Senator Lincoln's Floor Speech

For more information on health reform, click here to visit Senator Lincoln's Health Care Resource Center.

Click here to read the full text of the "Patient Protection and Affordable Care Act."

The full text of the speech Senator Lincoln delivered on the Senate Floor on Saturday, November 21, 2009 at 1:20 CT is below:

The Patient Protection and Affordable Care Act
Senator Blanche L. Lincoln
Saturday, November 21, 2009
Senate Floor
Washington, DC

MR. PRESIDENT, I've asked for this time not only to address my colleagues in this body but to speak directly to my constituents at home in Arkansas.

After many months of debate on health care, we are nearing another important step in a very deliberative process.

Today, we are voting on whether to continue to discuss how to improve health care in America, or to stop the debate.

I personally have carried the mantle to improve health care for Arkansans throughout my public service, and many others with me have as well.

Over the last several decades, the advance of medical technologies and our nation's changing demographics have placed new demands on our health care system that it is not designed to meet.

Our vote later this evening is not the first step toward making the necessary adjustments in health care and it will not be the last.

The Finance Committee on which I serve, and which is led so ably by my good friend from Montana, Chairman Baucus, has produced what I still describe as the most responsible approach to health insurance reform.

We deliberated for more than 22 months, incorporating recommendations from experts all across our great nation, and proved with our bill that America can achieve unprecedented health insurance reforms that expand coverage, reduce costs and provide stability for those with existing coverage.

We accomplished these goals without posing long-term risk for taxpayers.

It was not a perfect bill, but I can honestly say that I will fight hard so that our final product will more closely resemble the common-sense, deficit-reducing plan we produced in the Senate Finance Committee.

At times like this, I think it is important to remember the very reasons we began this debate:

Small businesses and working families are reaching the breaking point financially because of the relentless rise in health care costs. Nationally, our economic recovery will only be slowed by the inflationary cost of health care;

Taxpayers and the insured are already bearing the cost of medical treatment for the uninsured at the most expensive point of delivery - emergency rooms;

Health care in America today is a model that waits until people get sick rather than focusing on wellness, prevention, and good management of illness that keep people out of the hospitals and from having the most costly care needs.

Our current health care system wastes money and is so inefficient that the United States spends more than twice as much per person, while insuring a smaller proportion of our population, than the average spending in 29 other industrialized nations;

There simply aren't enough health insurance options available to most Americans today, when in at least 17 states - including Arkansas - only one insurance company controls more than half the insurance market, and in at least 22 states still only two carriers control half the market or more.

Patients and doctors are routinely making treatment decisions with little or no objective information about which treatments are the most effective;

American capitalism is based on choice and competition, because when these elements are present, consumers can most always find the most value for their money.

That's not true in health care, so by creating health insurance exchanges through which small businesses and individuals can choose from a menu of private plans, we can enhance cost transparency, create head-to-head competition, and allow market forces to reduce prices.

These are facts, and whether we are Republican or Democrat or Independent, I believe that we can agree on them.

I know that the great majority of Arkansans believe these facts and want to see us accomplish these reasonable goals.

For months now, groups from outside my state have assigned various motives to my deliberations on health care and tried to define the meaning of my vote.

According to the last tally, there has been more than 3.3 million dollars worth of media ads purchased in Arkansas by groups from outside our state...certainly none by me, and most with my name in the ad.

Still, I've approached this issue like I always do. These outside groups seem to think this is all about my re-election. I don't think they know me very well. I am focused on my opportunity to influence the final version of health care reform legislation in a way that most helps my state.

I've avoided the extremist claims from the left and the right and tried to pull the common sense solutions from among all the policy options so that we get health care reform that benefits Arkansas.

That's our job in this body...to represent our states in the U.S. Senate.

Truth is, this issue is very complex. There is no easy fix, and it's imperative that we build on what is already working for health care in America and not turn away from the problems we face.

We keep building until we can truly say one day, that all American citizens have access to quality, affordable health care.

In order to improve upon and build upon what we already have, I do not support the creation of a so-called "robust," government-administered public plan.

I believe that we should work to make sure we do not expose American taxpayers and the Treasury to long-term risk that could occur from future government bailouts of a public plan.

Rather than create an entirely new government-run health care plan to compete with private insurers, I support health insurance reform that focuses on changing the rules of our existing employer-based private health insurance system.

I believe we should change the current rules that permit insurance companies to bully their customers and cherry pick healthy patients, so we can force them to compete with each other.

My first loyalties are with the people of Arkansas...not insurance companies, the health care industry or my political party.

In fact, I authored an amendment during consideration of legislation in the Senate Finance Committee which limits taxpayer subsidies for health insurance companies that pay their top executives millions in salaries.

Responsible health insurance reform should ensure that insurance executives aren't receiving a personal windfall and the companies they work for are not receiving excessive tax breaks, while at the same time profiting from a government requirement on consumers to buy insurance.

The reason we are having this vote is because our Republican colleagues object to beginning debate and consideration of amendments on health care legislation.

Although I don't agree with everything in this bill, I have concluded that I believe it is more important that we begin this debate to improve our nation's health care system for all Americans rather than drop the issue.

Attempts by the National Republican Party and other conservative groups to portray this as a vote for or against this particular health care reform bill is untrue and deliberately misleading.

The vote tonight will mark the beginning of consideration of this bill by the full U.S. Senate, not the end.

The Republicans have sought to revive their political party by opposing any real solution to our nation's health care crisis.

In fact, this is a vote for or against a procedure that allows us to begin open debate on health care reform. It is nothing more or less.

Put simply, those who vote yes on this first vote believe our nation's health care system needs reforming and are ready to have an honest and open debate on the floor of the U.S. Senate about how to best achieve that reform.

I will not allow my decision on this vote to be dictated by pressure from my political opponents nor by liberal interest groups from outside Arkansas that threaten me with their money and their political opposition.

The fact is, I am serious about changing our health care system, as most Arkansans and most Americans are.

I am not with those who seek to avoid the debate, nor with those who use political attacks to achieve their narrow goals.

I will vote in support of cloture on the Motion to Proceed to a bill.

But let me be perfectly clear. I am opposed to a new government-administered health care plan as a part of comprehensive health insurance reform, and I will not vote in favor of the proposal that has been introduced by Leader Reid.

I, along with others, expect to have legitimate opportunities to influence the health care reform legislation that is voted on by the Senate later this year or early next year.

I am also aware that there will be additional procedural votes to move this process forward that will require 60 votes prior to conclusion of the floor debate.

I have already alerted the Leader, and I am promising my colleagues that I am prepared to vote against moving to the next stage of consideration as long as a government-run public option is included.

The public option as a part of health insurance reform has attracted far more attention than it deserves.

While cost projections show that it may reduce costs somewhat, those projections don't take into account who pays if it fails to live up to expectations. If in fact, premiums don't cover the cost of the public plan, it is taxpayers who are faced with the burden of bailing it out.

My colleagues, we simply cannot ignore the growth in the federal government since 2000.

I can assure you that the American people have NOT ignored it.

According to the American Institute for Economic Research, government spending grew by 55 percent under President Bush.

And as he we was leaving office, government launched a massive bailout of Wall Street.

Then, it was the domestic auto manufacturing industry that needed taxpayer funds to survive. And finally, in order to revive a dying economy, it took a government economic recovery package to save or create hundreds of thousands of jobs.

We can argue about the necessity of these unprecedented steps but we need not argue about the impression they made on the American people.

We should be stopping the growth of government, not expanding it more.

Without the public option, we can still force private insurance plans that participate in the exchanges to provide standard benefit packages that are easy to compare and are more fairly priced.

We will be bringing millions of new customers to the exchanges, so insurers should be motivated to lower their prices.

I have appreciated the dialogue with Leader Reid regarding my concerns that remain about this bill and look forward to continuing that dialogue on improvements that I feel are necessary.

I will be asking my colleagues to consider these additional, important changes that I believe will improve our chances for real health insurance reform that can also enjoy the support of most Arkansans, most Americans.

These include:

that the legislation remain deficit neutral, now and in the future and curbs future costs;

that it protect Medicare benefits for seniors and extend solvency of the Medicare program;

that it improve accessibility and affordability of health insurance for employees and owners of small businesses, and the self-employed, through access to health insurance exchanges and tax credits;

that it enhance choice and competition of health insurance plans for small businesses and individuals without the inclusion of a government-run public plan option; and

that it build our nation's health care workforce and ensure continued access to quality health care providers, especially in rural America.

Today, I know that I will ultimately be held accountable by my constituents in Arkansas for my votes on health care, not the National Republican Senatorial Committee nor by any other groups from outside my state.

I know that my decision to support the upcoming cloture vote on the Motion to Proceed is not my last, nor only, chance to have an impact on health care reform.

In conclusion, Mr. President, I am optimistic and encouraged about the step we are preparing to take in the Senate to amend and craft a bill that will improve access to quality, affordable coverage options for the residents and businesses of my state who need relief; a bill that improves the quality and efficiency with which we deliver health care in America...all without adding to our nation's deficit and while lowering the costs of health care over the long term.

I am committed to using every power of my office to achieve success on this issue by enacting needed reforms that will benefit the people of Arkansas and the nation.

I have spent these last several months in a passionate dialogue with my constituents about health care reform.

It wasn't just the town hall meetings where I heard from Arkansans. I've had hundreds of conversations with many of them, in groups and one-on-one.

They may not be in agreement about solutions, but I can assure my colleagues that each Arkansan I speak to expects us to roll up our sleeves and get this right.

Following the vote tonight, the bill that will be laid before us will not be the only possible solution.

I know that my decision to support the cloture vote on the Motion to Proceed is not my last or only chance to have an impact on health care reform.

And my strongest hope is that each of us in this body can lay political fortunes aside and make the tough, common-sense choices that our constituents expect of us.

We may not get this opportunity again in our lifetime.

Today, I'm thinking about the Arkansas working family that can't pay their mortgage because of their sick child's medical bills.

I'm thinking of the Arkansas small business owner who told me that more than 20 percent of the cost of running his business now goes to health insurance for him and his workers.

And, I'm thinking about the 450,000 Arkansans who have no health insurance.

I'm not thinking about my re-election, the legacy of a President or whether Democrats or Republicans win this debate.

I look forward to working with the Leader and my colleagues in the days and weeks ahead as we strive to solve a problem whose solution is long overdue.

Thank you. Mr. President, I yield the floor.