John Barrasso

Mr. BARRASSO

Mr. BARRASSO. I am fine with voting on this, but it doesn't mean anything. I think it is absolutely meaningless, the Baucus amendment. I want to get to the heart of the matter, the meat of the matter, which is the Crapo amendment. That is the one I think makes the difference for the American people. If I were a citizen sitting at home watching C-SPAN on a Friday afternoon saying, what is going on in the Senate, what do I want, what is going to help me, I would say I want to call my Senator and say: Vote for the Crapo motion because that is the one that is actually going to help keep money in my pocket. The sense of the Senate? Oh, that is nice, but it is meaningless. I am ready to vote right now for the Crapo motion because that is the one I think is going to help possibly save my job if I am at home and working. I am worried about unemployment in the country, I am worried about the taxes and the impact that is going to have. Because I worry if we don't get these taxes out of here, it is going to be a job killer for our Nation and for families all across this country, in Idaho, in Wyoming, in Kansas, in Kentucky. I think we have great concerns for the economy and the 10-percent unemployment. We need to get those taxes out of there now.

Mr. BARRASSO. Well, we should not. We need to be fair. We need to deal with this in a realistic way. But the bill in front of us now is going to raise taxes $500 billion, it is going to cut Medicare by almost $500 billion for our seniors who depend upon it, and for people who have insurance they like, it is going to increase their premiums. They are going to end up paying more than if no bill was passed at all. That is why, across the board, more people would rather have this Senate do nothing than to pass this bill we are looking at today. They understand the impact on this Nation and our future is devastating. This will cause us to lose jobs, with the taxes; it will cause us to lose care in small communities; and for our seniors who depend upon Medicare, they are going to throw more people into Medicaid, another program where half the folks now can't find a doctor who will see them. All in all, there is nothing I see about this bill or any of the new changes and certainly nothing in this report that says to the American people: Hey, you might want to think about this. The American people have thought about it. This report tells the American people this is not what they want for health care in this Nation.

Mr. BARRASSO. For people all across the country, costs are still going to go up. The cost of doing business will go up. For families who buy their own insurance, the cost of their premiums will go up. For people who are on Medicare, they are going to see tremendous cuts into that program, and they depend on that for their health care. So costs are going up for people who pay for their own and for businesses that try to build jobs. We know small business in this country is the engine that drives the economy, and according to the National Federation of Independent Businesses, 70 percent of all new jobs come from small businesses. They are going to be penalized to the point they are not going to be able to add those new jobs. The NFIB says we will lose across the country 1.6 million jobs over the next 4 years as the government keeps collecting the taxes but doesn't even give any of these health care services because those have all been delayed for 4 years.

Mr. BARRASSO. My answer to that is they are objective. That is why we did not get this report--I have the same copy my colleague from Arizona has. This just came out, and the reason is because they wanted to take the time to study the bill which they got in the middle of November. So they needed the time to actually go through point by point what the implications were. The Senator talked about the one segment where they talk about they ``face a significant risk of failure.'' They actually go on to say: ``This will eventually trigger an insurance death spiral.'' This is for people who depend upon Medicare for their health care. There is an Associated Press story out today that says this provides a sober warning--a sober warning--today to Members of the Senate. This is a time when the Senate raised the debt limit in this country by over $1 trillion. As the old saying goes--I say to my friend who served in the Navy--they are spending money like drunken sailors, and yet they want to keep the bar open longer. They want to increase the debt at a time when our Nation cannot afford it, when we have 10 percent unemployment. The folks who know Medicare the best and can look at this objectively and share with the American people what their beliefs are as to what the impact is going to be say that is going to be devastating for patients who rely on Medicare for their health care--our seniors--and devastating for small community hospitals. I see the former Governor, now Senator of Nebraska, is here, and he knows, as I do from Wyoming, the impact on our small community hospitals. But as the Senator from Tennessee said, this is all being done in a back room. We are not privy to the newest changes, which I think are actually going to make matters worse. The New York Times today says Democrats' new ideas would be even more expensive. Questions exist about the affordability. What we are dealing with is a situation that is unsustainable, and that is why the newest poll out today by CNN-- certainly not biased one way or the other--finds that 61 percent of Americans oppose this bill. It is the highest level of opposition to date because more and more people are seeing and learning the truth about what is being proposed in the bill before the Senate.

Mr. BARRASSO. It does say that. The President has said he wanted to bend the cost curve down. This report says, if we do these things that are in the Reid bill, costs of care will actually go up faster than if we did nothing at all. That means for people who buy their own insurance, the cost of their premiums will go up faster than if this Senate passed nothing at all.

Mr. BARRASSO. It is happening. It will get worse under the proposal that is ahead of us. That 90-percent figure is actually a high number. I know a number of physicians and hospitals, especially in rural communities, that get reimbursed less than that. The ambulance services do not even get reimbursed enough from Medicare--these are volunteer ambulance services--to fill the ambulance with the gas for taking somebody the long distances from where they may have fallen and hurt themselves, broken a hip, to get them all the way to the hospital. This is across the board bad for America. We say we want patients to be able to get care. If you throw a whole bunch more people on to this boat that is already sinking, which is what the Democratic leader is now trying to do, it is going to make it that much harder for our hospitals to stay open, especially in these communities where there is only one hospital providing care--much more difficult. But with any young physician coming out with a lot of debt, trying to hire the nurse and pay the rent and the electricity and the liability insurance and all of that, these do not even cover the expenses. That means they have to charge more to the person who does have insurance, the cost shifting that occurs. As a result, for people who have insurance, they are going to see their rates going up. For people who rely on Medicare, it is going to be harder to find a doctor. For those who are put onto Medicaid, with the aid for those who need additional help, which the Senate majority leader is trying to put more people into that area, it is going to be harder for them to find care. Across the board, there is nothing good with this proposal. What we have seen today documented from the folks who are objective and look at the whole picture, they think it is actually as bad--they admit it is as bad as we have been saying it is. They say you guys have been right, what you are saying about the cost of care, the impact on health care. And their phraseology is such that I think they absolutely pinpoint all of the reasons that the American people, now by a number of 61 percent, oppose this bill we are taking a look at. That is why the Mayo Clinic has said, in the letter from their executive director of their Health Policy Center, ``Expanding this system to persons 55 to 64 years old will ultimately hurt patients by accelerating the financial ruin of hospitals and doctors across the country.'' That is what we are looking at.

Mr. BARRASSO

Mr. BARRASSO. To follow up, the small communities of this Nation have great concerns about these cuts in Medicare because the small community hospitals that stay open know they have to live within their means. When Medicare cuts total over almost $\1/2\ trillion, it is the small communities that have just one hospital in a frontier medicine mode taking care of people who may live 50, 100, or 150 miles away, those hospitals' very survivability is at stake. That is why we cannot pass this bill, which will hurt seniors, raise taxes on the American people, cost jobs, and cause people who have insurance to have their premiums raised. For all these reasons, this bill is the wrong prescription for America.

Mr. BARRASSO. I thank my colleague from South Dakota because South Dakota and Wyoming are very similar in many ways. Both have rural areas all spread across the State, with people needing health care. And I have seen it. I have seen the concerns from people, but also from small businesses. My colleagues mentioned the National Federation of Independent Business. A lot of businesses in Wyoming are members of that organization, and rightfully so, because small business is the engine that drives the economy. They are the job creators in this country. I see these taxes--4 years of taxes--before the first health care services are given as going to hurt our small businesses in Wyoming. It is going to hurt small businesses all around the country. In one of the morning papers, it talks about the plans that are being presented by the Democrats, with all the increases in health costs--the fines, the taxes, that this will cost 1.6 million jobs before the first health care services are given in 2013--1.6 million jobs across the country. That affects all of our States. At a time when unemployment is at 10 percent, at a time when Investor's Business Daily, this morning, says: ``Job Cuts Hit Hardest on Low-Skill Men; Outlook Is Gloomy,'' at a time when we are looking at an outlook which they call in the headlines of the front page of their paper ``gloomy,'' why would we say: Lets increase taxes on Americans, and then cut Medicare from our seniors who depend upon Medicare, and lets not improve services for 4 more years? It is no surprise then that the Republican leader would come to the floor and say we have now reached an all-time high of American people opposed, completely opposed, to this piece of legislation. The Republican leader read a poll that said 61 percent of Americans now oppose this bill. Well, it is because they are learning more about it. The more people of America see what is in this bill, the more they realize they cannot believe any of the promises that were made by the Democrats, by the administration, the promises that were made, and the polling shows it. Two specific questions that were asked in the poll were two specific promises that the President made. One is, he said he will not sign a bill if it adds one dime to the deficit. OK. We do not want to add to the deficit, although the Democrats want us to vote this weekend on raising the debt level by well over $1 trillion. And why? Because they cannot control the spending. But the question was, do you think the Federal budget deficit would or would not increase if this bill is passed--when the President said it will not raise it by a dime? Mr. President, 79 percent of Americans said this is going to increase the deficit. Only 19 percent believe what the President is telling the American people. Then the question of taxes. The President said: My plan will not raise your taxes one penny. What do the American people think when the President speaks? Question: Do you think your taxes would or would not increase? This is the CNN poll the Republican leader just talked about, done earlier this month: Do you think your taxes would or would not increase? The number of people who believe their taxes will increase if this passes, 85 percent. Eighty-five percent of the American people believe they are not getting it straight from the President of the United States. Only 14 percent believe him when he says he will not raise taxes a penny. So we have the Democrats bringing forth a bill--to me, as a practicing physician in Wyoming, taking care of families in Wyoming, talking to doctors, talking to patients, having townhall meetings in the State, having telephone townhall meetings, the Democrats bring forth a bill that the people of Wyoming and the people of America realize is going to cost them more, is going to add to the deficit, and hurt the health care they receive. Eighty-five percent of Americans are happy with the health care they receive. They do not like the cost. They do not like the price. But this bill we are looking at is going to raise premiums for people who have insurance. The President promised that for families all across America, their premiums would drop by $2,500 per family. But if you go out there trying to buy insurance, if this bill passes, you are going to end up paying $2,100 more than you would otherwise if nothing passes. That is why the majority of Americans say we would be better off if nothing passed. That is what the American people say. The Democrats seem to be ignoring the voice of the American people. At a time of 10 percent unemployment, at a time when the National Federation of Independent Business points out that we will lose over a million more jobs if this passes, we should be looking at ways to help small businesses hire more workers, hire more people. The small businesses continue to be the engines that drive up the economy. Senator Collins from Maine was on the floor and gave an explanation of some of the taxes on all of the small businesses in Maine. If you have 10 employees and you go to an 11th employee, if this bill passes, that small business gets penalized for growing their business. We want to have an opportunity to hire people. She also explained that if we actually try to work ways through small businesses to give raises to people, those businesses get penalized from a tax standpoint. As I look at this health care bill, we need health care reform that is going to bring down the cost of care. This bill is going to raise the cost of care for all Americans. It is going to hurt our seniors by taking almost $500 billion out of Medicare, a program on which the seniors depend. It is going to raise $500 billion in taxes which is going to hurt the engine that drives the economy. It is going to hurt small business. It is going to cause people to lose their jobs. I think it is foolish for people to continue to support this bill. It makes no sense. I listened to my colleague from South Dakota who showed the chart that says 21 days until the tax increases begin but almost 4 years until the benefits begin. What do the people in South Dakota have to say about this?

Mr. BARRASSO. Mr. President, I would respond to my colleague from Texas that I think she is absolutely right. The more people learn about this bill and the details of the bill, the more the American people oppose this bill. My colleague from Texas made a wonderful point yesterday and again today when she said if they start this tax collecting right now, do we even know the money is going to be there 4 years from now to start supplying the services. There was a story in today's USA TODAY talking about unemployment in this country, and the story says: Public Gain, Private Pain. For Federal workers there is a hiring boom. The Federal Government is adding jobs this year at a rate of nearly 10,000 per month. We have read about all of the different bureaucracies that will be brought into play if this passes: over 70 new bureaucracies, 150,000 more Federal employees, more Washington bureaucrats to make rules and regulations that affect the people of America. It talks about the 10- percent unemployment in the country. It says, it is the new Federal jobs--not the small business jobs, the Federal jobs--that have helped bring down the unemployment rate from 10.2 to 10 percent. It is the Federal jobs. I am looking at all of this money that Washington is going to collect. I used to think it was a big gimmick so they could say, Well, we have kept the number under $900 billion. I still believe it is a big gimmick, but I am concerned they are going to spend the money as well so the money won't be there, which is the point of the Senator from Texas, who has been very fiscally conservative, out there always making sure we are not spending the taxpayer money in any way that is not a wise use of the money. Is that one of the concerns the Senator has? I know the Senator from South Dakota has similar concerns: Will the money be there if they are going to hire more Washington bureaucrats, which is what USA TODAY says?

Mr. BARRASSO

Mr. BARRASSO. Mr. President, I have great concern about the cost of health care for American families. We see it with our seniors certainly, as they will be seeing Medicare cuts. In this bill, there is $464 billion in Medicare cuts, but there are taxes that are going to go up, which will impact all of the people in this country. I remember a promise the President made. He said his plan would not raise taxes one penny. He went on to say: not your income taxes, payroll taxes, capital gains taxes--any of your taxes. We are seeing that taxes are going up, and in a way that is basically--you hate to say it, but it is a gimmick in this bill, where they are going to collect taxes for 10 years but only give benefits for 6, and it is the last 6 years. As my colleague from Texas said, they are going to start collecting taxes--today is December 10--on the 31st of this month, 21 days from now, but the services would not be given for 4 years. That is how they get the number under $1 trillion, and it is at a time when the President makes a statement that this would not add a penny or a dime to the deficit. Eighty percent of the American people don't believe it because they know what is in front of them. They know what it is like to live their own lives. Is this what the Senator from Texas is seeing as well?

Mr. BARRASSO. You cannot go home and say that with a straight face. There are many rural areas in our States. People see through all this. There are two articles next to each other in today's New York Times. One talks about the details of the secret agreement they are working on behind closed doors. It says: ``Details Are Scanty.'' Right next to it it talks about: ``For Rural Elderly, Times Are Distinctly Harder.'' These are the people who are going to see taxes going up, these are the people who are going to see cuts in Medicare. I want to read the first paragraph because this is from Lingle, WY, a community in my State. It talks about Norma Clark, 80. It says: Norma Clark, 80, slipped on the ice out by the horse corral one afternoon and broke her hip in four places. I am an orthopedic doctor. I have taken care of these over the years. Alone, it took her three hours-- These are the kind of wonderful Americans we have-- Alone, it took her 3 hours to drag herself 40 yards back to the house through snow and mud, after she had tied her legs together with rope to stabilize the injury. This is a person who is on Medicare, and they are going to cut $464 billion from Medicare, and they are going to use gimmicks that are going to harm our people. I have a former Governor and a former chief of staff for a Governor's office. You know in the rural parts of your community, I say to Governor, now the Senator from Nebraska, you have people like that-- hard-working people who expect honesty from a government, and they are not getting it in this bill which is going to tax for 10 years and only give services for 6.

Mr. BARRASSO

Mr. BARRASSO. I have. People know there is an advantage to being in this program, and that is why they sign up for it. That is why citizens all around the country have signed up for Medicare Advantage. They realize there is value in prevention and there is value in coordinated care. There is value in having eye care, dental care, hearing care. There are advantages to wanting to stay healthy, to keep down the cost of care.

Mr. BARRASSO. I would add to that, following on my colleague from Oklahoma, that there is the coordinated care, which is one of the advantages of Medicare Advantage, but there is also the preventive component of this. We talk about ways to help people keep their health care costs down, and that has to do with coordinated care and preventing illness.

Mr. BARRASSO. We want to keep our seniors healthy. That is one way they can stay out of the hospital, out of the nursing home, and stay active. Yet with the cuts in Medicare Advantage, the Democrats have voted to do that--to cut all the money out of this program that seniors like. Eleven million American seniors who depend upon Medicare for their health care choose this because there is an advantage to them. My colleague from Oklahoma, the other physician in the Senate, has talked, as I have, extensively about patient-centered health care--not insurance centered, not government centered. Medicare Advantage helps keep it patient centered. So when I see deals being cut behind closed doors where they are cutting out people from all across the country and providing sweetheart deals to help seniors on Medicare Advantage in Florida in order to encourage one Member of the Senate to vote a certain way, I have to ask myself: What about the seniors in the rest of the country, whether it is Texas, Oklahoma, Tennessee, or Arizona? A lot of seniors have great concern, and I would hope they would call up and say this is wrong; we need to know what is going on, and to ask why it is there is a sweetheart deal for one selected Senator from one State when we want to have that same advantage; and why are the Democrats voting to eliminate all this Medicare money.

Mr. BARRASSO. Additionally, the Senator from Arizona talked about the closed-door meetings, secretly trying to come up with things. There was an article in the paper today that the Democrats are turning to actually throwing more people on the Medicare and Medicaid rolls as they are trying to come up with some compromise; the idea being it is going to be compromising the care of the people. They are trying to put more people onto the Medicaid rolls. The Senator from Tennessee has said many physicians don't take those patients because reimbursement is so poor. It is putting more people into a boat that is already sinking. They want to put more people on Medicaid and more on Medicare, but at the same time they are cutting Medicare by $464 billion. This is a program we know is already going broke. Yet they want to now put people age 55 to 64, add those to the Medicare rolls, which is a program we have great concerns about. Special deals for some, cutting out many others, now adding more people to the Medicare rolls--to me, this is not sustainable. Yet these are the deals that are being cut less than 100 feet from here off the floor of the Senate, when we are out here debating for all the American people to see the things we think are important about health care. Jobs are going to be lost as a result, if this bill gets passed. People who have insurance will end up paying more in premiums, if this bill is passed. People who depend on Medicare, whether it is Medicare Advantage or regular Medicare, will see their health care deteriorate as a result of this proposal. I turn to the Senator from Arizona, who has been a special student of this.

Mr. BARRASSO. That is one of the reasons that Medicare Advantage was brought forth. I know a lot of Senators from rural States supported it because it would allow people in small communities to have this advantage to be in a program such as that. It could encourage doctors to go into those communities to try to keep those people well, work with prevention. The 11 million people who are on Medicare Advantage know they are on Medicare Advantage. They have chosen it. It is the fastest growing component because people realize the advantages of being on Medicare Advantage. If they want to stay independent, healthy, and fit, they sign up for Medicare Advantage. I would think people all across the country, who are seniors on Medicare but are not on Medicare Advantage, would want to say: Why didn't I know about this program? As seniors talk about this at senior centers--and I go to centers and meetings there and visit with folks and hear their concerns--they are converting over and joining, signing up for Medicare Advantage because they know there are advantages to it. For this Senate and the Democrats to say: We want to slash over $100 billion from Medicare Advantage, I think the people of America understand this is a great loss to them and a peril to their own health, as they lose the coordinated care and the preventive nature of the care.

Mr. BARRASSO. I would concur that this is actually taking a step backward. That is why the Senator from Florida has demanded they make accommodations for the people of Florida. The people of Wyoming want those same accommodations, as do the people of Arizona and Texas. Because 11 million Americans have chosen the Medicare Advantage Program because it does help coordinate care. It has preventive care. It keeps it more patient centered as opposed to government centered, insurance company centered. That is the way for people to stay healthy, live longer lives, and keep their independence. We have seen cuts across the board on Medicare, whether it is home health, nursing homes, hospice care, Medicare Advantage. And across the board, they are cutting Medicare in a way that certainly the seniors of this country do not deserve. They have paid into that program for many years and they deserve their benefits.

Mr. BARRASSO

Mr. BARRASSO. No objection.

Mr. BARRASSO. Mr. President, I appreciate the comments from my colleagues. I think we are hearing around the country that we do need health care reform. We need to get costs under control. We need to have patient-centered reform, not government-centered reform, not insurance- centered reform. We need to not cut Medicare. We need to not raise taxes. We need to not make things worse for the American people. From what I have seen of this bill--and I worked my way all the way through it--it makes things worse for the American people, not better. This is not the right prescription for health care in America. With that, I yield the floor.

Mr. BARRASSO. As my colleague from Georgia knows, there is no way you can save Medicare when you cut that kind of money out of it. How, when they cut physicians' payments by 23 percent, are we going to have physicians going to any of our small communities in South Dakota, in Georgia, in Wyoming, where we have many people who depend on Medicare for their health care? I worry about access to care. Our colleague, Senator Isakson, yesterday talked about home health care and how, for pennies on the dollar, you can help people. It provides a lifeline for people who are homebound. It keeps them out of the hospital, out of the nursing homes. Instead, this Senate, the Democratically led Senate, yesterday voted to cut $42 billion out of home health care, which people in our small communities and in the rural areas of our State depend upon. So there is no way this program can stay solvent. It is hard for me to fathom and, clearly, hard for the people of Wyoming to fathom, how with all this budget trickery it is going to work for people who need to go to see a doctor or to have a home health care provider in many of our rural communities. We all have townhall meetings, and when I go to townhall meetings, people say: Don't cut my Medicare, don't raise my taxes, and don't make things worse for me than they are now.

Mr. BARRASSO. I have a question for my Senate colleague from South Dakota who is here. We heard the majority leader, Senator Reid, come to the floor a few minutes ago and talk about how this bill is going to get premiums under control, keep the cost--for people who have insurance, keep their premiums under control. I saw a chart from the Senator from South Dakota yesterday that said for 90 percent of Americans, those who have insurance now, if we did nothing and did not pass this bill, the premiums would be lower than if we do pass this bill; that passing this bill actually will raise premiums, in spite of the fact the President of the United States promised, while campaigning, that he would lower the cost of premiums for American families by $2,500. I would ask my colleague from South Dakota, isn't it true that if this bill passes, Americans wanting--feeling they have been promised that premiums would be reduced, are they not doomed to disappointment?

Mr. BARRASSO. If I could follow up with a question for my colleague from New Hampshire, because as I read the Sunday New York Times, it said the Bennet amendment was completely meaningless--the Bennet amendment was meaningless. It also goes on to say, Senator McCain is trying to keep that $500 billion in Medicare, but the Democrats are trying to take that money out of Medicare and, as the article says, the editorial says: to finance coverage for uninsured Americans but not people on Medicare. So it does seem the New York Times, at least in this segment, got it right: that the Bennet amendment that our colleague from Georgia referred to is meaningless, that the cuts are going to come out of people who depend upon Medicare for their health care to pay for a whole new government program and not to focus on Medicare. Well, don't we owe it to these seniors who have paid into the program and who have been promised the program to save that program first?

Mr. BARRASSO. I thank the Presiding Officer. Mr. President, I have been looking at the bill, which, to me, is going to hurt the health care system of our country. I am a physician. I have taken care of families in Wyoming for 25 years, and I think if we want to get costs under control, if we want to help families all across America who are struggling with their health care needs, we need to focus on an amendment that is before us today, brought forward by the Senator from New Hampshire. I ask my friend and colleague from New Hampshire, is it not true that the numbers we are looking at are underreported? It is going to be much more expensive and the cuts are going to come from our seniors, those who are vulnerable, those who depend on Medicare for their health care, and we need to make sure and promise the American people we will be protecting those folks who depend on Medicare for their health care?

Mr. BARRASSO. Mr. President, I ask unanimous consent to engage in a colloquy with my colleagues to discuss the issues at hand.

Mr. BARRASSO

Mr. BARRASSO. Standing on the Senate floor, looking at so many colleagues from States with a lot of rural areas, it is a challenge to have people who can provide these excellent services, who are very well trained, know how to do it, how they can provide the services in these small communities. We have dealt with that in Wheatland, WY, and New Castle, WY, where the expense for the malpractice insurance for those physicians was so high that even though they didn't deliver that many babies in these small communities, they could not afford and the hospital could not afford to allow them to continue to deliver any babies. The amount of money they would receive from delivering babies was not enough to cover the insurance. In New Castle, WY, there were three physicians qualified to deliver, but the number of deliveries was such they ended up with no one delivering because they wanted to take one night and the next and the next. So you have communities all across our country that are losing highly qualified medical practitioners-- whether it is cardiologists, surgeons, trauma surgeons, whether it is obstetricians, gynecologist. We are seeing this all over our communities. The Senator from Tennessee is here. There are a lot of small communities where they are going to lose those. We are seeing it in the cuts yesterday for home health. Those people are not going to be available to deliver small community care, lifeline, homebound, keeping them out of nursing homes, keeping them out of hospitals. There are real consequences of this bill, not just with the junk lawsuits--that is a big part of it--but also with the Medicare cuts, also with the increased taxes we are seeing in this bill and how that is going to affect small businesses, which are the engines that drive the economy of this country--and profoundly. We heard the Senator from South Dakota show the premiums families are going to have to pay for insurance are going to climb faster if this bill becomes law than if nothing were passed. Even though the President promised that families in this country on average would see a $2,500- per-year decline in premiums, the President's own numbers people say: Sorry, it is going to go up $2,100. That is a $4,600 shift for every family who tries to buy their own health insurance. That is what we are seeing in Wyoming. I ask my colleague from Tennessee if he is seeing the same things at home.