Partisan Senate Health Care Reform Bill is Disappointing, Grassley Says

Mr. President, we have been waiting for many weeks while the Democratic leadership worked behind closed doors to write a new health care reform bill. Rather than try to build consensus for a bill that could get broad based supported, they toiled in secret. But at long last, this new health care reform plan is finally public. They have come forward to at last reveal the legislative language for the health care reform bill the Democrats intend to bring to the floor.

We know where they started. We know the changes they’ve made along the way. Those in this chamber will recall that we worked for months in the Senate Finance Committee on health reform. Senator Baucus and I worked very carefully in committee to try to develop a bipartisan reform plan.

Health care is one-sixth of the economy. We are on course to spend upwards of 33 trillion dollars on health care in this country over the next decade. That’s right.... 33 trillion dollars. Already our health care system is on an unsustainable path. Our current health care entitlement programs—Medicare and Medicaid—are both on very unsound financial footing. Not only are both programs in jeopardy financially but the magnitude of the problem is a real threat to the federal budget. Starting in 2008 the Medicare program began spending more out of the hospital insurance trust fund than it is taking in. That deficit spending in that trust fund is the beginning of the end for Medicare unless something is done.

The Medicare Trustees have been warning us for years that the hospital insurance trust fund is going broke. They now predict that it will go broke in 2017. To keep Medicare going for future retirees means finding a way to bridge the gap for a 75 trillion dollar unfunded liability. And this must be done in a manner that does not worsen health care quality or access for beneficiaries. And likewise, the Medicaid program, which serves 59 million[1] low income pregnant women, children and families, is on very shaky financial ground.

The Government Accountability Office has reported to Congress that states are reaching a crisis. The GAO models predict that state spending will grow faster than state revenues for at least the next ten years. The impact of declining revenues is clear. Here is what GAO has said about the situation: "Since most state and local governments are required to balance their operating budgets, the declining fiscal conditions shown in our simulations suggest that, without intervention, these governments would need to make substantial policy changes to avoid growing fiscal imbalances.”

This too is the crisis facing the Medicaid program today. So both of the two major federal health care programs are in serious trouble.

These are major problems with some of the most significant implications for our country. And if reforms to health care are not done carefully, they will make this situation far worse, not better. And anyone listening would have no doubt of the ability of Congress to make it worse.

These dire economic implications are not the only thing at stake with health care reform. Besides the significant economic implications of health reform, this is a bill that affects everyone in another very important way. It affects everyone’s health. By changing the way we get health care in this country, it touches the lives of every family, every senior, every child, every student...everyone.

And it makes changes to health care that will be nearly impossible to undo. The reforms these bills contemplate will make long lasting changes to our health care system. These are changes all of us will have to live with for decades to come.

So health reform presents this chamber with a bill that has significant economic implications – at a time when all eyes are focused on the economy. It’s a bill that affects everyone’s health care. And it’s a bill that will make permanent changes to our system of health care.

For all these reasons, it makes it all the more important that changes of this magnitude be done with broad based support in this chamber and across this country. In the Finance Committee, we believed strongly that a bill of such significance should be done with broad based support. Under the leadership of Senator Baucus, the Chairman of the committee, we started last year with the bipartisan health reform summit. We held 20 hearings. We held three public forums this year on options for financing, coverage and delivery system reform. We invited in experts from across the country. We invited anyone to submit input to the committee on those options and we received over 600 sets of comments on the option papers.

Senator Baucus and I developed the broad outlines of what we believed would be a good reform package. That broad outline reflected the input of that open and public process. We took that outline and we sat down with four other leaders in health care in this chamber. That group became known as the Group of Six. And that group began meeting in June to take that framework and finish the important details. We met for untold hours. We consulted with experts at the Congressional Budget Office and the Joint Committee on Taxation. We invested a tremendous amount of time and effort to develop a bipartisan package.

But then Democratic leaders grew impatient. They wanted the reform bill to be finished faster. They were more concerned with health reform getting done right now instead of getting it done right. We said we needed to give the process the time it needed. We said we were not going to be bound by arbitrary deadlines. We wanted to get the job done right. But when the first of September rolled around, they were not willing to give the Group of Six any more time. And as a result, the Democratic leaders pulled the plug on that bipartisan work. And the hope for a bill with broad bipartisan supported ended at that point.
And ultimately, the Finance Committee reported out a bill that did not have that broad bipartisan support that we had hoped for earlier in the year. The bigger and far more liberal agenda driven by the White House and the Democratic leadership went beyond where the true consensus on reform exists.

Now the next step in this process has been to merge together the bills from the HELP committee and the Finance committee. And that job fell to the Democratic leader and the chairmen of the two committees. But then ultimately, their Leader even excluded the two chairmen from the process. That process began on October 2nd. So the rest of the Senate has been waiting ever since that time. Waiting to see what would emerge from behind those closed doors. But then people started to complain about how long it was taking to develop the merged bill. And when that happened, lo and behold we started to hear from the Democratic Leader what the Group of Six had been saying. He too started saying he was not going to be bound by any artificial timeline. He too started saying he was going to take whatever time he needed. Imagine our shock and dismay when we heard this. All the impatience we heard about how long our bipartisan process was taking.

They pulled the plug on that effort out of impatience. And my suspicion is that only now is there the realization of how hard it is to assemble a comprehensive health care reform plan.

But now at long last we see the merged bill. Now we know what is in it. The bill has undergone many changes since the Democrats decided to do a partisan bill and they are not positive. They have moved more and more to not just a partisan agenda ...they’ve moved to an extreme agenda. It’s an agenda so extreme that they are having difficulty finding the votes just among the Democratic ranks. They have 60-vote control in the Senate. They have an overwhelming majority in the House. And yet they are trying to blame Republicans for slowing down the process.

But it is not Republicans who are slowing this down. It is not because of Republicans that it took so long to merge the two Senate bills. It is not because of Republicans that it took the House so long after July to finally vote on a bill.

The reason for their difficulties is that their left wing is driving the health reform agenda so far to the extreme left. It is so far to the left that they are having trouble getting everyone on their side to support their agenda.

In the other body, 39 Democrats voted against Speaker Pelosi’s plan. And you can be sure we would have seen a bill in the Senate much sooner than now if all 60 Democrats were lined up behind this effort. But this is where we are. Now, let’s look at what has been produced. What changes have been made to produce the merged bill.

I’ll highlight a few of the changes I find most disturbing. As I highlight these issues, it will be clear that this bill is already sliding rapidly down the slippery slope to more and more government control of health care.
It still has the biggest expansion of Medicaid since it was created in 1965. It has gotten bigger since the Finance Committee started.

It still imposes an unprecedented and intrusive federal mandate for coverage backed by the enforcement authority of the Internal Revenue Service.

It still increases the of the government by $2.5 trillion when fully implemented. It’s gotten even more expensive since the Finance Committee started.

It still gives the Secretary of Health and Human Services the power to set prices and define benefits for private health plans. That's a lot of government power in Washington over people's lives.

It still will cause health care premiums for millions to go up, not down.

It still imposes new fees and taxes. These new fees and taxes will total about a half trillion dollars over the next few years. On the front end, these fees and taxes will cause premium increases as early as 2010. And these fees go into effect four years before most of the reforms take effect in 2014.

And at a time when we are all focused on getting the economy back on track and getting people back to work, this bill's fees and taxes will kill jobs and make it harder for business to expand or even stay afloat.
As I said when this process started, the bill that was released by the Finance Committee was an incomplete, but comprehensive, good faith attempt to reach a bipartisan agreement. But ever since that moment, the bill has moved farther and farther away from that approach on several key issues. Now we can see clearly that the bill continues its march leftward. It continues to take shape into an extreme agenda driven by the far left. This far left partisan change is precisely what Republicans feared would occur at later stages in the legislative process. Today we still see that those fears were legitimate and justified.

Nevertheless, I still hold out hope that at some point the doorway to bipartisanship will be opened once again. I hope that at some point the White House and Leadership will want to correct the mistake they made by ending our collaborative bipartisan work. I hope at some point they will want to let that bipartisan work begin again. And then, they need to back that effort and give it the time needed to get it right. But it is clear that today is not the day when that is going to happen.

[1] Source: Kaiser’s Family Foundation, November 2008 fact sheet

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