Michael Enzi

Mr. ENZI

Mr. ENZI. Mr. President, I rise in support of Senator Judd Gregg's amendment, which would prevent the Medicare cuts in the Reid bill from being used to pay to create a new entitlement program to cover the uninsured. I do not oppose covering the uninsured. Nor do I oppose reforming the Medicare Program. We should do those things. What I oppose is the Reid bill. This is the wrong approach to solve these problems. The amendment offered by my friend from New Hampshire highlights the main problems with the Reid bill and suggests a better approach. His amendment would protect the savings from the Medicare Program, and prevent them from being used to create a new entitlement. This would mean that this new program would not have to rely on cuts to Medicare to fund its operation. It would also reserve all of the money taken from Medicare so that it could be used to fix the problems in the Medicare Program. Some Democrats have argued that we are not creating a new entitlement program. They are simply wrong. Just like Social Security, Medicare and Medicaid, this bill will commit the Federal Treasury to paying for these new subsidies for the uninsured forever. That means that, as Federal spending continues to grow, this new program will continue to grow. It will crowd out other federal spending priorities, like education and national defense. Any future attempts to modify or restrain its growth will be met by cries of indignation, arguing that cuts would devastate access to health care. If anyone has any doubts, they should look at the transcripts from our debate on the Deficit Reduction Act. In 2005, Congress tried to reduce Medicare spending by about $20 billion and enact modest reforms to the Medicaid Program. These programs would have strengthened the long-term solvency of these programs and helped reduce the Federal deficit. In response, Senator Reid called that bill an ``immoral document.'' The junior Senator from California said she strongly opposed the cuts in the bill, because they would ``cut Medicare and Medicaid by $27 billion.'' Yet today, these same Members and the rest of my Democratic colleagues want to create a new entitlement program that will spend hundreds of billions of dollars. And they would pay for it by cutting $464 billion from the Medicare Program. I believe these facts highlight why we need to adopt the Gregg amendment. I don't believe we should create a new entitlement program, which will permanently obligate our children and grandchildren to pay its costs. If my colleagues insist on doing it, however, at a minimum we need to guarantee that any new program has a stable and reliable source of funding. The Medicare cuts in this bill are neither stable nor reliable. My Democratic colleagues have spoken at length about how the Medicare provisions in this bill will bend the growth of heath care spending. That is unfortunately far from accurate. If you don't believe me, listen to what other nationally recognized experts have to say. According to the New York Times, the CEO of the world renowned Mayo Clinic dismissed the reforms in the bill. Dennis Cortese said the Reid bill only took baby steps towards revamping the current fee-for-service system. The dean of the Harvard Medical School, Jeffery Flier, said that the bills being considered in Congress would accelerate national health care spending. I wish there were more actual reforms in this bill. I applaud some of the efforts that Senator Baucus included that will create incentives for coordinated care and rewarding providers who provide higher quality. I believe those are exactly the types of things that we should be doing to improve the Medicare Program. Unfortunately, the savings from these actual reforms are a few pennies compared to the dollars of arbitrary payment cuts included in this bill. According to the Congressional Budget Office, all of the savings from the various policies to link Medicare payments to quality and encourage better coordination of care in the Reid bill provide less than $20 billion in total savings. In contrast, the Reid bill includes over $220 billion in arbitrary payment cuts to health care providers, including hospitals, nursing homes, home health agencies and hospice providers. The Reid bill also includes an additional $120 billion in cuts to Medicare Advantage plans. Those are not reforms. Instead they represent the best efforts of folks in Washington to guess how much it actually costs real doctors and nurses to provide health care services to Medicare beneficiaries. These cuts are an excellent example of how government price controls work. Medicare does not negotiate payment rates with providers, like private insurers. Medicare uses price controls to set payment rates. Experts in Washington then look at various reported costs, revenues and profits of health care providers and then decide how much we should pay health care providers. I have often said that everyone thinks they know everything about a business, until they actually have to run it. As a former small business owner, I want to assure them, it is actually a lot harder than it looks. The Medicare cuts in this bill are based on the efforts of folks in Washington to decide how much it costs to run a nursing home in Cheyenne or a home health agency in Gillette. Based on their past track record, I don't have much confidence in their abilities. In 1997, Congress passed the Balanced Budget Act. It contained over $434 billion in Medicare payment cuts. Lots of really smart folks in Washington made arguments similar to those we are hearing today about how these cuts would not harm providers or beneficiaries. What happened after these cuts went into effect? Within two years, these cuts had driven four of the largest nursing home chains in the Nation into bankruptcy. Vencor, Sun Healthcare, Integrated Health Services and Mariner Post- Acute Network all filed for bankruptcy. Between them, they operated 1,400 nursing homes that provided care for hundreds of thousands of Medicare beneficiaries. Similarly, the bill also included cuts in payments to Medicare + Choice plans. After these cuts went into effect, one out of every four plans pulled out of the Medicare Program. Millions of beneficiaries then lost the extra benefits that these plans had provided. Given this track record, I have grave concerns about what the Medicare cuts in the Reid bill would do to Medicare beneficiaries and the doctors, hospitals and other providers who treat them. I have even greater concerns about using any estimated savings from these cuts to fund this new entitlement program for the uninsured. That is why we should pass the Gregg amendment. Rather than relying on cuts that could devastate the Medicare Program, let's find a stable and reliable funding source that we could use to pay for health care reform. The Gregg amendment says that savings from any Medicare cuts should be reserved for the Medicare Program. That way, if the Washington experts again got it wrong, we will not have already spent all the savings on another program.

Mr. ENZI

Mr. ENZI. Madam President, first, I ask unanimous consent that an article that was discussed earlier and had some objection to it--but that objection has been resolved now--from FactCheck.org be printed in the Record.

Mr. ENZI. Madam President, I yield 5 minutes to the Senator from Maine.

Mr. ENZI. Madam President, how much time do we have?

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

Mr. ENZI. That would be fine with me, and I would even allow the Senator from Minnesota to go first. I would use the same amount of time he uses.

Mr. ENZI. Madam President, how much time do I have?

Mr. ENZI. Madam President, the agreement was that whatever time he took, our side would get.

Mr. ENZI. Thank you. Madam President, the first thing I wish to do is mention that some of these things are facts, particularly if you go to specific situations. In Wyoming, our home health care is a specific situation, and we have had letters pouring in. I have one here from the Home Health Care Alliance of Wyoming, and I ask unanimous consent that it be printed in the Record.

Mr. ENZI. Madam President, the letter says: Over the past 10 years the Medicare home health benefit has taken a larger hit in spending reductions than any other benefit. As home health has become an increasingly important part of our health system with highly skilled and often technically complex services that enable millions of senior citizens and disabled Americans to avoid being hospitalized or admitted to nursing homes, these home health services save Medicare millions of dollars each year. I believe that further reduction in home health payments will place the quality and availability of home health services at risk. I urge you to oppose the cut in Medicare dollars for home health agencies throughout our Nation. The New York Times today pointed out that in the Reid bill: Home care would absorb a disproportionate share of cuts. It currently accounts for 3.7 percent of the Medicare budget, but would account for 9.4 percent of the cuts in the Senate bill according to the Congressional Budget Office. That is from the New York Times. The last time Congress made similar cuts was in the Balanced Budget Act in 1997 when about 15 percent of home health agencies ended their participation in Medicare. So there is a history on this that shows that if we do what we are talking about doing here, we will put people out of business and we will put an end to services to seniors and the more rural----

Mr. ENZI. Sure.

Mr. ENZI. Reserving the right to object, and I will not, I wish to make a clarification that you wouldn't object to a couple of people without alternating so that we can have a couple of people who also go without alternating. Hopefully, we can make some arrangements on the time. I would like a provision that if one goes longer, the other side can go longer too. With that provision, I have no objection.

Mr. ENZI. Madam President, I yield time to the Senator from Nevada.

Mr. ENZI. Mr. President, reserving the right to object, would it be possible for the Senator from Arizona to do a 5-minute speech and then the Senator from New Jersey do his speech?

Mr. ENZI. I am willing to let her go as well, and we will make up the time on our side after that.

Mr. ENZI. The Senator from Arizona, the Senator from New Jersey, and then the Senator from Michigan.

Mr. ENZI. Mr. President, I have found this afternoon to be very interesting. We have actually two debates going on at the same time, and sometimes they do not seem very related, but they are. One of the amendments we are debating is the one authored by the Senator from Arkansas, and it limits the deductible compensation for insurance executives to $400,000. Then we have the Ensign amendment which suggests that we should do the same for lawyers bringing junk lawsuits, although it doesn't go quite as far or is not quite as unreasonable in that it only limits it as a portion of the lawsuit. Of course, one of the reasons being given on the Senate floor for supporting the amendment of the Senator from Arkansas is that Republicans are funded by insurance companies. Well, I have to object to that kind of wording. We could make a lot of insinuations about who junk lawsuits are being supported by and where the money from those folks goes. The Democrats say: Well, the evidence is that the insurance companies are putting so much money into defeating this piece of legislation. Well, I found out the pharmaceutical industry is now so firmly in the President's camp that it is developing plans to spend $150 million promoting the plan on TV. That certainly makes me kind of curious as to why the Arkansas Senator did not include executives of pharmacy companies in her piece of legislation. Mr. President, I don't begrudge anybody anything that they make, but I do find it interesting that the CEO of Abbott Laboratories makes $28 million, the Allergan CEO makes $14 million, the CEO of Bristol-Myers Squibb makes $23 million, the CEO of Eli Lilly makes $12 million, the CEO of Johnson and Johnson makes $29 million--the Senator from New Jersey was mentioning these things, so I checked--and the CEO of Merck, which is New Jersey based, makes $25 million; the CEO of Pfizer, $15 million; Schering-Plough, $18 million; Valeant Pharmaceuticals, their CEO makes $20 million; and Wyeth Pharmaceuticals' CEO makes $25 million. Why would we want to leave these people out of the same formula? Is it because they are taking the side of passing the bill as opposed to the side of opposing the bill and informing the people? We ought not to be about that sort of thing. Mr. President, I ask unanimous consent to have printed in the Record an article from CBS News titled, ``White House & Big Pharma: What's the Deal?''

Mr. ENZI. Mr. President, I am sorry the Senator from Minnesota finished his presiding in the Chair. I will still address the question to him--I did not expect him to give me an answer at the moment anyway--because he said there was a 428-percent increase in profits for the insurance companies. I didn't quite get what the dates were, but he was talking percentages. As the accountant, I like to talk dollars. I would like to know what those dollars were from that first year to the final year because, for example, if a person makes $1 in the first year and in the last year cited they make $5.28, that is a 428-percent increase. If you start with the low number of zero, you can have an unlimited--or infinity--increase in whatever year you pick after that, if they even make a penny. So percentages can give some bad numbers. Also, the Senator from New Jersey was talking about administrative costs, and so was the Senator from Minnesota. I would like to get the figures from Minnesota to see how that is working--to have a limitation of 91 percent of all insurance money going to evidently pay claims-- because I am not aware of the administrative costs being quite that low in almost any business. Again, as the accountant, I find that most people--and when I say most people, I would include my colleagues-- think most businesses are pretty simple. But when I visit one of those businesses, and I learn a little about it, I find that when I scratch the surface, there is a lot going on that the average person out there couldn't handle. Some of that shows up in the legislation that we do. For instance, Cash for Clunkers. That was supposed to be a 4-month program. We ran out of money in 4 days. That shows how much we knew about the car business. So when we are talking about these different things, I got involved with some of these administrative costs when I was working on health plans. I did small business health plans, and that is something that has been rattling around here for about 12 years. It still is, and now it is 15 years. Now, how that works is that it allows small businesses, through their associations, to group together to form a big enough pool so that they can effectively lobby against insurance companies or negotiate with providers. They can make these associations across State lines, even make them nationwide if that will work better. Presently, they have to do it within their own State. That is the law that we have set up. But I found an example of one in Ohio that is very successful. It works well. That is kind of how I modeled my small business health plan. When I did small business health plans, I was taking on the insurance companies. They were pretty upset that I was doing anything in that area, and they joined with some other people to keep me from getting cloture on the motion to proceed to the debate on that. So I know how tough health care is to move along. But Ohio has that association within its State boundaries, and it works because they have a huge population. We have less than 500,000 people who live in Wyoming, and so if you break that down by associations, it would be small pools, and you don't get the actuarial value out of it that you would if you go to a big population. But in Ohio they can do it within the State, and in Ohio they did do it within the State. It brought down the cost of health insurance. It brought down the cost. Now, not only that, the biggest savings was actually in administrative costs. It costs a lot more to keep track of all of the claims and everything from a small business than it does from a big business. The bigger the pool, again, the more capable you are of handling unusual situations. But administrative costs came down from 37 percent to 12 percent, which is a 25 percent savings. Every business would like to have that. But that is how much it costs to administer small ones, so that is why they wanted to group together to form associations to form this bigger pool, which we haven't been able to do. I would ask the Chair how much time I have remaining?

Mr. ENZI. I do want to make some quick comments about the junk lawsuits. We do have to do something about that. When I am talking about junk lawsuits, I am talking about a bunch of them being filed these days that are $25,000, $45,000, $95,000, or whatever is less than what it would cost to defend that lawsuit because if it is less than what it would cost to do the lawsuit, the insurance company is going to say: Let's just pay them and we will be saving money. It is bad precedent and it leads to more junk lawsuits being filed. It is interesting to note that both lawyers who are with the insurance companies and lawyers who are with the people who have been harmed don't want to have tort reform. That kind of surprised me. Then I thought: Well, they probably learned a lot of this in law school. In law school they probably are taught how important it is to somebody's retirement. Then I remembered the Old West and the story about how when one lawyer comes to town, he is broke. But if they can get two, they can both make a good living. It does take lawyers on both sides working these lawsuits, and it does amount to a lot of money. So we do have to do something, particularly in the medical area, because we could save $45 billion a year if we were to have something done about junk lawsuits, particularly with OB-GYNs. We are losing all of them in Wyoming, and it is because there is such a long tail on it. Somebody can sue for 18 years after they are born. So the OB-GYNs have to pay a lot longer insurance tail than that. We had one dramatic case of a doctor attending a basketball game in Douglas. The reason he chose to announce his retirement is because he couldn't afford the insurance he had to pay. The reason he did is because he had birthed almost every kid on both teams. So the mothers there don't have OB-GYN help as a result of his retirement, simply because of what it cost him for insurance.

Mr. ENZI. I thank the Chair, and I yield the floor.

Mr. ENZI

Mr. ENZI. Yes, Mr. President, I wish to speak.

Mr. ENZI. Mr. President, it is my understanding that I would be in charge of the next 30 minutes and then it would revert to the other side for 30 minutes after that.

Mr. ENZI. It is also my understanding that at any time there is an agreement to vote, we will cancel out what we are doing. But there is no agreement yet. I thank the Senator from Connecticut for setting up my speech so well. He said there was not anyplace that anybody can show any decline in guaranteed benefits. With what I am about to say, I will try to do that. Of course, the words ``guaranteed benefits'' do not show up anywhere in what we are doing. ``Benefits'' does but not ``guaranteed benefits.'' In my opinion, getting to be in a nursing home or being able to see a doctor, some of those ought to be considered guaranteed benefits. I will get into that a little bit in my speech and cover some of these areas that I think are very important to seniors. I am opposed to the $\1/2\ trillion of Medicare cuts in the Reid bill that are not going only to solve Medicare. Some of my Democratic colleagues have attempted to argue this bill does not cut the Medicare Program. They further said that such cuts are justified and will not harm the program. They have also argued that no beneficiaries will lose their benefits--their guaranteed benefits. They are very careful on that, and I understand why they are careful on that because there are other benefits that are being cut that will be considered by those people who will lose that benefit to be a guaranteed benefit. Unfortunately, all of those statements are false. It does not matter how many times my colleagues repeat these claims, they do not become any more accurate. This bill cuts $464 billion from the Medicare Program. It slashes payments to hospitals, nursing homes, home health agencies, and hospices. These are cuts to the Medicare Program, and I even have the page numbers on those. The moneys from these cuts do not go to shore up Medicare. The money goes to new programs for others. These cuts will affect the care provided to Medicare beneficiaries. The American Health Care Association, which represents nursing homes, said the cuts in the Reid bill would force layoffs, lower salaries, reduce benefits, and ultimately would hurt patients' quality of care. A commission was set up to make even more cuts to save Medicare. It is in the bill. There is a commission in there. So with the side deals that have been made with lobbyists, the only place these cuts can come from is from seniors. I will cover that in a little more detail later. I have heard similar statements from home health providers, that is more than $40 billion in cuts; hospice providers, which is $8 billion in cuts; and hospitals, which is $130 billion in cuts. If these Medicare cuts go into effect, it could drive many providers out of the Medicare Program. That will mean patients do not have the care they expect and they need. Some of my Democratic colleagues have accused us of trying to scare Medicare beneficiaries. If seniors are scared by our statements, they should be terrified by what the administration has to say about the Democrats' health reform bill. The administration's own chief actuary, Richard Foster, recently wrote that the steep Medicare cuts in the House-passed health reform bill would make it difficult for many providers to remain profitable and cause them to end their participation in Medicare. He went on to note this could jeopardize Medicare beneficiaries' access to care. As the senior Senator from Tennessee noted yesterday, it is the Medicare cuts in the Reid bill that are actually scaring seniors. Medicare beneficiaries understand that if providers are no longer able to take Medicare patients, they--the seniors--will not get care. A lot of grandmas and grandpas have figured it out, and they are not going to stand for it. The chairman of the Finance Committee has repeatedly said this bill will not cut or reduce any guaranteed Medicare benefit. That statement seems to ignore what this bill will do to providers. If a Medicare patient cannot get into a nursing home, they do not have nursing home benefits. If they can't find a home health aide willing to take Medicare patients, they do not have home health benefits. So the promise for coverage, when you can't get a doctor to see you, is not health care. You don't have benefits if you can't get a provider to treat you. Unfortunately, that is exactly what this bill will do. Some of my Democratic colleagues have also attempted to justify the Medicare cuts in the Reid bill by arguing that many of the trade associations representing health care providers have endorsed this bill. They are correct that several Washington-based trade associations and their lobbyists have endorsed the Reid bill. It is probably worth exploring why some of the groups have chosen to endorse this legislation. In some cases, motivation is obvious. Some drug manufacturers are clearly motivated by self-interest and greed. They negotiated a secret deal with the White House that will actually increase what Medicare spends on brand-name drugs--brand-name drugs. They didn't touch the generics. They are interested in the brand-name drugs. Under the terms of their deal, the drug manufacturers will provide discounts on brand-name prescription drugs when the seniors are in the Medicare coverage gap--known as the doughnut hole. They make the payments directly to the customer. It doesn't go through Medicare but directly to the customer. That way they can maintain the customer contact and keep them addicted to the brand name. Generics are cheaper. A lot of people, when they go to the doughnut hole, switch to generics because that saves them money, and it saves us money. When they get through the doughnut hole, they will stay with whatever they are on while in the doughnut hole. So if they are forced to stay on a brand name to get a little extra discount as they go through the doughnut hole, they will stay with the brand name when the taxpayers are paying for it when it goes above the doughnut hole, which is the rest of the year. That could be a huge number. So while it looks generous by the drug companies, beware; their generosity is suspect with what they will make when it gets through the doughnut hole. Under the terms of the sweetheart deal between the White House and the drugmakers, discounts are provided for these brand-name drugs. This will encourage seniors to continue to get those more expensive drugs, and it will actually cost the taxpayers $15 billion because the deal will actually increase Medicare costs. In other cases, provider groups were promised special deals if they agreed to support the Reid bill--or whatever bill we were working on at that time. For instance, recent press reports have described how the American Medical Association was promised a permanent fix to the Medicare payment formula for doctors if they agreed to support this bill or a 1-year fix if there was an end to junk lawsuits. Under current law, doctors' Medicare payments are scheduled to be cut by more than 40 percent over the next decade. That is already in place. That is not a part of the bill. The cost of fixing the flawed government- mandated formula will be more than $250 billion. We know that because we have debated it on the Senate floor, and we decided we were going to have to pay for that if we were going to do it. So let's see, $464 billion in Medicare money we are using on other things. That is why I keep saying Medicare money only ought to go to Medicare benefits, and that $250 billion for the doctors' fix might make it possible for people to see the doctors. I can understand why doctors want to fix this flawed government price-control system--and that is what it is because they are telling the doctors what they can charge a customer, regardless of how long a time it is going to take them to take care of that patient. For a lot of them, they have discovered it costs more than what they are able to get. If they continue to do that, they have to go out of business. That is kind of the small business philosophy: You take in less money than what it costs to be in business, and you are out of business. So I don't think they like that kind of a government price-control system. As a result, 40 percent of the doctors will not take a patient on Medicaid, and it is growing in percentage now on Medicare in the same way. When you fix the price, some people can't afford to provide it for that, so they can't take those patients. I was talking to a friend of mine from Florida who said: Every time you call a doctor now, they say: Are you on Medicare? If you say yes, they say: We are not taking any new patients. If you can't see a doctor, you don't have a benefit. It shows the exact problems that result from letting government bureaucrats use price controls to set payment rates. What I don't understand is why the AMA continues to support the bill when they got nothing for their deal. We didn't fix the $250 billion problem, and we haven't fixed the junk lawsuit problem. I remember the President appearing at the National Convention of the American Medical Association and promising that there would be tort reform; that there would be an end to these junk lawsuits. All of our attempts, either in the HELP Committee or in the Finance Committee, to even bring that up have been either voted down or denied. As a result, there is nothing in this bill that is going to solve that problem. The bill does nothing to fix the Medicare payment formula for the doctors. Instead, it cuts $464 billion from Medicare and uses that money to cover the uninsured. Even if these cuts can be made without hurting seniors, the Republicans are saying: Use the money only for Medicare. Medicare money for Medicare. Medicare funds should be used to fix Medicare's problems, such as this flawed payment formula that keeps doctors from taking seniors. Taking hundreds of billions of dollars out of the Medicare Program now will only guarantee that it will be much harder to permanently fix the doctor payment issue in the future. I cannot understand why the AMA continues to support this terrible deal for doctors. If you can't see a doctor, your benefits--your guaranteed benefits--have been cut. Apparently, the members of the AMA don't like the deal either. At a recent convention, up to 40 percent of the current membership of the AMA voted to reject this deal. I know that is not a majority, but most associations survive by consensus agreements. That means almost all of their membership agrees with the tack they are taking, not just slightly more than half. Their membership is less than 20 percent of all doctors. It is a dwindling association. Let's see, less than 20 percent of the doctors had 40 percent that opposed it. We are getting down to some pretty small percentages of those who supported what the AMA did in their deal. Finally, many provider groups have been reluctant to speak out against this bill because they have received threats from the White House and congressional Democrats. Nursing homes, home health agencies, and hospice providers have all reportedly been threatened with further cuts--further cuts--if they speak out against the bill. Is that freedom of speech, or is it just bad ethics? They have reportedly been told that any public statements of opposition to the Reid bill will lead to even more severe cuts. These providers have had to make the choice to silently accept devastating cuts rather than oppose them and risk being utterly destroyed. One of the Medicare Advantage providers is Humana, and I will use them as an example. CMS said they couldn't let their customers know what was about to happen, and chastised them for sending out a letter. I thought the customer deserved to know and that we were in a new era of transparency. That doesn't sound very transparent to me. So how can that happen in America? At any rate, I hope my colleagues and the American people will take these facts into account when they hear Senators talk about provider groups supporting this bill. Unfortunately, health care provider support for this bill is being driven primarily by greed or stupidity or fear. We know this bill will not fix the problems in the American health care system. It will not lower health care costs. It will not lower insurance premiums. It will still leave 25 million people uninsured. What this bill will do is spend $2.5 trillion and guarantee a much bigger role for the government in dictating how health care will be provided in this country. If you are not under Medicare, yes, your government is going to tell you what is adequate coverage, and they are going to force you to buy it or pay a penalty. Given the recent experiences that doctors have had with Medicare price controls, this is not an outcome that bodes well for America's health care providers or their patients. I remind everybody that in August there was an uproar, and that uproar continues. We don't notice it as much because we are not going to get to go home this weekend to talk to our constituents. That might be by design because we already know what our constituents are saying. They are saying: This bill is a bad deal for us. Where is the promise that you were going to cut costs for us? Where are the other promises that were made with this health care reform? I would mention that the CBO found that premiums in the individual market will rise by 10 to 13 percent more than if Congress did nothing. That is CBO. Family policies under the status quo are projected to cost $13,100 on the average, but under this health care bill it should jump to $15,200. That is not very good news for the people in my State or any other State. No big cost rise in U.S. premiums is seen in the study, said the New York Times. The Washington Post declared: Senate health bill gets a boost. The White House crowed that the CBO report was more good news about what reform will mean for families struggling to keep up with skyrocketing premiums under the broken status quo. The Finance chairman, the Senator from Montana, chimed in from the Senate floor that health care reform was fundamentally about lowering health care costs. Yes, lowering costs is what health care reform is designed to do-- lowering costs. But then he said: And it will achieve this objective. Except that it won't. CBO says it expects employer-sponsored insurance costs to remain roughly in line with the status quo. That is the failure of this bill. Meanwhile, fixing the individual market is expensive and unstable, largely because it does not enjoy the favorable tax treatment given to job-based coverage. You know, if you are buying insurance on your own, you are not getting a tax break on it. If companies buy insurance for the people working for them, they are getting a tax break. In my 10 steps to solving health care, I mentioned and worked on making that fair. You have to be fair for both sides. The Wyden-Bennett bill concentrates on making it fair for both sides. That is one of the issues people in this country are concerned about, making it fair for both sides. This bill doesn't make it fair for both sides. Talking about fixing the individual market, that is expensive and it is largely unstable, I will say again, due to the favorable tax treatment given to job-based coverage which was supposed to be the purpose of reform. But CBO is confirming that new coverage mandates will drive premiums higher. Democrats are declaring victory, claiming these high insurance prices don't count because they will be offset by new government subsidies. About 57 percent of the people who buy insurance through the bill's new exchanges that will supplant today's individual market will qualify for subsidies that cover about two-thirds of the total premium so the bill will increase cost but then disguise those costs by transferring them to taxpayers from individuals. Higher costs can be conjured away because they are suddenly on the government balance sheet. The Reid bill has $371.9 billion in new health taxes that are apparently not a new cost because they would be passed along to consumers. Or perhaps they will be hidden in lost wages. This is the paleoliberal school of brute force wealth, redistribution and a very long way from the repeated White House claims that reform is all about bending the cost curve. The only thing being bent here is the budget truth. Moreover, CBO is almost certainly underestimating the cost increases. Based on its county-by-county actuarial data, the insurer WellPoint has calculated that this bill will cause some premiums to triple in the individual market. I don't go by WellPoint, I go by what I found out in Wyoming itself and that is an accurate picture, particularly for the young people in our State. Those who are young and healthy will see a 300-percent increase. I think they are going to notice that. I don't think they are going to be happy with it. Other associations have come to similar conclusions. The reason for that is the community rating, which forces insurers to charge nearly uniform rates regardless of customer health status or habits. Habits is an important one on that. CBO does not think this will have much of an effect, but costs inevitably rise when insurers are not allowed to price based on risk. That is why today some 35 States impose no limits on premium variation and 6 allow wide differences among consumers. That is not just WellPoint that is saying that. I have some peer- reviewed documents that also show that same thing from people from different colleges. They have found that the State community rating laws raise premiums in the individual market by 21 percent to 33 percent for families and 10 to 17 percent for singles. In New Jersey, which also requires the insurers to accept all comers, so-called guaranteed issue, premiums increased by as much as 227 percent. Let's see, we just had some elections in New Jersey and things didn't go well there. It probably wasn't just tied to insurance costs. The political tragedy is that there are plenty of reform alternatives that would reduce the cost of insurance. According to CBO, according to the Congressional Budget Office which we quote a lot, they did an evaluation on the relatively modest House GOP bill. The Republicans in the House were limited to one amendment. There were three amendments total in a 1-day debate and passage of the health care bill over there. That roused a lot of people in America, too. If you only get one amendment, they had to do what we have avoided doing. We have four different bills out there that solve what the President said he wanted solved. That is not counting the Wyden-Bennett bill that also solves what the President said, that is not included in this bill. What the House put together--it is relatively modest, but it would actually reduce premiums by 5 percent to 8 percent in the individual market in 2016 and by 7 to 10 percent for small businesses. It would not increase the premiums, it would decrease the premiums. The GOP reforms would also do so without imposing huge new taxes. We have concentrated in the last few days about talking about the Medicare money that is being stolen to provide for the changes. We have not talked yet about the extra taxes that are going to be put into place. That is the other half of the package. But the Democrats do not care because this bill, they say, is about lowering costs. No, it is about putting Washington in charge of health insurance at any cost. I see the Senator from Wyoming is here. We have 10 minutes remaining on our time. If the Senator wishes to make some additional comments? He and I have been traveling in Wyoming.

Mr. ENZI. I yield the time to my colleague.

Mr. ENZI. That is the way I read it. That is the way the people in Wyoming are reading it and that is apparently the way people all over the country are reading it, particularly seniors. Seniors are the ones upset about what is happening and it is easy to see why. Even though the AARP says this is a good bill, they are saying: Wait a minute. I know people in the nursing home. I know people--some of them are saying I am in the nursing home. I am hearing what is going to happen at my nursing home if these cuts go into place. As I said continually, we can call them anything we want but the seniors are saying those are cuts. Those are cuts in my benefits. Those are cuts in what I expect. Those are cuts in what I have been getting. Whether you call it guaranteed benefit or just plain old benefits or whatever it is, they are saying, yes, we are being cut.