night operations. we do intend, the night operations ultimately acknowledge the afghan constitution and afghan law but the process specifically of the execution of that operation has yet to be negotiated. it is not my intention that night operations lose their momentum, which is really what gives them their effectiveness, and so any specific conversation about the issuance of warrants or a prior review of mission folders by judges, it's very premature at this point and in fact i have not been involved in any negotiations specifically about that at this point, sir.

the presiding officer: the senator from mississippi. mr. wicker: we are in morning business, are we not? the presiding officer: we are. mr. wicker: i rise to speak on the second-year anniversary of the health care patient protection and affordable care law. i will be joined shortly by a few of my colleagues. i would ask unanimous consent that at that point we engage in a colloquy. the presiding officer: without objection. mr. wicker: thank you. madam president, on friday of this week, two years will have passed since president obama signed the patient protection and affordable care act into law. this actually is a sad anniversary, because more than enough time has gone by to reveal the failures of this massive, burdensome piece of legislation. the fact that 26 of our 50 states, more than half of the states, are part of the legal challenge currently under review

by the supreme court points out the inevitable truth. this is a law that simply does not work. the case which will be argued in a few days will be one of the most consequential supreme court cases of my lifetime. consequential not only because it deals with this massive, burdensome piece of legislation, but because the implications goes so much further. the implications of this supreme court case will decide the scope of the commerce clause. and, indeed, madam president and my colleagues, if the supreme court decides that this law can withstand constitutional scrutiny, then this large, massive federal government can in fact do almost anything. there will in fact be hardly any limitations under the constitution in the bill of rights on the power of the

united states federal government. americans are right to be disappointed with obamacare, and they're right to want to repeal. and regardless of the outcome of the supreme court case, this congress can decide -- and as a matter of fact, the people of the united states will have a chance in november, as we do every two years, to decide. a recent gallup poll shows that twice as many americans think the law will make things worse for their families than those who believe it will make things better. 72% of americans believe the individual mandate is unconstitutional. the truth is that americans deserve affordable, high-quality health care. not a 2,700-page, big-government piece of legislation that taxes, spends and regulates. the president's health care law has not lowered the cost of

health care as promised. it has not created jobs as promised. it has not reduced the deficit as promised. and so, this week we mark an anniversary, not with progress but with bitter realities. president obama and his joint session to congress in 2009 assert that his plan -- quote -- "will slow the growth of health care costs for our families, our businesses and our government." in fact, last week the nonpartisan congressional budget office and joint committee on taxation updated their outlook of the health care laws' impact on the federal government. not surprisingly, their latest analysis says obamacare will cost even more than anticipated. and the anticipated costs were high indeed. but they say that the health

care law will cost nearly $1.8 trillion over the next decade, or double the estimated cost that accompanied the bill when democratic majorities, democratic super majorities passed it in 2010. this is hardly the relief that president obama promised. during his campaign, the president said the plan would reduce health care premiums by an average of $2,500 per family. instead premiums have grown by nearly that much since he was elected. i see i'm joined here by two of my colleagues, the distinguished senator from wyoming and the distinguished senator from kansas. there are a number of other promises that we can talk about today. i will -- i know we don't impugn motives around here. it's against the rules.

but one has to wonder did advocates of this massive law actually believe these promises or were they simply duped and mislead? and i don't know which is worse. but i know that my colleague, dr. barrasso, himself a physician, who is on the front line of this issue, has griffin this a great deal of thought. so at this point i ask him to join into this colloquy. mr. barrasso: madam president, i stand here with my friend and colleague from mississippi because he and i both attended in his home state of mississippi, a meeting at a hospital where we met with doctors, also met with patients, met with people from the community while the debate and the discussion was being conducted about this health care law. at the time people were asking the sorts of questions because they had heard the promises. would this actually lower the cost of insurance by $2,500 a

family? that's what people wanted. that's what they expected. the other question: will i really be able to keep the care that i have and the doctor that i have if i like it? now here we are a couple of years later, the second anniversary of this health care law being passed, and i'm here with my friend and colleague from mississippi, and it just seems to me that the questions that were asked by your constituents, by the doctors in those communities who take care of the patients, by the patients, the hospital administrators that we talked to that day in his home state of mississippi, and it does seem that many of these promises have been broken. the costs seem to go up higher than had this health care law not been passed at all. the numbers and the statistics that we're hearing now from the budget office on the cost seem to be much, much higher than what the president promised. parts of this health care

lawmakers the so-called class act -- law, the so-called class act, it comes out with schemes to make it seem like the cost of the health care law would be much less than what the american people now know it to be. it's no surprise to me -- and i see this in wyoming and i'm sure you see it in mississippi, and i would imagine the senator from kansas who is on the floor, has seen the same thing at home. he has gone to hospitals, in just about every hospital in the state of kansas as he's traveled around. what we're all seeing is this health care law is even less popular now than when it was passed. that's what i hear at town hall meetings. when i ask do you think you're going to actually pay more under the health care law, every hand goes up. when you say do you think the quality and available of your -- availability of your own care at home is going to go down? again every hand goes up. if i could ask my colleague from kansas if he's hearing the same things. then i know we're also joined by

the senator from arizona. mr. moran: i appreciate the opportunity to join my colleagues on the senate floor today, especially the senator from wyoming, a doctor, who is such an expert on the topic of really not just the moment, not just the day, but the topic of what our country faces. i would tell you that i do spend a lot of time in hospitals across our state talking to health care providers, talk to go patients, to doctors, to administrators, trustees. in fact, there's 128 hospitals in our state. i have visited all of them. and there is just genuine concern about the future of the ability for health care to be delivered in communities across our state. and you add to that the physician and other health care provider community, this health care reform act is creating significant challenges. my interest in public service started a long time ago with the belief that we live our lives in rural america, in my state of kansas, in a pretty special way. when i came to congress, it became clear to me that if our

communities were going to have a future that it was dependent upon the ability to deliver health care close to home. and those rural communities across our nation often have high proportions of senior citizen populations where medicare is the primary determining factor of whether or not they can access health care. and so when the affordable care act was passed, many promises were made. but one of the things that was sold to the american people, or at least the attempt was made to sell to the american people was there will be greater access. i would certainly say that one of the promises that is not being kept about the affordable care act is the likelihood that there is going to be greater access for americans across our country to health care. because this bill is underfunded, it's not paid for. the consequences are that the administration is already proposing, congress will always be looking for ways to reduce spending when it comes to health

care. and the most lickly target is the payments that medicare phaeuplts -- makes to health care providers which sometimes doesn't cover the services. when we look for access to health care, every time a decision will be made in order to try to make this more affordable, we're going to see fewer and fewer providers able to provide the services necessary to folks across the country, but especially in rural communities where 60, 70, 80, even 90% of the patients admitted to the hospital are on medicare. one of the problems with the affordable care act is the reality that it will reduce the access to health care by people who live in rural america. and we will see fewer physicians accepting patients on medicare. we will see fewer hospital doors remain open, all done in a way that, as this bill takes $500 billion out of medicare to begin

with, we set, the congress that passed this, the president who signed this legislation set the stage for there to be less affordable health care available to americans across the country, but especially for constituents of mine who live in a rural state like kansas. mr. wicker: if i could jump in on the issue of medicare, because i have a quote here from president obama, july 29, 2009, quoting specifically from the president. medicare is a government program, but don't worry, i'm not going to touch it. as a matter of fact, only months later, he signed into law the obamacare act which takes half a trillion dollars from medicare and it touches on the very issue that the senator from kansas was referring to with regard to medicare access for people in rural kansas. i yield to my friend from -- mr. mccain: i point out to my

friend from mississippi that the first amendment we had on the floor of the senate when we were considering obamacare was to restore that $500 billion and it was voted down on a party-line basis. i want to thank my friends for allowing me to engage in this colloquy. i'd like to discuss with my friends, probably in my view what really encapsulates the problems with this legislation. the commitment began was that we would provide affordable health care to all americans, which meant we had to put a brake on inflation in health care because health care was becoming unaffordable, the highest quality health care in the world. nothing in my view -- i'd like to ask my colleagues -- describes that more of how this whole plan went awry than the so-called class act. late in the debate, the class act was thrown in to provide long-term care for seniors, which seems like a worthy cause,

but the whole thing was a gimmick. it was described by senator conrad, our distinguished chairman of the budget committee, called it a ponzi scheme of the first order, the kind of thing that bernie madoff would have been proud of. so they foisted that off on us. why? well, initially because of c.b.o. scoring that it would show an increase in finances into -- and revenues into the whole obamacare program. but as soon as those people paying in became eligible, then obviously the reverse happened. thank god for senator gregg, former senator of hall of fame, who had an adopted -- amendment adopted that said the program would be solvent over 75 years before the program could be implemented. if it hadn't been for that, the class act would be here today. and then in october, last

october, the secretary of health and human services issued a report confirming that what many of us knew was inevitable, that the secretary could not certify. the class act solvency is required under law. here we went through this exercise franticcally searching for ways to increase revenue, at least the way that c.b.o. does scoring, so we did the class act, and thank god senator gregg of new hampshire put in an amendment that said it would be viable over 75 years. there is no way. not a snowball's chance that they were ever going to be able to certify over 75 years that it was going to be a viable program. so it was kind of entertaining. guess what late on a friday night the secretary of health and human services said that she could not certify that the program would be solvency

throughout a 75-year period. so the result of this was obviously that they didn't have the false revenues that c.b.o. could score, they didn't have a program that could provide long-term care for seniors, and again, as the senator from north dakota aptly pointed out, this ponzi scheme of the first order faced and met a well-deserved death. but that's why the american people, the overwhelming majority of the american people, disapprove of this whole exercise, disapprove of obamacare. they want it repealed, they don't support it, and i'm proud to say that in this election, we will decide whether we repeal and replace obamacare or not, and the american people care about it. mr. wicker: let me summarize what the senator from arizona has just said. the class act was sold to the

american people as a budget deficit reducer. it was going to reduce the deficit. no sooner was it signed and they started looking at it that the administration itself said we know it's unworkable and we abandon it, we're not even going to try to enforce it. that's the result. mr. mccain: they would have kept it on the books had it not been for the amendment of the senator from new hampshire that said they had to certify that it would be solvent over a 75-year period. now, if it hadn't been for that amendment, we would have the class act today, a ponzi scheme in being where people are paying in and that is scored as revenues, and then some years later when they retire, obviously, the reverse would have been true. and i have yet to hear one of my colleagues come over and admit that they were wrong about the class act. i'd love to hear some of those who strongly advocated for it. my friend from iowa, senator

harkin, said so we get a lot of bangs for the buck as one might say with the class act that we have in this bill. senator whitehouse said certain colleagues on the other side of the aisle have argued that the class plan would lead to a financially unstable entitlement program and would rapidly increase the federal deficit. that is simply not accurate. i look forward to my colleagues who supported and voted for the class act to come over and agree that it was, as senator conrad pointed out, a ponzi scheme. mr. wicker: i know our friend from south dakota has joined us and is eager to join in this discussion, so i wonder if he has anything he would like to add about the broken promises that were made during the passage of obamacare. mr. mccain: let me just say, the point is, the whole point of reforming health care was to reduce the costs of health care. that was the -- that was the goal. we all know we cannot sustain,

medicare cannot be sustained for the american people if the inflation associated with health care continues. so the whole object of this game was to reduce the costs of health care and preserve the quality of health care. does anybody think that that was achieved with this legislation? that's why the american people have figured it out. i'd ask the senator from south dakota. mr. thune: i would just echo what the senator from arizona has said about the class act. he was down here as was i and i think many of us when we were debating this to say this is a program that is destined to be bankrupt. in fact, if you look at what even the independent medicare actuary was saying, that was described, the class act was, as unworkable, and they said it would collapse in short order within the health and human services department, there was a nonpartisan career staff who privately called the class program -- quote -- a recipe for disaster, end quote. there was plenty of advance warning that this thing wasn't going to work. as the senator from arizona

correctly pointed out, it was used as a gimmick to make the overall cost of this thing look less and therefore bring it into balance. we now know, of course, that the class act couldn't work. they have had to acknowledge that and the amendment that was put on by the senator from new hampshire, senator gregg, that forced them to certify and made that abundantly clear. but to the senator from mississippi's point, the whole purpose of the exercise was we have got to do something about the cost of health care. we have got to get health care costs down for people in this country. in fact, the president of the united states when he was running for president said, and i quote -- "if you have got health insurance, we're going to work with you to lower your premiums by $2,500 per family per year. we won't wait 20 years from now to do it or ten years to do it. we will do it by the end of my first term as president of the united states." end quote. i'm sure the senator from arizona probably remembers very well many of these statements. but the facts tell a different story, madam president. if you look at what health care

costs are doing and even what was predicted by the congressional budget office, they said that the law was going to increase health insurance premiums by 10% to 13%, which means that families purchasing coverage on their own were going to have to pay an additional $2,100 a year more because of the new law. that's actually been borne out. if you look at the cost of health insurance for people in this country today, it's gone up, not down. it's gone up dramatically since the president took office, about 25% for most americans. so all these promises about getting costs under control, all the promises about being able to keep what you have, all the promises about, you know, this being done in a way that would protect medicare, we all know that medicare was slashed to the tune when it's fully implemented of a trillion dollars. and if you look at the taxes that were imposed by this, a trillion dollars in new taxes, the american people got a bad, bad deal. they know it. that's why the public opinion

polls show that. mr. mccain: even though we have shut down the office, the class act, even though the secretary of health and human services has said that they can't certify that it will be fiscally sustainable over 75 years, it's still on the books. isn't the class act still on the books? do you think that it might be appropriate since we can't comply with the law that maybe we could repeal that portion of the law? would that be something we might think about? in fact, i think it might be a pretty good amendment. mr. thune: a good amendment. and by the way, we have that amendment. we would be happy to offer it. we tried to call the bill up. it was objected to by the democrats to get rid of it. because the bad thing about bad ideas around here is they tend to come back. this is a bad idea that ought to be put away once and for all, and yet it is on the books, as the senator from arizona has pointed out. i don't know why after all the evidence out there now that has

been put forward, including the health and human services secretary saying this will not work, we continue to maintain this on the books in hopes i think that for some at least in the administration that it can be resurrected at some point in the future. but this is a bad idea. it was a bad idea then, it will be a bad idea in the future, because it can't -- it just doesn't pencil out. you cannot make it work. the only thing it does is saddle future generations with massive amounts of debt. mr. wicker: let me ask my colleagues about another promise. i know they are going to call time on us in just a few moments. does anybody recall hearing this staple from the president of the united states in 2009 -- if you like your health care plan, you will be able to keep your health care plan, period. no one will take it away, no matter what. unquote, the president of the united states, june 15, 2009. what happened to that one?

mr. barrasso: even the administration admits that wasn't true. small businesses, people who get their insurance through small businesses are going to have a very difficult time continuing to provide coverage for people because of the mandates, the washington mandates that say you have to provide washington-approved insurance. i mean, that's the problem, is that people have what they like. it may be something that they want, that they need, they can afford, and now they are being mandated to have something that they may not want, may not need and may not be able to afford. so, again, you have another broken promise, which is why senator coburn who has practiced medicine for about a quarter of a century -- and i practiced medicine for about a quarter of a century, have come out with a report released yesterday, called warning, side effects, a checkup on the federal health law. fewer choices. that means people can't choose to even keep what they had. fewer choices, higher taxes, more government, less innovation. none of those things are the things that the american people have been promised by the

president. mr. mccain: in addition to that, could i ask the senator how many new regulations have been issued and how many new regulations do we anticipate as a result of this legislation? mr. barrasso: from the looks of this over 2,000-page law is going to result in over 100,000 pages of regulations, pages worth of regulations. i know there is one part of the law, a couple of pages, four to six pages, they had 400 pages of regulations and 50 pages of legal guidance. you talk to hospitals, and i know that those of us travel and visit with hospitals in our states. they say we're spending money on consultants and lawyers to help us understand the law, and it's money we ought to be spending on patients and on equipment and on technology for our hospital to provide care in our community. the senator from kansas has visited over a hundred hospitals in his state. i think he's heard exactly the same thing.

mr. moran: it's certainly true. the point that was made earlier about benning this cost curve down, it doesn't do it, it can't do it. that creates the problem that we now all face, how do we have access to affordable health care if you're not reducing the cost of health care. and so the end result, in my view, is that americans will have less options, less options for their own plans. as employers, they will provide either less options or no options for employees. so the idea that you're going to get what you -- keep what you have, that begins to disappear if you're employed. if you're a senior citizen and medicare has been your primary provider, again back to this idea we didn't bend the cost curve, so in order to make health care affordable, when the legislation fails to do that, we find other gimmicks to do that. and one of the things that this bill creates is ipab, this so-called independent agency that is going to make decisions about what is covered by your health care plan, and the goal will not be to be better quality

health care. the goal of the ipab will be to reduce expenditures. so as the promise was made you get to keep what you have, it becomes something totally different than what you experienced in your health care plan, either in your own private health care insurance or as a beneficiary of medicare. and so even though presidents own medical actuary estimates that the law will increase overall national health care expenditures by $311 billion during the first ten years alone and that private health care insurance premiums will rise 10% in 2014, so if we're complaining today about the increase in premium costs, there's more to come. 2014, the medicare actuary says another 10% increase in your health care premiums. at the center for medicare and medicaid services, their economist found that the increasing growth rate in health

care spending will occur in every sector of health care, and more recently the congressional budget office, our neutral provider of analysis, says the cost of the health care law may be substantially higher than earlier estimated. one of the things that i would suggest that we should have done that never happened -- if you want to keep what you have, if you want to have access to health care in rural and urban and suburban places in the country, one would think we would do something permanent about fixing the reducing payments to physicians, so-called doc fix. one would have thault in health care reform -- would have thought in health care reform that would have been front and center because if you don't have a physician providing the service, you don't have health care. yet, we have a medicare system that's going to reduce the payments. in fact, expected this year it would have reduced payments to physicians 30%. the reality is that no longer will physicians accept medicare patients, and that option you were promised to keep what you have disappears one more time.

in fact, town hall meeting parsons, kansas, this year a physician on the front row says senator, you need to know that i no longer accept medicare and medicaid. i will take cash, but i'm not able to afford to provide the services based upon the medicare reimbursement rate that i get. and you add all the paperwork in trying to comply with medicare and medicaid, and it's no longer financially feasible for me in this small town to provide the services that my patients need under medicare. we're going to see a lot less access because, once again, the failure, the promise that have made to reduce, to bend the cost curve down, to reduce health care costs, to reduce premiums, was totally false. mr. wicker: so the promise was not to touch medicare. that promise has not been fulfilled. the promise was to reduce the deficit. that turned out to be an empty promise. you know, also we were told by

the president and by speaker pelosi that this bill would create jobs. the president said it was a key pillar for a new foundation for prosperity. how has that turned out? former speaker pelosi said in its life, the health care bill will create four million jobs. 400,000 almost immediately. of course neither of those has come true. the nonpartisan c.b.o. has estimated that the health care law will reduce america's workforce. this is a bipartisan c.b.o. reduce americans' workforce by 800,000 jobs over the next ten years. and that fact has been confirmed by the united states chamber of commerce. mr. thune: i say to my colleague from mississippi is one of the areas where jobs may be created is in the federal government because it's going to take an awful lot of federal bureaucrats to oversee and lots

of new i.r.s. agents to complement this legislation -- to implement this legislation. when it comes to private-sector job creation, the thing about this is it raises the cost for hundreds coverage -- for health insurance coverage for employers. it raises taxes on a lot of people involved in health care -- the presiding printed in the record. the presiding officer: without objection. mr. harkin: i'd like to be notified when i have one minute left. the presiding officer: okay. mr. harkin: two years ago president obama signed into law what i believe will be remembered as the most forward-thinking and humane -- humane -- reform of our health care system since medicare. just like the republicans opposed medicare when it came in, and they still want to get rid of it -- if you look at the ryan budget that came out, what do they want to do? privatize medicare. they have been at it ever since. and now they don't want this humane reform that we passed two years ago. when the affordable care act became law, i said this, i said we have made america a more compassionate and a more just

society. i believe this with even greater conviction now. and in listening to my colleagues, my friends on the other side of the aisle, you would think this is all just about little nuts and bolts and this and that, but it's about humaneness. it is about compassion. it is about justice. and, yes, it is about making the system -- the system -- work better for patients, not just for insurance companies and the insurance industry. now, we've moved ahead to implement the law. the results have been striking. every american now is protected against abusive insurance companies practices of the past. let me put it another way. because of the health reform law, americans now have protections that every senator in this chamber has enjoyed for years. under the federal employees health benefit program, we now have extended that to americans. i listened to my friends on the other side of the aisle, they want to take it away from americans but keep it for themselves.

oh, no, they don't want to give it up. well, i think what's good for senators ought to be good for the american people. this is a chart of -- this is emily schlichting. she testified before my committee last year. here's what he *f -- here's what he she said. young people are the future of the country. we need the affordable care act because it is literally an investment in the future of this country. why did she say that? because she suffers from a rare autoimmune condition which insurance companies would not even cover. but because we have said that they cannot now discriminate if you have a preexisting condition, emily gets insurance coverage. plus she can stay on her parents' health insurance program. so far the law has extended

coverage to more than 2.5 million young people like emily, and they want to take it away. they want to take away emily schlicthing's insurance coverage. that's what it's all about. they want to appeal the affordable care act. obamacare. and what it means is that 2.5 young people like emily will lose their insurance. they don't talk about that. they don't talk about that. now, right now here's the coverages that americans have: banning lifetime limits. let me read about ross daniels and amy ward from wes des moines, weigh weigh. after developing a rare lung infection, amy needed intensive treatment including a course of medication at -- get this -- $1,600 a dose. $1,600 a dose. her insurance policy had a $1 million lifetime limit. without health reform's ban on

lifetime limits, this couple would have had to declare bankruptcy. after this experience, ross said he couldn't understand why opponents wanted to repeal it. he said -- and i quote -- "it is hard for us to believe that so many of the g.o.p. candidates would have us go back in time where an illness like this would have forced us or any other family, for that matter, into bankruptcy. so, as to what the republicans said, they want to take this protection away from amy ward, ross daniels and millions of other americans. 100 million people are helped by the banning of the lifetime limits. we've covered vital preventive services, free of charge, that benefited more than 80 million people now get free preventive care. it allows young people to remain on their parents' coverage until age 26. i can't tell you how many families i've talked to in my state of iowa who said this has been a godsend to them and to

their kids. here's a preventive. we all know prevention is the best thing we can do to change our sick care system into a health care system. here's what the affordable health care act does on prevention. before health care reform, colorectal cancer screening was covered only by 68%. 68% by insurance companies. cholesterol screening only covered by 57%. tobacco cessation, only 4%. under the affordable care act, colorectal cancer screening, cholesterol screening and tobacco cessation, all covered at 100% by every insurance company. 100%. not 57% or 68%. but 100%. and we all know that early screening means that people live longer, and it cuts down on health care costs. so millions are now receiving free preventive care. 86 million americans had at

least one free preventive service in 2011. a million iowans in my state received at least one free preventive service in 2011. the republicans want to take this away. that's what it's about. americans now have preventive care. they now are able to keep their kids on their policy until they're age 26. they now have a ban on lifetime limits. we now have a ban for children up to age 19 on preexisting conditions. that is all -- that's what they want to do. they want to take this away. i say don't let them take this away from the american people. the presiding officer: 50lot hi. mr. barrasso: it does seem that way to me with the fact that two years out, senator coburn and i put together a report on what we're finding, a checkup on the federal health law, and the title is