Michael Enzi

Mr. ENZI

Mr. ENZI. I want to continue on with why we are trying to change this. The Galen Institute--Grace-Marie Turner wrote about 70 changes to ObamaCare that occurred after it went into effect. And those changes include the ``employer mandate delay, individual mandate delay, preserved benefits to the military and VA, and reduction of funding to agencies used for implementation of ObamaCare including IPAB, CO-OP's, and IRS.'' Co-ops are an interesting thing. I was suggesting during the time that ObamaCare was being considered that small business health plans might make a real difference in costs for small businesses. Now, the only thing I can see on small businesses in here is that if you are a small business and you have over 50 employees, you have a problem. I have people in Wyoming who come to me and say: I have this business. It is working really well, and in the next town over--and most of the towns aren't big enough to hold two of the same kind of store--so in the next town over, I would like to put in the same kind of shop. My question to them is: How many employees do you have? Most of them have said: Well, I have about 48 employees. I said: How many will you need in the other store? They said: Well, I hope to need the same amount of people. I said: Well, the way this works, you are going to come under much increased healthcare costs, and you better take a look at that before you make your expansion. So it has cost jobs that way. Now, with small business insurance, with the small business health plan-- Ms. WARREN addressed the Chair.

Mr. ENZI. Mr. President, I think what we have is a motion to commit and the right for the other side to do other amendments. I would hope that some of them would be constructive, but I am not expecting that. As I said, I have been listening for 3 days and actually listening a lot longer before that time. I could talk about some of the things we can learn from ObamaCare, because we should. We can learn that decisions have to be made by the patients and not by the bureaucrats for the government. There are some key examples of when the government starts making those decisions. I don't have to pick on ObamaCare for it necessarily; the VA has had a few problems, and I am sure all of you have been working casework on what the VA has been doing. That is where the government and the bureaucrats are making decisions. We have been through some enormous times on that. That is why we did the Choice Act. And the Choice Act had a lot of problems. That is government healthcare. People say: Well, Choice got to go outside of the government. That is not quite true. I think the folks with the VA picked the companies you have to go through for healthcare, and when they did, they didn't want it to be efficient. They wanted as much of it as possible to come back to the VA. I am sure all of us, as we travel across our States, are running into people who are having problems with providers not getting paid or not being able to get their appointments. If you check with the providers, you find out what kind of a terrible process they have to go through to get paid. That is government healthcare. In my State, I provide the VA with a list every week of the new cases I have of people who are not getting care. That shouldn't happen. But they told me when I first inquired: Well, there are only two doctors who haven't been paid. I said: That is impossible. There are more than two doctors in my own town who haven't been paid, and there are a lot of towns in Wyoming-- when I go to them, I hear that they are not paid. They said: One was not paid for 30 days, and one wasn't paid for 45 days. I said: Well, I don't know why either one wasn't paid before those kinds of deadlines. But I can tell you there are a lot more problems than that. So if we are thinking about going to a Federal healthcare--and I guess we are not because we had that vote a little bit earlier on whether we would have a single-payer system. I was amazed at the number of people who chose not to vote on that. At any rate, I don't think that is where America wants to go. I have had some people ask me about that. I have given them some suggestions on where to check to see what kind of care they would get under that, and they have come back to me and said: I don't think that is where we want to go. I know the other side of the aisle has wanted to go that way for a long time. When I first got here, Phil Gramm was one of my mentors, and I really appreciated all of his advice in so many areas. One of the things he said to me was, you have to watch out for healthcare because where the Democrats want to go is to single-payer healthcare. In other words, they don't care who drives the train as long as it wrecks. So I look back on ObamaCare and I say: Man, this was 18, 19, 20 years ago that he told me this. Is that where ObamaCare is supposed to go, to wreck the train so we can go to single-payer? I don't think so, but I think we are on the way to a train wreck, and I am not hearing a lot of disagreement about the train wreck. I am hearing some disagreement about the amount of calamity in the train wreck but not on whether there is going to be a train wreck. There are a number of things we could do to take care of the costs that have gone up under this. That can be confronted within a free market as opposed to the government-run, government-controlled market we are under now. One of them is to reduce the tax burden. I did notice that I have a lot of people in Wyoming--again, we are one of the smallest or least populated in the Nation. We are big in land mass, but we are small in population--In Wyoming, $5.6 million was collected from people for fines for not having the adequate healthcare. Those were people who said: Wait a minute, I have to spend so much on my healthcare and then a high deductible that I am never going to get anything out of it. So when I calculate the annual cost, the $1,700 that I have to pay as the fine--or $1,500, somewhere in that range--is cheaper than paying for all those premiums and then a deductible if anything ever happens to me. These are real people I am talking about.

Mr. ENZI. Mr. President, I have heard so many times that the other side would love to be cooperative, but I have yet to see cooperation. I am not going to take questions; I am going to--I really would appreciate it if you would just take some time to look at the bill. I have heard the rhetoric.

Mr. ENZI. Yes, and I have an hour, whether I use it or not. As I said, for the past few days I have been yielding time to the other side. I haven't gotten much satisfaction out of that. I have listened for the last hour, and I didn't get any satisfaction out of that either. I did sit through all of it. I did listen to it. Again, it is complaints about the process, but not constructive suggestions on what could be done. There are taxes, mandates, regulations, lack of competition in the marketplace, increasing costs. When I travel across Wyoming, I have people who have come up to me and they say: My insurance premium is bigger than my house payment, and it is growing. And they said: If something happens to us, my deductible is bigger than my year's premium. That shouldn't happen in America, but that is where we are. Those aren't isolated cases; those are a lot of cases. That is the situation we find ourselves in. We are not trying to hurt anybody; we are trying to fix some of these things. As I said, for 8 years, every time there has been a waiver--that is part of that thing that I mentioned about the 70 changes to ObamaCare so far--a lot of those were in the way of waivers. Every time there was a waiver, I said: Why are we waiving this? Why don't we just fix it? I was told: It is not broke; it just needs more time. Well, it has had more time. Last year--this was before the election, so you can't blame us. We had no idea who was going to be the President. We had no idea who was going to be in the majority. Last October, people started pulling out of insurance markets, and rates increased dramatically. You can't put that blame on us.

Mr. ENZI. No.

Mr. ENZI. I allowed the other side to have their hour. I expect to have this hour, even if some of it is in silence. I mentioned reducing the tax burden. We could also eliminate some regulations. We really need to take a look at some of those regulations within the essential health benefits and see if everybody needs all of them or if there are some they would opt out of, given the opportunity, because they know they will never need them. There are a lot of examples of that. We could eliminate the mandates from the Federal and State. We have the elimination of the Federal mandates in this bill, both the individual mandate and the employer mandate. We could also increase competition within the marketplace by increasing flexibility. Some of these things we can't do, particularly to the level we would like to do them, but we could have more competition if we could increase the number of insurance companies. Competition makes a difference. I have had a number of people, though, who have suggested to me that the biggest thing we could do would be to pass the medical liability reform because doctors are practicing defensive medicine, which drives up the cost, so that if they are ever in a lawsuit, they can prove they did every possible thing that they could ever imagine or that anybody could raise as an issue. There is a cost to doing that. One of the suggestions----

Mr. ENZI. I will not.

Mr. ENZI. It has been suggested that the government could have an appropriate role in healthcare by maybe using advanceable, refundable credits to prevent any lapse in coverage. One of the problems we have right now is that people can wait until they have something terrible happen to them, and they can sign up for insurance on the way to the hospital--you can't pay when you are in the ambulance, and you can't pay when you are getting treatment, and you can't pay when you are getting rehab--and when they are done, they drop out of it. It is hard for an insurance company to figure in the cost of something they are not going to get paid for at all. There have been a number of suggestions. I don't know whether they are any good. I could throw them out. One of them is that if you don't keep continuous coverage, you should have to pick up your own expenses for the first 6 months. That would encourage people to have continuous coverage. It is just one possible suggestion. There is a role for government within this setting, and that is requiring some transparency within the system, encouraging the development of new healthcare competition, prevention of collusion between healthcare companies, and having prices posted. I remember a hearing we had once--

Mr. ENZI. Earlier I mentioned the CO-OPS. I would have preferred the small business health plans. I didn't think the CO-OPS would work. CO-OPS were included in ACA. These plans were meant to provide competition with existing health insurance companies. It was an opportunity to set up insurance companies that actually were funded. The CO-OPS were given $2.4 billion in ``federal loans.'' The CO-OPS were prohibited from having former healthcare executives with managerial or accrual experience. The CO-OPS were conceived to drive down the premiums by providing competition and underselling the cost for policies. More than half the 23 CO-OPS went out of business in 2015, but 8 of the remaining 11 CO-OPS were in financial trouble. The number of CO-OPS is now down to 7 (4 of the prior CO- OPS went bankrupt in 2016). Examples of how the CO-OPS that have failed and have cost the taxpayers. In 2015 alone, there was a huge amount of money lost and also cost the enrollees in the CO-OPS their insurance. New York Health Republic, 23,000 policies lost, $57 million dollars lost in the first half of 2015. Iowan and Nebraska CO-Opportunity Health, 120,000 policies canceled, $146 million dollars lost. Arizona CO-OP, 59,000 enrollees lost their insurance, $90 million dollars lost. Colorado CO-OP, 89,000 enrollees insurance canceled, $72 million dollars lost. Ms. HASSAN addressed the Chair.

Mr. ENZI. No.

Mr. ENZI. Continuing: The [Health and Human Services] and administration officials knew that the CO-OPS were at risk even before they received their first ``loan'' in 2014. Senator Rob Portman, Chairman of the Senate Permanent Subcommittee on Investigations, said that the HHS knew of serious problems concerning the failed CO-OPS enrollment strategies, pricing and financial management before the department ever approved their initial loans. Dr. Mandy Cohen, the director of the CMS, testified before a House subcommittee that 8 of the 11 remaining CO-OP companies were in serious financial difficulty and receiving ``enhanced oversight'' and ``corrective action.'' Dr. Cohen did not explain what that ``corrective action'' or ``enhanced oversight'' consisted of nor could she indicate the enrollment figures and the possibility of financial survival for the CO-OPS that were being monitored. Also, 4 more CO-OPS have failed over the first half of 2016, leaving only 7 remaining. I am not sure what today's number is. The HHS continued to make these federal loans though they knew the CO-OPS were failing. Under the small business health plans, there is no requirement to have the Federal Government fund it unless we want to fund more oversight. I am not opposed to that either. So What are the American People Think of This? There has been greater than $1 billion dollar loss of taxpayer money to CO-OPS that have gone bankrupt. Only 7 of the initial 23 CO-OPS remain in business. The CO-OPS were constructed as a way of providing competition against existing companies, however in order to do that they underpriced their products. No company can survive if they take in less than what they put out in services and understandably, the majority of CO-OPS have gone out of business. That could be something to do with their being prohibited from having former healthcare executives with managerial and accrual experience. This was known by the HHS before the first ``federal loans'' had ever been approved. Over 800,000 people have lost their insurance because the CO-OPS have gone out of business and there are more to come. It speaks to the fact that the HHS and ObamaCare Administration had very little regard for the American taxpayer and the American people. The disturbing question is whether any of the taxpayer's money will be returned. I did say those were loans, and there aren't many left that can pay back the loans, which is a little bit of a difficulty. Of course we did hear that ObamaCare was supposed to bend the cost curve down. I ought to point out some facts on that as well. From 2009 to 2012 healthcare, spending grew less than 4 percent, as spending started increasing dramatically in the first quarter of 2014. This was the start of the implementation of the legislation. Subsequent healthcare spending from 2015 showed a 6.8% rise. In 2016, it is estimated to increase to 6.5% spending growth. We know from last year, which isn't included in this, that it started doubling at that point. Deductibles both inside and outside ObamaCare exchanges have increased enormously and will continue to increase. Healthcare costs are now increasing more than inflation. Why has spending increased? There has been increased utilization services. The increased healthcare spending thus led to higher insurance costs. A particular cause of increased spending related to ObamaCare is a marked increase in deductibles and health insurance premiums in the ObamaCare exchanges. Additionally, because of the increased number of patients with Medicaid expansion there have been increased costs. Healthcare costs [will] continue to rise. The total healthcare spending for 2016 is to increase to over $3 trillion dollars. I will get some updated numbers on that. Total healthcare spending . . . rate of spending increase. Medicaid increased: 11% Medicare increased: 5.5% Private insurance spending increased: 4.4%. If I would have known that Medicare was going to be mentioned, even though it is not in the bill, I would have shown the little chart that I have, which shows how much revenue we get for different mandatory spending that we have. All of those mandatory spendings are in a little bit of trouble because the revenue streams to take care of them are not sufficient. At one point, they were sufficient in some of them, and the federal government doesn't have any place to park cash. The federal government puts bonds in a drawer and spends the cash. That is kind of double dipping because there is nothing there for later. There is a Social Security trust fund. I have learned from trust funds that you have to find money to put in before you can take money out. I never saw a trust fund that operated that way until I got here. We have some crises that are coming up. We are going to compound healthcare because for Federal pensions, we really don't put any money away for them. We require businesses to put it away, and we have had some other suggestions. I have some small pension plans I would like people to look at, some pooling for that, which I think would encourage more people to have pension plans in small business. But the cost of administration is extremely high unless they can share in that. All of them would require that there be money put away to be able to cover with reasonable growth in the interest of the fund so that what was promised could be taken care of. In 2006, Senator Kennedy and I worked on saving some pension plans, trying to make sure that promises that were made could be met. We did a pension bill that needs to be redone again, particularly for some sectors of the pension. The private sector is required to put away money. When the market goes down, it increases dramatically the amount of money that they need to put in and creates some problems for business. The point I am making is that the Federal Government doesn't do that with any excess funds we get. I don't care if it is in healthcare or Social Security or where it is, those excess funds are allowed to be spent with bonds put in a drawer, with the promise that the full faith and credit of the Federal Government will cover them. I don't know how many people at home believe that, but that is what it is. How has the battle for the quality of healthcare fared? This gets covered in this book too. Here is a little bit on the quality of healthcare and outcomes. The infant mortality rate . . . has been used by politicians and others in political debate to describe the inferiority of the U.S. healthcare [system]. U.S. ranked only 30th in the world (and the neonatal mortality below that). When you look at this data, however, you find a very different picture. The United States followed the World Health Organization definition that a live birth is any infant that shows any sign of life, i.e. a baby that takes a single breath or has a heartbeat. . . . Other countries however including both developed and underdeveloped countries use different standards. The definition of ``live births'' varies between different countries. For example, in Switzerland a newborn has to be 30 cm. long to be considered a live birth. In Belgium and France, infants have to be at least 26 weeks to be considered as live births. Infants less than 24 weeks gestational age are excluded from registries of live birth in multiple other countries including Japan and Hong Kong. In Canada, Germany, and Austria, the newborns weighing less than 500 grams are not considered viable and are excluded from the infant mortality rates. What I am saying is, there are games that can be done with that, with the performance ratings, with the life expectancy data, with the Commonwealth Fund. All of these things are issues that we are embarrassed about and things we ought to be working on, things we ought to improve, things we ought to help with our country. We need to be looking at all of those outcomes--the cancer outcomes, the cardiac disease outcomes, the stroke outcomes, the chronic illness outcomes, the hypertension outcomes, the diabetes and cholesterol outcomes. We know that the earlier and more effective there is treatment of the disease, the better treatment of the disease for chronic disease, the better the results are. The more accessible and better technology there is, the more access to specialty care for early diagnosis and treatment, better preventive screening, and the inventiveness of the American people. I think it was today--my days blend together these days with this healthcare that we are working on. I was visited by a couple of young people from Wyoming who have diabetes. We have put some additional money into research. We, as a Senate, don't say exactly where that money has to go because we shouldn't be kicking the tires on the different diseases and figuring that out. I worry about where we might put the money, if that were the case, because we are affected differently than what our constituents are. Both of these young people were on a pump, and I have gotten to meet Dean Kamen who invented the pump. It is kind of an interesting story. Of course, that wasn't his first medical invention. His first medical invention was actually when he was a junior in high school and his brother was doing a residency in a hospital that handled transplants for infants. They were mentioning some devices similar to a needle in which medicine can evidently go through. This was needed for transplant of a kidney. He was lamenting they didn't have that capability. He went down to the basement and figured out how to make one of those. That was his first patent. You probably know him more for the patents of the Segway. After he made some money, he got to experiment with some different things. One of them is that mobile thing that police use and shopping centers use and tourists use where you ride around on a Segway. He built that for a specific medical purpose, which was to figure out a way to have a wheelchair that could climb stairs. Instead of building a ramp and being limited where there wasn't a ramp, he figured out a wheelchair that could climb stairs. It could do a number of other things too. For instance, if the person in a wheelchair went to a cocktail party, they could rotate the wheels up so they were at standing level to everybody else. He had a lot of problems getting it through FDA. He finally got it through FDA, then was told there are other wheelchairs that are less expensive so we are not going to pay for that. I think another company is coming back in to do that. It is an outstanding experience to sit in a wheelchair and go downstairs with it. He worked on this diabetic pump. It is interesting how he got into the diabetic pump. He was told pregnant women who are on insulin, if they take the insulin doses, they wind up often with babies that have a bigger head, which makes the delivery a bit more difficult. Everything changes so the head becomes normal after a period of time, but it is a problem at childbirth. He thought, what if we gave them a dose of insulin over a longer period of time; would that have an effect on the infant? So he invented a machine which started out being a fairly good- sized machine, but it worked. If they got their insulin over a slow period of time, but sufficient insulin, the baby didn't have the larger head. Well, this man is a businessman. He said: That is good. That will provide part of a market, but there ought to be a bigger market for it. He said: I wonder if men would have any benefit from having a diabetic pump? So he was able to have a trial and found out that also worked. He worked it down to be smaller and smaller and is working on other kinds of inventions that will do better things. We need to keep putting things into innovation. I said a lot of times: If there is a problem in America and we put on a small incentive, there will be somebody who will figure out how to turn that into something very useful. Mr. President, I think I have been requested by Senator Schumer to have 2 minutes, and to have 5 more minutes by UC perhaps for others, but I would ask that at the end, Senator Cornyn be allowed 2 minutes before the vote.

Mr. ENZI. I was wrong. I need 5 for Senator Cornyn.

Mr. ENZI. I ask for the yeas and nays.

Mr. ENZI

Mr. ENZI. Mr. President, section 3001 of S. Con. Res. 3, the concurrent resolution on the budget for fiscal year 2017, allows the chairman of the Senate Budget Committee to revise the allocations, aggregates, and levels in the budget resolution for legislation related to healthcare reform. The authority to adjust is contingent on the legislation not increasing the deficit over the period of the total of fiscal years 2017 to 2026. I find that amendment No. 667 fulfills the conditions of deficit neutrality found in section 3001 of S. Con. Res. 3. Accordingly, I am revising the allocations to the Committee on Finance, the Committee on Health, Education, Labor and Pensions, HELP and the budgetary aggregates to account for the budget effects of the amendment. I am also adjusting the unassigned to committee savings levels in the budget resolution to reflect that while there are savings in the amendment attributable to both the HELP and Finance Committees, the Congressional Budget Office and Joint Committee on Taxation are unable to produce unique estimates for each provision due to interactions and other effects that are estimated simultaneously. This adjustment supersedes the adjustment I previously made for the processing of amendment No. 267. This adjustment applies while this amendment is under consideration. Should the amendment be withdrawn, fail, or lose its pending status, this adjustment will be null and void and the adjustment for amendment No. 267 shall remain active. I ask unanimous consent that the accompanying tables, which provide details about the adjustment, be printed in the Record. --

Mr. ENZI

Mr. ENZI. What is the time situation?

Mr. ENZI. Madam President, I ask unanimous consent that the actions scheduled to take place at 11:30 this morning occur at 3:30 p.m. today and that all other provisions of the previous unanimous consent agreement remain in place.

Mr. ENZI. Mr. President, I ask unanimous consent that the reading of the amendment be dispensed with.

Mr. ENZI. Mr. President, I have 12 requests for committees to meet during today's session of the Senate. They do not have the approval of the Democratic leader; therefore, they will not be permitted to meet past 11:30 this morning, but I ask unanimous consent that a list of committees requesting authority to meet be printed in the Record.

Mr. ENZI. Mr. President, I listened with a lot of interest to the Democratic leader's comments this morning and his proposal that there would be cooperation if we went to a system of putting it back through committees and doing that, but I have to say that we would have a lot more confidence in getting a solution if there were a single positive suggestion from the other side for a change. Until that happens, there isn't much confidence on our side that the promise of bipartisanship is going to happen. They keep saying that it isn't perfect, but they don't put forward ideas for any of the changes. We have been suggesting changes for several years, and we have been told each time that it just needed a little more time, that it was a perfect bill. Soon we will be trying to do a budget. It would be nice if we had some suggestions on budget items that were positive things. I put out that offer as well. The reason we are having this is that more than 7 years ago, President Obama and congressional Democrats imposed a risky, partisan healthcare experiment on America that ultimately led to skyrocketing healthcare costs and collapsing insurance markets for millions of Americans across the country. This riverboat gamble has caused a stark and dramatic outcome. Currently, there are projected to be 50 counties across the Nation that will not have a single insurer participating in the ObamaCare exchange. To add further insult, Americans seeking affordable coverage in these almost 50 counties will still be fined under the ObamaCare mandate for not having health insurance. In other words, many Americans will either be forced to pay for insurance they cannot afford or pay a penalty for not having health insurance under this so-called Affordable Care Act, which they can't even access. Where are these people supposed to go? What can we do to help? Again, we are looking for some positive suggestions. My colleagues on both sides of the aisle know that this healthcare experiment has failed and that we must work together to free Americans from these mandates and put healthcare decisions back in people's control. Today, Senate Republicans are taking an important step to rescue the millions of hard-working families trapped by ObamaCare's taxes and mandates. We are trying to repair the Nation's broken healthcare system because we now have a President in the White House who shares our commitment to improve America's healthcare system and make better care available to all Americans. One of our top priorities in Congress has been to provide relief for hard-working Americans from ObamaCare, which has pushed insurance markets to the brink of collapse. In Wyoming and across the country, premiums for hard-working families are soaring while choices for patients have dwindled. As I travel across Wyoming, I have a lot of people who tell me that their health insurance costs more than their mortgage and, if they ever need healthcare, they have a deductible that is bigger than that. Simply put, ObamaCare stumbled out of the starting gate on the very first date the healthcare.gov website launched. You might remember how you couldn't get on the website or how you got kicked off after you had done a lot to put in information. Yes, ObamaCare stumbled out of the starting gate on the very first day that the healthcare.gov website was launched, and it has consistently failed to deliver on its core promises while hurting far more Americans than it is helping. One thing both parties should agree on is that an accessible and affordable healthcare system should be available to each and every American family, and I truly hope my colleagues on both sides of the aisle will work with us to find common ground on healthcare that truly delivers better care. Millions of Americans have been suffering under President Obama's healthcare law, and this past fall our Nation voted for a change. These hard-working Americans made it clear that fixing our healthcare must be a top priority for Congress and the President. This week, we are delivering on that promise of relief from ObamaCare. Making America's healthcare system more efficient and effective has always been an important and challenging endeavor for the public and private sector alike. President Obama and his congressional Democrats pushed Washington into the healthcare market, inflicting far greater uncertainty, cost, and disruption into the healthcare landscape than anyone ever imagined. By taking the important steps necessary to untangle Americans from this unworkable, unpopular, and unaffordable law, hard-working families can expect to see stability in the skyrocketing healthcare costs and egregious penalties imposed on them by the ill-named ObamaCare concept of ``affordable care.'' If you are young and healthy, ObamaCare has made it an easy choice to opt out of health coverage. But for those not so fortunate, for those who must have coverage, soaring healthcare costs are becoming a stunning reality. I have constituents in Wyoming who have written to me with worry and concern about their surging health insurance premiums. I assume that my 99 other colleagues have received many letters like one I received from a family in Gillette, WY. They recently wrote me that under ObamaCare they are paying more than $2,400 a month-- essentially taking on more than another mortgage. In their letter to me, they write: Mike, we are small business owners in Gillette, WY. Between Obama trying to kill the coal, oil and gas industries and his insurance fraud, we are stuck between a rock and a hard place. I just paid a $2400 Blue Cross Blue Shield of Wyoming Health insurance bill. I can't keep doing that. I am a real person with real problems created by my own government. HELP

Mr. ENZI. Mr. President, I yield such time as the Senator from Kentucky needs.

Mr. ENZI. Mr. President, I suggest the absence of a quorum.

Mr. ENZI. I object.

Mr. ENZI. Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ENZI. Mr. President, Senator Blumenthal, the Senator from Connecticut--I ask for 3 minutes from our time, and we will allot that as long as we preserve the full time for the Senator from Wisconsin.

Mr. ENZI. Mr. President, I thank my colleague from Wisconsin, my fellow accountant, for doing a good job of accounting there and providing some charts that very explicitly show what he has been working on, what he has been encouraging people to do, and some solutions. That is what we keep looking for within the criticism that we are getting from the other side of the aisle--some solutions. Earlier this year, Congress took an important first step in fulfilling the promise of repealing ObamaCare by passing a budget resolution that paved the way for this debate that we are having right now and paved the way for some real healthcare reforms that we are currently debating. These reforms are focused on rescuing the millions of hardworking families who are trapped by ObamaCare's taxes and mandates. You heard one example from the Senator from Wisconsin of a family who is paying excruciatingly high prices for their healthcare only to find out that they have $16,000 in deductibles, which makes it very difficult to utilize it at all. Is that insurance, if you have to pay $16,000 before the rest kicks in? What we are doing here is working to stabilize collapsing insurance markets that have left millions of Americans with no options. We improve the affordability of health insurance. We preserve access to care for Americans who have preexisting conditions while we safeguard Medicaid for those who need it the most by giving States more flexibility. We ensure that those who rely on this program will not have the rug pulled out from under them. Most importantly, we liberate the American people from the onerous ObamaCare mandates of purchasing insurance they do not want and/or cannot afford. Additionally, these bills can reduce the Federal deficit, the amount the Federal Government overspends each year, by billions of dollars. They can also end up saving taxpayers billions more by improving and reforming the way Medicaid operates. These aspects of the bill are enormously important. This will be the first time in a generation that we will have even attempted to rein in any of these programs and put them on a sustainable path--the ones that are threatening to bankrupt our country--without pulling the rug out from under people, as you saw from the charts by the Senator from Wisconsin. By reducing spending, lowering the tax burden on hard-working families, and curbing our national debt, which now stands at almost $20 trillion and is on its way rapidly to $29 trillion, we will be ensuring a brighter and stable fiscal future for our children and our grandchildren. Actually, with that kind of debt, we are almost ensuring a brighter and stable future for ourselves. We are in trouble. While my colleagues complain about using the reconciliation process to untangle the country from this unworkable, unpopular, and unaffordable law, they should remember that they actually employed the exact same procedure to secure the passage of ObamaCare, without having any input or assistance from Republicans, and rushed it through both Houses of Congress in less than a week. Senate Republicans are responsibly utilizing this reconciliation process to address the healthcare crisis that has been thrust upon America by former President Obama and congressional Democrats. There is also the common misconception that some of my friends across the aisle have promoted--the idea that ObamaCare is a runaway success and that repeal will be tearing down a functioning program. This is, simply, not true. My Democratic colleagues know it is not true. Former President Obama knows that it is not true, and the American people, certainly, know it is not true. Here is the reality. ObamaCare has put our health insurance markets on the brink of collapse in many parts of the country. As I pointed out in an earlier speech, that began in October of last year, which was before the elections. It has nothing to do with what has transpired since the elections. ObamaCare put our health insurance markets on the brink of collapse in many parts of the country, and what the Republicans are tackling now is what President Obama and congressional Democrats simply could not bring themselves to do when they had control, which was to fix the problems they had created. This may be because ObamaCare has enshrined their idea that bigger government is better and that any changes, unless done by Executive action under the President, were out of the question. In their zeal to protect this flawed program, they may have missed it when President Obama himself admitted last year that the law had real problems. He said: There are going to be people who are hurt by premium increases or lack of competition and choice. He went on to say that these problems are simply called ``growing pains.'' Now, these growing pains have forced millions of Americans across the country to grapple with impossibly high health insurance premiums for plans they do not want, out-of-reach deductibles to help with common prescriptions, and disappearing insurance providers to even be allowed to shop for better coverage. As I noted earlier, for more and more Americans, there is only a single insurer from which they can select health plans, and they may soon not have a single ObamaCare insurer, as 50 counties already do not have one, and others are threatened. Thousands only have one choice. In fact, on the Federal exchanges, one in five consumers will only be able to select plans from a single insurer. Many residents across the country will have only one choice of health insurer. This includes my home State of Wyoming, as well as the entire State of Alaska. What does this lack of competition mean? Premiums are surging for hard-working families, who now have to choose between unreasonable insurance rates or an unreasonable fine. If my colleagues wanted yet further evidence that competition lowers prices, they need look no further than their constituent mail. In Wyoming, some families will be forced to pay more than 30 percent of their total income on premiums in order to obtain healthcare coverage, which often includes deductibles of over $1,000. One family faced premiums of more than $1,600 a month. As an alternative, their tax penalty for not carrying coverage was only $1,700 for the year. That is a $1,600-a-month premium charge or a $1,700 penalty for not covering it for the whole year. So guess what they did? They paid the fine because they could not afford the insurance premium, let alone the deductible. I think $5.3 million in fines were collected in Wyoming from the people who could not afford the insurance. They took the lesser alternative of paying a tax penalty, which gave them nothing. For those who are lucky enough to be able to afford insurance, particularly in the individual market, under the new health law, premiums are expected to increase faster in 2017 than in previous years. Some States will see insurance premiums rise by as much as 53 percent. That is in 1 year. We are talking about a 4-year doubling of cost. This will be a 50-percent cost increase in 1 year. That is truly a healthcare emergency. Not doing anything and accepting the status quo is simply unacceptable to millions of Americans suffering under this law. Now that we have discussed why we are doing this, it is important to also ask how we hope to help these suffering Americans. It is vital that we stabilize collapsing insurance markets that have left millions of Americans with no options, while reestablishing the affordability of health insurance. Our bill will also preserve access to care for Americans with preexisting conditions, and it will safeguard Medicaid for those who need it most by giving States more flexibility, yet ensuring that those who rely on this program will not have the rug pulled out from under them--contrary to the scare tactics being put forth by ObamaCare's defenders. Most importantly, Congress is working to free the American people from the onerous mandates to purchase insurance they don't want or can't afford. Congressional Republicans and our President are focused on securing the future of Americans' healthcare system and truly understand the importance of restoring the trust of hard-working taxpayers. What we are doing here under reconciliation, which is a budget process, will not solve all the problems. There will be an opportunity for bipartisan investigation, support, and changes if the other side is willing to do that. There are some things that need to be done immediately to protect the American taxpayers and the people who want to have healthcare. So I ask everyone to focus on securing the future of America's healthcare system and to try to understand the importance of restoring the trust of hard-working taxpayers. Thank you, Mr. President. I yield the floor.