Opening Statement on the Fiscal Consequences of the Health Care Law

Chairman Paul Ryan, House Budget Committee

Welcome all, to the first House Budget Committee hearing of the 112th Congress.

Before we get started, I want to thank Ranking Minority Member Chris Van Hollen for his cooperation in getting the Committee rules adopted and with this hearing. Also, for starting a little early, so we can get a head start on the day.

Why is this the Budget Committee’s first hearing and why is it focused on health care?

Let’s put it very simply: Our fiscal problem is a health care problem. Health care spending is driving the explosive growth in our spending and our debt.

The new health care law was sold under the guise of fiscal responsibility. The claim was that the government would spend trillions of dollars, add millions to a new government-controlled health care program, and create two new open-ended health care entitlements – all in order to lighten our budgetary burden.

Most Americans understand that something is just not adding up here.

Today’s hearing is intended to peel back the layers of the law – and its maze of mandates, dictates, controls, tax hikes, and subsidies.

Many try to distort our criticism of the health care law and say that we are criticizing CBO. Actually, quite the opposite is true. I think CBO does a very good job. We ask them to do a lot under short notice and they perform very admirably. The analyses performed by CBO, Mr. Foster and others, enabled us to unpack the law’s budgetary smoke and mirrors and reveal its true fiscal impact.

We face a choice of two futures – and nowhere is this choice more clearly defined as it is in health care.  Down one path lies the managed decline of a government-run system on the verge of bankruptcy.

There is an alternative path and it is a path that leads to true choice and competition in health care. It is modeled after the health care system we ourselves in Congress enjoy. It puts patients first – with providers competing for our business.

But before we can get there, we must reject the notion that a centrally planned, bureaucratically run health care system can produce more favorable outcomes than one managed by doctors and patients.

Do we want a system that is command and controlled, price controlled, formulaically controlled by government or do we want a system where the patient is the center? Where the patient is sovereign. Where they get to decide.  Where providers, doctors, hospitals, insurers compete against each other for our business or do we want them competing for favoritism from a shrinking pool of government resources.

While I’m opposed to the President’s health care law, I want to find solutions to these problems. That’s why I’ve worked with other Democrats to come up with other proposals to try and find answers to these. Alice Rivlin and I most recently teamed up on a proposal in the fiscal commission. She and I do not see eye-to-eye on everything, but we tried to come together, to compromise, to try find a way to fix some of these problems — to address our health care problems and our fiscal problems. I hope we can continue to build bipartisan support for policies that create incentives in our health care system to enhance quality, reduce cost, and promote patient satisfaction.

It is an honor to welcome our first witness: Rick Foster, Chief Actuary for at the Centers for Medicare and Medicaid Services. Time and again, Rick’s unbiased actuarial reports have proved difficult to square with the claims made by the law’s proponents, specifically with respect to the direction of health care spending as a result of this law.

After Rick’s testimony, we will hear from a panel of three witnesses.

Dennis Smith, the newly confirmed Secretary of Health Services in my home state of Wisconsin: Dennis has tremendous experience in this area serving as Medicaid director at HHS on the previous administration. He will give us a sense of what the impact of the law is on the states.

Next, Jim Capretta, a former associate director at the Office of Management and Budget: Few in my mind have made as compelling a case as Jim on both the costly consequences of this law and the path forward to advance real reform.

And we’ll hear from Paul van de Water of the Center for Budget and Policy Priorities. Paul has an impressive background and I welcome his thoughts to advance an informed debate on this critical issue.

I look forward to today’s discussion; I thank our witnesses for joining us and for starting a little bit early; and with that, I will yield to Ranking Member Van Hollen for an opening statement.