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John C.
Republican TX

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  • Nomination of Melvin L. Watt to Be Director of the Federal Housing Finance Agency—Continued

    by Senator John Cornyn

    Posted on 2013-12-10

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    CORNYN. Madam President, 4 years ago Members of both parties came to this Senate floor virtually every day to discuss the problems with America's health care system and offered suggestions for how we could remedy that.

    I distinctly remember being here on Christmas Eve, 2009, at 7 in the morning and witnessing a party-line vote on ObamaCare. All of our Democratic friends voted for it, and all Republicans voted against it. I guess the most charitable thing I can say is that our Democratic friends actually thought it would work while Republicans were skeptics about this big government takeover of one-sixth of our national economy.

    Well, 4 years later the cost of ObamaCare has become abundantly clear. I don't think it is an exaggeration to say that ObamaCare is the biggest case of consumer fraud ever perpetrated in this country. A law that [[Page S8588]] was supposed to expand coverage to those without it has instead caused millions of people with coverage to lose their coverage. A law that was supposed to improve patient access has instead resulted in smaller provider networks where people are restricted in terms of the doctors and hospitals they can see, making it much more likely that people will not be able to keep their doctors, should they want them. A law that was supposed to bend the cost curve down has instead caused individual and family premiums to skyrocket.

    We have heard story after story that even if the premiums are lower, people, due to copays and deductibles, are finding themselves with thousands and thousands of dollars of deductibles they didn't previously have, meaning it is more money out of their pocket before the insurance actually kicks in.

    We were told this was supposed to make Medicaid the safety net program for the most economically disadvantaged among us.

    We were told that Medicare for seniors was supposed to make them stronger. Instead it has made them weaker.

    A law that was supposed to help our economy has instead hurt our economy by discouraging full-time job creation, because if you have a full-time job your employer has to pay for the full ObamaCare pricetag. Due to ObamaCare businesses have been moving people from full-time work to part-time work.

    A number of labor organization leaders went to the White House a few months ago and called the implementation of ObamaCare a nightmare. They said it made full-time work part-time work. It is worse than that.

    ObamaCare has hampered medical innovation by taxing the very people who build medical devices here in America and is causing them to move those businesses offshore or simply cut down their hiring. It has placed costly new burdens on small businesses, the entities which produce as much as 70 percent of the new jobs in America. It is not the Fortune 500 companies that create the vast majority of jobs in America, it is the small mom-and-pop operations, the entrepreneurs who create those jobs, and that is who ObamaCare hits the hardest.

    It is no wonder our economy continues to struggle. It is no wonder the labor participation rate--the number of people who are actually in the workforce--is at a 35-year low. People have given up looking for work, and that is an American tragedy.

    As I stand here today, the broken promises of ObamaCare are causing enormous distress and financial hardship for people all across my State of Texas and all across America. It is undeniable that millions of Americans have lost their insurance because of ObamaCare despite President Obama's almost daily recitation that if you like what you have, you can keep it. He was making that promise as late as 2012, and we knew it wasn't true. We knew it was not true--and he knew it wasn't true--as early as 2010 when we debated some restrictive grandfather regulations from the Department of Health and Human Services.

    Senator Enzi, who was the ranking member of the Health, Education, Labor and Pensions Committee, tried to get it fixed, and again we saw a party-line vote. All of our Democratic friends said, no, let's not provide flexibility for the grandfather provisions. Let's maintain the rigid grandfather provisions which have now resulted in more than 5 million people getting notices telling them that even though they like the policies they have, they can no longer keep them. That is why I have said this is one of the biggest cases of consumer fraud ever perpetrated in the United States by virtue of its scope and the audacity with which these promises were made time and time again, which are demonstrably not true. They are false.

    We know ObamaCare is leading to a dramatic spike in insurance premiums for many people who buy their insurance in the individual market. My colleagues will recall that during and after the 2008 Presidential election, President Obama repeatedly told Americans his health care plan would reduce their health care premiums for a family of four by about $2,500. I don't know where he came up with that number, but it turned out to be just another broken promise.

    According to the Kaiser Family Foundation, annual premiums for employer-based family health insurance increased by nearly $3,000 between 2009 and 2013. In other words, the President was $5,500 wrong. Rather than going down $2,500, they went up $3,000. For that matter, a recent study by the Manhattan Institute estimated that ObamaCare will drive up individual premiums by an average of 41 percent.

    I don't know many hardworking American families who can afford a 41- percent increase in their health care costs as a result of a law promising that health care would be more affordable. The single biggest increase, according to this study, will be in the majority leader's home State of Nevada where individual premiums are projected to rise by an astounding 179 percent. The increases in New Mexico, Arkansas, and North Carolina are 142 percent--that would be New Mexico; 138 percent, that would be Arkansas; and 136 percent in North Carolina. What do each of these States have in common? They are represented by Senators who voted for this bill, perhaps believing what the President said would be true, but their constituents are having to pay the price.

    Such premium increases are particularly burdensome for senior citizens and other folks on a fixed income. For example, recently in Copper Canyon, TX, one of my constituents wrote to me and said that because of ObamaCare, her monthly premiums were increasing by $200, which is only $27 less than her monthly Social Security income. In other words, it takes up almost the entire amount of her Social Security check for her to purchase this insurance. That is wrong.

    In addition to premium hikes, many Americans entering the ObamaCare exchanges are facing higher deductibles. I mentioned that a moment ago. In a front-page story just yesterday in the Wall Street Journal, it was reported that many ObamaCare deductibles are so high that people with modest incomes may not be able to afford the portion of medical expenses that insurance doesn't cover. What is that all about? In fact, according to one study, the average deductible for the cheapest individual coverage on the Federal ObamaCare exchange is 42 percent higher than the average deductible for individual health insurance earlier this year, before most of ObamaCare kicked in--a 42-percent higher deductible. As we know, many of these deductibles we are hearing are in the $4,000 and $5,000 range for individuals and they are up to $10,000 or more for married couples. I don't know many households in Texas or across America that can absorb $10,000 in a deductible for their health insurance policy. Certainly that doesn't strike me as a success if the purpose is to cover health care costs and to prevent people from suffering economic hardship as a result. That strikes me as an epic failure. In other words, ObamaCare is making it significantly harder for many Americans to pay their bills, to buy groceries, and take care of their families.

    Again, as I have said many times before, it didn't have to be this way. It didn't have to be this way. In 2009, polls demonstrated that the overwhelming majority of Americans who had health insurance liked what they had, and they were broadly satisfied with it. I assume that is why the President said: If you like what you have, you can keep it, because about 90 percent of the respondents said: We like what we have. So if you are the President trying to sell this so-called Affordable Care Act, you wouldn't want to scare that 90 percent of people into thinking they can't keep what they have even though they like it. So you misrepresent what you are selling. You tell people you can keep what you have and your premiums are going to go down and it is all going to be all right.

    If we had focused on those people who either did not have coverage or who had inadequate coverage--obviously a smaller subset of Americans than the whole country--if we focused on them and dealt with their challenges in purchasing health insurance, we could have done much better. There were millions more who had low-quality Medicaid coverage that many doctors refused to accept because, in my State, Medicaid pays a doctor about 50 cents on the dollar compared to private insurance. Many doctors said: Look. I [[Page S8589]] want to see more Medicaid patients, but I simply can't afford to do it. I have to opt for higher paying private insurance patients. We know Medicare was facing a fast approaching bankruptcy date. What Congress could have done--what we should have done--is to enact sensible, narrowly drawn, targeted reforms, No. 1, aimed at improving the coverage options for each of these groups and strengthening and preserving Medicare and Medicaid. We needed to bring down the costs, not jack up the costs.

    If we ask most people the biggest problem they have with their health insurance, they say it costs too much, and we have made it worse. It is worse, not better. To bring down the costs, we could have allowed people to buy health insurance across State lines. I know that doesn't sound like a panacea, but most States have captive insurance markets and many State legislatures, including the Texas legislature, have mandated coverage that many people simply don't want, but it adds to the cost of their health insurance. So I could have the choice to buy insurance across State lines if we enacted this reform. If I liked the insurance coverage of Wisconsin or Louisiana or somewhere else, and if that suited my needs, I could buy it there and we would have a true competitive market and people would compete based on quality and price, but we don't have that now.

    What else could we have done? We could have expanded the use of tax- free health savings accounts paired with high deductible plans, such as the kind I talked to a number of my constituents in Austin, TX, about who are employed at Whole Foods. They cover roughly 80 percent of the out-of-pocket costs for health insurance through health savings accounts and high deductible insurance, and the employees--I think it is still the case; it was then--still vote on an annual basis for what kind of coverage they want. They vote for this type of coverage because they are satisfied with it and it gives them a sense of ownership, which is actually true, because the money put in a health savings account they get to keep and if they don't use it on their health care, then they get to save it, the same as with an IRA or something such as that. But it also changes the calculation. It makes people much smarter shoppers and it moves us further along to a system where people can shop for their health insurance and their health services as they do with everything else and it will bring down costs and it will improve quality of service as a result of competition for that business.

    We could have cracked down on frivolous medical malpractice lawsuits which cause defensive medicine. Just think about it. If a doctor is worried about losing everything they have worked a lifetime to achieve in terms of assets and their medical practice, the last thing they want to do is be subjected to a lottery-type lawsuit. So the easiest thing for those doctors to do--I know they don't do it on purpose--is make the decision to provide a test or a treatment based not so much on a patient's clinical situation but based on their desire to not be sued and to not be second-guessed 2 years later when somebody comes in and says you should have done this or that. So the temptation is to do everything and to run up the cost of health care coverage.

    These are just a few examples. But by lowering costs across the board, these reforms--which I talked about and which the President and his political party rejected--could have helped people who already had coverage and we could have helped those who previously could not have afforded coverage. Some people--if I have heard it one time, I have heard it a thousand times--said we need ObamaCare because people with preexisting conditions couldn't get coverage. That is a serious concern. But we already have in place high-risk pools in the States, and if we needed to help those States provide coverage to people with those high-risk health conditions, we could have done it a whole lot cheaper and a whole lot more efficiently than creating this huge monstrosity, this huge bureaucracy, this huge expense known as ObamaCare.

    We could have increased funding to the high-risk pools that were already operating in about three dozen States. The irony is that the people in the high-risk pool in Texas got a letter that said their coverage has been canceled effective December 31--the very people ObamaCare was supposed to help--your coverage is canceled because ObamaCare kicks in January 1. But because people were worried about their ability to get on the exchanges due to the Web site problems, the Texas legislature and the Texas Department of Insurance decided to extend the coverage of the high-risk health insurance pools in Texas so people wouldn't fall through the cracks because of this train wreck of a rollout of ObamaCare.

    How about Medicaid. We hear a lot of discussion about Medicaid. I have already mentioned that Medicaid only reimburses doctors about half what a private insurance policy would, so a lot of doctors simply can't afford to see a new Medicaid patient. In Texas, only one doctor out of three will see a new Medicaid patient for that reason. It is not because they don't want to; it is simply because they can't afford to do so. We could have made it a lot easier for States to bolster their Medicaid Program and deliver targeted policies that would allow them to manage Medicaid populations, for example; create a medical home, for example. But because of the redtape Washington refused to cut, Medicaid ends up in many instances being an appearance of coverage, but people can't find a doctor who will see them. What good is that? That is, to me, a sleight of hand and part of the reason I call this one of the biggest cases of consumer fraud in American history.

    To help Medicare patients--who are, of course, our seniors--we could have increased private competition and patient choice by embracing the premium support model that was endorsed by 10 members of President Clinton's Medicare Commission back in 1999. That is not a partisan solution; it is one President Clinton's Medicare Commission embraced back in 1999.

    The reforms I have just outlined would have given us a genuine national marketplace for individual health insurance. Unfortunately, our friends across the aisle and our President decided to take a different path with the Affordable Care Act or ObamaCare. Unfortunately, the folks who designed ObamaCare consciously chose to destroy the individual market and force millions of people to pay for Washington-mandated coverage they didn't need and they didn't want and at a price they can't afford. Rather than adopt measures to bring down the costs and coverage issues for a subset of the population, the roughly 10 percent who weren't among those 90 percent who said they like what they had, the President and his allies chose to wreck the existing health care system--to wreck it, to make it worse, not better.

    As a result, they have made the cost problem worse. They have jeopardized physician access for millions of Americans who like their current health plans and wish to keep them. And, of course, now the administration is boasting that the Web site is mostly fixed. Indeed, by most objective reports, people are not experiencing the same sort of epic failure they did when they first tried to get into the Obama exchanges. But at this point the President and his allies have lost all credibility with regard to other aspects of ObamaCare, which I have mentioned. Fixing the Web site will not fix the underlying deficiencies of ObamaCare. These are not glitches. These were baked in the cake. These were designed. This is the way ObamaCare was created and was supposed to work, notwithstanding the fact that the American people had been sold a bill of goods to the contrary.

    Indeed, the only way to solve America's biggest health care challenges is a do-over, to replace ObamaCare with the sort of patient- centered reforms I mentioned a few moments ago. ObamaCare may be a complete disaster, but it is not too late for us to work together to fix what is broken and to start over.

    I yield the floor.

    The PRESIDING OFFICER. The Senator from Wyoming.

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