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John T.
Republican SD

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  • Emergency Unemployment Compensation Extension Act—Motion to Proceed

    by Senator John Thune

    Posted on 2014-01-08

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    Read More about Emergency Unemployment Compensation Extension Act--Motion to Proceed

    THUNE. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.



    The PRESIDING OFFICER (Mr. Coons). Without objection, it is so ordered.

    Mr. THUNE. Mr. President, we just heard a very eloquent speech given by [[Page S114]] the Republican leader on the Senate floor about the history of the Senate and the role it has played in our democracy, its past, and what could be its future if we can restore it to where it once was.

    The leader talked a lot about what used to be taken for granted around here, such as the committee process working and functioning where committees reported legislation out, worked on it, and brought it to the floor.

    We had an amendment process. When legislation got to the floor, it could actually be debated. We would have amendments offered and amendments would be voted on. Individual Senators had an opportunity to offer amendments and could thereby be the voice our people who elected us to be here in the Senate.

    Unfortunately, in many respects with this current Senate, the wheels have come off. We find ourselves with a process where typically the amendment tree is filled, which blocks amendments from being offered. Perhaps the best factoid with regard to that is that there have only been four Republican amendments voted on since July--half a year. Over the course of half a year, we have had four Republican amendments that were voted on in the Senate. In any institution where there is any form of open debate and open amendment process, there is going to be a lot more votes than that, and I think that is very telling about where we are.

    I was here as a young staffer back in 1985 and 1986. At that time Senator Bob Dole was the majority leader in the Senate. It was a very different place. I worked on some issues for my boss, and he had his opportunity, as did other Senators at that time, to come to the Senate floor, offer amendments, and speak out on behalf of his constituents on issues that were important to them and important to him, and that is something that has become a bygone era.

    I also had the opportunity--prior to being elected to the Senate--to serve in the other body, the House of Representatives, where things are very structured. There is a rules committee there that basically regulates what legislation comes to the floor, what amendments will be made in order, and how much time is allowed for debate on each amendment. That is how that institution was structured.

    The Senate, as Senator McConnell the Republican leader pointed out earlier, is a very different institution by design. Our Founders wanted it to be different. Senator Alexander, in his remarks, talked about an author who described the Senate as a touch of authentic genius. We have gotten very far away from that in terms of its historic role and certainly what should be its role today as we debate major policy and major legislation that impacts over 300 million Americans.

    Today I come to the floor to discuss an issue that was debated here a few years ago, which is an example--a byproduct, if you will--of one- party rule, where a big piece of legislation is jammed through in a partisan way; that is, ObamaCare.

    My colleagues on the Democratic side recently spent a lot of time talking about income inequality. After 5 years of stagnation in the Obama economy and an ever-growing gap between the rich and poor, I say it is high time for us to talk about that. But a critical part of that discussion that Democrats don't want to have has to be the ways in which ObamaCare is contributing to the problem.

    As the last few months have made clear, ObamaCare is making it worse for millions of Americans. Huge premium increases and soaring out-of- pocket costs mean that families will have to take money that they would have used to buy their first home or pay for a child's college education and use it instead to pay for health care. Crippling mandates on employers mean that fewer jobs are available for the unemployed and hours are reduced for workers. As if the economic problems caused by the law aren't enough, recent weeks have made clear that the quality of care is likely to diminish thanks to the President's health care law.

    Contrary to the President's promise that you could keep the doctor you had and liked, millions of Americans are discovering they will be losing their doctors this year and their choice of replacement is limited. Why? Because ObamaCare provides an incentive for insurers to limit the pool of doctors--and I might add hospitals as well--that you can visit. The President's health care law placed a number of new burdens on insurers, from new taxes to a requirement that everyone with preexisting conditions be covered at the same rate as healthy individuals.

    On top of that, the law gave States the authority to tell insurance companies how much they are allowed to charge for their health plans. As a result, insurance companies are facing huge new cost increases with very few ways to cover those costs. Many companies have chosen the one cost control measure still available to them; that is, limiting their networks of doctors and hospitals.

    In California, for example, as a Time magazine article recently reported, Blue Shield offered doctors a choice--be reimbursed up to 30 percent less for medical care or be excluded from the network. The Time article was entitled ``Keeping Your Doctor Under ObamaCare Is No Easy Feat'' and goes on to report that ``among the providers who declined to accept the lower rates were some of the state's most prestigious--and expensive--hospitals, including Cedars-Sinai Medical Center in Los Angeles and hospitals affiliated with the University of California.'' There is a reason these hospitals are prestigious and expensive. They are on the cutting edge of medical research and offer breakthrough treatments that are unavailable at many other hospitals. People come to these hospitals when other treatments have failed, and they often find hope. But these kinds of hospitals--world-class, cutting-edge facilities--are the hospitals most likely to be excluded from exchange plans.

    Time reports that ``a December 13 McKinsey study of 20 U.S. Metropolitan areas found that two-thirds of ACA plans analyzed had `narrow' or `ultra' narrow networks, with at least 30 percent of top 20 hospitals excluded for coverage.'' The consequences of these narrow or ultranarrow networks are many. First, of course, these networks might not include your doctor. If you have been forced off your health plan into a new private plan or exchange plan, your new plan may not cover the doctor you have been seeing for years--the doctor you like and who knows your medical history. This is detrimental to any patient, but for someone who is being treated for a serious illness, this could be devastating.

    Switching doctors midstream while being treated for cancer or another serious illness could have a disastrous impact on the quality of the care the patient receives.

    In addition to losing the doctor you have and like, these narrow networks also mean your choice of a replacement will be limited--at times severely limited--and that the same quality of care may simply not be available in the new network.

    Still another consequence, as Time points out, is the distance people may have to travel to get to their doctor or hospital. Excluding hospitals from an insurance network may not present a huge travel problem for urban residents--the article notes--but residents in rural areas may be forced to drive a long way to reach a hospital in their network.

    Time quotes Kaiser Family Foundation senior fellow Karen Pollitz, who notes that exchange customers in central Maine have to travel as far as Portland to reach a covered hospital. That could be a 2\1/2\-hour drive. That is not exactly ideal if someone is, say, having a baby or a serious health crisis.

    Let's suppose that you do somehow find an affordable plan on the exchanges that does cover your doctor. You still may not be able to get care. A recent FOX News article focused on expert warnings that the health exchange system may start to look a lot like Medicaid, the Federal health insurance program for the poor. Similar to the exchanges, Medicaid features narrow provider networks, as many doctors either refuse Medicaid patients all together or limit the number they see because of Medicaid's lower reimbursements.

    So what is the result? Medicaid patients generally face worse outcomes than patients with private insurance.

    [[Page S115]] They wait longer for doctors if they can get in to see them at all. The survey published in the New England Journal of Medicine found that 66 percent of children on Medicaid were denied appointments with specialists compared to just 11 percent of children covered by private insurance. Patients on Medicaid are more likely to suffer complications and spend longer in the hospital, and they are more likely to die from cancer, surgical complications, and other problems.

    Unfortunately, this could soon be the future of those forced into narrow networks on the exchanges. Patients will be denied access to top doctors and hospitals and will be forced to compete with other patients for access to a limited number of health care providers. Even those Americans whose plans cover their preferred doctors will not necessarily be able to get in to see their doctor if he is forced to start limiting the number of exchange patients he takes.

    Analysts, Fox News warns, ``emphasize . . . that having health insurance won't necessarily translate into access to health care.'' Let me repeat that: Analysts emphasize that having health insurance won't necessarily translate into access to health care.

    This is what the grand promise of ObamaCare has come to: Even those who have managed to make their way through the broken exchange Web sites and find an affordable plan still may not be able to get health care.

    Is this the rosy future we were promised? ObamaCare was supposed to fix our health care system. The President promised it would reduce costs and expand access to care. Every American was supposed to benefit. Instead, millions of Americans have lost their plans. Health insurance costs have soared. There are parents who now can't afford to insure their children and cancer patients who are losing their doctors and hospitals. Those few who have gained coverage are facing a system well on its way to becoming a copy of Medicaid.

    Surely we can do better. We have to do better. It is time to abandon the failed ObamaCare experiment and move on to real health care reform. We can do that and we should do that.

    I yield the floor.

    The PRESIDING OFFICER. The Senator from Massachusetts.

    Truth in Settlements Act Ms. WARREN. Mr. President, I rise to support the Truth in Settlements Act. This bipartisan legislation, which I introduced earlier today with my colleague from Oklahoma, Dr. Coburn, will help the public hold Federal agencies accountable for the settlements they make with corporate wrongdoers.

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