Video of the floor speech is available here.
Floor Speech of Sen. Chuck Grassley
Obamacare is Unaffordable for Too Many Americans; Medicaid Emphasizes Spending Over Quality
Delivered Tuesday, July 11, 2017
I rise today to share real stories of real hardship from hard-working families in my home state of Iowa.
Seven years ago, Americans were promised that the Affordable Care Act would make health insurance cheaper and health care more accessible.
Well, I won’t pretend to break any news here. The facts speak for themselves: Obamacare is not living up to its promises. When passing the law, the other side made promises they knew they couldn’t keep.
The irony here is the so-called Affordable Care Act is anything but affordable.
I’ve heard from many Iowans who tell me in no uncertain terms: They cannot afford to buy health insurance because Obamacare is unaffordable.
One Iowan wrote:
Quote: “I am forced to pay $230 a month for a health care plan that covers NOTHING until I reach $11,000 in deductible. So on top of paying 100 percent of my medical bills anyway, now I also have to pay for insurance I can’t use.” End of quote
How did we get to this point?
Seven years ago, I stood right here on the Senate floor and predicted what would happen to the cost of insurance if Obamacare passed.
Let’s take a walk down memory lane for a moment. Here’s what I said in October of 2009:
Quote: “And while some of the supporters of these partisan bills may not want to tell their constituents, we ALL know that as national spending on health care increases, American families will bear the burden in the form of higher premiums. So let me be very clear, as a result of the current pending health care proposals, most Americans will pay higher premiums for health insurance.” Unquote.
I don’t have a magic crystal ball. But it was easy to read the writing on the wall. I knew that layers of new taxes and burdensome new mandates in Obamacare would lead us to where we find ourselves today: A broken health care system that is not better off than it was seven years ago. For millions of Americans, it’s much worse.
So where do we go from here?
After seven years of rising premiums, soaring deductibles and climbing co-pays, Republicans are committed to fixing the damage caused by the Affordable Care Act.
Not only is it unaffordable for too many people, it is unsustainable. Obamacare is unable to fulfill its promises to the American people.
Here’s what every lawmaker in Congress ought to agree on:
Insurance isn’t worth having, if patients can’t afford to use it.
And the facts are clear. A one-size-fits-all, government-run plan is driving insurers out of the exchanges, driving up premiums, driving away customers, and driving up the tab to the taxpaying public.
Obamacare has over-regulated, over-taxed and over-sold its promises to the American people.
Obamacare has not healed what ails the U.S. health care system. It’s time to move forward.
I also want to talk about Medicaid for a moment.
Medicaid, as we know it, is not sustainable.
The federal government and states spent $553 billion on Medicaid in 2016. That amount is very close to $593 billion spent on our nation’s defense.
Every decade since Medicaid started, it has grown faster than the economy. Medicaid is now unmatched as a driver of the deficit of this country.
We cannot sit by and leave this kind of debt to our children and grandchildren.
But dollars are not the only metric by which we measure Medicaid.
Medicaid is a program that should supply health care to diverse populations and should have quality measured. But it does not.
Medicaid dollars should be spent efficiently, but they are not.
Activists in Washington, D.C., are fighting to preserve this status quo and scaring the daylights out of people.
Yet, Iowans tell me that there are waiting lists for Medicaid waivers to obtain services for children with disabilities. Others tell me that medicines that will cure diseases are rationed to be used only with those with the most advanced disease. In other words, you have to get really sick for Medicaid to cover medical expenses.
It is a fact that Medicaid is not working the way it should for everyone.
The time to act to preserve and improve Medicaid as the safety net for our most vulnerable is now.
Before they were opposed to Medicaid reform, 46 Democratic senators wrote to President Clinton and expressed “strong support” for Medicaid per capita caps. The letter went on to say it would give states the flexibility to achieve savings without cuts to essential services.
That is what the current proposal aims to do as well.
We are proposing per capita caps as a way to make sure tax dollars are spent wisely on the most vulnerable people in our nation.
Medicaid dollars should be spent on a child with cystic fibrosis who needs a blockbuster drug. A person with severe mental illness should be able to rely on Medicaid for care.
Medicaid cannot continue to be a limitless credit card to the states to spend money without any accountability to the people who need it.
I urge my colleagues to put aside their partisan dogma and work to solve this problem for the American people.
Text of Democratic senators’ letter to President Clinton:
Washington DC, December 13, 1995.
President William J. Clinton, The White House, Washington, DC.
Dear Mr. President: We are writing to express our strong support for the Medicaid per-capita cap structure in your seven-year budget. We have fought against Medicaid block grants and cuts in the Senate, and we are glad you acknowledge the importance of our position.
We support a balanced budget. We are glad you agree with us that we can balance the budget without undermining the health of children, pregnant women, the disabled, and the elderly.
The savings level of $54 billion over seven years included in your budget will require rigorous efficiencies and economies in the program. However, after consulting with many Medicaid Directors and service providers across the country, we believe a reduction of this level is possible to achieve without dramatic limits on eligibility or cuts to essential services. States will need flexibility to achieve these savings, and you have taken steps toward granting it in your bill.
We were encouraged that your Medicaid proposal does not pit Medicaid populations against one another in a fight over a limited pot of federal resources.
We were further encouraged to hear Chief of Staff Panetta relay your commitment to veto any budget not containing a fundamental guarantee to Medicaid for eligible Americans.
We commend you on the courage you have exercised in making these commitments to Americans eligible for Medicaid. There is a bottom line when it comes to people's health; do not allow the current Congressional leadership to further reduce our commitment to Medicaid beneficiaries.
Your current proposal is fair and reasonable, and is consistent with what we have advocated on the Senate floor. We urge you in the strongest possible terms to hold fast to these commitments in further negotiations. We are prepared to offer any assistance you may need in this regard.
Sincerely,
Bob Graham; John Breaux; Jay Rockefeller; Herb Kohl; Patrick Leahy; Frank R. Lautenberg; Ted Kennedy; Tom Daschle; Patty Murray; Barbara Boxer; David Pryor; Barbara A. Mikulski; Max Baucus; Paul Simon; Kent Conrad; Wendell Ford; Harry Reid; Paul Wellstone; Richard H. Bryan; Ernest Hollings; Dianne Feinstein; Tom Harkin; Byron L. Dorgan; Chris Dodd; J. Bennett Johnston; Joe Lieberman; Paul Sarbanes; Carol Mosely-Braun; John Glenn; Jeff Bingaman; Carl Levin; Bill Bradley; John F. Kerry; Bob Kerrey; Joe Biden; Daniel K. Akaka; Dale Bumpers; Daniel Inouye; Chuck Robb; J. James Exon; Howell Heflin; Claiborne Pell; Russ Feingold; Daniel P. Moynihan; Sam Nunn; Robert C. Byrd.
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