October 13,2009

Grassley: Partisan Health Care Reform Bill is Deeply Flawed

Mr. Chairman, first of all, I want to commend you for bringing this markup to where it istoday. It seems like a long time since we started on September 22nd. We’ve been able toair our differences and have the votes. I wish I felt better about the substance of the bill.The chairman’s mark has undergone many changes during this process and they are notto the good. I’ll highlight a few of the changes I find most disturbing. As I highlightthese issues, it will be clear that this bill is already sliding rapidly down the slippery slopeto more and more government control of health care.

It has the biggest expansion of Medicaid since it was created in 1965.It imposes an unprecedented federal mandate for coverage backed by the enforcementauthority of the Internal Revenue Service.

It increases the of the government by at least $1.8 trillion when fully implemented.It gives the secretary of Health and Human Services the power to define benefits forevery private plan in America and to redefine those benefits annually. That’s a lot ofpower over people’s lives.

It will cause health care premiums for millions to go up, not down.It tightens further the new federal rating bands for insurance rates. That means thatmillions who are expecting lower costs as a result of health reform will end up payingmore in the form of higher premiums. The new rating reforms alone will raise premiumsby as much as 50 percent on millions.

It imposes new fees and taxes. These new fees and taxes will total about a half trilliondollars over the next few years. On the front end, these fees and taxes will cause premiumincreases as early as 2010 even before most of the reforms take effect.

Then after forcing health premiums to go up, this bill makes it mandatory to buy it.On several occasions, Republicans tried to take the chairman’s mark in a differentdirection. We tried to ensure that the President’s pledge to not tax middle-incomefamilies, seniors, or veterans was carried out. We were rebuffed every step of the way.And Republican efforts to provide consumers with a lower cost benefit option wereconsistently defeated – this means that despite the promises, a lot of people aren’tactually going to be able to “keep what they have.”

It imposes higher premiums for prescription drug coverage on seniors and the disabled.And it creates a new Medicare commission with broad authority to make further cuts inMedicare and it makes that commission permanent.

In our group of six negotiations, I resisted making the commission permanent. And Icertainly wasn't going to agree to target prescription drug premiums.

But this bill now requires the Medicare commission to continue making cuts to Medicareforever. The damage this group of unelected people could do to Medicare is unknown.What's more alarming is that so many providers got exempted from the cuts thiscommission would make that it forces the cuts to fall directly on seniors and the disabled.The Congressional Budget Office has confirmed that the commission structure requires itto focus its budget axe on the premiums seniors pay for Part D prescription drug coverageand for Medicare Advantage.

Sooner or later, it has to be acknowledged that, by making the commission permanent,those savings are coming from more and more cuts to Medicare.

Finally, I can’t help but note the incredible cynicism in an amendment that took benefitsaway from children. That amendment was offered and passed because the chairman’smark had the audacity to let children get covered through private insurance.In 41 states, children would have received access to the EPSDT benefit.EPSDT benefits cover vitally needed services for children such as rehabilitation services,physical, occupational and speech therapy particularly for children with developmentaldisabilities.

But those benefits were deleted by Rockefeller Amendment C21. Now children in 41states won’t have access to health care and they’ll be left in a grossly underfunded publicprogram. And they lost these important benefits.

What this mark up has shown is that there is a clear and significant philosophicaldifference between the two sides.

Throughout the markup, we have focused on trying to reduce the overall cost of the bill.We were told ‘no’.

We focused on trying to reduce the pervasive role of government in the chairman’smark. We were told ‘no’.

We tried to make it harder to for illegal immigrants to get benefits. We were told ‘no’.We tried to guarantee that federal funding for abortions wouldn’t be allowed under thisbill. We were told ‘no’.

We tried to allow alternatives to the individual mandate and harsh penalties. We weretold 'no'.

We tried to reward states with extra Medicaid dollars if they passed medical malpracticereform. We were told not just ‘no’ but shockingly we were told Medicaid isn’t even inthe committee’s jurisdiction.

We have watched while the other side has expanded public coverage.We saw Democrat amendments move millions from private coverage into publiccoverage.

We saw Democrat amendments create new government programs that cover familiesmaking close to 90 thousand dollars.

And at the end of the day, after raising billions in new taxes, cutting hundreds of billionsfrom Medicare, and imposing stiff new penalties for people who don’t buy insurance, andincreasing costs for those that do … 25 million people will still not even have healthinsurance.

I don’t think this is what the American people had in mind when we promised to fix thehealth care system.

As I said when this process started, the chairman’s mark that was released 27 days agowas an incomplete, but comprehensive, good faith attempt to reach a bipartisanagreement.

But then the modification pulled that attempt at bipartisan compromise very far toward apartisan approach on several key issues.

With this markup nearing its conclusion we can now see clearly that the bill continues itsmarch leftward.

The broad bipartisan character of the reform proposal has changed.

This partisan change is precisely what Republicans feared would occur at later stages inthe legislative process.

Today we see that those fears were legitimate and justified.

Nevertheless, I still hold out hope that at some point the doorway to bipartisanship will beopened once again.

I hope that at some point the White House and leadership will want to correct the mistakethey 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.