GRASSLEY: Last night, I argued for passage of my amendment to this reconciliation bill to have health care reforms enacted yesterday apply to leadership and committee staff in Congress and to the president and vice president, president's Cabinet, and White House staff. All of these people remain untouched by the reforms that have taken effect for the rest of the country.
If my amendment isn't passed, then President Obama will not live under the Obama health care reforms, and neither will the congressional staff, who are most responsible for helping to write this overhaul. That sends a message to the people at the grassroots, is that the health reforms are good enough for you, but not for us.
This amendment follows my efforts last year to make sure that there wasn't a double standard and that public officials who passed the laws and worked so hard to get laws changed experience the laws themselves. The new health care law requires members of Congress and their personal office staff to get their health insurance through the new exchange because of my amendment that got adopted last September in the Finance Committee and is in the bill that the president signed.
The principle is one I fought for going back two decades when I first offered legislation to apply a lot of civil rights, labor, and employment laws to Congress for the first time, because over the previous 60 years, Congress passed about 12 laws exempting itself from. In other words, we had one law for Capitol Hill, one law for the rest of the country. And getting health insurance for the White House and members of Congress through the exchange follows on that same principle.
I will also pursue my amendment to secure specific changes to the way that Medicare calculates payments to physicians and unfairly penalizes rural doctors, making it increasingly difficult for Medicare beneficiaries in rural states finding doctors.
There are two issues behind my amendment. First, the reconciliation bill from the House is accompanied by a letter from the secretary of HHS committing to a new study on geographic disparity. I don't want to risk the fix that I got in the health care reform enacted yesterday to new data that could emerge from this study, because that data could be hurtful to rural reimbursement rates.
The study is wrapped up in a board that is supposed to cut Medicare spending, and that likely on -- that's unlikely to result in improvements for rural areas.
Second, one of the special deals in the health care reform that became law yesterday gives extra payments to five selected frontier states. They'll get more money at the expense of every other state, and the fact that they're getting a better deal under the new law will make it harder to build support for changes to help rural states everywhere, even -- with an even hand.
And, of course, that's what rural states have always stuck together, in the past, to do everything for rural America in the same way, so I hope senators don't let politics get in the way when you have these special deals to make sure that these important policies are established in a way that is equitable and fair. These formulas determine how well Medicare works or doesn't work for beneficiaries in rural states.
Kathie Obradovich?
Are we turned on here? Maybe I can't hear people. Kathie? OK. Let's go on to Kris (ph) at Mason City.
QUESTION: Yes, well, can you hear me?
GRASSLEY: Yes, I can hear you.
QUESTION: OK. For one thing, have you in the past attempted to pass legislation that would require the full Congress and the president to abide by the same kind of health care that the rest of the country has?
GRASSLEY: Yes. And I'll bet you're a real young girl, because in 1995, I got this bill passed, and so I'm very happy to tell you about it. Starting in 1938, through a lot of laws that fall in the category of labor, workplace safety, discrimination, civil rights, Congress exempted itself from those laws.
Then starting about 1990 -- but I finally got it done in 1995 -- I passed the Congressional Accountability Act, and that act brought that exemptions -- those exemptions to an end. So now I'm an employer. I hire a staff here of about 25 people that help me do my job here.
You know, I didn't have to worry about paying overtime, didn't have to worry about safe workplaces under OSHA, didn't have to worry about violating discrimination cases. You know, I'm not going to name the 12 laws, but we can give you a list if you want them.
And the Congressional Accountability Office now makes sure that OSHA comes around and inspects my office, like they do the ABC Corporation in Mason City. I have to abide by the civil rights legislation. If my staff that isn't management works overtime, they have to be paid overtime wages and things of that nature.
So, yes, I've been at this business of trying to make sure that Congress lives under the laws as passed for a long period of time. And so my act to get congressmen, senators, and our staffs, getting our insurance from the exchange followed on that, and my amendment that I offered in December to cover the president and vice president was in the same vein as the one offered yesterday, but Reid would not let my bill be voted on before Christmas, and so now I have this opportunity through the reconciliation bill to do that.
And I also have an opportunity then to -- to do something that Reid undid in the -- in the secrecy of his office when -- when this amendment that I got adopted covered every congressmen and senator and every staff on Capitol Hill, he had the chutzpah of not having leadership staff and committee staff covered under the Grassley amendment.
So I'm also going back and undoing what he had the chutzpah to do, you know, like if your leader -- if you work for the leader, if you're on committee staff, you're better than other staff. Well, that isn't true. They aren't any better than we are, so I'm closing that loophole, and then I'm going after the executive branch political appointees, as well as the elected president and vice president.
QUESTION: You know...
GRASSLEY: And doing it in the same vein, that -- that they ought to experience the health care that they're foisting on everybody else.
QUESTION: And -- and, Senator, may I ask one more thing? And that is, what are you hearing from Iowans about the new health care reform bill?
GRASSLEY: Well, I think my letters are running -- and I actually get more e-mails than letters -- but running about similar to what you've seen national polls showing, about 35 percent to 38 percent opposed to it and about, you know, 55 percent to 60 percent against -- now, wait a minute. Yes, I said that right, 35 percent to -- let's say 35 percent to 40 percent opposed to this bill, not opposed to health care reform, to this bill, and then 60 percent, let's say, for -- oh, I said that.
QUESTION: No, I'm -- you know, I was just asking, as far as the health care reform bill itself, what were you hearing from Iowans?
GRASSLEY: Yes, basically 35 percent opposed to it, about 60 percent -- no, 35 percent in favor of it, 60 percent opposed.
QUESTION: OK.
GRASSLEY: Yes. And then there is a national poll, CNN, that is about the same, opposed 59 percent, in favor 39 percent. And I think Iowans are telling me roughly the same thing.
OK, then that was Kris (ph).
QUESTION: Thank you.
GRASSLEY: Kathie Obradovich?
Tina Hinz of -- or is that "Hinz"? -- of the Waterloo Courier?
OK, Mike Glover?
Tom Beaumont?
QUESTION: Senator, what are your actual expectations that these amendments that you're talking about today will be taken up and voted on?
GRASSLEY: Well, they'll be taken up and voted on, because I don't think under reconciliation there's any way you avoid votes that come up at the end that we refer to as vote-o-rama, so we will get votes. I've already offered one, and then I have the other one to offer.
QUESTION: Do you...
GRASSLEY: But one -- one is laid down last night in my remarks.
QUESTION: Do you expect them to both be voted down along party lines?
GRASSLEY: Oh, yes, I didn't answer that part of your question. Well, I hope not, but here's what I've been told. And -- well, I haven't been told face to face, but I heard many times that Reid has promised Pelosi he's got 51 votes to pass the bill, and presumably then he's got 51 votes to kill all the amendments, but only time is going to tell that.
QUESTION: Thank you.
GRASSLEY: Joe Morton?
QUESTION: Yes, Senator. What -- obviously, there's still some business to wrap up on the reconciliation part of this, but the main health care bill is now the law of the land. What's the best way to deal with that? Should Republicans be pushing to repeal it outright? Or are there individual changes that can be made over the next few years that might improve it? Or what's the best strategy for Republicans going forward?
GRASSLEY: Well, I'm not sure that I want to make a knee-jerk reaction of what the response should be, but, obviously, not only are Republican congressmen opposed to it, but most Republicans at the grassroots are opposed to it. And -- and -- and an overwhelming share of people at the -- in the independent category opposed to it.
I think you've got to gear in on the fact that there's too much spending, too much taxes, too much debt, and there's an awful lot of Washington takeovers in it. And -- and that's something we have to be considering.
And I think that that if I'm in a position of calling for repeal, I would expect at the same time, because so many people in this country feel -- and most senators feel that there are some things that need to be done with health care reform, that -- that -- that you -- you're naturally going to be talking about replacing it, but that isn't any different than what Republicans have been talking about all the time.
There are some things in the bill that are almost consensus, but when you have the absence of medical malpractice reform, we have not selling insurance across state lines, there's this individual mandate in there that we think is unconstitutional, there is a tendency towards rationing. These things have to be taken care of.
But we ought to be thinking, of course, in repeal of the Medicare cuts, consideration how bad Medicare is already in, as an example. And there is some sweetheart deals in it that can legitimately be dealt with.
So it's still in the process of considering exactly what the next steps are, but, obviously, one of them is to listen to the grassroots. That's what we've been doing for a long period of time, and we shouldn't ignore like the majority party and the president's ignored grassroots feeling. They're only goal is to make history and -- and forget what the people of this country want Congress to do.
Jim Boyd?
Ed Tibbetts?
QUESTION: Hi, Senator, I wanted to ask you about your second amendment, the Medicare language that's in the health care law now. How far would -- would that language go towards fixing this rural disparity problem?
GRASSLEY: Oh, it'd go a long ways, because you're -- now you're -- we're going back to what I offered in September and was in the bill, and to make sure that nothing that's in the reconciliation bill undoes what -- what I hope to do.
The -- that amendment is part of the health care reform that became law today, tells Medicare officials to use accurate data, and my concern is that when you bring the Institute of Medicine in for nothing more than a study, we have it worked out, for the two years, we have hold harmless, and then the -- the agency is expected to have an alternative.
And the reason for a solid alternative is that that automatically goes into effect. You don't have to wait for Congress to act. You don't have to read a study. And it's got to be based upon solid data.
And, you know, the whole -- I mean, there's many reasons for moving in the way from the formulas the way they are, but when you -- just one example. When you go to office practice expense for a doctor, and for years -- and I'm not sure we became aware of this until two or three years ago -- but for years, HHS, CMS has been using rent for residential apartments.
And that is just not intellectually honest and may be -- and they say, well, that's all we had available. Well, let's get some real solid figures and use real data that's pertinent to the business that you're trying to benefit.
QUESTION: And if I might follow up, this is -- this is a permanent fix? And if so...
GRASSLEY: Yes. Yes. Yes, permanent fix.
QUESTION: And so what would it -- what would it mean in terms of real dollars for -- for providers in Iowa?
GRASSLEY: Well, all I can say now is that where we are right now on a -- on a hold harmless position, we're going to be there for two years. And then this -- then CMS has to put a new formula in place based on it, and there's no way that I can judge what that does.
But we know that we get hurt when you use residential property in Iowa as -- as compared to residential property in New York, as an example, as a basis for reimbursement. And -- and we're talking about -- we're talking about the part of the formula that we call office practice expense.
QUESTION: All right, thanks.
GRASSLEY: OK. Tim Rohwer?
QUESTION: Yes, Senator. Getting back to your opening comments, it sounds like this is not the first time that the government officials have passed bills that they don't follow themselves. Why is that, do you think? I mean...
GRASSLEY: Yes, well, I'm going to give you the argument of my opponents in the four or five years I was fighting prior to 1995 to get this done. And you're going to laugh when I tell you their argument. But it was under the speech and debate clause of the federal Constitution, where somebody -- where -- where it says that anything Chuck Grassley says on the floor of the United States Senate or, I suppose, it expands to the committees as well can't be used against me. In other words, I can't be sued.
And the argument was used that, as an extension of the speech and debate clause, everybody we hire is protected. Because they work for us and what they do for us, they ought to be protected under the speech and debate clause, or I ought to be protected for whatever they do, and so there's a -- because of the speech and debate clause, we shouldn't have laws apply to us that apply to a lot of other people. Now, it's OK for me if you laugh at that.
QUESTION: And, also, you know, you mentioned that people in the letters and e-mails are opposed. Did they give any specific reason, I mean, the cost or the taxes?
GRASSLEY: Well, from senior citizens, it's a $500 billion or more cut in -- in Medicare. From -- from young people who know that they want to self-insure or not have insurance, they're against the individual mandate. A lot of people are writing in because they don't want the IRS into their business more than they are already for income tax, in other words, checking to see if you got health insurance.
And -- and -- and this -- I probably haven't heard much on this point, but Congressman Camp, the ranking Republican of Ways and Means, says this is going to bring 16,000 more IRS employees on the job, just checking on this, and $5 billion to $6 billion a year more.
And then I think that another way to answer your question is that we're getting a lot of people opposed to health care reform, not just because of health care reform by itself, but because they see it as just breaking the bank, leaving a greater legacy of debt to our children and grandchildren, and they see it like the straw breaking the camel's back that, first of all, they nationalized General Motors, and then credit, and then the stimulus bill doesn't keep unemployment under 8 percent, and cap and trade is going to increase household expenses by $1,800 and -- and, you know, tripling of the national debt.
And then it comes along, this $2.5 trillion health care bill, and they just see as a terrible legacy of debt leaving to our children, plus -- plus the fact of just the domination of government of health care that they have seen gone awry in other countries through increased rationing.
Christinia Crippes?
QUESTION: Hi, Senator. I just wanted to back up a little bit and see where you stood on the reconciliation bill itself. I mean, is this an improvement over what was -- what the Senate passed before? Is it -- does it make a difference?
GRASSLEY: The answer to that is that it takes more -- it makes it worse. It takes more out of -- it takes more out of Medicare than what we did in the House. It increases taxes $50 billion more. I guess to be more accurate, the Medicare cuts are $66 billion more. Then it has Medicaid expansion by 1 million more.
And let me explain to you why that's -- here we are putting 15 million, 16 million people on Medicaid, and Medicaid only pays about 60-some percent, although for two years, it's going to pay the same as Medicare, but then after that, they're not going to pay what Medicare pays, and they never have.
So we're promising 15 million, 16 million people you're going to get health care through Medicare, but there aren't going to be enough doctors taking Medicare, because doctors don't want to lose money. So they won't take -- it's just a false sense of security that they're going to have medical care when they -- when they don't.
And then here's a real big one. This bill also includes a nationalization of student loans; 19 million students are going to be overcharged in this bill, overcharged this way. The government borrows money at 3 percent. It's going to loan it to the students for more than 6 percent. And -- and in regard to these student loans, it's going to bring on short term $500 billion of new debt while you're waiting for these student loans to be paid off.
And, you know, it's going -- it's going to unemploy 31,000 people that work in banks to help it give student loans. And you know what they're going to replace it with? Four call centers. Now, can you imagine, four -- well, maybe four call centers can take care of the 19 million students, but you think they're going to get the same service?
And I'll tell you, the American parents and students are voting on this thing with their feet over the last 20 years, because there's been an opportunity to have direct student loans, and very few colleges and individual students are using the direct student loan. They're using their banks because that's where they get the service that they need.
And so we're going to not give the people that choice. So what you have is the federal government taking over another operation from the private sector. And it's almost like Obama's thinking in terms, if you can find it in the yellow pages, the government ought to be doing it, you know?
So -- but -- but then, also, they use this extra money that they're getting from the students, because the government borrows money at 2.8 percent, loan it out at 6.8 percent, that's overcharging the 19 million students $1,700 to $1,800 over a 10-year loan, assuming they got a $25,000 debt when they get done with college, and it spends -- it takes $8.7 billion of health care. Now -- or to help fund to health care. That's why they put these two bills together. It helps lower -- it helps make it look like it's more cost-effective.
So you -- so you got college students, where college tuition is going up, the cost of education's going up, they want to nationalize student loans and give $8.7 billion of it to health care. Now, does that -- that really doesn't add up.
QUESTION: Can I just add one quick follow-up?
GRASSLEY: Yes. Yes.
QUESTION: I guess, then, is it fair to say that, even if the amendments that you are introducing get adopted, that it's going to be hard to support the health care bill, reconciliation package?
GRASSLEY: Oh, you know, our whole point as Republicans is listen to the people, and the people are against this, and the Democrats are ignoring public opinion and going to vote for it regardless, because, you know, in their words, they want to make history. Well, you know, just make history and ignore the people in a representative form of government?
QUESTION: Thank you.
GRASSLEY: Courtney, Dubuque?
QUESTION: Hi, Senator. I'm just wondering about what your opinion is on the attorney general -- I guess the people who are urging their attorneys general to file suit about the individual mandate. Do you think that that's a good idea? Do you think that might work?
GRASSLEY: Well, I don't know whether it will work, because I've objected to the individual mandate, and that's what the courts' opinion -- I think that's the only point that the courts are bringing up, that you -- that the federal government under the 10th Amendment doesn't have the authority to make you buy anything, you know. If they make you buy health insurance today, are they going to make you buy bread tomorrow? I don't know.
But anyway, that's the basis for it. And, of course, since I think the individual mandate's unconstitutional, I would -- I would -- would encourage that issue being solved as quickly as we can.
Now, to be perfectly -- to be intellectually honest with you, there are some constitutional authorities on the other side of the issue that say that the federal government does have the authority to make you buy something.
OK. I've gone through the entire list. Anybody else want to get in? OK, thank you all very much.