Chuck Grassley

Mr. GRASSLEY

Mr. GRASSLEY. Fifteen minutes.

Mr. GRASSLEY. I will let the Senators speak, and I will speak tomorrow because I have to go to a meeting. I will let the unanimous consent agreement stand.

Mr. GRASSLEY. I cannot keep it to 10 minutes, and I cannot shorten it. So I will let the unanimous consent agreement stand.

Mr. GRASSLEY. Mr. President, if the Senator is asking me that question, I will tell him that he is absolutely right, not based upon what I say or what the Senator says, but every spring the trustees of Social Security and Medicare look ahead 75 years and they predict what the income and the outlays are going to be based upon the population and the projected growth of the economy and all that stuff. Right now, they are projecting $37 trillion of shortfall over that 75-year period of time. They already told us, and it has materialized, that in the year 2008 we started paying more money out of Medicare than was coming into Medicare, and by the year 2017, as the Senator correctly stated, the trust fund will be out of reserves.

Mr. GRASSLEY. In Medicare.

Mr. GRASSLEY. Mr. President, I had a chance to hear a great deal of what the Senator from Alabama said. I think I would highlight that what he said is what he is hearing from the grassroots of his State, which is very much what I hear from the grassroots of my State: people are very concerned about this piece of legislation leading to the nationalization of health care, similar to what they have seen this administration previously do this year with the nationalization of General Motors, partial nationalization of the financial system--a big deficit. And then they see the money being spent on this bill--$2.5 trillion after it gets fully implemented. And where are you going to get money? And what is that going to do to the economy? And, more importantly, what sort of a legacy is that leaving to our children and grandchildren? He also correctly stated that I do visit every county every year. The number of counties the Senator had was just a little bit high. We only have 99 counties. But for the 29 years I have been in the U.S. Senate, I have held a town meeting in each one of our counties every year. So I do have the benefit of 2,871 town meetings as a basis for suggesting what people tell me face to face, besides the large number of phone calls we get. You cannot believe the number of phone calls that are coming in now, the number of e-mails we are getting--historically high. I have never had that before on any issue. I assume it is the same for the State of Alabama, contacting their two Senators as well. Mr. President, I rise to bring up an issue that is a relatively new issue in this debate, as in the secrecy of the negotiations that are going on around Capitol Hill on the issue of health care reform. These secret negotiations actually started about October 2 when Senator Reid, the leader, had to merge the bill out of the Senate Finance Committee and the bill out of the Senate HELP Committee into one bill. It took a long period of time to do that. We are in the second week of debate. I hope people realize that 99 Senators ought to have the same privilege that 1 Senator had of getting a grasp of this huge 2,074-page bill. There are still negotiations going on because the leader still does not have locked down the 60 votes that it is going to take to get to finality. So some of these discussions are: what can we do to get a few votes if we do not have a so-called public option? And the latest of that is: Well, allow people to buy into Medicare. So I want to speak about that issue because it sounds pretty simple. It may get 4 more votes and may get 60 votes, but it is bad. It may be good politically, but it is bad for Medicare and particularly for Medicare in rural areas where we have a difficult time keeping hospitals open, and we have a difficult time recruiting doctors in rural America. So I would talk about the recent news reports of a proposal being concocted behind closed doors to allow 55- to 64-year-olds to buy into the Medicare Program. Supposedly, this idea has been put on the table to get the votes for supporters of having a brandnew government-run health plan and the people who do not like that. Back in the spring, such a proposal came up during the early stages of our Finance Committee's health care reform efforts. The idea was originally proposed by President Clinton even going back to 1998. I opposed such a proposal back then, and I oppose such a proposal now. I oppose the proposal because of its negative effect on the Medicare Program and our senior citizens who use Medicare. The best way to describe the effect of this proposal on the Medicare Program and its beneficiaries is to quote former Senator Phil Gramm of Texas when he was asked about President Clinton's proposal when President Clinton put that proposal on the table back in 1998. Senator Gramm said this about President Clinton's proposal, which would be applicable today as our colleagues are studying it: If your mother is on the Titanic, and the Titanic is sinking, the last thing on Earth you want to be preoccupied with is getting more passengers on the Titanic. Since its inception in 1965, the Medicare Program has helped ensure senior access to health care. But, as the Senator from Alabama and I were just discussing, the problems with health care and Medicare are such that Medicare is already under extreme financial pressure. So why would you load more people into a system that Senator Gramm of Texas was referring to as the Titanic? You would not load more people on it as it was going to sink. This is not to say that this entitlement program, Medicare, is not in need of improvement, but having the 36 million Americans who are age 55 to 64 buy into the program is not an improvement. Even groups supporting the Reid bill, such as the AARP, are pointing out the severe shortcomings of such an approach. Last summer, the AARP Public Policy Institute published an analysis of the Medicare buy-in concept. In their report, the AARP points out the potential for increased Federal entitlement spending. AARP said: Expanding the program to more people could raise federal spending even further if their care is made affordable through subsidies that would be funded by the existing Medicare trust funds. And do not forget the effects of adverse selection from a Medicare buy-in program. Here AARP has studied it, and this is what they say about that: . . . the premium may be too uncompetitive for those who don't use much health care and unaffordable for those with modest incomes. This may limit buy-in enrollment and drive up cost further. So this means that this buy-in proposal is likely unsustainable. And we all know what happens when the government creates an unsustainable new program. What happens? The taxpayers end up on the hook for bailing it out down the road sometime. We all know the Medicare Program has $37 trillion in unfunded obligations. We all know about the pending insolvency of the Medicare Program. The trustees say so every spring. The Medicare hospital insurance trust fund started going broke last year. In 2008, the Medicare Program began spending more out of this trust fund than was coming in through the payroll tax. The Medicare trustees have been warning all of us for years that this trust fund is going broke. They now predict that it will go broke right around the corner in 2017. Well, as the AARP has pointed out, adding millions to the Medicare Program would almost certainly make things much, much worse for the fiscal health of a program that is not in very good financial shape. This proposal would also make things worse for the 45 million Medicare beneficiaries who paid into the program over the years and are receiving benefits under the program. Since we started debate on this 2,074-page bill, Members on this side of the aisle have questioned the wisdom of slashing Medicare by $\1/2\ trillion and then using the savings to start a new Federal entitlement program. We on this side have stressed that provider cuts of this magnitude will make it financially harder for providers to care for beneficiaries. We have pointed out that this will worsen beneficiary access to health care, as providers stop treating Medicare patients. Adding millions more Americans to Medicare on top of the $\1/2\ trillion in Medicare cuts in this Reid bill would make beneficiaries' access to care much worse. But do not take my word for it. Even national hospital associations such as the American Hospital Association and the Federation of American Hospitals are opposing this proposal. They are mobilizing their ranks against this proposal even as I speak. Yes, the same groups that agreed already--and this was back in June--to $155 billion in Medicare cuts--and they did that in an agreement with the White House and got sweetheart deals in this bill-- do not want the Senate to go the route of expanding Medicare for people under 65 years of age. The American Medical Association has also opposed this proposal. These groups recognize the potential for financial disaster by boosting the number of patients with coverage that pays well below cost. This Medicare buy-in proposal would also jeopardize retiree benefits. Going back to the same AARP analysis that I have quoted, they concluded that a Medicare buy-in program could further reduce employer-sponsored health benefits. According to the AARP: . . . a buy-in program might displace retiree coverage now available through [their] employers. Still quoting AARP, they said: As health care costs tend to rise with age, employers might have the incentive to find ways to avoid offering private coverage for early retirees. . . . So with fewer patients with higher paying private coverage, there is less opportunity for providers to cost-shift to make up for low Medicare payments, because everybody recognizes the Federal Government does not pay 100 percent of costs. This would make it even harder for providers to treat Medicare beneficiaries, and as a result, beneficiaries would have an even harder time finding a provider to treat them. I come from a rural State where Medicare reimbursement is already lower than almost every other State in the Nation, so I have serious concerns about the ability of the Iowa providers to keep their doors open if more and more of their reimbursement is coming from Medicare. I know this is a concern that is shared by rural State Members of this body from both sides of the aisle. But losing providers to serve Medicare beneficiaries would only be the beginning of access problems caused by a Medicare buy-in program. Because if you think it would be tough to keep existing Medicare providers, think how hard it would be then to recruit new ones. Provider recruitment is already a major problem in rural States, particularly my State of Iowa. This issue comes up during my meetings with constituents in Washington or during the townhall meetings I hold in each of Iowa's 99 counties every year. It is already a challenge under the current Medicare Program for Iowa to compete for providers with urban areas where Medicare reimbursement is higher. I hear countless stories from constituents where they make great efforts to recruit doctors only to lose them to areas where Medicare reimbursement is higher. The Medicare buy-in will only make this situation worse in my State of Iowa, because more and more reimbursement would come from Medicare. So the current and future Medicare beneficiaries would be assured of limited access to providers because of this buy-in. AARP pointed out another flaw in this buy-in proposal. In their analysis, AARP warned that there are large cost-sharing requirements in Medicare, so buy-in enrollees would still be exposed to significant cost sharing. Maybe these buy-in enrollees would have the resources to purchase supplemental Medicare policies to defray these cost-sharing requirements. Perhaps AARP is thinking of making even more money by selling supplemental policies to these retirees. I share the goal of getting more Americans covered, but expanding the Medicare Program to early retirees is not the answer. Medicare beneficiaries have paid in to this program all these years and rightfully have the expectation to receive the benefits to which they are entitled under the program. The Medicare buy-in proposal would jeopardize these benefits. It would jeopardize existing retiree benefits. It would leave retirees exposed to significant cost sharing. It would be unsustainable and taxpayers would end up footing the bill. I yield the floor.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, today I am offering legislation to make permanent a number of education-related tax relief measures. My legislation also improves and makes permanent helpful provisions for 529 plans and the American Opportunity tax credit for education. At the first hearing I held when I became Chairman of the Finance Committee in 2001, I made clear that education tax policy was a priority of mine. As Chairman, I was able to remove the 60-payment limit for deducting student loan interest and I was able to increase the income limits for that deduction. This was not the only time I fought hard to allow students to deduct their student loan interest. In 1997, I was able to re-instate the student loan interest deduction that Congress had eliminated from our tax laws. However, the 60-payment limit on the deductibility of student loan interest remained. I ensured that the 2001 tax relief bill took care of that problem. Other incentives for education that I was able to enact into law in 2001 included raising the amount that can be contributed to an education saving account from $500 to $2,000; making distributions from pre-paid college savings plans and tuition plans tax-free; and making permanent the tax-free treatment of employer-provided educational assistance. These tax policies and many others, including those for school renovations, repairs and construction, have proven their value to Iowa students in dollars and cents, year after year. The tax relief has delivered measureable educational assistance to Iowans and students and families nationwide, making education more affordable and accessible. One draw-back of enacting these provisions in the 2001 tax relief bill, however, is that there was a sunset provision attached to that entire piece of legislation. All of the tax relief needs to be made permanent. Especially the education-related tax provisions. That is what my bill today does. My bill makes these provisions permanent. It is no coincidence that I am introducing my education tax bill on the day the President of the United States talked about jobs. Our economy demands well-educated workers. The popularity of education tax incentives is good news for workers who find themselves unemployed or who want to go back to school to advance, or even change, their careers. Congress is willing to consider permanent tax relief for companies to buy machinery. Why isn't Congress willing to make an investment in people? That is what tax relief for education is. An investment in our future. It is just as important as job-creating tax incentives for businesses. Some will say we can't afford this, but we really can't afford to lose billions of dollars of help for Americans working hard to educate their kids. Education has made this country great. We should not let this opportunity pass us by. We should not let these education-related tax provisions expire. We should also continue to help make education affordable for families and students. This makes education accessible for all. I look forward to working with my colleagues on passing this bill. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, opponents of the Gregg amendment claim the Reid bill doesn't technically change the law on guaranteed benefits for beneficiaries. But they are ignoring the fact that while those benefits may be ``technically guaranteed,'' if the cuts put health care providers out of business, then those guarantees will be nothing more than useless words in the Medicare Act. Guaranteed benefits are not worth much without health care providers that can treat patients, provide home health services, and run hospitals and hospice agencies. These claims are not good enough to assure seniors who have paid into the Medicare Program for all these years. It is not good enough for protecting access to health care services and the benefits that our seniors have been promised. My colleague from New Hampshire in his amendment would back up those claims with very real enforceable mechanisms to ensure that Medicare savings are not being used to fund a whole new program at a time when the trust fund is just about broke. The Gregg amendment is needed to protect the Medicare Program. After all, if you knew the Medicare Program already had $37 trillion in unfunded obligations, would you be assured without an enforcement mechanism to back up those promises? No guarantee is worth the paper it is written on without an enforcement mechanism to back it up. That is what the Gregg amendment is all about; otherwise, it is just a meaningless guarantee that our friends on the other side of the aisle are talking about. It is not real without an enforcement mechanism. Let me say for a third time, the Gregg amendment provides that enforcement mechanism. It makes guarantees real. It then goes much further than just the words we get from the other side of the aisle to make sure that what seniors have they will actually get when needed. Opposition to the Gregg amendment shines light on this issue. If the Gregg amendment is not approved, it should be clear to everyone watching that all the guarantees that are made from the other side of the aisle that Medicare is protected in the Reid bill are worthless. As a result, I hope everyone will be watching carefully how the other side votes on the Gregg amendment. The Gregg amendment is essential for protecting the Medicare Program. It is essential for making guarantees real. The way the Gregg amendment works to enforce those guarantees is quite simple. The Gregg amendment would make sure the Medicare Program is not used as a piggy bank to spend for other purposes. It would make sure the Medicare Program is not being raided to fund this new program, as the other side claims. Under this important amendment, the Director of the White House Office of Management and Budget and Medicare's Chief Actuary would both be required to add up non-Medicare savings in the bill and compare that total to the total of new spending and revenues in this bill. The Gregg amendment works then that if the non-Medicare savings don't offset all the new costs, then the Treasury Secretary and the Health and Human Services Secretary would be prohibited from implementing the new spending or revenue provisions in the bill. By doing so, the Gregg amendment would ensure that non-Medicare savings are, in fact, paying for the new spending in this bill. It would ensure at the same time that Medicare itself is not being used to pay for new spending in the bill. It is very simple, very straightforward. It brings common sense to this whole argument that has been full of a lot of nonsense before now. The amendment, therefore, would prevent massive government expansion at the expense of Medicare beneficiaries. Massive expansion of government is one thing, if it is paid for, but it is quite another thing if you take the money out of a trust fund that is on its way to being broke and use it to set up a brandnew entitlement program to the tune of $464 billion. As opposed to the mere nonbinding sense-of-the-Senate resolution the other side has offered to pretend to protect Medicare, this Gregg amendment requires action, action that has to be taken to protect the Medicare Program. The Gregg amendment is the enforcement mechanism for the guarantees the other side says they are making to protect Medicare. Slashing Medicare payments to start up another new and, in fact, unsustainable government entitlement program is not the way to address big and unsustainable budgets. Amendment No. 2939 I would like to take a little bit of time to discuss the Pryor amendment. I have always been a strong supporter of transparency. In order to have a successful free market, consumers need to have information. I can't think of any reason, besides my strong objection to the underlying 2,074-page bill, to oppose the Pryor amendment. It is pretty straightforward. It requires that the Secretary of Health and Human Services have a rating system for private health plans. That sounds OK to me. An informed consumer makes better decisions. So I don't object to the Pryor amendment. But I do object to the fact that the Pryor amendment is more proof that this bill is not being crafted out in the open on the Senate floor. The Associated Press has confirmed, based on an e-mail circulated by Democratic staff, that the Bennet amendment of last week to protect Medicare was simply ``a message amendment.'' The New York Times went on to call the Bennet amendment ``meaningless.'' Now we have a Pryor amendment that requires a level of transparency that, in fact, is already required by the bill. If you look at page 134, the bill already describes a rating system developed by the Secretary that consumers can use to choose the right health insurance plan. So if the underlying bill is already doing this, I can only assume this amendment by my friend from Arkansas is specifically designed to buy time so the White House and Democratic leadership can cut deals and twist arms behind closed doors. That is right. The American people need to know this bill is not being written on the Senate floor. In fact, we have a 2,074-page bill before us that took since October 2, until we took it up, for one Senator, the majority leader, to put together. Somehow the other 99 Senators shouldn't have 3 weeks to look at a bill that took well over a month to put together. Then we had the President here yesterday speaking to his caucus. That kind of obviates any efforts to get bipartisan support for this bill. I think it gives further proof that it is not only partisan but that what this final 2,074-page bill is, we don't know yet. They are trying to put together some sort of a group that can get 60 votes to get a bill passed. Do we really know what sort of a Christmas present we are giving to the American people with this health reform bill? I don't think so. I yield the floor.

Mr. GRASSLEY. Madam President, for the benefit of my colleagues waiting to speak, I don't think I will speak much more than 10 minutes. Before I speak on my purpose for coming to the floor to support Senator McCain's amendment, I want to take a couple of minutes to go over a source of information that is no longer credible, which has been used in debate on the floor several times, used throughout the year-- information that has been in letters to the editor of Iowa newspapers. The most recent hearing of this was when the Senator from California rose to talk about the quality of our health care and the reference to the fact that the United States is 37th out of all of the nations of the world in quality of health care. I don't deny we have to do a lot to improve the quality of health care in America. I even admit that in this legislation, though I oppose the bulk of this 2,074-page bill, there is a lot in the bill that has to do with the enhancing of the quality of care. We keep hearing about the United States being 37th in quality. That comes from a World Health Organization analysis that was made back in the year 2000, ranking the United States among all the other nations. It is a 10-year-old report that was flawed in its analysis at the very outset. Yet it is repeated as if gospel truth by almost anybody who wants to denigrate America's health care system and build a case for this monstrosity of a bill we have before us. When I call it a monstrosity, I will say it has some very good provisions in it that would enhance the quality of care. The World Health Organization no longer produces such a ranking table because of the complexities of the task. The rankings were flawed because they judged health care systems for problems--cultural, behavioral, and economic--that are not controlled by health care. There is no differentiation between the quality of medical systems and other factors, such as diet, exercise, and violent crime rates, which ought to be taken into consideration when considering a nation's delivering quality of health care. The editor in chief of this 2000 report of the World Health Organization, Philip Musgrove, called the figures `` . . . many made-up numbers,'' and the result a ``nonsense ranking.'' Dr. Musgrove, an economist who is now deputy editor of the journal Health Affairs, said he was hired to edit the report's text but didn't fully understand the methodology until after the report was released. Once he left the World Health Organization, he wrote an article in 2003 for the medical journal Lancet criticizing the rankings as ``meaningless.'' The U.S. health system spends more than any other country per capita and was ranked 37th out of 191 due to that spending alone. Prior to considering how much we spend, the United States was ranked 15th, not 37th. The Dominican Republic, Costa Rica, and Morocco ranked 42nd, 45th, and 94th before adjusting for spending levels. After the adjustment for spending levels, can you believe it? They ranked above the United States--35th, 36th, and 29th, respectively. The United States ranked first in responsiveness. That means respect for persons and prompt attention. Americans understand and appreciate this quality care. This will be lost in this massive health care reform bill when the government takes more control. Experts in the field of health, such as Mark Pearson, head of health for the Organization of Economic Cooperation and Development, OECD, was quoted as saying: It's a very notorious ranking. Health analysts don't like to talk about it in polite company. It's one of those things that we wish would go away. I hope my colleagues will take that into consideration when they bring up the rationale for this bill, that it is because of that World Health Organization study, which I think what I said and a lot of other things you can say about it ought to put it into proper perspective. For my support of the McCain motion to bring equalization among the 50 States for the Medicare Advantage portions of this bill, I have spent the past 28 years in Congress working to make sure that rural Iowans have access to the same quality of health care as people living in more urban areas. Medicare, since 1965, has been a national program. Well, it is a national program with traditional Medicare. But before we brought equity to Medicare Advantage, it wasn't a national program. It was a program for California, Arizona, Texas, New York, Florida, Chicago, or near the Midwest, maybe Omaha. Since Medicare Advantage was not a national program, and since Medicare since 1965 has been a national program, I set out in the Medicare Modernization Act to bring equity to rural America just as we have in urban America. I fought to make sure that seniors living in rural areas would have the same choices as seniors living in Miami, New York City, or Los Angeles. That is simply saying that wherever you live in the United States, you have Medicare--traditional Medicare. Before then, wherever you lived in the United States, in most rural areas you didn't have Medicare Advantage. Since Medicare is a national program, people living in rural America ought to have the same choice as those in urban America. Today that is the case. Seniors in every county in Iowa have a choice between traditional Medicare and Medicare Advantage. That is a big improvement, since prior to the Medicare Modernization Act not all Iowans had that choice. I can narrow it down to 1 out of 99 counties-- Pottawattamie County, across from Omaha, had Medicare Advantage. The other 98 counties didn't have it. I want to tell you, there are still inequities, because Iowa providers offer high-quality care that leads to less utilization. Iowans get approximately $1,500 less per year in Medicare Advantage benefits than seniors living in Florida. Under this bill, Iowans will see even less in Medicare Advantage benefits. It looks like that won't be the case for some lucky Floridians. In another one of those backroom deals--a backroom deal that seemed to be needed to get 60 votes, backroom deals that are still being attempted to get 60 votes--the Senator from Florida, in one of these backroom deals, was able to secure a provision in the Finance Committee bill that would make sure that seniors in certain Florida counties are able to maintain their current benefits. I am not talking about the so- called guaranteed benefits that Democrats say they are protecting. The provision secured by the Senator from Florida will also protect additional and extra benefits for Floridians. In pushing for this amendment, the senior Senator from Florida said: It would be intolerable to ask senior citizens to give up substantial health benefits they are enjoying under Medicare. I guess Floridians weren't satisfied with the promise that has been made throughout the last 2 weeks of debate on this bill to protect the so-called guaranteed benefits. Seniors in Florida still wanted the lower cost sharing, wellness programs and vision, hearing and dental benefits they have come to rely on. Now we have the Senator from Pennsylvania filing an amendment to help Medicare beneficiaries in Pennsylvania protect their extra benefits, to get these extra benefits that people on Medicare Advantage have. I am guessing that seniors in Pennsylvania must have also picked up on the Democrats' hollow promises to protect guaranteed benefits but not worry about other benefits. In fact, the presence of these special deals is proof that this bill is cutting Medicare benefits. It is even proof that some Senators are worried about going back to their constituents and trying to explain the difference between cutting guaranteed and additional benefits, and explaining why they voted to cut Medicare Advantage benefits by 64 percent. Why else would these special deals be necessary? I am here to ask my colleagues, why should seniors in Florida or Pennsylvania get to keep their extra benefits, while more than 9 million seniors in other parts of the country see an average cut of 64 percent? To quote the Senator from Florida, isn't this also intolerable? My colleagues on the other side talk about efficiency and fairness, but they are supporting a bill that maintains the highest Medicare Advantage payments in the country, while slashing benefits in higher quality rural areas. One of those higher quality rural areas is the State of Iowa, where we are fifth in quality but near the bottom of 50 States in reimbursement on Medicare, whereas other States are fiftieth in quality and No. 1 in reimbursement on health care. All of this doesn't sound very efficient or fair to me. Senator McCain's motion is pretty straightforward. It goes State by State. I am not going to read all 50 States, but it says here that 1 million--it is going to benefit the 70,000 Medicare Advantage enrollees in Arkansas. It is going to benefit the 198,000 Medicare Advantage enrollees in Colorado. In Iowa, it is probably something in the neighborhood of 63,902. It will make sure that seniors in every other State in the country--red States and blue States--get the same deal Senator Nelson got for Florida. A vote for the McCain amendment is simply a vote for equity. But a vote against the amendment is a vote to favor backroom deals that put the interest of a handful of Floridians above 10 million seniors across the country. I urge my colleagues to support all seniors and vote for the McCain motion. I yield the floor.

Mr. GRASSLEY

Mr. GRASSLEY. Madam President, there are a number of issues that this amendment raises. Some are health care-related, most are not. First, this amendment amends section 162(m) of the Tax Code--a tax law intended to curb excessive executive compensation. Unfortunately, section 162(m) has been a disaster. It has encouraged companies to cook up complex design packages so as to avoid the limitations under the law. Actually, excessive executive compensation exploded as a direct result of section 162(m)--which was enacted back in 1993. I have consistently made it clear that the outrageous pay practices of many companies must stop. True pay-for-performance must be the cornerstone of any compensation package. And the boards of directors, compensation committees, and shareholders must all be partners in practicing good corporate governance. We should look to reform section 162(m) of the Tax Code, not add to it. And we should look at whether Congress needs to reform the way corporate governance is practiced. This amendment adds to section 162(m). It does not reform it. This amendment does nothing to empower shareholders to hold the corporation's board accountable. All it does is hurt shareholders by taking money out of the company and giving it to the government. That is right. By limiting a corporation's deduction, shareholders are the ones who are disadvantaged, not the corporation. My friends on the other side of the aisle forget that seniors are often shareholders who rely on dividends and capital gains for income to live on day in and day out. So actually, my Democratic friends are enacting policies that will hurt seniors. All in an effort to show the country that they have it in for the big, bad insurance companies. I also find it interesting to hear my friends say that it is unfair for insurance companies to get a taxpayer funded ``subsidy'' in the form of a tax deduction. First, all corporations are allowed to deduct compensation as a business expense. Big, small, private, and public corporations get this same tax deduction. Are these companies getting a tax subsidy? If so, why not take the subsidy away from them? Now, my friends on the other side may argue that these restrictions are just like those Congress passed in T-A-R-P. And the way the legislation works, they would be correct. But, the executive compensation restrictions in T-A-R-P were conditions for receiving taxpayer dollars. My constituents in Iowa would call them bailouts. Now my friends may argue that health insurance companies are benefiting from their reforms and they should pay their ``fair share.'' They may also say that they are receiving the government-subsidized tax credits for health insurance, which is taxpayer dollars. The main reason why the government is subsidizing health insurance for low-income individuals is because the Reid bill forces people to buy health insurance. If you force people to buy insurance, you have to make sure it is affordable for them to buy. This has forced the government to spend close to $400 billion on these tax credits, which is one of most expensive parts of the Reid bill. And the cost of these tax credits are paid with higher taxes, fees, and penalties on the majority of Americans. Paid by many of those who earn less than $250,000 a year. Data from the Joint Committee on Taxation tells us that 38 percent of tax returns making under $200,000 in 2019 will see a tax increase under the Reid bill. Yet only 8 percent of tax returns in 2019 will be benefiting from the tax credit. That doesn't seem balanced. Finally, this amendment directs the revenue generated from it to the Medicare trust fund. I commend my Democratic friends for crafting policies that would help shore up Medicare. What is interesting is that this bill cuts Medicare. To the tune of $400 billion--that is billion with a B. And the money raised from cutting Medicare is not being directed to help shore up Medicare. Rather, the money is being spent on expanding and creating new entitlement programs. The Joint Committee on Taxation scored this amendment as raising $651 million over 10 years--that is million with an M. So what we have here is $400 billion in cuts in Medicare that is being used for other spending, in exchange for $600 million which would be directed Medicare trust fund. Doesn't seem like a fair trade. Do my friends on the other side feel guilty for using Medicare money for non-Medicare purposes? And to make up for this guilt, they decided to direct non-Medicare-related money to the Medicare trust fund? I will close by saying that my Democratic friends will take to the floor and say that anyone who votes against this amendment is ``in the pockets of the insurance companies.'' I will first tell my friends that they should look in the mirror. Then I will say opposing irrational policies that add complexity to our tax laws is not protecting insurance companies. Let's get on to reforming our health care system, instead of voting on amendments so my Democratic friends can (1) look like they are taking it to the insurance companies, and so they can look like (2) they are helping Medicare solvency.

Mr. GRASSLEY. Mr. President, I rise to speak in favor of the amendment of the Senator from New Hampshire. Because as I have been saying, the people who wrote the excesses of the Reid bill appear willfully ignorant of what is going on in the rest of the economy outside of health care. We are a nation facing very challenging economic times with industries in financial crisis and Federal debt increasing to all-time highs. So we should be considering a bill that would create jobs and prevent this country from being burdened with a bigger and more unsustainable Federal budget instead of this health bill. But instead, we are now considering a bill that cuts half a trillion dollars from the Medicare Program to fund yet another unsustainable health care entitlement program. You have heard from Members on this side of the aisle about how flawed this approach is and how these drastic Medicare cuts will threaten beneficiary access to care. Medicare's chief actuary at the U.S. Department of Health and Human Services has warned Congress in his report that these cuts could jeopardize access to health care for beneficiaries. In fact, a number of Members on the other side of the aisle have made clear that they share our concerns when they joined us to vote in favor of motions to eliminate these cuts. Most of the Members on the other side of the aisle, however, claim that this bill does no such thing. They claim that Medicare money is not being used to start up yet another unsustainable entitlement program that we clearly can't afford. They claim that the Reid bill doesn't technically change the law on guaranteed benefits for beneficiaries. They are ignoring the fact that while those benefits may be technically guaranteed, if the cuts put health care providers out of business, then those guarantees will be nothing more than useless words in the Medicare Act. Guaranteed benefits are not worth much without health care providers who can treat patients, provide home health services, run the hospitals and hospice agencies. These claims are not good enough to assure seniors who have paid into the Medicare Program all these years. It is not good enough for protecting access to the health care services and benefits they were promised. So the Gregg amendment would back up those claims with a real enforceable mechanism to ensure that Medicare savings aren't being used to fund a new program. The Gregg amendment is needed to protect the Medicare Program. After all, if you knew that the Medicare Program already had $37 trillion in unfunded obligations, would you be assured without an enforcement mechanism to back up those promises? No guarantee is worth the paper it is written on without an enforcement mechanism to back it up. Otherwise, it is just a meaningless guarantee. It is not real without an enforcement mechanism. The Gregg amendment provides that enforcement mechanism. It makes the guarantee real. Opposition to the Gregg amendment will shine a light on the issue. If the Gregg amendment is not approved, it should be clear to everyone watching that all the guarantees they are making that Medicare is protected in the Reid bill are, in fact, worthless. As a result, I hope that everyone will be watching carefully how the other side votes on the Gregg amendment. Now supporters of the Reid bill trumpet the fact that their drastic and permanent Medicare cuts extend the life of the program. I agree that we can't ignore the pending insolvency of the Medicare Program. The Medicare hospital insurance trust fund started going broke last year. In 2008, the Medicare Program began spending more out of this trust fund than it is taking in. The Medicare trustees have been warning all of us for years that the trust fund is going broke. They now predict that it will go broke right around the corner in 2017. But rather than work to bridge Medicare's $37 trillion in unfunded liabilities, this bill cuts half a trillion dollars from the Medicare Program to fund yet another unsustainable health care entitlement program. By diverting Medicare resources elsewhere, this bill ignores other major problems in the Medicare Program, like fixing the physician payment flaw with the sustainable growth rate formula, or SGR as it is known. So the few years of extended life this bill would give to the Medicare hospital insurance trust fund is a Pyrrhic victory. Because the drastic and permanent Medicare cuts in this bill will worsen health care access and quality. And the Reid bill leaves problems that have long been vexing Congress like the fatally flawed physician payment formula unsolved. The Reid bill will leave Congress with few options for fixing these problems. So the Gregg amendment is essential for protecting the Medicare Program. It is essential for making those guarantees real. The way the Gregg amendment works to enforce those guarantees is quite simple. The Gregg amendment would make sure that the Medicare Program is not used as a piggy bank to spend for other purposes. It would make sure that the Medicare Program is not being raided to fund this new program as the other side claims. Under this important amendment, the director of the White House Office of Management and Budget and Medicare's chief actuary would both be required to add up non-Medicare savings in the bill and compare that total to the total of new spending and revenues in the bill. If non-Medicare savings don't offset all the new costs, then the Treasury Secretary and the HHS Secretary would be prohibited from implementing the new spending or revenue provisions in the bill. By doing so, the Gregg amendment would ensure that the non-Medicare savings are paying for the new spending in this bill. And it would ensure that Medicare itself is not being used to pay for the new spending in the bill. It is that simple. The amendment therefore would prevent massive government expansions at the expense of Medicare beneficiaries. As you can see, this amendment has teeth. This amendment is real. As opposed to a mere nonbinding sense of the Senate resolution that the other side has offered to pretend to protect Medicare, the Gregg amendment requires action to protect the Medicare Program. The Gregg amendment is the enforcement mechanism for the guarantees the other side says they are making to protect Medicare benefits. Slashing Medicare payments to start up another new unsustainable government entitlement program is not the way to address a big and unsustainable budget. That is why I support the Gregg amendment. And I urge my colleagues to do the same. Vote to protect Medicare. Vote to keep Medicare from being used to fund a separate new program. Vote to keep Medicare funds from being siphoned off. Vote to put in place a real guarantee that Medicare funds won't be used. Vote to back up those promises with real action. I yield the floor.

Mr. GRASSLEY. Mr. President, I had a chance to hear the Senator from North Dakota. I am not rising to speak on that issue right now, but I support him in that effort. I thank him for working with my staff over a period of years to develop a bill that does not violate any of our trade agreements. That is an important aspect of the work of the Senate Finance Committee on which I serve. I look forward to that debate coming up.

Mr. GRASSLEY. I yield.

Mr. GRASSLEY. I thank Senator Dorgan. He gave a very good description just now of how careful this piece of legislation--of which I am a cosponsor--would go not only to make price transparency and price competitiveness much better for the American consumer but to guarantee the same safety we would for drugs imported as we do for drugs produced here. I rise to speak in a generic way about this 2,074-page bill that is before us, to speak about people who have raised questions about whether this bill is or is not a first step toward a government takeover of health care. I take the position that it is definitely a first step in that direction. If you spend a little bit of time watching any of the cable news stations, you will hear someone talking about how the current health reform proposals represent a government takeover of our health care system. The phrase ``government takeover'' has become a common talking point for people opposed to this pending bill. Unfortunately, these opponents rarely explain why this bill warrants such a claim, that it is a step toward government takeover of the entire health care system or the nationalization of health care. Supporters of these bills don't do much better as well. These supporters dispute the claim but at the same time they seem unaware of all the new roles and responsibilities the Federal Government is taking on in this 2,074-page health care reform bill. I want to explain why I see the pending bills as a government takeover of our health care system. I don't come to the floor to scare people or misinform them. I am more than willing to listen to different points of view. But if I am going to use the phrase ``government takeover,'' I want to make sure other Senators--and particularly my constituents in Iowa--know what I am talking about. I wish to start with the simplest example of government takeover, the government-run plan. It is sometimes referred to as the public option. This one seems to be pretty straightforward. In other words, the government-run plan is a pretty straightforward example that people can understand the government getting more involved. If you wonder maybe sometimes why the public at the grassroots is a little bit concerned about the takeover of health care by the Federal Government, remember that it was only a few months ago the Federal Government nationalized General Motors, as an example, and has partially nationalized individual banks and financial institutions--in a sense, taking a big step toward nationalizing the whole financial system with the Federal Reserve system's intimate involvement and the Secretary of the Treasury's intimate involvement in a lot of decision making there or decisions that affect the entire financial system. We are here with the prospect of building upon other things that have happened this year, having the Federal Government take over health care. The public option is one step in that direction. I see a government-run plan, whether it is an opt out, an opt in, a trigger or a straight government plan paying Medicare rates, as this country's first step toward a single-payer system. A single-payer system is a government-run system, one system for the entire country, as in Canada, without options or choices that people have. I don't want you to take my word for it. Let's look at a quote from Representative Jan Schakowsky of Illinois: A public option will put the private insurance industry out of business and lead to single payer. I have another quote by Representative Barney Frank of Massachusetts: If we could get a good public option it could lead to single payer, and that's the best way to reach single payer. Judging by these quotes, I would say both of these prominent Members of the Democratic party agree that the so-called public option is a first step toward government taking over our health care system. But we don't need to rely only upon sound bites. Let me explain why I see the government-run plan leading to a single-payer system. The government- run plan may start out with some rules to keep it from having an unfair advantage over private insurers. Supporters might say it is on a level playing field with private insurers. They may say it would have to pay the same rates, form networks, and be independently solvent. But I remind people, when they hear those promises today, why something the government is doing can be competitive and not unfair competition with the private sector. Those same kinds of promises were made during the Medicare debate way back in 1965. Supporters of the bill in 1965 promised the new government health insurance program would not interfere with the practice of medicine and would pay fair reimbursement rates. But over time, as the costs of the program exceeded projections, the government broke promises it made. The pending bills represent a government takeover of our health care system, because I believe the same thing that happened in 1965 with Medicare, the government breaking its promises, will also happen with the so-called public option. In fact, I want to quote from a recent Wall Street Journal article: Any policy guardrails built this year can be dismantled once the basic public option architecture is in place . . . That is what has always happened with government health programs. Isn't that what Representative Schakowsky and Representative Frank were saying? Start in a very simple way, saying to people the private sector needs competition. Government will give that competition. But start with a government-run plan so you can end up with a single-payer system, regardless of how innocent it sounded when you first started out. Slowly but surely, the government plan would take over the market. This is just one example of why I see the pending bills as a government takeover of our health care system. But there are others. I wish to take a look at some health insurance reforms that are within this bill. All of these insurance reforms aren't bad as separate items. But coupled with all the bad things in the bill, it makes it difficult to sort out the good things. For instance, I support stronger rules and regulations for private insurers. This is within the principle of the Federal Government's constitutional power to regulate interstate commerce, going way back to 1944 or 1945. The Supreme Court ruled that. Then Congress passed the McCarran-Ferguson Act and gave it right back to the States to do, where it has been basically regulated. But this bill brings a lot of that regulation back to the Federal Government. I do support some stronger rules and regulations. Congress should make sure that people are not discriminated against because of preexisting conditions, and people should not have to stay up at night worrying about whether their insurance will be there when they get sick and need it most, just as you wouldn't want your fire insurance on your house canceled at the same time the fire starts in the house. Those are the kinds of reforms I say are good in this bill and could get strong bipartisan support. But the pending bills go much further than creating stronger rules and regulations. First, let's keep in mind that under current law, health insurance is primarily regulated under McCarran-Ferguson at the State level. State insurance commissioners and legislatures set most of the rules. The health reform proposals being debated in the Senate and over in the House would have the Federal Government take over these responsibilities. Under the present bills, the Federal Government, either through the Secretary of Health and Human Services, or a newly created office of health choices commissioner, or an unelected Federal health board is going to decide what health insurance has to look like. What every health plan has to cover is what the Federal Government is going to decide. It is not just a case of ending discrimination. It is a case of the Federal Government saying what that health insurance plan needs to look like. If your current coverage does not meet one of the bronze, silver, gold, or platinum categories set up by the Federal Government--despite the President's promise--you may not be able to keep what you have. The Federal Government is also going to set a national standard for how much insurers can vary prices between younger and older beneficiaries. These reforms will result in drastic price increases, particularly for younger and healthier beneficiaries. This means millions of people who are expecting lower costs as a result of reform will end up paying higher premiums. So the Federal Government will decide how much plans can charge and what benefits can be covered. To help make these decisions, the Federal Government will have a newly created comparative effectiveness research program. This program would be similar to the ones in Great Britain and other foreign governments that decide which treatments you can and cannot have. I want everyone to understand that the principle of comparative effectiveness research in and of itself is not something I oppose because I think when it is used as a way of informing patients and providers about best practices, it is a good thing to have. But I am also worried this research could be used as a tool for government to ration care. Especially the reason for my concern is the recently passed House bill failed to include a prohibition on rationing that was in their original discussion draft. That discussion draft of the House bill, H.R. 3200, stated that the committee should ``[e]nsure that essential benefits coverage does not lead to rationing of health care.'' But, unfortunately, that line was not included in the final bill. Now, that makes you wonder: When everybody says comparative effectiveness research is not going to be used to ration care, then why would you object to a statement saying: ``Ensure that essential benefits coverage does not lead to rationing of health care.'' Why wouldn't that be in the bill if that is what you believe? So under these pending bills, you have the Federal Government telling private plans how much they can charge and deciding what benefits they have to cover. Then the Federal Government is going to tell them-- again, a Federal intervention in health care and a step toward more nationalization--they are not only going to tell them what benefits they have to cover, but then the Federal Government is going to tell you that you have to buy it. Understand, as far as I know, in the 225-year history of our great country, the Federal Government has never said you had to buy anything--buy or not buy anything. They do not tell you. Somebody is going to say: Well, the States make you buy car insurance. Well, under the 10th amendment, the States can do anything they want to that is not prohibited by the Federal Government. But the Federal Government is a government of limited power. So you have the Federal Government saying you have to buy health insurance. But the government takeover does not stop there. The proposed bills also include the biggest expansion of the Medicaid Program since it was created in 1965. The bills force 14 million more Americans into Medicaid, even though many doctors will not see Medicaid patients. Under current law, the government already pays for about 50 percent of health care. But with the new subsidies and massive Medicaid expansion, the Federal Government will eclipse the private market when it comes to paying for health care services. I am sure some of my colleagues saw recently released data from the inspector general showing that about 12 percent of Medicare payments were payment errors that could be the result of fraud, waste, and abuse. It is no wonder then that Medicare is scheduled to be insolvent within the next 10 years. Clearly, the government cannot afford or even manage the programs it has now. But here we are debating the single largest expansion of government health care in history embodied in this 2,074-page bill. So I would like to review why I see the current bill as a government takeover of our health care system. First, there is a government-run plan that will drive private health plans out of business. In fact, some Democratic legislators have said publicly they see it as a first step toward a single-payer system. Second, States will no longer be in charge of their own insurance markets. The Federal Government is going to take over the responsibility of setting premiums and defining benefits. So regardless of whether you are getting your health insurance through an employer or on your own, when you go to buy a new policy, the Federal Government is going to tell you what you can and cannot buy. If you do not buy the coverage the government has chosen for you, you could end up paying a new tax or even end up in jail under this new intrusive health insurance mandate that is going to be enforced by the Internal Revenue Service. Interestingly, an analysis of similar health reform legislation said the IRS would have to grow by 25 percent in order to manage all the new taxes, fees, and mandates. By the way, I have written a letter to the Secretary of the Treasury trying to get exactly some estimate of how much money it is going to take for the IRS to administer this program, and we do not have an answer yet. Finally, we have the single largest expansion of Medicaid since its inception. Current proposals plan to add 14 million people to the Medicaid Program--a program that States already cannot afford. All of this begs the question then: At more than 2,000 pages, and about $2.5 trillion in spending when fully implemented, how can anyone say the pending bills do not represent a government takeover of health care? From the government-run plan, to a Federal takeover of private health insurance, to a massive expansion of Medicaid, I find it hard to call the pending bills anything else. The American people want lower costs, higher quality, and better access. That is clear. I share these goals, but I cannot support any bill that I believe hands our private system of medicine over to a bunch of Washington bureaucrats. That is not what my constituents want, and it is not what this country needs. I yield the floor.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I yield 5 minutes to Senator Coburn.

Mr. GRASSLEY. Mr. President, I yield 5 minutes to the Senator from Georgia.

Mr. GRASSLEY. I yield to Senator Murkowski for 5 minutes.

Mr. GRASSLEY. Madam President, I yield myself 5 minutes.

Mr. GRASSLEY. I rise to tell my colleagues why I am going to vote against the Lincoln executive compensation amendment. This amendment picks out one set of executives in the entire health care arena and singles out that one set of executives for limits on compensation. In the entire health care sector of the economy, this amendment suggests that only one group of executives warrants this sort of special treatment, and that happens to be the executives of health insurance companies. This amendment then takes that excess compensation that apparently Congress knows is the appropriate amount for compensation and devotes that excess money to the Medicare trust fund. Well, a very commonsense question in this town of nonsense is, why not limit compensation for executives in other areas of health care? What about the executives of hospitals? Shouldn't their excess compensation go to protect Medicare? Why not executives of nursing homes then? Why not executives of medical device manufacturers? Why not limit compensation on the people who run home health agencies? Why not limit compensation for doctors? Why not limit compensation for executives at the drug companies? Well, let's wait a second on that one. We know the answer to the one about why not include drug companies. This amendment can't touch drug company executives because their industry cut a secret deal where they agreed to some things in this bill, and they are going to get a huge payoff in profits once this goes into effect, as long as they don't open their big mouth and fight this legislation. Of course, this all adds up because if you are watching TV at home, or even here on the Hill, big PhRMA is running ads all over the country in support of this 2,074-page Reid bill. If the idea is for Congress to set the precedent of limiting compensation to protect the Medicare trust fund, then shouldn't we branch out even beyond the health care industry? We could get a lot of compensation--or we could get a lot of income into the Medicare trust fund by limiting compensation beyond health care to say, for instance, executives of trade associations or union leaders or trial lawyers or baseball players or movie stars. But, no; this amendment focuses on one specific group of executives who weren't going to be bought off by this bill. So let's just call this amendment out for the brazen political stunt it is, and if we do that, vote it down. I wish to remind everyone in closing that I asked the sponsor to include drug company executives in her amendment but was turned down. I yield the floor and yield 5 minutes to Senator Brownback.

Mr. GRASSLEY. Madam President, I yield 10 minutes to the Senator from Texas.

Mr. GRASSLEY. Madam President, I yield the remaining time to the Senator from Wyoming.

Mr. GRASSLEY. Madam President, I yield to the Senator from Alabama 10 minutes.

Mr. GRASSLEY. Madam President, I yield myself such time as I might consume on this side. I listened to the distinguished majority whip. I don't know how many times we on this side have to tell him that if they want to read Republican bills here is an opportunity to come and read them. They do exist and they have existed for a long time, going back to some of their entries into the Senate in the spring. Another thing I heard was that Republicans have no ideas, taking on the insurance companies. I would refer him to the Coburn-Burr bill that does away with the discrimination, that insurance companies cannot deny health insurance because of preexisting conditions. I heard him say we are newfound supporters of Medicare. Let me suggest to him that when we learned from the complaints of his party 4 years ago, when they were berating the fact that we wanted to take $10 billion out of Medicare and how that was ruining Medicare--we are faced now with $464 billion out of Medicare and we think they have talked out of both sides of their mouth, in the sense that 4 years ago, if Medicare would be hurt if $10 billion were taken out, surely if $464 billion were taken out, it is hurting Medicare. I rise not to take on the Senate majority whip at this point but I rise because we keep hearing from the other side about how premiums are going to go down. I referred in previous remarks in this past week to a letter sent to Senator Bayh that provides a very comprehensive analysis of what health insurance premiums will look like as a result of this Reid bill now before us. That reminds me of one other thing the Senate majority whip said, that we want to delay action on this bill. What we want to have is 99 Senators have the time to consider what is in this 2,074-page bill, when you have to remember that in the secrecy of the Senate leader's office, Senator Reid's office, from October 2 until about the Saturday before Thanksgiving, it took that long in secrecy to put two bills together out of two separate committees. That is one Senator putting together the 2,074-page bill we have before us. Don't you think that 99 other Senators ought to have at least that same period of time to consider what is in this bill? I think so. Anyway, getting back to the increase in premiums and Senator Bayh's letter from the Congressional Budget Office saying that premiums are going to go up, I wonder if anyone has actually read that letter. I hear a lot of people saying this letter proves that premiums would go down under the Reid bill, even though that is not what that letter says. So I am here to tell people what the letter says. The letter makes it very clear that premiums will increase on average 10 to 13 percent for people buying coverage in the individual market. I think you saw a specific figure given by the Senator from Texas, that in his State for a large percentage of the individual market premiums would go up, just for people in the State of Texas. I have a chart here in case you missed what this letter actually says. The people who keep saying premiums are going to go down conveniently forget to mention this 10 to 13-percent increase that is going to happen for the individual market. No, they would prefer to talk about 57 percent of Americans in the individual market who are going to get subsidies. Yes, it is true. The Government is spending $500 billion of hard-earned taxpayers' dollars in addition to the cuts they are having in home health care that is a pending amendment before the Senate. These cuts and these tax increases cover up the fact that this bill drives up premiums faster than current law. I repeat, premiums will go up faster under this bill. Supporters of this bill are covering up this increase in costs by then handing out these subsidies. But if you are 1 of the 14 million people who does not get a subsidy--well, what? You are out of luck. You are stuck with the fact that this is 10 to 13 percent more expensive and, coupled with it, an unprecedented new Federal law that mandates that you buy and purchase insurance. Some may say this is the individual market, it only accounts for a small portion of the total market. Again, if you are comfortable, as the other side seems to be, with 14 million people paying more under this bill than they would under current law. I wish to also have you look at the employer-based market. The Congressional Budget Office analysis says this bill maintains the status quo in the small group and large group insurance market. Is this something we ought to be celebrating, maintaining the status quo? Are expectations so low at this point that Democrats are celebrating that this bill will increase premiums for some 14 million people and maintain the status quo for everybody else? I am being generous in using the phrase status quo, because this bill actually makes things worse for millions of people. This bill is so bad that Democrats are trying to convince the American people that this is more of the same when even that is not the case. What happened to bending the growth curve? In other words, the inflation we have historically had in health care costs, going up three or four times the rate of inflation, going up now 8 or 9 percent even when we have deflation in the economy at large? What about the President's promise that everyone will save $2,500? According to CBO, almost every small business will pay between 1 percent more or 2 percent less for health insurance. That means compared to what businesses would have paid under current law, this bill will raise premiums 1 percent or maybe decrease them by a whopping 2 percent. That doesn't sound like this bill is providing real relief, and $2,500 in savings for every American, as President Obama pledged repeatedly during the campaign, is not going to happen. The larger businesses will pay the same or up to 3 percent less for health insurance. Once again, that doesn't sound like relief, it sounds like more of the same. In fact, the Congressional Budget Office has confirmed that between now and the year 2016, premiums will continue to grow at twice the rate of inflation. I thought Congress was considering health reform to put an end to the unsustainable premium increases. This bill cuts Medicare by $500 billion, raises taxes by $500 billion, restructures 17 percent of our economy, spends $2.5 trillion, and some of my colleagues on the other side of the aisle are celebrating that they have achieved the status quo when in fact the situation will be worse. I thought the status quo was not something that was acceptable to most Members of this body. Our constituents want to lower costs. That is their main concern. That is what our constituents begged for, lower costs. But this bill fails to address that concern. It raises premiums and, despite offering new ideas throughout the committee process and on the floor, Republicans are being accused of supporting the status quo when our bills are right here for anybody to look at if they think there are not any ideas we would put forth. The Congressional Budget Office has spoken and it is pretty clear my colleagues across the aisle are not only OK with the status quo, they are OK with making things worse--higher taxes, higher premiums, increased deficits and less Medicare. Just think, we are approaching the Christmas holiday season and a Christmas gift coming from this Senate, with a 2,074-page bill: higher taxes, higher premiums, increased deficits, $464 billion cuts in Medicare and not doing anything about inflation in health care costs. They are celebrating that they spend $2.5 trillion to raise premiums for 14 million people, not bending this growth curve, not cutting costs. Don't take my word for it. You have to read this letter from the Congressional Budget Office. It is there in black and white as evidenced by the chart I have here. I yield the floor.

Mr. GRASSLEY. Regular order.

Mr. GRASSLEY. I yield the remaining time on our side to Senator Thune.