During the health care debate in the Senate, few lawmakers have attracted more attention than Democrat Senator Ben Nelson of Nebraska. But while Nelson has been reluctant to discuss his views on the legislation in question, his Republican colleague from Nebraska, Sen. Mike Johanns, has become increasingly outspoken on health care policy.
In an extensive interview with Health Care News in December, Johanns expressed his deep concerns over the possible costs of the Senate’s bill. In November 2009 Johanns joined with 24 other GOP senators in sending a letter to Majority Leader Harry Reid (D-NV) asking for a comprehensive Centers for Medicare and Medicaid Services (CMS) report on the Senate’s health care bill—a report which ultimately indicated the bill would increase health expenditures by $234 billion.
“Our budget staff has been digging into the bill. It is clearly going to cost about $2.5 trillion over two years,” said Johanns.
Tax Concerns Paramount
Johanns expressed concerns over not just the total cost of the health care bill but also how it would be financed.
“This legislation has historic tax increases,” said Johanns. “Taxes will increase about 496.3 billion dollars. We see some new features including a Medicare 1.95 percent payroll tax, as well as a tax on some health care plans. If you want to get cosmetic surgery, if you want to get your teeth whitened, you better hurry up, because Reid wants to tax it. You’ll also see Medicare cuts of about 464 billion dollars.”
Michael Cannon, director of health policy studies at the Cato Institute in Washington, DC, believes Johanns’ concerns about costs are valid.
“This bill will result in tax increases on the sick, seniors, wages, health insurance, medical devices, prescription drugs, health savings account holders, medical savings account holders, cosmetic surgery, and more,” said Cannon. “Plus, with the individual mandate there will be a tax that would likely cost $1.5 trillion. Additionally, there will be future taxes necessary when the cost of this legislation exceeds projections and Congress reneges on the spending cuts.”
No Deficit Reduction
While Senate Democrats have touted their plan will result in deficit reduction and President Obama has promised to sign a deficit-neutral bill, Johanns says their actions don’t match their rhetoric.
“Democrats are pointing to deficit reduction, but it’s a gimmick because that depends on delaying benefits,” said Johanns. “Any possible savings are already erased in one month by deficit spending.”
Abortion, Immigrants Big Issues
Johanns also addressed the controversial issue of abortion funding included in the legislation, an issue which has put Nelson in the limelight.
“Polls show as high as 60 percent or more of Americans don’t want abortions funded. The Senate version of this plan guts the Hyde Amendment,” said Johanns. “We will be entering a whole new era where the government directly finances abortion.”
Senate Democrats have argued the funds for abortions will be segregated from the general funds, but Johanns calls this approach unacceptable.
“It’s a bookkeeping gimmick, an argument already rejected by the prolife community on the House floor. What they are saying is it isn’t actually public funds, it is subsidies, and it doesn’t really purchase abortions,” said Johanns. “But that’s wrong. A premium is a premium, and the government is going to have its dollars in that pot. To say you are going to segregate the funds doesn’t pass muster. It can’t be done.”
Johanns also expressed concerns about how the Senate bill would apply to illegal immigrants.
“We can say we aren’t going to provide coverage, but the challenge you run into is if you don’t do identity verification you won’t know if there are illegals being covered,” said Johanns. “Word will spread very quickly that verification isn’t happening.”
On December 8, Senate Democrats came to an agreement on moving the Senate bill forward, attaining the 60 votes needed to begin debate. But questions remain regarding whether Reid can count on moderate Democrats, including Nelson, Louisiana’s Mary Landrieu, Virginia’s Jim Webb, and Arkansas’ Blanche Lincoln, and Independent Joe Lieberman of Connecticut, to support cloture on the legislation.
When asked if he expected a sustained filibuster on the health care legislation, Johanns said his colleagues are holding their opinions close to the vest and he cannot be certain what will happen until the final roll call. But he is confident the bill as it currently stands will not deliver on its proponents’ guarantees.
“I think this bill is bad policy for the nation. I don’t care if you are a liberal or conservative or independent. It doesn’t do what the president promised,” said Johanns. “You will lose your current insurance. This will bend the cost curve.
“The American people are sophisticated and knowledgeable and they just aren’t buying it,” he added. “Taxes are going up, Medicare will be cut, and premiums are going to be raised. This is not the right policy. We can get a bipartisan bill. This is simply an attempt to drive a political agenda. This is too important. We need to drive a good health policy agenda.”
Sarah McIntosh ([email protected]) teaches constitutional law and American politics at Wichita State University in Kansas.
Centers for Medicare and Medicaid Services: “Estimated Financial Effects of The ‘Patient Protection And Affordable Care Act Of 2009”: