March 23, 2012 Dear Senator, The undersigned 16 organizations representing grassroots, policy, taxpayer, senior and medical

professional groups urge Senate Republicans to aggressively seek opportunities to vote on full repeal of the Patient Protection and Affordable Care Act (PPACA). We also urge you introduce bills and push for individual votes on the damaging provisions that continue to be revealed within the law. While a majority of voters still support repeal, there are deep rumblings of concern about what they perceive to be inaction on the Hill, particularly from the Senate. We must affirm and solidify the support for repeal with affirmative steps and constant opportunities to remind people why this onerous bill is bad for patients, for seniors, for taxpayers, for doctors - for this country. In a recent Quinnipiac University poll, 52% of registered voters nationwide said Congress should repeal the law. A Kaiser Family Foundation poll of nationwide adults has only 42% with a generally favorable overall view of the law. In November, nearly 66% of Ohio voters rejected the individual mandate, adopting a constitutional amendment that "preserves the freedom of Ohioans to choose their health care and health care coverage." Doctors the ones on the frontlines in medicine also point the finger squarely at PPACA for problems in medicine. A recent poll by the Doctor Patient Medical Association found that they believe that PPACA will reduce the quality of care for their patients (78.7%) and that it is the single factor that has made them more pessimistic about the future of medicine (74.8%) As the second anniversary of PPACA's signing draws near, more damaging research and information continues to be revealed every month. The CLASS Act has been shown as a bait and switch accounting trick designed to mislead the public and Members of Congress as to the real costs of the PPACA in order to mask over $70 billion in PPACA's total cost over its first decade - fully half of the claimed deficit savings by PPACA proponents. IPAB's panel of 15 independent, unelected bureaucrats with unilateral authority and whose decisions are freed from judicial and administrative review will most certainly cut payments to physicians under Medicare, will limit patient access to, and quality of, medical care. The CBO's recent estimates are staggering: PPACA's cost could be as high as $2.134 trillion through 2022 alone. As many as 20 million Americans could lose their employer-sponsored health benefits by 2019. As many as 49 million more Americans could become dependent on government-sponsored health care by 2019. Individual and employer mandate penalties may be as high as $221 billion through 2022 alone. The House has show tremendous leadership with votes on full repeal, CLASS Act, IPAB and others, though defunding to slow implementation is still devoutly sought. As a critical election approaches in November, particularly now that we know whats in it, the American people deserve to see where their elected Senators continue to stand on PPACA. Continued debate and votes on the Senate floor will remind Americans which Senators are obstructionists to the effort for repeal. It will remind

the people that Congress is divided, and repeal-supporting Republicans do NOT control both houses something most apparently do not now recognize. It will remind them that PPACA is still the law of the land, something that, remarkably, many assume is no longer the case. Further, these votes will electrify the individuals and organizations we represent to ensure that a Congress and President are elected in November that will enact repeal in 2013. Our organizations collectively have organized and delivered millions of letters, calls and petitions to your offices, calling on the repeal of PPACA. Were beating the drum as loudly as possible, but we need more from you. We ask you to continue your leadership on this vitally important issue and force as many votes as possible until PPACA is repealed.

Sincerely, Kathryn Serkes CEO & Chairman Doctor Patient Medical Association Ken Hoagland Chairman Restore America's Voice Foundation Grover Norquist President Americans for Tax Reform Jim Martin Chairman 60 Plus Association Heather Higgins President & CEO Independent Women's Voice Tim Phillips President Americans For Prosperity Eric Novack, MD US Health Freedom Coalition Amy Ridenour Chairman The National Center for Public Policy Research Jane Orient, MD Executive Director Association of American Physicians & Surgeons David Williams President Taxpayers Protection Alliance Amy Kremer Chairman Tea Party Express Andrew F. Quinlan, President Center for Freedom and Prosperity Pete Sepp Executive Vice President National Taxpayers Union Joseph L Bridges President and CEO The Seniors Coalition Andrew Langer President Institute for Liberty Colin A. Hanna President Let Freedom Ring