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Senate Proceeding on Mar 1st, 2010 :: 0:25:45 to 0:47:10
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Lamar Alexander

0:25:38 to 0:25:58( Edit History Discussion )

Lamar Alexander: quorum call: mr. alexander: the presiding officer: the senator from tennessee. mr. alexander: mr. president, call be vitiated. the presiding officer: without objection. mr. alexander: mr. president, i ask consent to speak in morning business for up to 15 minutes. the presiding officer: without objection. mr. alexander: thank you. mr. presi would the chair please let me know when i have consumed 12 of the 15 minutes. the presiding officer: yes, sir.

Lamar Alexander

0:25:45 to 0:47:10( Edit History Discussion )
Speech By: Lamar Alexander

Lamar Alexander

0:25:59 to 0:26:19( Edit History Discussion )

Lamar Alexander: mr. alexander: thank you very much. mr. president, it was my privilege last thursday, along with somother members of the senate, to attend a health care summit at the invitation of present obama. it went on a long time, and we learned one thing we already knew, that our president is smart, knows a lot about health care. and so i stayed the whole time.

Lamar Alexander

0:26:20 to 0:26:43( Edit History Discussion )

Lamar Alexander: but it gave those of us on the don't have the opportunity to have as often, which is to be on center stage and let the american people know, a, who we are and, b what our ideas are. so it was a terrific idea for us to say, for example, that we are -- our goal is to reduce health care costs, that we'd like to

Lamar Alexander

0:26:44 to 0:27:04( Edit History Discussion )

Lamar Alexander: move step by step toward that goal. we identified a number of areas, for example, allowing insurance to be transferred across state lines, limiting junk lawsuits, which would bring down the cost of premiums, which is what americans want. during the discussion early on, actually, the president and i had a little disagreement about whether his plan, which is based

Lamar Alexander

0:27:05 to 0:27:26( Edit History Discussion )

Lamar Alexander: on the senate bill, which passed on christmas eve, would raise premiums. what i had said in my opening remarks on behalf of republicans was that millions of americans under the democratic plan would pay higher insurance premiums because of government mandates and taxes. the president says that's wrong. i cited a congressional budget

Lamar Alexander

0:27:27 to 0:27:48( Edit History Discussion )

Lamar Alexander: ofce report to show i was right, and rather than dispute the president of the united states in public, i thought i had had enough time to make my case -- i said i would send li him a letter, which i did that same day. so i would like to ask unanimous consent the letter that i gave to president obama on thursday. the presiding officer: without objection.

Lamar Alexander

0:27:49 to 0:28:10( Edit History Discussion )

Lamar Alexander: mr. alexander: the president's argument -- but today what i'd like to do in the next few minutes is explain why i believe i am correct; that under the president's health insurance plan, which is based upon the senate plan, for millions of americans premiums would go up, because of one-size-fits-all government mandates, because of

Lamar Alexander

0:28:11 to 0:28:31( Edit History Discussion )

Lamar Alexander: taxes that are passed on to consumers, but for other reasons as well -- by shifting costs when you dump 15 million people or 18 million people into a program called medicaid, what happens is, we don't pay the doctors and the hospitals well enough to take care of those folks so they shift the cost to people who are paying with private insurance and premiums

Lamar Alexander

0:28:32 to 0:28:52( Edit History Discussion )

Lamar Alexander: go up. costs for young people will go up under this plan because if you put in a rule at that says my insurance at my age can't go up more than a certain amount, compared with my son's insurance, then his insurance goes up.

Lamar Alexander

0:28:53 to 0:29:17( Edit History Discussion )

Lamar Alexander: and because in a scheme like the democratic plan depends upon requiring everybody to buy insurance, there is a weak provision for that, and i suspect many young people would just rather pay the $750 fine rather than the $2 -- by a $2,500 insurance policy, which they think they can't aforward. the president made the point in

Lamar Alexander

0:29:18 to 0:29:39( Edit History Discussion )

Lamar Alexander: his unusual very persuasive way, that wait a minute, you'd be getting better insurance. as george will said on abc's "this week" yesterday, he sai "if the government required you to buy a better, more expensive car, even if it was better than the car you've got, it would still be more expensive, wouldn't it?"

Lamar Alexander

0:29:40 to 0:30:00( Edit History Discussion )

Lamar Alexander: and that's the case with the president's health care plan. in fact, premiums will go up for millions of americans. up more than they otherwise would over the next several years, and we all know how rapidly they're rising. and the whole exercise that we're going through over the last year is to bring premiums down.

Lamar Alexander

0:30:01 to 0:30:23( Edit History Discussion )

Lamar Alexander: not help drive premiums up. what i said to the president with respect was that the congressional budget office on november 30 said this about the senate bill. the congressional budget office -- quote -- "and the joint committee on taxation estimate that the average premium per person covered for new nongroup" -- that means individual

Lamar Alexander

0:30:24 to 0:30:45( Edit History Discussion )

Lamar Alexander: policies -- "would be about 10% to 13% prior in 2016 understand that the same in the same year under current law. if you buy an individual policy that means not a policy with your employer, that by 2016, it

Lamar Alexander

0:30:46 to 0:31:07( Edit History Discussion )

Lamar Alexander: will be at an average of 10% to 13% higher than it otherwise would. mr. president, i ask unanimous consent to include in the record the relevant parts of the congressional budget office letter of november 30 to senator evan bayh on this point. the presiding officer: without objection. mr. alexander: the president said wait a minute, the premiums in the individual market will go down 14% to 20%.

Lamar Alexander

0:31:08 to 0:31:30( Edit History Discussion )

Lamar Alexander: that's also in the same letter. and, of course, he's right about that, they go down because of administrative efficiencies and new enrollment, but he left out that there are other factors there that the government mandates will drive them up 27% or 30% or, in the end, the average, as the c.b.o. said, premium per person covered in an individual policy would be up

Lamar Alexander

0:31:31 to 0:31:53( Edit History Discussion )

Lamar Alexander: 10% to 13%. now, the bill has subsidies in it for some americans. the same letter says about half of americans who buy in the individual market will get a subsidy. well, we are paying for that subsidy but let's concede that point. still, that leaves half of the people in the individual market

Lamar Alexander

0:31:54 to 0:32:14( Edit History Discussion )

Lamar Alexander: for whom premiums will go up on an average of 10% 2013%. now, why -- my 10% to 13%. now, why is that? one reason is because the senate bill says people will have to buy a richer policy than they have today. that means it has a higher actuarial value. they call it in the bill minimum creditable coverage.

Lamar Alexander

0:32:15 to 0:32:35( Edit History Discussion )

Lamar Alexander: it means this is the amount of insurance i think you should have before you buy a policy. that might b a good decision. it undoubtedly would be good to have the insurance. it just costs more, 27% to 30% more than today's average. the national federation o independent businesses wrote a december 12 letter in opposition

Lamar Alexander

0:32:36 to 0:32:56( Edit History Discussion )

Lamar Alexander: to the senate bill saying -- quote -- "that the benefit mandates will put small business owners" -- quote -- "at risk of having to drop coverage due to increases that outpace their health budgets." mr. president, i'd like to ask unanimous consent to include the letter from nfib from senator reid and senator mcconnell of december 8.

Lamar Alexander

0:32:57 to 0:33:18( Edit History Discussion )

Lamar Alexander: the presiding officer: without objection. mr. alexander: the one-size-fits-all provision in the democratic bill says that all individual and small group policies muff an actrial -- must have an actuarial value of 60%. now, senator susan collins of maine, who was the insurance commissioner in maine herself, made a speech on the senate floor and pointed out that 87%

Lamar Alexander

0:33:19 to 0:33:40( Edit History Discussion )

Lamar Alexander: of the policies, the individual policies that are purchased in maine today would cost more under the reid bill. mr. president, i'd like to ask unanimous consent to include in the record senator collins' repos of december 18. the presiding officer: witho objection. mr. alexander: she used the example the most popular individual market policy sold in maine cost a 40-year-old about $185 a month.

Lamar Alexander

0:33:41 to 0:34:04( Edit History Discussion )

Lamar Alexander: under the senate bill, that 40-year-old would have to pay at least $420 a month, more than twice as much for a policy that meets the new minimum standard or face a $750 penalty. now, it is true that maine citizens, like all americans, about half of them would receive subsidies to help them buy that policy, but the other half of

Lamar Alexander

0:34:05 to 0:34:25( Edit History Discussion )

Lamar Alexander: the7%, their average premium is going to go up under the democratic bill. we believe americans ought to have more choices than that. that's a fundamental difference of opinion. should washington decide you need to buy a richer policy or should you decide that for yourself based upon the other needs in your family?

Lamar Alexander

0:34:26 to 0:34:47( Edit History Discussion )

Lamar Alexander: the congressional budget office does state, as i have mentioned, that there are a number of enrollees, about half, would have the subsidies and that's in the letter that i've already introduced into the -- into the record. but someone's paying for those subsidies, mr. president: the taxpayers are paying for them.

Lamar Alexander

0:34:48 to 0:35:10( Edit History Discussion )

Lamar Alexander: which brings up the second reason that i said on thursday that premiums for millions of americans in the individual market will go up. the commonsense ideas that if you tax an insurance company or a medical device company or a manufacturer of drugs, they'll pass the taxes on to whom?

Lamar Alexander

0:35:11 to 0:35:31( Edit History Discussion )

Lamar Alexander: to us, who are buying insurance policies, or medical devices, or drugs. so we end up paying. in fact, one part of the president's proposal delirately does that. it's a 40% excise tax on insurance company for what we call cadillac plans, the high-cost private insurance plans. the joint committee on taxation

Lamar Alexander

0:35:32 to 0:35:52( Edit History Discussion )

Lamar Alexander: on february 24 -- and i'd like to ask consento include their letter in the record -- the presiding officer: without objection. mr. alexander: -- says that that 40% excise tax will raise $32.7 billion, all of which will be passed along to consumers in the form of higher insurance premiums. now, that may be a good thing,

Lamar Alexander

0:35:53 to 0:36:14( Edit History Discussion )

Lamar Alexander: mr. president, because, in fact, i think it is because it helps to discourage the purchase of more expensive policies but it does raise premiums in the individual market. and the -- the joint committee on taxation memorandum on high-cost plans dated september

Lamar Alexander

0:36:15 to 0:36:35( Edit History Discussion )

Lamar Alexander: 29 says the excise tax would be mainly passed along through increases in premiums. i'd like to ask consent to include that letter in the record the presiding officer: without objection. mr. alexander: and because the new taxes index to regular inflation plus 1% instead of medical inflation, which goes up very much higher and quicker, the new tax, like the alternative minimum tax, will

Lamar Alexander

0:36:36 to 0:36:56( Edit History Discussion )

Lamar Alexander: pretty soon start to hit chevy and buick insurance policies and not just cadillac policies. but there are other taxes in the president's proposal -- they're up to $500 -- half a trillion dollars in new taxes -- which will be passed on to consumers. $20 billion on excise taxes on lifesaving medical devices,

Lamar Alexander

0:36:57 to 0:37:17( Edit History Discussion )

Lamar Alexander: $33 billion on drugs, $60 billion on health insurance companies. in a c.b.o. and j.c.t. letter to senator grassley of december and october, both of last year, both said these taxes will be passed on to patients, increasing health insurance premiums. i'd like to include those letters in the record. the presiding officer: without objection.

Lamar Alexander

0:37:18 to 0:37:38( Edit History Discussion )

Lamar Alexander: mr. alexander: the center for medicare and medicaid services, the chief actuary of the obama administration, said "we anticipate such fees would be generally passed through to health consumers in the form of higher drug and device prices and higher insurance premiums." that was on december 10 of this year about the senate bill. i'd like to include -- i ask consent to include the relevant portions of that letter in the

Lamar Alexander

0:37:39 to 0:38:00( Edit History Discussion )

Lamar Alexander: record. the presiding officer: without objection. mr. alexander: the lewen group said on october 30 -- quote -- " "costs would increase steadily reflecting the various excise taxes included under the act. total health insurance spending would increase by 32.1% by 2019."

Lamar Alexander

0:38:01 to 0:38:21( Edit History Discussion )

Lamar Alexander: i'd like to ask consent to include within the record the relevant portions of the lewen group report. the presiding officer: without objection. mr. alexander: the national association of independent businesses letter says the same. i thank the president. there are other reasons why the premiums will go up. there is -- mr. president, seeing no one else here, i wonder if i might ask for five additional minutes.

Lamar Alexander

0:38:22 to 0:38:42( Edit History Discussion )

Lamar Alexander: the presiding officer: without objection. mr. alexanr: i thank the president. here's a third reason, in addition to government mandates and taxes, that will cause premiums to rise. we call it cost-shift. premiums will increase because the bill dumps 15 million -- 15 million to 18 million more americans into the government

Lamar Alexander

0:38:43 to 0:39:03( Edit History Discussion )

Lamar Alexander: program called medicaid. this is the analysis of the chief actuary on january 8, 2010. i'd like to include the relevant portions -- i ask consent to include that in the record. the presiding officer: without objection. mr. alexander: the point is, is medicaid only pays doctors and hospitals about 60% of the costs of serving the 60 million

Lamar Alexander

0:39:04 to 0:39:26( Edit History Discussion )

Lamar Alexander: patients who are now there. the democratic bill would add 15 million to 18 million more patients, so what do the doctors and hospitals do? they see these patients but then they shift the costs to the patients they see who have private insurance. the president himself said that that adds about $1,000 to every

Lamar Alexander

0:39:27 to 0:39:49( Edit History Discussion )

Lamar Alexander: policy today, this cost-shifting. and i -- and i've included that from -- that comment from the chief actuary. the price waterhouse coopers report on the senate finance bill on october 2009 said -- quote -- "the net effect of the bills before congress will made the medicare and medicaid cost-shift even more severe,

Lamar Alexander

0:39:50 to 0:40:10( Edit History Discussion )

Lamar Alexander: raising the cost of private insurance premiums for large employers by $255 a year between 2015 and 2019." i'd like to ask unanimous consent to include the relevant portions of the pricewaterhouse coopers report. the presiding officer: without objection. mr. alexander: younger americans will pay higher premiums under the democratic plan because, as i mentioned earlier, it will

Lamar Alexander

0:40:11 to 0:40:31( Edit History Discussion )

Lamar Alexander: mandate that there can't be more than a difference of -- that i can't pay more than three times as much as my son could pay for an insurance premium. that might help keep my premiums down but it's going to send his up, pretty far up, because 42 states, including tennessee, allow more variance of that.

Lamar Alexander

0:40:32 to 0:40:54( Edit History Discussion )

Lamar Alexander: so young people across america, who include about 40% of the uninsured, are in for a big surprise when their policies jump up 30% to 35%, is what the oliver wyman report of september 28 said theirs might do. or when, since they're uninsured, they're required to buy insurance and they find the insurance they're required to buy is very expensive. i'd like to ask unanimous

Lamar Alexander

0:40:55 to 0:41:15( Edit History Discussion )

Lamar Alexander: consent to include in the record the relevant portions of thely oliver wyman report. the presiding officer: without objection. mr. alexander: finally, mr. president, the young and the healthy can skip out of that. that will drive up premiums. they may decide they will pay $750, fine, than pay $750 for an insurance policy they think they don't need.

Lamar Alexander

0:41:16 to 0:41:38( Edit History Discussion )

Lamar Alexander: the american academy of actuaries wrote a letter on the reid bill on november 20, said, "any premium vairgses by age limited to 3.1 ratio between the highest and lowest premiums," and then it goes on to say, "would cause higher pmiums on average relative to current premiums." i ask consent to include in the record the letter from the american academy of actuaries,

Lamar Alexander

0:41:39 to 0:41:59( Edit History Discussion )

Lamar Alexander: november 20, 2009. now, all in all, mr. president, these factors suggest why, when senator collins took a look at maine, she found that 87% of people in maine are paying less for their individual policies than the policies would cost under the reid bill.

Lamar Alexander

0:42:00 to 0:42:21( Edit History Discussion )

Lamar Alexander: it is true that half or more of them would receive some subsidy which would reduce their cost, but around half of them will pay more. and in tennessee, bluecross blueshield, which covers about one-third of ten's individual market -- of tennessee's individual market, estimates the premiums for those individuals will increase by 30% to 45% under the reid bill.

Lamar Alexander

0:42:22 to 0:42:44( Edit History Discussion )

Lamar Alexander: and i ask unanimous consent to include a chart which demonstrates that. the presiding officer: without objection. mr. alexander: at our summit on thursday, there were a number of good ideas about reducing health care costs that the president seemed to share with republican members who were there, and there was some obvious irritation on the part of the majority leader and others when

Lamar Alexander

0:42:45 to 0:43:05( Edit History Discussion )

Lamar Alexander: we said th there are a trillion dollars of cuts in medicare, which there are, mr. president. and our real objection to it is that the cuts are not used to ve medicare, which is going broke, but spent on a new program. and there are a half a trillion in new taxes. there are a half a trillion in new taxes. and as i just said, they tend to increase premiums for millions of americans.

Lamar Alexander

0:43:06 to 0:43:29( Edit History Discussion )

Lamar Alexander: there are premium increases. there is a deficit increase. now, it is true that the c.b.o. has said that what was presented to them didn't increase the deficit but what was not include -- included in what was presented was paying doctors to serve patients in the government program. that's like having a horse race without the horses. i mean, how are you going to have a comprehensive health care

Lamar Alexander

0:43:30 to 0:43:50( Edit History Discussion )

Lamar Alexander: bill and not include within its cost paying doctors to serve patients in the government programs. and when you put it in, the deficit goes up. and then there's the problem of the passing off to states these expanded medicare -- medicaid costs without paying for them. i know as a former governor --

Lamar Alexander

0:43:51 to 0:44:12( Edit History Discussion )

Lamar Alexander: and i see the former governor of virginia in the chair -- i struggled with that every single year, and all the governors are today of both parties. they don't want us sending them a bill for expanded health care. they can't pay the bills they've got. and -- and we shouldn't do that. if we want to expand it, we should pay for it. that's another part of the bill. mr. president, i came to the

Lamar Alexander

0:44:13 to 0:44:33( Edit History Discussion )

Lamar Alexander: floor today to, one, to express my appreciation to the president for inviting us thursday. it gave us a chance to show who we are and what we're for. i thought it was a good discussion. i believe there are eight or ten, maybe a dozen different good ideas senator coburn and people on both sides of the aisle suggested. some differences between those ideas, but basically they

Lamar Alexander

0:44:34 to 0:44:54( Edit History Discussion )

Lamar Alexander: represent a way to move forward to reduce health care costs. that's really what we ought to do. we don't do comprehensive very well in the united states senate. immigration, comprehensive immigration failed of its own weight. comprehensive economy-wide cap-and-trade seems to be failing again of its own weight. comprehensive health care is

Lamar Alexander

0:44:55 to 0:45:16( Edit History Discussion )

Lamar Alexander: very difficult to pass. that shouldn't be a surprise to any of us. this is a very big, difficult, complicated country with people of many different background. in my judgment, we're just not wise enough for a few of us to rewrite the rules for 17% of our economy, and i think the

Lamar Alexander

0:45:17 to 0:45:39( Edit History Discussion )

Lamar Alexander: american people have tuned in to that. they want us to fix healthare, but they want us to reduce costs. i would say again that we on the republican side are ready to set that goal. and as we said 173 different times on the senate floor last year, we've offered six steps to move toward that goal. maybe the president can think of six more. maybe we can think of six more.

Lamar Alexander

0:45:40 to 0:46:00( Edit History Discussion )

Lamar Alexander: we d that with the "america competes" act. we asked national ademies what are the ten steps that would help us to become more competitive as a country. they gave us 20. we passed most of them. in clean energy we're coming closer together on nuclear power, offshore drilling and energy development. those are steps towards a goal that would be a more sensitive

Lamar Alexander

0:46:01 to 0:46:22( Edit History Discussion )

Lamar Alexander: way for us to work. in the meantime, the unpleasant truth is the current bill that's being considered -- cut medicare and not spend it on medicare -- will raise taxes. and it will, as i've tried to demonstrate today with respect to the president, raise premiums for millions of americans because of one-size-fits-all

Lamar Alexander

0:46:23 to 0:46:44( Edit History Discussion )

Lamar Alexander: government mandates and tax increases. mr. president, i would finally like to ask unanimous consent to include, following my remarks and the other documents, today's editorial from the "wall street journal" detailing how the massachusetts health care plan has unexpectedly caused premiums to rise over the last couple of years and what lesson there

Lamar Alexander

0:46:45 to 0:46:51( Edit History Discussion )

Lamar Alexander: might be in that for u i thank the president.

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