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Mr. President, I rise in opposition to the reconciliation legislation the Senate is currently considering.  Like many of my colleagues, I first read this legislation when it was filed in the House last week – and one of my first thoughts was: what a difference 15 months makes.
Today the Senate is debating legislation that will increase health care costs for working Americans and wipe out a successful, bipartisan 45 year old student loan program – without a single Committee hearing or even a mark-up.
This bill is an attempt to fix what are perceived to be the problems with the health reform legislation that the Senate passed on Christmas Eve of last year.  These fixes are being considered because the American people overwhelmingly oppose this legislation.  Unfortunately this bill does nothing to fix the problems that prompted this opposition. 
Nothing in the bill before us will prevent half a trillion dollars from being cut from the Medicare program to create a brand new entitlement program for the uninsured.
If this bill is passed, millions of Medicare beneficiaries will lose the extra benefits they currently receive.  In fact, this bill will actually make matters worse, cutting even more money than the provisions in the Senate bill.  One out of every four Medicare beneficiaries are already enrolled in Medicare Advantage plans, and every one of them will see their benefits reduced.
If this bill is passed, the care of Medicare beneficiaries across the country will still be put at risk because of unsustainable payment cuts to hospitals and nursing homes.  The President’s own chief Medicare actuary said these cuts could jeopardize Medicare beneficiaries’ access to care.  He said that as a result of these cuts, roughly 20 percent of all hospitals and nursing homes in the country would become unprofitable, which could lead them to “end their participation in the Medicare program.”
If you can’t go to a hospital or get a doctor to treat you, you don’t have health care.  But this bill does nothing to fix the Medicare payment cuts in the Senate health reform bill.
This bill will still cause health insurance premiums to increase.  The Congressional Budget Office said the Senate bill would increase premiums by 10 to 13 percent for individuals.  This bill does nothing to stop these increases.  In fact, the bill also contains provisions that will increase premiums for the 85 percent of Americans who already have health insurance. 
This bill does nothing to stop health care costs from increasing our national debt.  The CBO estimates of the bill are required to ignore the issue of Medicare payments to physicians.  The bill does nothing to fix the scheduled Medicare payments to physicians.  Does the Majority really believe that Medicare payments to doctors will be cut by 21 percent later this year? 
In addition to assuming massive reductions on Medicare payments to doctors, the health care reform bill also relies on budget gimmicks and other unsustainable payment cuts to allow its sponsors to argue that it will not increase the deficit.  As Ruth Marcus wrote recently in the Washington Post, claims that the bill will reduce the deficit are “premature at best and delusional at worst.”
Rather than creating this new entitlement, we should be using the savings from Medicare to pay to fix Medicare’s problems.  These payment issues are not going away, and this or a future Congress is going to have to pay for them, or increase the debt.
The reconciliation bill before us also raises taxes by 569 billion dollars.  If you can believe it, that’s 50 billion more in new taxes than the original Senate passed bill.  So, the “fix-it” bill we have in front of us will put even more pressure on small business owners and entrepreneurs who could help lead our nation’s economic recovery. 
This bill also does nothing to stop the billions of dollars in new job killing taxes created by the Senate health reform bill.  Unfortunately, the policies in this bill will only make this situation worse for workers and businesses across America.  This bill will increase to $52 billion the new taxes imposed on employers, which will eliminate millions of American jobs and reduce wages for millions of other American workers.
The nation’s unemployment rate is 9.7 percent.  Millions of Americans have lost their jobs and millions more go to work every day worried about keeping the job they have.  Businesses of all sizes are struggling to keep their doors open and are finding it harder and harder to make ends meet. 
Mr. President, we have shed more than 3 and a half million jobs since January of last year and the average work-week is now down to 33 hours for the American worker.  Yet the bill before us today will actually make that situation worse.  The Congressional Budget Office has told us that the new job killing taxes in the Senate bill will lower wages across this country.  
Rather than addressing the issue and enacting reforms that would lower health insurance costs, the Majority’s health care bill instead increases the taxes that these businesses will have to pay – taking money away from hiring new workers.
When I’m home in Wyoming, which is nearly every weekend, my constituents ask me, “What does health care reform mean for me?”  Unfortunately, I have to tell them that if the Senate bill becomes law, their jobs and their paychecks will be in danger. 
I also found it ironic that on the very day President Obama signed a so called “jobs bill”, Speaker Pelosi released a reconciliation bill that contains $52 billion dollars in job killing taxes.
Mr. President, these problems are the real reasons the American people opposed the Senate health reform bill.  Unfortunately, the bill before us fails to address any of the fundamental problems with that bill.  If the legislation we are debating today is enacted, taxes will still be raised by $569 billion.  $525 billion will still be cut from the Medicare program.  Wages will still be reduced and jobs eliminated for millions of Americans. Health insurance premiums will still be driven up and 23 million people will still be left without insurance coverage.  We need to do better than this and I believe we can.
While most of the discussion today will focus on health care, we must not forget that this bill drastically alters decades of education and labor policy.  Specifically, I am speaking about the elimination of the 45 year old Federal Family Education Loan (FFEL) program, which has successfully helped millions of Americans realize the dream of a college education, and the shift to the government-run Direct Loan (DL) program.  This radical change is happening without a single Senate hearing or mark up in the Health, Education, Labor and Pensions Committee, where I serve as the Ranking Member.   
The Administration and the Majority have been promising students since the beginning of this Congress that their Pell grants would be increased dramatically so that college would be ‘affordable’.  Even with this bill, this promise rings hollow.  What does the transfer of $36 billion to the Pell grant program really get for students?  First, it kicks the can down the road by only partially filling the unmet Pell obligation for this year which was promised in the so-called stimulus bill.  The remainder, only modestly increases by $50 the maximum Pell grant award.  In exchange, students are forced into the one-size-fits-all government-run Direct Loan program, while Congress continues to do nothing about the real problem, which is the runaway cost of college education. (Chart) 
Schools have had the choice of switching to the Direct Loan program for nearly 20 years, but most – just over 4,000 as of March 1st -- have chosen to remain in the FFEL program.  Why?  Because FFEL provides services that meet individual student needs far better than the cookie cutter approach of the government-run Direct Loan program. 
This rushed and dramatic shift puts at risk the availability of guaranteed loans for thousands of students this fall.  Under the terms of this bill all 4,000 plus institutions of higher education now in the FFEL program will be required to participate in the DL program as of July 1, 2010, less than four months from today.  I do not believe that these schools or the U.S. Department of Education have the time or capacity to successfully meet this deadline. 
And the experts at the Department seem to agree.  According to a February 20, 2010 Department of Education procurement document, schools need between four and six months to successfully switch to the Direct Loan program.  As a result many schools will not have in place what it takes to get needed aid to students this fall.
Yes, it is true that reconciliation has been used to affect student loans in the past.  However, in those instances, it was used to ‘level the playing field’ between the two loan programs and provide greater access by students to loans.  This bill is nothing more than a government takeover that will turn the Department of Education into one of the largest banks in the nation, and transfer billions of dollars from middle class students and taxpayers to pay for only a modest expansion of the Pell Grant program which does nothing to lower the cost of college.
I will propose amendments that address out of control college costs, that give schools time to thoughtfully switch to the Direct Loan program, that make transparent the actual costs of Direct Loans, that fund an authorized and proven access and completion program, and that put real money toward debt reduction.
The Majority will tell you that what they are doing is being done at no cost to the taxpayer.  I, as the only accountant in the Senate, disagree with this assertion.  In the FFEL program, private lenders provide the capital necessary for fund billions of dollars of student loans each year.  With the Direct Loan program, the Treasury will provide all the capital for these loans, which amounts to nearly $100 billion every year.  Where does this money come from?  It comes from increasing the public debt and the American taxpayers, many of whom do not have a college education.  Shifting the financial burden from those who directly benefit from a college education raises concerns about equity, and again does nothing to address the larger problem of the rapidly increasing costs of a college education. 
This bill also removes safeguards against fraud and abuse from the Black Lung Benefits program.  The Black Lung Benefits Act provides monthly payments and the cost of medical treatment to coal miners disabled from pneumoconiosis (black lung) arising from their employment in or around the nation's coal mines, and provides monthly payments to surviving spouses and other dependents.  This bill will establish a retroactive presumption of causation and entitle individuals to lifelong benefits which will be paid for by the employers, insurers and, in cases where the employer is already out of business, by the taxpayers directly. 
Taxpayers have already paid more for this program than they expected. The estimated benefits costs when it was enacted in 1975 were $3 billion. However, by 2004 the federal government had paid out over $42 billion.  Last year, the taxpayers kicked in another $6.5 billion to refinance the program.  The changes in this bill will send the program back into a debt spiral by eliminating any need to prove causation.  I’d like to submit for the record a letter from three prominent West Virginia doctors who also oppose the provision because it “does not take into account the current state of diagnosis and treatment of Black Lung.” 
<submit for the record letter from the Medical Dir. of the W.V. Offices of Insurance Commissioner, the Chair of the W.V. Permanent Total Disability Board, and the Chair of the W.V. Occupational Pneumoconiosis Board>
While everyone supports providing these benefits to qualified miners and their families, we should not strip out safeguards against fraud, waste and abuse in this program that were specifically added to the program by Congress with overwhelming bipartisan support.
I’ve said numerous times during my tenure in public service that the first role of the government is to do no harm.  While I know many people are well versed on the intricacies of how these programs operate, I’ve studied these issues in depth for years, and have a track record of legislative success on both the health and education front, because I first listen to my colleagues and regularly work across party lines. This legislation falls short on many fronts, has not been the subject of Senate hearings, is being jammed through this institution too quickly, and should be rejected by the Senate. 
Want to see how this bill impacts you? Interested in how and when small businesses will be impacted? Click the PDF below to see a timeline for new taxes taking effect and other major provisions in the health care reform bill.