Congressman Paul Ryan (WI) Testifies Before House Rules Committee on Health Care Reconciliation Bill
“Thank you Chairwoman Slaughter, Ranking Member Dreier. It’s a pleasure to be here today. The Budget Committee reported out the reconciliation bill but also, obviously, we realize it’s going to appear in tandem with the Senate bill, so I want to address both. This legislation would produce a sweeping overhaul of our healthcare sector, about 1/6 of our economy.
It will fundamentally change the relationship between patients and their doctors and put Washington in control of their healthcare. It will raise taxes by $569.2 billion, just as the economy is struggling to get out of a recession and create jobs. It will add a new $2.4 trillion entitlement program on top of the fact that we already have $76 trillion in unfunded liabilities that we don’t know how to pay for.
Whether you share our opposition to this or you believe this bill should be enacted, I doubt there is any disagreement about the sweeping nature of this legislation or the convoluted process that’s unfolding here. I’m sure the majority will cite cases of reconciliation abuse – rules that package bills in one vote of Saturday sessions and Sunday votes. But you will not find the mix of abuse that will occur to gain enactment of this legislation. This is unprecedented, it is absolutely breathtaking. You in the room are the experts on the House Rules, so I want to focus my comments on the extraordinary and unprecedented abuse of the budget reconciliation process.
Budget reconciliation has been abused in the past. This is one of the reasons why the Senate adopted the so-called Byrd rule. But reconciliation has never, ever been abused to the extent that it is today. Let’s just think about what we’re doing here. We are using last year’s budget resolution, which has a target of $1 billion of deficit reduction reconciliation instructions, to sweep into law a $2.4 trillion entitlement. The DRA of 2006 was $40 billion; 1997 was something about $170 billion. So we now have before us a budget resolution that says “just find a token $1 billion, $1 billion in deficit reduction, oh and while we do that, why don’t we create a new $2.4 trillion entitlement.”
We are not governing here today. We are greasing the skids to abuse the budget reconciliation procedure which was intended to control the government, not expand it. The key goal of the 1974 Budget Act, which is governing this process, was to reign in the President’s power and give the Congress the means to control the budget. Today, the Budget Act is being used ironically by this President to jam through the largest expansion of entitlement spending in over 40 years.
Let’s take a quick look at the price tag. Everybody talks about the Congressional Budget Office. They’re very good people, they’re clearly being overworked, they do their jobs very well, but their job is to score what is put in front of them. Let me just talk about what’s put in front of them.
What has been put in front of them is a piece of legislation full of gimmicks. When you strip away the gimmicks, when you strip away the double-counting and the faulty assumptions, it is clear that this overhaul does not reduce the deficit and it does not contain costs.
I think the Speaker kind of let the cat out of the bag yesterday, when in her press conference she said “You know what? We are going to pass the ‘doc-fix.’” So I asked the CBO, they gave me a letter which I would like to ask unanimous consent to put in the record, what’s the cost of this thing then if we do pass the “doc-fix,” as the Speaker is claiming we will do? Right away, this wipes out the savings, the claim of $138 billion in deficit reduction, and gives us a $58 billion deficit right there, the CBO’s letter yesterday shows us that.
Now, I brought a chart, which I shrunk because it’s a small room, and it may be too big as well, so I’m sorry, Tom, if you don’t mind. Let’s take a look at the fuzzy math that’s just inside this bill.
From looking at the letters we’ve gotten from CBO, just yesterday and a few days before, they’re claiming $138 billion in deficit reduction in this bill, and that’s all the smoke and mirrors. But take a look at the Class Act.
That’s $70 billion of premiums, which is supposed to go to pay the benefit of the Class Act, but are instead being sequestered away to pay for this new entitlement. Then you’ve got $53 billion of new Social Security taxes. When Social Security taxes come in, they’re supposed to be reserved to pay more benefits. But, again, you’re just making more raids on the Social Security trust fund to pay for this new entitlement. And then the CBO tells us, you’re going to have to have a lot of money to run this program – $10 billion to the IRS to hire about 16,000 IRS agents to police the enforcement of this mandate on every American, about $55 billion just to go toward bureaucracies to run this new government takeover of healthcare, and just on the Part A trust fund, yesterday’s CBO letter makes it extremely clear, all this money, through these Medicare cuts, is not going to extend the solvency of Medicare. CBO is extremely clear about that.
It is going to pay for this new entitlement. Just from the Part A trust fund for Medicare, that’s $398 billion coming from Medicare to go toward this new entitlement. Looking at just the CBO letters we’ve received, this bill over 10 years gives us a $454 billion deficit.
So, it’s very, very clear that, when you strip away the gimmicks, when you look at the fact that this treats Medicare like a piggy bank to create new government programs, what we are doing here is we are imposing a new entitlement, that we don’t know how to pay for, on top of the other entitlements we don’t have money for. We’re imposing job-killing tax increases on American people at a time we’re trying to create jobs.
And, finally, let’s just take a look at the architecture of this legislation. It is designed to give the federal government control over what kind of health insurance is available for all Americans, it mandates that Americans buy health insurance that is determined by Secretary of HHS, it tells us how much healthcare is enough, and it tells us what treatments are worth paying for. I don’t think this is what people sent us here to do.
In the House we’re up for election every other year, the entire body is up for reelection. The Framers designed this institution to be closest to the people. I would simply implore you: they want transparent government, they want accountable government, and bringing forward a rule that deems a 2700 page bill- a takeover of the entire health care sector, the creation of $2.4 trillion entitlement- deeming this into law, without actually having the courage to have a clean up or down vote in the people’s house, as representatives of the people. This is not good democracy, this is not good government. One of the cornerstone principles of this nation that the founders created is we have government by consent of the governed, that’s not what’s happening here, we are turning this principle on its head.
I would simply implore you don’t go down this path. Give us clean votes. More to the point, the shame of all of this- and my friends on Ways and Means know this, is we’ve been offering ideas as well, we’ve been offering solutions. We have asked you to work on this on a bipartisan basis, step by step, piece by piece: work on the uninsured, work on preexisting conditions, work on costs, work on prices, work on the deficit.
Instead, I realize you have a big majority, I realize you have all the power in Washington; you chose to go it alone with one party rule. I simply want you all to know that we too believe the current system of healthcare is unsustainable. It needs to get fixed, it is bankrupting families, it is bankrupting people with preexisting conditions. We don’t want to have 30 or 47 million people uninsured whatever number you chose, pick it. We want to fix this!
But the answer is not for the federal government to take over the health care sector, impose $569.2 billion in new tax increases to kill jobs, and to raid Medicare by the tune of $532 billion- not to extend its solvency, but to create a new entitlement, and so that is why we are opposed to this bill.”