Congressional Budget Office estimate that when fully implemented, this law will increase insurance premiums on a family policy by an average of $2,100 a year. Therefore, the affordable care act is hardly affordable and increases the already high premiums people have to pay for insurance.

The President's own Chief Actuary at the Center for Medicare Services reported that the law will increase national health care costs by $311 billion in the first 10 years alone--increase is the key word here. The goal of reforming the Nation's health care system initially was to reduce the skyrocketing costs for Americans, not increase them. Yet, we are now being told by the experts and the President's own people that Obamacare will increase costs.

I also wish to speak about the impact of this law on businesses. I talked to dozens if not hundreds of businesses across the State of Indiana, both in the campaign year of 2010 and then last year traveling as a Senator throughout the State. The President's health care prescription results in bad side effects for American businesses by hitting job creators with new taxes and new regulations that they desperately don't need at this point in our struggle to regain economic growth. Take the employer mandate. The law penalizes businesses that do not provide employees with government-approved health care plans. Beginning in 2014, American businesses with more than 50 employees will be fined $2,000 per employee if they do not offer a health insurance plan approved by the Federal Government.

I have talked to a number of business people who have gone through painful negotiations with their workers and with their laborers and with staff. They have put together a health care plan that is accepted by both management and by employees who recognize that if they cannot maintain some semblance of control over costs, the jobs might not be available in the future because the company cannot afford to keep people at work. So in recognition of all of this negotiation that goes on and the contractual obligations that both sides work to achieve, understanding that if the business is hit with too much tax and too many regulations the business may not survive, those plans now come under the scrutiny of the Federal Government, and the Federal Government will determine whether those plans are sufficient and adequate. If it determines they are not, then a fine is levied against the business.

I cannot tell my colleagues how many business people told me: Look, I would rather pay the fine than have the government impose all of these new regulations on us when we are working carefully with each employee to make sure they have their basic insurance needs covered. Yet, if we are forced into a set plan of set procedures for every employee, then I have two choices, the business people say: I can either refuse to do so and pay the penalty of about $2,000 per employee, or I can let people go. The bottom line is, if I can't make my bottom line, I cannot keep these people employed.

The arbitrarily fixed basis that small businesses under 50 employees will not be subject to this leaves manufacturers and business people who are slightly below that level--say at 45 or 40 or 35--a dilemma as they are seeking to expand their business. ``As soon as I hire No. 50, then my business is no longer exempt. So what do I do? I freeze out hiring more people and look to double up people's salaries or put people on overtime.'' At a time when we have over 12 million people looking for a job and millions of people underworked or working two and three part-time jobs to make ends meet, we are imposing this law on them. It could not have come at a worse time.

Then there is a medical device tax and several other taxes that are included in this bill that we continue to find as we read the fine print.

Indiana is a State that is home to a lot of medical device manufacturers. In fact, there are over 300 registered medical device manufacturers that employ 20,000 Hoosiers in the State of Indiana and another 28,000 people who benefit from that employment. There are more than 400,000 workers employed nationwide by this industry.

So what did the ObamaCare plan propose? Well, we need some pay-fors. To pay for the law, the administration decided to impose a 2.3 percent tax on these medical device manufacturers.


Mr. COATS. Thank you, Mr. President.

These medical device manufacturers are employing people at an average rate of about 41 percent greater than the average worker rate of pay in my State, so these are desired jobs. But, again, employers and manufacturers of medical devices are telling me they are being forced to go overseas because of the burden of regulation and a tax that has nothing to do with the essential program of the health care plan.

That is not the only tax that is imposed in this law. There are many hidden taxes here that we are just learning about. Let me name five: the excise tax on charitable hospitals; the drug industry tax, separate from medical devices; the health insurance industry tax; the insurer excise tax; and a Blue Cross-Blue Shield tax hike.

The Joint Committee on Taxation found that the health care law imposes more than $550 billion in new taxes and penalties, most of which will fall on the middle class.

Third, the impact on the State of Indiana.

ObamaCare forces States to expand Medicaid rolls so significantly that it will be imposed--and this has been talked about earlier today--upon the States in a way that can cripple their ability to try to find some balance in their budgets. In Indiana, where our budget is in far better shape than many other States, we still cannot afford the current Medicaid Program, let alone the projected new costs that will be required under the ObamaCare law.

An outside group has estimated that $3.1 billion in new costs over the next decade will be imposed on Indiana taxpayers if the 1.5 eligible Hoosiers enroll in Medicaid as a result of this health care law. This added expense does not include any payment relief to providers and, therefore, shifts costs to patients by driving up premiums for all Hoosiers.

In conclusion, we have to ask the question: What is the remedy for this fatal disease called ObamaCare? Well, the remedy may lie with the Supreme Court. They are hearing arguments on this today, and will for the next 2 days, and we will have a decision on the constitutionality of this law by the summer. But the health care debate also, most likely, will end up back here in Congress one way or another, and that leaves us the responsibility of addressing this.

From forcing individuals to purchase insurance, to taxing successful job creators and burdening State budgets, I believe the health care law is so deeply flawed that it must be scratched and replaced with real reform, reform that lowers the cost of care, allows the doctor--your doctor, not the government--to decide the kind of medical care you need, and provides flexibility to States.

Real health care reform lowers costs, it improves access to quality care, empowers individuals, and preserves personal liberties; and that is not what we have in the law that currently is on the books. So whether through congressional legislation or court action, ObamaCare needs to be overturned and replaced with commonsense provisions that put patients--not government, not bureaucrats--in charge of health care decisions.

ObamaCare has proven to be the wrong prescription, and it is time for a new treatment. Americans want reform that remedies our ailing health care system, not one that weakens it and drives it deeper and drives us deeper as a Nation into debt.

Mr. President, I yield the floor.


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