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HOUMA Louisiana's two U.S. senators clashed Tuesday over health-reform legislation expected to win approval Christmas Eve.
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In speeches from the Senate floor, distributed to media outlets, Republican David Vitter and Democrat Mary Landrieu debated the costs and benefits to Louisiana, its residents and the nation.

Vitter cited critics' description of the bill as the 'Louisiana Purchase,' a jab at Landrieu's deal to secure $100 million to $300 million in Medicaid money for the state just before announcing her support for the legislation.

Vitter said he agrees Louisiana deserves the money because of an inequity in the way Medicaid payments to the state were skewed by Hurricane Katrina.

'It's a shame that the merits of that fix, which are very real, have been completely lost in this debate because of the way this Louisiana fix has been used and abused in trying to pass this mega bill,' Vitter said.

The health-reform bill, he added, would be better described as the 'Louisiana Sellout' because it would add at least $1.3 billion to the state's Medicaid burden over the coming decade, dramatically expanding the health program for the poor.

Later Tuesday, Landrieu defended her action on the Medicaid money.

'Those who have dubbed this provision the 'Louisiana Purchase' know little about lawmaking and even less about my views on health-care reform,' she said. 'This Medicaid fix alone would not have been enough to earn my vote on this legislation. This was one of literally a dozen priorities I had as the Senate considered health care reform.

'I am voting for this bill because it achieves the goals I laid out at the beginning of this debate: It drives down costs and expands affordable health-care choices for millions of families and small businesses in Louisiana and around the nation. Any claim to the contrary is a pathetic lie meant to derail this bill, a tactic that was all too common during this debate.'

LANDRIEU SUPPORTS

Among Landrieu's arguments in support of the bill:

Cost of doing nothing: In Louisiana, the average family spends more than $12,000 each year for health insurance, or almost 100 percent of earnings from a full-time job paying minimum wage. Since 2000, the amount that working families are charged for health insurance has risen by 91 percent.

'If Congress stood by and did nothing, those costs would nearly double in the next six years, with economists predicting that Louisiana's families will pay a whopping $23,133 for insurance in 2016 an 85 percent increase,' she said. 'To state that in a different way, that means that if we do nothing, the average family in my state will be paying 60 percent of their income for health care. ... This is not unique to Louisiana these skyrocketing costs are burdening families in every state.'

Making coverage affordable: Insurance exchanges will make a wide selection of affordable policies available to businesses and residents, allowing consumers to compare costs and coverage and driving down costs through greater competition. Tax credits will help middle- to low-income residents, as well as small businesses, afford policies. And taxes and other efforts aimed at curbing excessive administrative costs and waste in the insurance industry are expected to drive down prices.

She offered an example of a family in Calcasieu Parish, where the median household income is $39,713. In the exchange created by the Senate bill, that family would receive an 'affordability credit' that limits what it spends on health-insurance premiums to about 5.6 percent of its income, or $2,225 a year.

'Considering right now the average Louisiana family is spending up to 28 percent of their income on health care, this is a huge improvement,' Landrieu said.

Bill is 'paid for:' 'There have been a number of false claims about how this bill will add to the deficit and be a burden to our children and grandchildren,' Landrieu said. 'The fact of the matter is that the bill is completely paid for and will reduce the deficit by $132 billion over the next 10 years and as much as $1.3 trillion in the following 10 years.'

VITTER OPPOSES

Among reasons Vitter cited in opposing the bill:

Costs to seniors: 'Louisiana seniors, like seniors everywhere, rely on Medicare. They've paid into it their whole lives. This bill cuts Medicare by $466 billion. Medicare now is already facing insolvency by 2017. So instead of fixing that in a real way, the bill steals almost half a trillion dollars from Medicare and uses it not within Medicare but to help pay for a brand-new entitlement.'

Vitter said that means cuts in home care, hospice, nursing homes and Medicare Advantage.

Costs to taxpayers: Vitter cited Congressional Budget Office estimates that say the bill contains $518 billion of tax increases nationwide.

'And this is after that often repeated promise that no one who earns less than $200,000 will be affected,' he said. 'Well, think again.'

The nonpartisan Joint Committee on Taxation has said 42.1 million Americans earning $200,000 a year will get a tax increase over the next several years.

Insurance will cost more: The Congressional Budget Office has said the bill increases overall health-care costs, which Vitter contends will boost premiums for consumers. And the biggest impact on businesses, he said, is a new mandate that directs most to have to either provide a government-defined health insurance benefit or pay a new tax. The National Federation of Small Businesses says that's going to cost the nation 1.6 million jobs.

'The practical reality for a lot of businesses is it's going to be cheaper to drop coverage and pay the new tax than to provide this new mandated, government-defined health insurance,' he said.

It subsidizes abortion: 'The bill forces pro-life taxpayers to, in many very meaningful ways, subsidize abortion,' Vitter said. 'Louisiana is one of the most proudly pro-life states in the nation, so that is particularly offensive.'

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