Executive Sessionby Senator Pat Roberts
Posted on 2013-12-11
ROBERTS. Madam President, I rise to address the nomination of
Cornelia Pillard for the DC Circuit. It appears to me the environment
in which we are discussing these nominations is a good example of the
new rules of the Senate. We are already getting a taste of the new
world order around here. It did not take long. It has only been a few
weeks but we are already experiencing life in the new Senate. Those in
the majority who wanted to change the rules are now certainly getting
It should have been obvious that the rule change would impact the Senate in many unforeseen ways. We in the minority have had to find other ways to make our voices heard. As we watch the majority use its new power to move whomever it wants through this body, we should realize that we have started down a course from which we will never return. Indeed, we should expect more changes in the future. The majority changed the rules because it did not like how they were operating to frustrate their ambitions and agenda. If other things come about that frustrate the majority, we may have new changes to get rid of those frustrations too. The invocation of the nuclear option has set us on an irreversible course.
A few weeks ago I came to this floor and quoted our former Parliamentarian Bob Dove. He and Richard Arenberg, one-time aide to former majority leader George Mitchell, wrote a book called ``Defending the Filibuster.'' This is what they said, and it bears repeating: If a 51-vote majority is empowered to rewrite the Senate's rules, the day will come, as it did in the House of Representatives, when a majority will construct rules that give it near absolute control over amendments and debate. And there is no going back from that. No majority in the House of Representatives has or ever will voluntarily relinquish that power in order to give the minority greater voice in crafting legislation.
Unfortunately, the majority didn't seem to care about the concern these wise men raised and went ahead with their rule change anyway. Now we are feeling the effect.
[[Page S8615]] This power grab is having other consequences too. Today I attended a hearing in the rules committee as the ranking member, for nominees to an agency called the Election Assistance Commission. You probably never heard of it. Madam President, I doubt if you have ever heard of it. It is a small agency with 4 commissioners--2 Democrats and 2 Republicans. Nominations to bipartisan commissions have traditionally been paired and moved jointly. This practice ensured each party has a voice in such bodies.
Before the rules were changed, the minority could be assured that their consent would be needed for appointments. That assurance is now gone. Will the majority just make its own appointments to commissions such as this now? I hope not. That is under discussion in the rules committee. But what motivation do they have to ever confirm any Republican nominee, if they so choose to even consider minority views in this regard? We are going down a dangerous path, and no one knows where it will lead.
The same is true in regard to the atmosphere that we find with the affordable health care act. For some reason, the executive has decided to make any changes to the law without really considering coming back to the Senate or the House or the Congress to make these changes. So in part I come to the floor to speak about an issue that continues to keep me up every night--and every Kansan as well--that is the implementation of this affordable health care act, the health reform law.
This is, indeed, the President's legacy legislation. Based on what I am hearing from Kansans at home, I would think the President would want to be remembered for something else entirely. Unfortunately, since the implementation of ObamaCare began, the stories and reports have only confirmed the many warnings that I and my colleagues have made during the debate for the last 3 years.
People cannot keep their coverage. Despite the many, even hundreds of promises made by this President and the supporters of this law, people are losing their coverage. Premiums are increasing, even though the President and supporters of this law said premiums would decrease by $2,500 for all Americans. Most of the stories I hear, and especially from Kansans, involve many hundreds of dollars in increases in monthly premiums.
Even more recently, folks are realizing that what they had to pay in out-of-pocket costs are going to skyrocket. Deductibles are higher and the products, drugs, and services Kansans have to pay to reach their deductible has virtually exploded. This doesn't even count the increases to copays and other costs that patients are seeing, especially with regard to prescription drugs.
This is being done in a way so that patients are getting the full information they need. So much for being the most transparent government in history.
Along these lines I believe it is my responsibility to come to the floor and remind Kansans about several other provisions of ObamaCare that patients may not be aware will put the government between the patient and the doctor--their doctor. During the health care reform debate, I spoke at length in the Health, Education, Labor, and Pensions Committee and in the Finance Committee, and on the Senate floor about something called rationing, a subject that is very controversial. Specifically, I want people to know about the four rationers--boards, commissions, whatever you want to talk about--the four rationers included in ObamaCare.
First is the CMS Innovation Center, the Center for Medicaid Services Innovation Center, which was given an enormous budget to find a way to reform payments and delivery models. What this really means is CMS can now use taxpayer dollars in ways to reduce patient access to care. It gives CMS new powers to cut payments to Medicare beneficiaries with a goal to reduce program expenditures, but the reality being that they will reduce patient access.
There are new authorities also granted to the U.S. Preventive Services Task Force. The USPSTF used to be a body that was scientific and academic, that reviewed treatment, testing, and preventive health data and made recommendations for primary care practitioners and health care systems.
I guess many would agree that is still what they do today. However, the weight of their recommendations holds significantly more weight as of today, due to the Affordable Care Act or ObamaCare. Because of this law, the health care law, the USPSTF, can now decide what should and, more importantly, should not be covered by health care plans. If the USPSTF doesn't recommend it, then it will not be covered by your health plan and you will bear the cost of the procedure. We are already seeing this with prostate exams, mammograms for breast cancer, which many people say have saved their lives. You reach a certain age and they will not do a PSA test. The same kind of criteria--with some degree--to mammograms.
Rationale No. 3, the Patient Centered Outcomes Research Institute or PCORI. This outfit was given millions and millions of dollars to do comparative effectiveness research, also known as CER. I am not opposed--I don't know of any Member in this body who is opposed--to research, especially when it is used to inform the conversation between a doctor and their patients.
But there is a reason this was formerly called cost-effective research. There is a very fine line between providing information to doctors and patients to help them make the right decision that works the best for them and then using that information to decide whether the care or treatment is worth paying for. I have long been concerned that this research will be abused to arbitrarily deny access to treatments or services in order to save the government money by Federal Government decree.
Finally, there is my personal nemesis IPAB, which stands for the Independent Payment Advisory Board, and is just now making news as various people within the media are finally recognizing IPAB. This is a board made up of 15 unelected bureaucrats who will decide what gets to stay and what gets to go in Medicare coverage. They will decide what treatments and services will be covered and which will not, all to allegedly save money with no accountability. There is no accountability whatsoever.
When proposed--I remember it well both in the HELP Committee and the Finance Committee--supporters of the health care law told me we are too close to our constituents. Really? We are too close to our constituents. It makes it too difficult to make the hard decisions. Let's have somebody else do it. It will be more fair. We know them too much. We trust them too much.
I could not believe it. I believe I am elected to make the hard decisions--I and others in this body--and take the hard votes. I believe that is the way Kansans and every other State constituency also wants it.
Even worse is the fine print of IPAB. Get this. If Kansans determine they do not like the direction the IPAB is taking and call my office, and every other office in the Senate, to ask us to do something about it--to ask me to do something about it--we in Congress can overturn their decision, but it has to be by a certain margin. On the surface this sounds OK until you realize the President will never support Congress overturning the recommendation of this Board, so he will veto it. Overriding a veto takes a two-thirds vote, which is 66 votes to overturn a decision by IPAB.
My colleagues have been changing the rules around here because they think 60 votes is too high a threshold. What are the chances of reaching 66 if a decision is made by IPAB with regard to Medicare? But wait. There is more. If the Secretary appoints a board unable to make recommendations for cuts to Medicare, then she gets the authority to make the decision of what to cut. This President has already cut one-half trillion dollars from Medicare to pay for ObamaCare, and he gave himself the ability to go after even more Medicare dollars and have no accountability with IPAB. This is egregious, if not ridiculous, but it is not new.
I have been talking about the four rationers for a long time and what it means to patients. I will have more to say about it when the opportunity presents itself.
What scares me, as I watch all the other warnings and broken promises [[Page S8616]] come true, is what is going to happen to Kansans--and I know other Senators have this same fear--when the warnings about the four rationers do come true.
We need to protect the all-important relationship between the doctor and the patient, which I believe the four rationers put at risk. In order to do that, we need to repeal--and most important--and replace ObamaCare with real reforms that work for Kansans.
The Farm Bill In this atmosphere of uncertainty and new Senate order, I would like to talk about another subject that is related, for the lack of any progress we might have.
This is becoming an all too familiar situation for Kansas farmers and ranchers and all of American agriculture. In some respects we are closer to signing a farm bill into law than 1 year ago, but we still have not yet completed this important task. As 1 of the 41 Members named at the conference committee in October, I was able to give a quick opening statement outlining my biggest priorities for the farm bill, including addressing regulations that protect crop insurance and reforming SNAP; i.e., food stamps.
Unfortunately, that was the one and only time the full conference committee has met to date. With time in short supply, the four principals of the agriculture committee both in the House and the Senate--the ranking member, the chairwoman, the chairman, and the ranking member in the House--are trying to make the majority of decisions as best they can among themselves and behind closed doors.
Sometimes you can get things done behind closed doors without 37 people offering their opinion. I understand that. But with all due respect to those Members, we have real policy differences that deserve to be debated publicly, particularly in the commodity and the nutrition titles. The other 37 of us have been ready and willing to be put to work. Yet the conference committee has only met once with no future meeting scheduled.
I am very disappointed that an agreement on the farm bill may be close and yet some of our ideas and suggestions and concerns will go unheard or unanswered, such as the new environment we live in, in the Senate.
As I said during the agriculture committee markup and our only conference meeting, I have real concerns with the direction of the farm programs in this year's bill. We have what are called target prices--we might as well just say subsidies or countercyclical payments or adverse market payments--which have proven to be trade and market distorting.
For some commodities these prices are set so high that they may cover a producer's cost of production. That is right. We have a government subsidy over the producer's cost of production. That will essentially guarantee that a farmer profits if yields are average or above average.
In this budget environment, and at a time when we are looking to make smart cuts, I simply don't know how to justify this subsidy program that can pay producers more than the cost of production and essentially becomes nothing more than an income transfer program, not a risk management tool.
After the committee markup, I had hopes we could improve the farm bill to more resemble the risk-oriented and the market-based approach the Senate had previously taken, working with the distinguished chairwoman from Michigan and myself as ranking member.
Last year I worked with the Senate leadership from both parties to consider the farm bill through, of all things, regular order. Everybody had a chance to offer an amendment. The first amendment that was offered had nothing to do with the farm bill. That amendment was by Senator Paul. Regular order gave all Senators the chance to improve the bill or make their concerns known.
However, this year we considered a mere 15 amendments. The last time around it was 73 with 300 offered. Although 250 amendments were offered this time, we only had 15 amendments. All amendments regarding the new target price program were blocked from consideration and votes on the Senate floor--all of them. Senator Thune had amendments, Senator Grassley had amendments, Senator Johanns had amendments, and I had amendments. We all serve on the agriculture committee.
Of course, the real problem with farmers planting for a government program and not for the market is that these programs only serve to extend the period of low prices due to overproduction.
Besides high target prices for all commodities, the House wants to recouple payments with current production for the first time since 1996. The Chamber of Commerce has warned that if we go down this road, we will quickly invite other Nations to initiate dispute settlements against the United States and do so with a good chance of success.
I also have longstanding WTO, World Trade Organization, concerns, and the United States lost--and I mean really lost--in a case to Brazil in part because of the decoupled price program. We are still paying for that.
I am hopeful we will come to some agreement that works without further setting us up for a further trade dispute not ruled in our favor.
Another sticking point seems to be SNAP, the Supplemental Nutrition Assistance Program. I think everybody is aware of that. It is important to note that at least 80 percent of the U.S. Department of Agriculture's budget goes to nutrition programs. SNAP was exempted from across-the-board cuts known as sequestration.
The Senate bill only trims $4 billion out of a nearly $800 billion program in a 10-year budget. That is less than 1 percent of a reduction. It doesn't cut anybody's benefits. It looks at eligibility and other problems that are within SNAP.
We have the responsibility to do more to restore integrity to SNAP, eliminate fraud and abuse, while providing benefits to those truly in need.
I offered an amendment during the committee markup and on the floor that would have saved an additional $31 billion for SNAP. I thought it was a smart and responsible way which would not take away food from needy families.
The House took a similar approach and also included work requirements for food stamps and found a total of $39 billion in savings. That is about a 5-percent reduction over 10 years.
It has also been mentioned that SNAP has already been cut by $11 billion this year. However, the end of the American Recovery and Reinvestment Act of 2009 stimulus boost for food stamps was a temporary increase in benefits to assist individuals and families hurt by the recession. The end of this temporary increase is in no way related to the farm bill, and the Congressional Budget Office agrees that no budgetary savings are achieved. Reconciling the difference between $4 billion and $40 billion in savings has proven very tough so far, if not impossible. However, unlike the majority of the programs in the farm bill, if we don't have a bill signed into law, the Food Stamp Program or SNAP will go unchanged and there will be no savings or reform to the program.
Last week I spoke with the Kansas Farm Bureau--800 members of the farm bureau and their families--and once again the No. 1 priority for virtually every producer was crop insurance. Even after the devastating drought over the last few years, crop insurance has proven to work. Producers from Kansas to Illinois and all over the country are still in business helping our rural families and our communities.
In 2013, producers across the country insured a record number of acres, covering nearly 295 million acres and over $123 billion in liabilities. The takeaway message is clear: More farmers are purchasing crop insurance policies to protect their crops than ever before. In both versions of the farm bill, we are able to strengthen and preserve crop insurance. We need to keep that commitment through the final legislation.
The farm bill is the appropriate time and place to also address regulatory overreaches by the Environmental Protection Agency and the rest of the administration that impacts farmers and livestock producers. In that respect, I appreciate the House addressing several burdensome regulations that I worked on in the Senate, including pesticides, farm fuels, tank storage, the lesser prairie chicken--bless their heart--GIPSA, mandatory country-of-origin labeling, also called COOL.
Overall, I am disappointed that it looks as though we will not finish the [[Page S8617]] farm bill before the end of this year, despite the need for certainty and predictability all throughout farm country, not to mention the Department of Agriculture. Our folks back home have to make business decisions regardless of the status of negotiations.
Just one example. Kansas wheat growers have already planted their 2014 wheat crop and have been required to certify their acres; they just don't know what programs will be available to them. While we all want to provide long-term certainty to farmers, ranchers, their families, and American consumers, we have already let one extension expire in September, and the House may pursue extending the 2008 bill yet again. However, our Senate majority leader, Harry Reid, said yesterday that even if the House passes a short-term extension of the farm bill, the Senate will not pass it.
A year ago in August I went to the floor, upset with the leader for failing to consider a bill the House passed to reinstate the livestock disaster programs from the 2008 farm bill in response to the devastating drought in the Midwest. It went on for 3 years. At the time, I called it shameful and an abdication of our duty to the cattlemen and women who feed the world and warned of the costs of inaction. We were able at that time to finalize a farm bill--still the same farm bill a year later--and our livestock producers are continuing to work to rebuild their herds after multiple years of drought. Yet livestock disaster programs remain on hold. Then the devastating blizzard hit the Dakotas and Nebraska this year, and those producers were left with little Federal support--a problem we could have addressed a year ago.
All of us on the conference committee and every Member throughout Congress should be equally troubled if we leave this year without addressing the farm bill. I am committed to resolving these difficult differences in order to provide certainty and a forward-thinking farm bill that is responsible to Kansans and farmers and ranchers and consumers as well as taxpayers.
We have to end this environment here where this so-called nuclear option has really gotten us into a hole that we keep digging, whether we are trying to get a farm bill done, whether we are striving to improve the affordable health care act or repeal it, or whether we have a commission that nobody has heard of in the rules committee that is sitting doing something, but we know not really what or what to do with it.
I see the distinguished Senator from Louisiana, who I think would like to be recognized at this time, so I yield the floor.
The PRESIDING OFFICER. The Senator from Louisiana.
Unanimous Consent Request--S. 1610 Ms. LANDRIEU. Madam President, I see my good friend the Senator from North Dakota on the floor today, and I wish to yield to her to begin this very important discussion on the importance of flood insurance relief for the country. She has been an outstanding spokesperson and a true advocate to help us get this right, this Flood Insurance Program that can help sustain the program itself for the benefit of the taxpayers as well as for the people in North Dakota, Louisiana, Pennsylvania, New York, and New Jersey who depend on it so much. So let me turn to our leader, Senator Heitkamp.
The PRESIDING OFFICER. The Senator from North Dakota.