An abridged transcript of Sen. David Vitter’s speech this morning on the health-care bill…

Mr. President, since this latest version of comprehensive healthcare reform was unveiled a few days ago – a 2,733-page bill – I’ve been looking at it very carefully especially with the Louisiana perspective and I want to share that perspective with my colleagues today.

Of course, Mr. President, we have heard the Senate health care reform bill referred to as the Louisiana Purchase because of the $300 million provision in it related to our Medicaid match rate.

Quite frankly, Mr. President, I don’t like that nickname for two reasons. First of all, the fact that we in Louisiana have to pay a higher Medicaid cost share under present law because of the hurricanes is a real inequity that I support fixing. 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.

But, secondly, Mr. President, I don’t like the phrase because it suggests that Louisiana, in general, would fare very well under the bill overall. And, really, nothing could be further from the truth. This bill, overall, sells Louisiana short. In fact, rather than the Louisiana Purchase, I think the bill could be very accurately called the Louisiana Sellout.

Now, what are those costs and what are those serious problems for Louisiana that I’m talking about?

Let’s start with Medicaid, the program for the poor and that $300 million fix for Louisiana. It’s certainly true that the fix is there, the $300 million benefit to the state under our Medicaid program.

But, Mr. President, that’s not the entire picture. That’s not even all of the Medicaid picture. Because, besides that fix in the bill, overall, there’s a dramatic expansion of Medicaid – and Louisiana state government and Louisiana taxpayers have to help pay for that expansion. And that extra cost to the state government, and to state taxpayers, is way more than the $300 million benefit. By very conservative estimates by the Louisiana Department of Health and Hospitals, it’s at least $1.3 billion over 10 years of full implementation.

Now, three things are important about these figures. One is obvious: $300 million is a whole lot less than $1.3 billion.

Secondly, this $1.3 billion over 10 years of full implementation is based on a very conservative estimate from the Louisiana Department of Health and Hospitals.

And third, while this Medicaid patch is a onetime fix, the greater Medicaid expansion costs go on forever. That means in the first 10 years of full implementation of this health care bill, the next impact on the state is at least $1 billion and it goes on from there.

I’m also very concerned about a lot of other groups in Louisiana, not just state government and the state budget – I’m particularly concerned about Louisiana seniors. Of course, 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.

That means cuts in homes, hospice, nursing homes and Medicare Advantage. There are over 151,000 Louisiana seniors on Medicare Advantage that are going to be particularly hard hit. They will not have that choice as it exists now under this bill.

I’m also very, very concerned about Louisiana taxpayers. According to the non-partisan Congressional Budget Office, 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. Well, think again. The nonpartisan Joint Committee on Taxation has said 42.1 million Americans earning 200,000 will get a tax increase over the next several years. That means hundreds of thousands of Louisiana taxpayers will get a tax increase. They’ll also pay more in the form of higher insurance premiums as CBO has said that this bill increases overall healthcare costs.

What about Louisiana’s small businesses? Surely, this bill protects them in the midst of this serious recession. Well, not exactly. The biggest impact on businesses is a brand-new mandate in the bill that directs most businesses have to either provide a government-defined health insurance benefit or they have to pay a new tax to the government. The NFIB, National Federation of Small Businesses, says that’s going to cost the nation 1.6 million jobs. Translated to Louisiana, that’s tens of thousands of additional lost jobs in Louisiana on top of our current high unemployment. This will cost us jobs on top of that.

The bill also creates an incentive for businesses to drop coverage. The practical reality for a lot of businesses is going to be cheaper to drop coverage and pay the new tax than to provide this new mandated, government-defined health insurance. So many employees who have coverage now that they are reasonably satisfied with are going to lose it. And that’s a big, big concern as well.

And just for good measure, the bill forces pro-life taxpayers to, in many very meaningful ways, subsidize abortion. Now, Louisiana is one of the most proudly pro-life states in the nation, so that is particularly offensive. Everyone who cares about life who has followed this issue, whether it’s the Catholic bishops or the National Right to Life, has said clearly the language in this bill doesn’t honor the Hyde Amendment that has been federal law since 1977.

So what do we have, Mr. President? We have a 2,733-page bill mega health care bill with all of these very serious problems for Louisiana.

If we really want to put Louisiana first, considering all these costs, we have to say no to this bill. If we really want to put America first, considering all these unsustainable costs, we have to say no to this bill. But we can and we should say yes to the right kind of health care reform.

This isn’t a debate about yes or no, health care reform or not. This is a debate about what the right kind of health care reform is. And to me, we need to start over with that right kind of reform.

To me, that would mean passing five, smaller, more targeted bills. Each one doesn’t need to be longer than 25 pages. Each one focused like a laser on a real problem that affects Louisianians.

In those five bills we should address pre-existing conditions. That’s a real problem in Louisiana. That’s a real problem in America. Let’s have a focused bill that does that.

Secondly, we should allow buying insurance across state lines. That would dramatically expand competition in the marketplace. That would lower premiums.

Third, let’s do something real about prescription drug prices. Let’s not sell out to PHARMA and cut a special deal with the pharmaceutical industry as the White House has. Let’s pass reimportation and pass real generics reform.

Fourth, let’s pass tort reform and take all of that unnecessary cost out of the system.

And fifth, let’s allow small business to pool across state lines to form larger pools of insurance and gain from that extra buying power. Why shouldn’t a restaurant in Baton Rouge that may only have seven or eight people to cover in health insurance be able to pull through the National Restaurant Association and enjoy similar buying power that Apple Computers or Toyota has and get the same benefit in the insurance marketplace?

Mr. President, I urge all of my colleagues to put their state first and vote no, to put our nation first and vote no, and to start anew with the right sort of focused reform as I have outlined.

Thank you, Mr. President.