Floor Statement of U.S. Senator Chuck Grassley

Response to Supreme Court Decision on Medicaid

Friday, June 29, 2012

Mr. President, the Supreme Court yesterday overturned the mandatory Medicaid expansion in the Affordable Care Act.

As of yesterday, the states now have a choice to expand or not expand coverage to the poorest people in society without being subjected to harsh federal penalties.

Mr. President, I'd like to draw attention to a speech I gave on the Senate floor on December 2011 on the subject of the constitutionality of the Medicaid expansion.  I expressed my concerns then about the potential impact of a Supreme Court decision on Medicaid expansion.

I said on the floor that day, "... A Supreme Court ruling in favor of the States in this case could not only jeopardize the mandated Medicaid expansion in the Affordable Care Act but could challenge the fundamental structure of Medicaid and have broader implications outside health care."

The concerns I expressed then have, to a degree, come true.

Reading from a Washington Post editorial this morning about the Court ruling on Medicaid, " ... this restriction of federal authority may have greater ramifications than the court's limiting of the Commerce Clause. One can imagine challenges to federal conditions across a wide spectrum of programs, including but not limited to the environment, education and transportation."

This decision overturns the mandatory expansion of the Medicaid program.  And while I realize most of the focus is on the decision related to the tax mandate, we should spend a moment talking about the consequence of the Medicaid decision.

Mr. President, one of the goals of health care reform was to provide coverage for people in need.

I would argue the people most in need of coverage are people without a job, people without an income, the poorest of the poor.

The Affordable Care Act required states to cover people below poverty through Medicaid.

States were mandated to expand to cover people below poverty.

Yesterday, the Supreme Court ruled that mandatory expansion unconstitutional.  Writing for the majority, Chief Justice Roberts said, " ... Nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care, and requiring that States accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."

With this decision, states now have the option to expand Medicaid to cover people below poverty.

Mr. President, the states had that option before the Affordable Care Act was passed.  So what does this decision mean in real terms?

It will be up to the states to determine if they will cover the poorest of the poor.  The federal government cannot guarantee coverage.

So now people with jobs will have to purchase insurance under the tax mandate.  People without an income, people who are below poverty are dependent upon the state in which they reside.

Now I know some people will believe that the choice is perfunctory, that Medicaid expansion will move forward because the federal government has offered to pay for more than 90 percent of the expansion.

But if you were a state, would you really trust a promise from a federal government that is $15 trillion in debt?

If you were a state, would you really trust an Obama Administration that proposed eliminating that special federal payment rate through a proposal known as the blended rate?

States will very reasonably be risk adverse.

States can now expand if they choose or not at all.

No one should assume for a second all states will expand to cover as much as was mandated under the Affordable Care Act.

Of course, you might think people below poverty could still get health care through tax credits, but the people who wrote this bill made people below poverty ineligible for tax credits.

That's right ... ineligible.

It's all or nothing for the poor with Medicaid.

With today's ruling, the answer is nothing.

On December 15, 2011, I said on the Senate floor that the expansion of Medicaid and the coverage of poor people was in jeopardy because, "... the White House and the Democratic majority put their partisan goals ahead of collaboration with Republicans and States to build legitimate public policy."

Today, that is the outcome.

When people with income, people with jobs are mandated to purchase health insurance and face a tax penalty if they don't, while the poorest people in society, those without job or income have a guarantee of nothing, I think victory laps are premature.

After this decision, a person in a family with an income of more than $80,000 a year would be guaranteed access to a subsidy to buy private insurance, while a person in a family with no income would be guaranteed nothing.

When people below poverty, the people who least can afford coverage or the consequence of not having coverage are left with nothing, that sounds like a failure to me.

If you can afford to have your brand new warehouse built from the ground up, who are you going to hire to build it?

The intelligent answer is simple: a reputable building contractor with happy clients and lots of experience, right? I mean, why on earth would you invest your hard-earned dollars to hire anyone less than a pro?

What about your office building or store? As a business owner, you know that it needs to have the right look and feel to be successful. Go ahead, go shopping or to the insurance guy or the doctor. Are the stores and offices run down with bad paint jobs and worn-out carpeting? Does the store you're buying from have empty crates and clothes blocking the aisles? Of course not. They're all clean and neat and professional - and most are decorated to impress the customer.

So why, then, would anyone take the opposite approach with their online business?

Believe it or not, at least half the people reading this right now have done exactly that. You've spent months, in some cases years, developing your product, becoming an expert in your field or writing your book, and then paid absolutely no attention to where or how it's presented and sold. That's just like buying beautiful new furniture and not having a house to put it in.

Do yourself a favor, when you've made the decision to open your business or sell your product online, make sure you have ALL the tools to make it successful. And for Pete's sake, make sure you hire the right developer. Here are a few tips to help you find that person;

1. Look for experience, reputation and track record. These are the three attributes to consider when engaging any professional. Find out about who you're entrusting your brand to. Ask for references - don't just look at the testimonials they've posted. Take a good look at their website. If it looks like a fifth-grader put it together, imagine how yours will look. Look at their portfolio or ask for a list of sites they have developed. If they can't show you immediately, or if they don't have at least four or five sites to review, what are they afraid of?

2. It's not always about the price. Do NOT cut corners. Don't go with the cheapest deal you can find just because it's cheap. Think about what you're buying: It's the vehicle that's going to generate your revenue. Your website is the last thing you want to cut corners on.

WARNING: Not going cheap does not mean you should go with the most expensive deal either; expensive doesn't always equal better.

3. Listen. You're buying talent and experience. You listen to your doctor, your lawyer and your accountant - they're the professionals, after all. Now think about that when you decide that you know better or more than your web developer. If you made the right choice in hiring the developer, then listen to what he or she tells you. If you're not willing to trust their judgment or advice, then save your money and build the site yourself. But don't complain about THAT decision later.

4. Have a plan. You need to know what your goals are and how to convey them to your developer BEFORE you hire anyone. If you aren't sure of your goals - WAIT. Do not hire anyone unless you are completely sure that they have a solid understanding of your needs and objectives.

5. Avoid any company or freelancer that has a "package." You've seen it before. You're searching for a web designer and you find 25 sites that have the Gold/Silver/Bronze package (or some cute little package names). They offer hourly rates and "additional page" costs. Here's a tip: stay away. There's no way a designer can give you exactly what you need based on his/her "package rate." Ask me 10 times and I will tell you 10 times - I can't give you a price if I don't know what your project is all about. Any pro developer will tell you the same thing. We need to know what we're developing before we know how much it's going to cost.

6. Know how to request a quote. Please don't ever email a developer and say, "Can you look at my site and tell me how much you would charge to redesign it or make it better?" Now, that's just asking for trouble, and here's why:

a) You are already telling the developer you have no idea what you need.
b) If the developer sends back an email that says, "I looked at your site and it would cost $xx.xx to redesign it or fix it" - RUN. Never hire a developer who doesn't want to talk to you first. A developer worth hiring is the one who wants to know about your project.

About Joe Thomas

Joe Thomas is the founder and owner of Left Brain Digital (www.leftbraindigital.com), a web development company. He's an award-winning web designer/developer with more than 18 years of experience in print and web design and development. Thomas' work became a major influence in graphic and web design in the "Y2K" era of the Internet's dot-com explosion.

Classrooms First recommendations promote consolidation and shared services

to redirect millions from back-office operations to students

SPRINGFIELD - June 29, 2012. The Classrooms First Commission has submitted a final report to Governor Quinn and the General Assembly with 23 recommendations to spur school district consolidation and streamline school district operations, with the goal of redirecting $1 billion to classrooms from administration spending, Lt. Governor Sheila Simon announced today.

Simon says she will work with state lawmakers in the coming months to introduce several legislative recommendations outlined in the report, "A Guide to P-20 Efficiency and Opportunity," that will reduce barriers to consolidation, boost use of shared services agreements and increase learning opportunities across the state.

Among the top priorities listed by the bipartisan advisory panel led by Lt. Governor Simon is the need to replace the state's consolidation incentive system. The commission recommends sun-setting current consolidation incentives in 2017 and replacing them with a system that is both affordable to the state and responsive to needs of merging districts.

The Classrooms First Commission was created last August by the Governor and General Assembly to reduce duplicative education spending and improve educational outcomes due to the state's budget constraints. The commission studied a Fiscal Year 2012 proposal to cut the state's more than 860 school districts in half, and found it would cost well over $3 billion under the state's current consolidation incentive structure. To rein in those costs, the report calls for incentives to sunset in five years and a commission to develop a new system based on a predictable, affordable formula or factors such as the square footage of a new district.

"We want Illinois to lead the nation in education performance, not bureaucracy," Simon said, "but taking a cookie cutter approach to efficiency ignores fiscal and educational realities. This report recommends several well-reasoned steps to spend smarter and expand opportunity. We lived up to our name to put Classrooms First."

Simon says while new incentives are being developed, lawmakers should implement several Classrooms First recommendations that promote consolidation in regions where it will produce cost savings and increase educational opportunity.

The first step is for Governor Quinn to sign Senate Bill 3252. The bill allows new "unit" or P-12 districts to gradually reduce their tax rate over four years following a consolidation. The maximum tax rate for a unit district is below the combined rate for separate elementary districts that feed into a high school district, so the legislation would give a district time to adjust to the lower tax rate, while still providing residents with property tax relief.

The second step is to make several legislative changes next Session that would reduce barriers to consolidation and cut red tape, Simon said. They would allow districts to merge with nearby neighbors when contiguous districts reject consolidation; expand the authority of regional board of school trustees to dissolve districts; and authorize districts to delay the effective date of a consolidation while waiting for construction funding.

"These recommendations eliminate bureaucratic burdens that keep districts from consolidating even when it makes sense," said Simon. "Removing these roadblocks will allow districts to focus on the merits and potential benefits of consolidation."

Within two years, the commission wants to see legislation authorizing the state to conduct feasibility and efficiency studies for districts in counties with small and declining school-age populations, which could lead them to consolidate. At that time, the state should also pilot a consolidation construction program that prioritizes funding for merging districts.

Beyond voluntary consolidation, the commission also recommended several legislative changes that would make it easier for districts to share staff and services beginning next Session and moving forward. One proposal would create a revolving fund to provide short-term, low-interest loans to seed cooperative service agreements or conduct efficiency studies; the loans would be repaid with the money gained through resulting streamlining. Another would permit districts to outsource non-instructional services if they were provided on a multi-district basis.

A third shared services proposal would authorize the Illinois State Board of Education (ISBE) to provide a web-based resource management program to districts so they can identify potential savings in five major spending areas: instruction, transportation, food services, administration and facility maintenance. A pilot program of a similar service in Ohio resulted in at least a 5 percent operational savings at participating districts. At that rate, Illinois districts could realize a net savings of almost $1 billion.

The Classrooms First report is the culmination of an 11-month, three-stage process that gave commission members the opportunity to review relevant research and Illinois data, create working groups to draft recommendations and collect public input from hundreds of administrators, teachers, parents and taxpayers from across Illinois. The commission held two sets of public hearings that were attended by nearly 500 people and included testimony from 85 individuals. Additional feedback was collected from 470 submissions to an online survey in the fall.

"When this commission was formed it was a political football, and it has been wrested away from that," said Brent Clark, executive director of the Illinois Association of School Administrators and a commission member. "We put this in a place where it could be talked about and not kicked around politically."

"You don't know what you don't know," said Paul Swanstrom, who represented the High School District Organization of Illinois on the Classrooms First Commission. "The Lt. Governor asked us to be open-minded and in so doing I think we have all learned things. One of the key elements of the success of this commission is we heard from people across the state about what they are doing, and the members of the commission were able to use this information in their deliberations."

Simon says she will begin meeting with stakeholders to move legislative recommendations in the coming year. To read the commission's final report visit www.ltgov.illinois.gov.

LiveWall® - A New Way To Grow Vertically

Davenport, IA/ June 27, 2012 - Whether you're converting to energy saving light bulbs, driving gas efficient cars, or recycling more everyone seems to be looking to make their world a little greener these days.  Now, one Quad Cities based company has another innovative product available which will make a huge impact on the green movement in the Midwest. Established as a licensed grower for LiveRoof® in 2007, Roof Top Sedums is now a representative for the new green wall product, LiveWall®.

LiveWall® is different from other vertical growing systems in that it is designed to grow healthy plants. Traditional green walls consist of either trellis or cable systems that rely on vines growing vertically from the ground upward to cover a building wall. Some other vertical growing systems require the plants to grow in an unnatural horizontal orientation, by planting into pockets or mail-slotted compartments mounted sideways onto the wall of a building. After 4 years of research and development, LiveWall ® answered the question, "How can healthy plants be grown on a vertical surface and attach to a building wall?"

Co-founder Teresa Nelson explains, "We are excited to have the launch of this new product available here in the Quad Cities.  This development is a big innovation in the green industry and is so versatile that it can be bought by the Do-It-Yourselfers for a personal fence, screen, or wall installation. LiveWall® can be planted with perennials, annuals, tropicals, vegetables, and even herbs. It can be custom designed to create unique wall installations on large commercial buildings or purchased as a smaller kit, with or without irrigation.  We are excited about the unlimited possibilities."

Inspired by traditional window boxes, LiveWall® features rows of easy to install planters oriented upwards to mimic natural plant growth. LiveWall® uses an integrated irrigation system with nozzles to deliver water resembling traditional rain flow over the plants. Planter inserts can be pre-planted and fully-grown ahead of time, so they look immediately beautiful and lush upon install, and easy to switch out as the seasons change.  Even during the dormant season, LiveWall® retains an attractive look, because the planters are offset and designed to have a brick-like effect.

About Roof Top Sedums: Roof Top Sedums was established in 2007 and is a Regional LiveRoof® Licensed Grower servicing Iowa, Western Illinois, Eastern Nebraska, Eastern Kansas, and most of Missouri.  The business is 100% women-owned and certified nationally as a Women's Business Enterprise as well as an Iowa Targeted Small Business.  Co-founder Roxanne Nagel explains, "Green roofs have become widely accepted as an integral part of sustainable renovations. We are equally excited about the future of LiveWall® and our role to provide an exceptional product in our region."  For more information on projects previously grown by Roof Top Sedums or information about the LiveRoof® System, visit www.rooftopsedums.com.