Johnny Isakson

Mr. ISAKSON

Mr. ISAKSON. That is correct. Social Security is another example of what happens when you don't have good fiscal discipline. Unfortunately, for the better part of half a century, when people have paid their FICA taxes to go into the Social Security trust fund, it goes in and then immediately it is replaced by an IOU and the money is moved to general appropriations and spent. That is why Social Security is going broke in 2037. I just got my statement last week, and on the cover--everybody ought to read their Social Security letter, the column on the right-hand side which tells you what the trustees are telling you about the solvency of Social Security. We cannot make any more hollow promises to the American people. We have to keep the promises we have made, and those promises are Medicare, Social Security, and Medicaid. So instead of expanding things we already can't afford, we need to be finding ways to stabilize them before we run off and make a promise we can't keep.

Mr. ISAKSON. The American people understand. This colloquy has been helpful to demonstrate something, I say to Senator Alexander. We on the Republican side have been accused from time to time of being obstructionists on health care reform. I think we indicated this morning we have been instructive, going on a step-by-step basis, dealing with the problems manageable one at a time, not sacrificing Social Security or Medicaid or Medicare, not sacrificing our States and forcing them into the impossible position of declining revenues and increasing costs through a mandated Federal program that, in the end, is only going to result in rationing of care to Medicaid-eligible beneficiaries and more and more pressure on our States already. We are not trying to obstruct anything. We find it very instructive that there are ways, on a step-by-step basis, that we can close the gap on the number of uninsured people without taking away the benefits others have. I thank the Senator for allowing me the opportunity to participate in this discussion. We are learning from our Governors. I have learned from my townhall meetings and from my visits in Georgia. We understand America is tuned in and a lot of America, 16 percent of it, needs attention for more affordable, accessible health care. Let's be about the business, on a step-by-step basis, of providing that and closing that gap without threatening to destroy the programs we have established over the years and promised to our seniors and to those less fortunate.

Mr. ISAKSON. I will tell you a little story that happened in the month of August that is indicative of what is going to happen in Medicaid services if we have the continuing pressure. I was in Forsyth, GA. It is about halfway between Macon and Atlanta. I had done a speech at the Law Enforcement Training Center and decided to go into the local sandwich shop in downtown Forsyth and have a sandwich and greet people and say hello. I had greeted people and said hello. There were about 10 of them in the room. I went up to get my sandwich. When I came back this lady had circled all the tables around and saved a seat for me, and said: Senator, we are going to have a townhall meeting. They started talking to me about their concerns. Toward the end of the meeting, one gentleman at the end of the table finally said: Senator, I want to tell you a story. I am a pediatric ophthalmologist. I am the last pediatric ophthalmologist who takes Medicaid patients. He said: I just want to tell you what is happening because of the pressure on Medicaid expenses. He said: I have a child right now who has a condition where if it is not addressed, the child will go blind. There is a medicine, it is very expensive, but it can restore the cornea and the lens and help that child to be able to see. We have submitted it three times to Medicaid, and they will not pay it. It is the only drug. There is not an option. There is not a generic substitution. It is one of the breakthroughs. So what we have already going on in health care and in our entitlement programs, but in particular in Medicaid, is we try and manage the expense by lessening the amount we reimburse. The unintended consequence of that is we lose physicians who finally say: I am just not going to take Medicaid patients anymore. Then, the ones who finally are doing it, then we start to see what they submit as a treatment not being approved for reimbursement. So the unintended consequence of putting even more pressure on the Medicaid system is going to put more pressure to ration health care for all Medicaid patients, and that is not fair nor is it right.

Mr. ISAKSON. It is interesting the Senator talked about that. By the way, his experience as Governor was a great experience for Tennessee, and the Senator's leadership in education was phenomenal. But already with the restricted economy we have today and the recession in my State, our teachers this year are having to take a minimum of 3, and at the university system a maximum of 6, furlough days without pay just to try and meet the balanced budget. Part of that is the pressure of Medicaid, which is an entitlement. We cannot decide to just not pay Medicaid, we have to do it. It is a Federal law; the State has to run it. What the States are having to do this year--my State of Georgia and I think the State of Tennessee has probably experienced some of the same thing--they are having to cut back on other programs in order to still manage Medicaid. In a State, when they say ``other programs,'' they are talking first and foremost about education. In Georgia, 54 percent of the budget is the university system and elementary and secondary education, one out of every two cents. Well, if they can't cut Medicaid because it is an entitlement, then they have to cut education first and foremost, which is the most important function of State government. So the unintended consequences of such a mandate are going to be devastating. They only have two choices: to continue to cut education or to raise taxes. Neither one of those are a good choice.

Mr. ISAKSON. Well, I think the majority leader is exactly right. There is a prime example of what happens when the Federal Government mandates a benefit or a program and doesn't pay for it; the States end up having to do it. Just take No Child Left Behind or take the Elementary and Secondary Education Act, and IDEA. Back in 1978 we mandated funds to be appropriated for individuals with disabilities in America. In fact, we mandated States spend 40 percent per FTE more on a special needs child than on a regular child. We never sent them a dime for about 20 years. We finally, in 1999, started paying part of that 40 percent. Now we are only paying half of it. So now we take Medicaid. Medicaid is a program, for the people out there who are listening today, where the States pay about one-third of Medicaid and the Federal Government pays about two-thirds. It changes a little bit, but that is about right. The State runs the program; the Federal Government mandates the program. When I was first elected to the Georgia Legislature, the expenses for Medicaid the year I was elected in the State budget were $20 million, State funds. That was 1 percent of the State's $2 billion budget. Now, today, this year, even with all of the cuts that have taken place, Medicaid is 12 percent of Georgia's budget. So it has grown from 1 percent of the budget to 12 percent of the budget in about 30 years. Plans in the health care bill that are being talked about in the Finance Committee and that have been talked about in the House would mandate an increase of 150 percent--from 100 percent of poverty to 150 percent of poverty for Medicaid eligibility. It is said the States will be held harmless until 2013 or 2014 but no promises after that. Let me tell my colleague what would happen to my State of Georgia if we raised mandatory eligibility to 150 percent of poverty and the State paid its third of that one-third, two-thirds matched by the Federal Government. It would raise Georgia's Medicaid budget expenses annually from 12 percent of our budget to 20 percent of our budget, $3.32 billion. States can't afford to do that. As the Governor of Nevada said, 43 of our States can't deficit spend; 43 percent of our States must balance their budgets. Medicaid has been carved on and worked on as it is to try and preserve it under the existing law. With a 150-percent increase in eligibility and no funds from the Federal Government guaranteed, the States would be put in a position of spending one penny out of every five on Medicaid, which is about 12 percent of my State's population. That is disproportionate and it is not fair. I think Senator Reid is exactly right. Our States should be held harmless on any mandated increases in Medicaid.

Mr. ISAKSON. The Senator from Tennessee has said frequently over the last couple of months that what we really need to do is take a step-by- step approach. Comprehensive health care reform's unintended consequences will be a disaster because it affects 17 percent of the economy. You are taking the entitlements and 86 percent of the people who have some coverage and you are threatening that they have to go into a government option. This Medicaid debate is a good example of how we need to take a step-by-step approach, we need to take first things first. In the report before our committee, the HELP Committee, on which we serve together, we spent 67\1/2\ hours in the markup on that bill during the months of June and July. We heard about the uninsured and the uncovered in America. Of that 14 to 16 percent we hear about, a number of them are Medicare or Medicaid eligible, and they are not enrolled. So the first step we ought to take is to say we are going to create a mechanism where every Medicaid-eligible person and Medicare- eligible person is covered, which would probably mean that when someone visits a hospital because they are ill and they are qualified for Medicare or Medicaid, they get enrolled automatically so that they do have the coverage. That is the first step we ought to take in terms of entitlement. Then we can take another part of the uninsured--those people you and I talk about, the independent contractors, small businesspeople--and we can allow the forming of risk pools across State lines and insurance sales across State lines and allow like professions to associate together to form larger risk pools to compete with major corporations. And then insurance becomes more accessible and affordable. This debate we are having over Medicaid and the Governors' immediate reaction--which is 100 percent of the Governors, not just a couple-- demonstrates to us that we need to slow down and take step-by-step approaches to begin addressing the uncovered and uninsured without creating unintended consequences that bankrupt States and ration health care.

Mr. ISAKSON. There is no question--when the Senator referred to independent contractors, I had a flashback to my 33 years in business. For 22 of those years, I ran a real estate brokerage company. I had accountants, secretaries, and backroom operators. All my salespeople were independent contractors. I provided group medical under ERISA for my secretaries, backroom operators, and my employees, but the Federal law--the IRS Code--prohibits an employer from providing health care to an independent contractor. So here we have another unintended consequence of a Federal mandate that says to somebody: Simply because of the way in which you establish yourself and earn your income, some people can get group medical coverage and some cannot. In the case of those who worked for me, it forced second-career, middle-aged people not to be able to participate in a group policy. They had to buy insurance in the spot market. That spot market in health care is expensive because there is no shared risk. You don't have young people, older people, and well people to balance the cost of the pool. You have one individual who, if they already have health problems, may be uninsurable because of a preexisting condition. It is important that we look at the existing unintended consequences in the Tax Code that prohibit companies from being able to offer group medical insurance to the independent contractors who work for them.

Mr. ISAKSON

Mr. ISAKSON. Under outside estimates--not mine--of the 47 million alleged uninsured, up to 16 million would have access to insurance because of associated health plans and small business reform. That is a third of the uninsured.

Mr. ISAKSON. The Senator from Arizona and the Senator from Georgia and I all sat through 67\1/2\ hours of markup in the HELP Committee on an 839-page bill, which was not scored and had 3 titles blank and they are still blank. We didn't have text during that debate on three titles within that bill, and what they are developing in the Finance Committee today, as I understand it, is concepts. The language is somewhere that we have not yet seen. This is too important for us to guess on and to take a chance on. It is most important that Congress know precisely what it is doing.

Mr. ISAKSON. Yes, I ran a small real estate company for 22 years. We tried--myself and other distinguished Senators--on the floor to pass small business health reform 3 years ago which would have made more affordable and accessible health care to those independent contractors, the small business people. It was rejected and we could not get a cloture vote.

Mr. ISAKSON. Those are the two things Republicans don't want, which is more debt to bankrupt our children and grandchildren and more taxes. Robert from Loganville was on my teletown hall meeting a week ago in Georgia. We were talking about the pay-fors. He said, ``Senator, I want to ask you a question. The administration keeps talking about there being a half billion dollars of waste, fraud, and abuse in Medicare. If that's true, why haven't you saved it instead of using it to save against a national health care?'' That is precisely right. The pay-fors they are talking about to keep us from going into debt are moneys that may or may not be there. They involve taxation and raising taxes on small businesses. Those are the things we don't want to do as Republicans.

Mr. ISAKSON. The Senator is precisely right, because as of right now, Medicare goes broke in 2017. That is only 8 years from now. In this bill, part of the pay-fors is to raise the cost of Medicaid on the States to a level that would take Georgia's Medicaid payments in 2014 by State tax dollars to be from 12 percent to 20 percent of our State budget. That is not the way to run a railroad.

Mr. ISAKSON. Absolutely.

Mr. ISAKSON. A lot of them are based in defensive medicine, which is practiced because of runaway lawsuits and verdicts. The administration's most recent comment about tort reform, to which the Senator from Arizona referred, was they want to do a study. A study is not what we need. What we need is action. That is one of the biggest contributors to the rising cost of health care we have.

Mr. ISAKSON. The other consequence of that is the threat of it, and the cost of becoming a physician is driving young people to go into other professions. We are going to have a shortage of providers, not just in physicians but nurses and caregivers, if we have an overly regulatory system and an indefensible tort system.

Mr. ISAKSON. It is raising the cost to the consumer because a lot of those types of things that are being taxed are purchased discretionarily and are not covered. They are paid for out of the pocket of the consumer. When you tax the medical device, you are just raising the cost of the medical device to the consumer.

Mr. ISAKSON. I completely concur with the Senator from Arizona and the Senator from Tennessee. There is common ground, but you have to be willing to find it. So far that has not been the case. When we get to that point, we can solve a lot of the American peoples' problems. Just ramming through something we cannot read, we cannot quantify, we cannot score is not the way to go about it.

Mr. ISAKSON. My only comment in closing is simply this: The Senator is exactly right. Once this horse is out of the barn, you can never put him back in. We have to get it right to begin with. We need to go back to the drawing board, have a bill we can read, and a bill we can afford.

Mr. ISAKSON

Mr. ISAKSON. First, I thank the chairman for the courtesy of allowing me to call up the amendment at this time and appreciate the courtesy of the Senator from Maine. I have requested in appropriations the designation which is included in this amendment which says the Secretary may--underline the word ``may''--appropriate $5 million to Morehouse College for the purpose of the curation and the care of the Martin Luther King, Jr., papers in Atlanta, GA, for the civil rights museum of history. Briefly, not to belabor the point, a number of years ago, as you may know, the family of Martin Luther King put up the King papers for auction to the highest bidder. A number of people in the State of Georgia and the city of Atlanta determined that those papers belonged to the world and raised $32 million amongst themselves to buy the papers to protect them forever for posterity. An issue came up in the U.S. House of Representatives to appropriate that money, and it didn't happen. Without those bidders, those papers would have gone to the highest bidder. Whether or not it would have remained in the public purview for posterity no one knows. But we do know because of the people and the mayor of Atlanta, Shirley Franklin, the distinguished Representative of our State, had the courage and fortitude and foresight to raise the money, and those papers are now under protection for the people of the world. The money is being raised to build the civil rights museum, and it will start in the not too distant future at Centennial Park in Atlanta. It will house the papers of Martin Luther King, but there are 10,000 exhibits within the papers of Dr. King. Therefore, Morehouse College has been designated to be the curator and protector of those papers, much as our archivists in the country do for the great historical documents of the United States. This money would go to assist Morehouse College as the curator to protect those papers, which will be in the public domain forever. I appreciate very much the distinguished chairman allowing me to offer the amendment. I hope at the appropriate time it will be adopted. I think it is an important contribution to the history of our country and future of civil rights and the world. I yield the remainder of my time. I suggest the absence of a quorum.

Mr. ISAKSON. I ask unanimous consent we set aside the pending amendment and call up amendment No. 2504.

Mr. ISAKSON. I ask further reading of the amendment be dispensed with.

Mr. ISAKSON

Mr. ISAKSON. Mr. President, I wish to honor in the Record of the Senate Fort Valley State University in Fort Valley, GA, and the schools leadership team, headed by its great president and alumnus, Dr. Larry E. Rivers. This fall, more than 1,500 new freshmen have started classes at Fort Valley State University, making their mark on their very first day as the largest incoming freshman class in the schools history. This large freshmen class allowed the school to exceed the enrollment goal set by Dr. Rivers. In fact, total enrollment has doubled since Dr. Rivers arrival at Fort Valley State University in 2006. The 2010 edition of Americas Best Colleges by U.S. News Media Group listed Fort Valley State University as No. 21 among historically Black colleges and universities. FVSU is listed among first-tier schools such as Spelman College, Howard University, and Morehouse College. Due to these great achievements by FVSU, the school is expanding at a rapid pace. A new $9 million stadium opened on August 29, 2009, to start the Wildcat football season. In addition, plans for 2010 include a $16.7 million science building and a $6 million student amenities building. Other plans for the future include a Family Development Center and the expansion of the Stallworth Agricultural Research Building to add additional laboratory space. The Georgia Board of Regents also recently approved new FVSU College of Education programs, including agriculture education 6-12, special education general curriculum/early childhood education P-5, middle grades education 4-8, and school counselor. The board of regents also approved online bachelors degree programs in political science, psychology and English--Technical English and professional writing--and offsite programs in criminal justice, business administration, and an online criminal justice franchise. It is also evident through the school's community outreach efforts that the young people who attend Fort Valley State University are putting the skills they learn in the classroom to even greater use in the surrounding community and are learning to make a positive difference in the lives of others. I am pleased to acknowledge the great work that is done each day at Fort Valley State University, and I appreciate the vision of Dr. Rivers and his team to ensure students receive the highest quality education possible.

Mr. ISAKSON

Mr. ISAKSON. Mr. President, I ask unanimous consent to be able to speak as in morning business.

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

Mr. ISAKSON

Mr. ISAKSON. Mr. President, this is a happy tribute to a young lady by the name of Melanie Oudin. Melanie is 17 years old. She was born in my hometown of Marietta, GA. She has a pair of tennis shoes that have the word ``believe'' on them. She started competing in tennis years ago. She was thought to be pretty good, so her parents--from the seventh grade on--home schooled her so she would have enough time every day to practice. Were they ever correct. As I am sure the President knows, a few weeks ago, at Wimbledon, this amazing young lady--17 years old, 5-foot-6-- took on the world of tennis and moved through the fourth round at Wimbledon. Along the way, she beat none other than the former world No. 1, Jelena Jankovic. She made all the newspapers and all the sports shows. But was she a flash in the pan? No. What happened this last couple of weeks in New York City at the U.S. Open proved this girl is the real deal because she advanced this time to the quarter finals, again defeating top-seeded players and former No. 1 players such as Maria Sharapova and Elena Dementieva, both outstanding players who lost to this little 5-foot 6-inch powerhouse from Marietta, GA. She did lose in the quarter finals, but she will eventually get to the top because she believes, she is committed, she is dedicated, and she has the support and love of a great family. She leaves soon to play in the Bell Challenge in Quebec City. She will probably move from 70th in the world to about 45th in the world. Mr. President, I am confident with her dedication and commitment, she will soon rise to No. 1. I pay tribute to the First Lady of my hometown, the tennis player of great renown, Ms. Melanie Oudin.