In This Section...

Sen. Murkowski [R-AK]: Mr. President, I rise to talk about the hidden taxes that American families could be forced to pay under the Baucus proposal if Congress doesn't cut half a trillion...

Record Text

HEALTH CARE REFORM -- (Senate - October 13, 2009)<p><center><pre>[Page: S. 10338]

Sen. Lisa Murkowski [R-AK]: Mr. President, I rise to talk about the hidden taxes that American families could be forced to pay under the Baucus proposal if Congress doesn't cut half a trillion dollars in Medicare services. Despite the score we saw last week by the CBO that there would be an estimated $81 billion in savings to the Federal Government, the fine print of that CBO letter paints a different picture and raises some real concerns about whether Congress has the stomach to cut $500 billion in services to the elderly and the disabled on Medicare.

This point was raised over the weekend. There were several editorials that ran in the Washington Post, Reuters, the Salt Lake Tribune, and the Colorado Springs Gazette, and they criticized the Baucus bill for unrealistically relying on $500 billion in savings in Medicare. These articles conclude that Congress is unlikely to enact Medicare cuts based on their annual action--our annual action--since 2003 that has stopped cuts to the doctors' reimbursement rates under the sustainable growth rates formula. This is what we call the SGR.

In 1997, Congress enacted the SGR formula, which automatically cuts Medicare reimbursement rates when annual spending for doctors' visits exceeds the SGR target. Every year since 2003, Congress has stepped in to prevent these cuts from going into effect. The question should be asked whether it is wrong for Congress to prevent these cuts. I suggest no, absolutely not. In fact, there is virtually unanimous agreement among Republicans, Democrats, and the President that the fixes must happen because the SGR is a flawed formula that doesn't accurately account for Medicare practice costs.

The SGR, however, is just one example of how Congress has been unwilling to not only prevent cuts to the Medicare Program but also unwilling to fix the flawed SGR formula. Except for 1 year, in 2002, when Congress allowed the 5.4-percent cut to go into effect, every year since then Congress has "fixed" the Medicare cut by affixing a Band-Aid, which has resulted in artificially adjusting the Medicare reimbursement rates and pushing larger "phantom cuts" into future years. Will this year's 21-percent cut to Medicare provider reimbursement rates go into effect? It is highly unlikely. In fact, the Baucus bill contains another Band-Aid measure that pushes this year 21-percent cut into 2010, with the notion that next year doctors will face an even larger, 25 cut under the Finance Committee proposal.

While the past is not always indicative of the future, I believe it is highly unlikely that we in Congress will witness any willingness to make a game-changing "audible" that forces half a trillion dollars in cuts to services for our seniors and for the disabled. The CBO has acknowledged this in a letter to Senator Baucus when they discussed the budgetary impact of the health care bill. CBO said:

The mechanism governing Medicare's payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments. .....The long-term budgetary impact [of the Finance Committee proposal] could be quite different if those provisions were ultimately changed or not fully implemented.

If, since 2003, Congress had stepped in to prevent Medicare cuts from going into effect, why should we expect Congress to now take the unprecedented step of cutting nearly half a trillion dollars from the Medicare Program? In fact, there was an editorial in the Washington Post last month talking about CBO's assumption of Medicare savings. They said:

Many Medicare "savings" are probably phony. Congress is likely to reverse them, as in the past. Put in that category about $200 billion in "savings" over 10 years from lower reimbursement rates for doctors, which Congress has repeatedly prevented from occurring. A separate $180 billion in "savings" from lower reimbursement for hospitals and other providers are similarly suspect. Together, these items provide about half the [Baucus plan's] financing. If half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn't he gotten started on the painless billions in "waste and fraud" savings?

That was in the Washington Post last month.

Just today, on the front page of the Washington Post, it was reported that the SGR fix included in the House bill, H.R. 3200, was stripped out of the health care reform bill that passed in three House committees of jurisdiction. Leaders in the House are citing the $240 billion cost of the SGR fix as the main reason for removing this provision. I believe Congress is being shortsighted in not addressing a major concern in the Medicare Program--a concern that not only would address reimbursement decreases that doctors have faced every year since 2002, but also the concerns about access to doctors that is worrying more and more Medicare patients every day. By stripping this important provision out of the House bill, Medicare patients are left crossing their fingers in the hopes that the SGR fix will ultimately be included in the health reform

We know the government has been promising to cut from the Medicare Program, particularly in the areas of waste, fraud, and abuse, since the Reagan administration. Yet spending continues to rise. There is no reason to believe this is going to ever change. I will not support cuts in services under the Medicare Program. I will ask my colleagues to give weighted consideration to whether they would be willing to tell their Medicare seniors and disabled constituents that they voted to cut $500 billion from their Medicare insurance. Inevitably, if the Congress cannot pass a measure to cut from Medicare, then the money will have to be made up either through increased taxes on average American families or in the form of additional deficits that will burden future generations of Americans.

Mr. President, with over $2 trillion spent on bailouts, stimulus, and cash for clunkers in just the past 22 months, we must be better stewards and more vigilant of the potential for additional costs to working families for expanding government services and creating more mandates for health insurance.

With that, I thank the Chair and suggest the absence of a quorum.

Chair: The clerk will call the roll.

Chair: The assistant bill clerk proceeded to call the roll.

Sen. Jim Webb [D-VA]: Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Chair: Without objection, it is so ordered.

Sen. Jim Webb [D-VA]: Mr. President, I ask unanimous consent to speak in morning business.

Chair: Without objection, it is so ordered.

Chair: The Senator from Virginia is recognized.

Sen. Jim Webb [D-VA]: I thank the Chair.

(The remarks of Mr. Webb pertaining to the introduction of S. 1774 are printed in today's Record under "Statements on Introduced Bills and Joint Resolutions.")

Sen. Jim Webb [D-VA]: Mr. President, I yield the floor and suggest the absence of a quorum.

Chair: The clerk will call the roll.

Chair: The assistant legislative clerk proceeded to call the roll.

Sen. Thomas Coburn [R-OK]: Mr. President, I ask unanimous consent the order for the quorum call be rescinded.

The PRESIDING Officer. Without objection, it is so ordered.