[Congressional Record Volume 163, Number 13 (Tuesday, January 24, 2017)]
[Senate]
[Pages S430-S432]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Replacing ObamaCare

  Mr. LANKFORD. Mr. President, in 2010, when I ran for Congress, all 
the questions circled around the Affordable Care Act. Every townhall 
meeting, every conversation, everyone who caught me in the grocery 
store, everywhere I went there was a conversation about the Affordable 
Care Act. What is going to happen? Where are things going to go? And 
there was a lot of concern about it.
  The President promised at the time that if you liked your insurance, 
your doctor, and your hospital, you would keep it, and it would just 
get better. Prices would go down; options for insurance would go up. 
There would be marketplaces where more and more companies would rush 
in, and that would drive the prices down.
  Now, 7 years later, the greatest fears of a lot of the Oklahomans I 
am around all the time have come true. Here is the crisis in Oklahoma 
dealing with health care: We have the highest rate increase in the 
entire Nation. Last year, our rates went up in Oklahoma 76 percent; the 
year before that, they went up 35 percent. That is an 111-percent rate 
increase in 2 years in my State. Over the course of the last 3 years, 
insurance companies have left my State. All 77 counties of Oklahoma now 
have one insurance carrier left. I met with that insurance carrier 
before, and they are seriously looking at how they stay functional in 
Oklahoma in the days ahead, which is a concern to me. There is a 
possibility that we may have zero on our marketplace in some counties 
and in some locations in Oklahoma.
  With a 76-percent increase, I have had some folks who caught me and 
said: Well, your State didn't expand Medicaid. That is the problem. If 
you had expanded Medicaid, then it wouldn't have been an issue. Well, I 
will tell you that a study from HHS has now come back, and they have 
confirmed that it is true. If our State would have expanded Medicaid, 
it would have reduced our costs by 7 percent. That means instead of 
having a 76-percent increase, as we had, we would have had only a 69-
percent increase of health care costs in our

[[Page S431]]

State. Zero competition, dramatically higher deductibles, dramatically 
higher premiums--every hospital in my State, rural and urban, has more 
charity care now and more bad debt now than they had 7 years ago.
  Insure Oklahoma, a program we set up a decade ago to take care of 
people who did not have access to insurance, continues to falter 
because my State is playing ``Mother May I?'' every year with the 
Federal Government on whether we can maintain a program that our State 
had and was growing. Small risk pools are not allowed. People still 
don't know the price of their health care. Electronic health records 
still can't talk to each other. There is still a rise in the cost of 
prescription drugs. We still have overlapping administrative costs on 
dual eligibles, Medicare and Medicaid, for senior adults. Compliance 
costs for our doctors, clinics, and hospitals have skyrocketed. 
Physician-owned hospitals, which we have quite a few of in Oklahoma, 
have been cut off and limited since 2010 and are slowly struggling just 
to be able to stay afloat. Fewer doctors are taking Medicare and 
Medicaid patients.
  On the horizon, it gets even worse because most people don't realize 
that the Affordable Care Act was backloaded and that the worst of the 
worst of it wouldn't be for several years out. Well, guess what. It is 
now several years out.
  Union households in my State are about to take a major hit with the 
Cadillac tax that is coming because union households in my State have 
insurance that is too good, and those individuals will face a tax 
increase.
  The insurance company tax is coming, which is a massive tax increase 
on insurance companies. They will pass that cost directly down to 
consumers, so it will go up again. We continue to fight off the 
Independent Payment Advisory Board, a board specifically set up to be 
able to cut options for patients if they cost too much. That is still 
out there on the horizon, not to mention the tax penalties that go up 
even more next year.
  People ask me: Why are you still focused on repealing ObamaCare? Why 
is this such a big deal? It is because the people in my State are 
struggling under the negative effects of this, and it has to be dealt 
with. Let me just give you a couple of real life stories.
  An Oklahoman from Altus, OK, in the southwest part of my State wrote 
me and he said:

       Senator Lankford, I came home tonight . . . having finished 
     cotton harvest and looking forward to celebrating with my 
     wife and kids. I was greeted at the supper table with somber 
     news about our health care premiums from my distraught wife. 
     Our premium is going from $960 a month to $1,755 per month! 
     That's with a deductible of $6,000. I can't even process how 
     to handle this. I think I'm through. Done with any hope of a 
     bright future for my family.

  An Oklahoman from Poteau, OK, wrote me and said:

       My husband and I have had Healthcare Marketplace health 
     insurance for the past 3 years. The first year my monthly 
     premium was over $1,200.00, this year I pay $1,923.84 
     monthly. Now I get a letter from [my health insurance 
     carrier] that my monthly premium will [go up next year to] 
     $3,540.07. That is an increase of approx. 84%. . . . How is 
     this possible? Why can't anything be done about this?

  When individuals ask me about ObamaCare, they say: You are just 
arguing about something because of disdain for the President. No, this 
is what we have disdain for; this is what people are frustrated about: 
People who work, people who pay for their health care insurance cannot 
pay their mortgage and their health insurance anymore because they are 
literally priced out of it. This is what Bill Clinton meant in October 
of last year when he made this statement:

       So you've got this crazy system where all of a sudden 25 
     million more people have health care and then the people who 
     are out there busting it, sometimes 60 hours a week, wind up 
     with their premiums doubled and their coverage cut in half. 
     It's the craziest thing in the world.

  I could not agree with Bill Clinton more on that because that is 
exactly what is happening in Oklahoma.
  But now, here is what is happening because for years Americans and 
Oklahomans have said: We have to do something to stop this. It is 
choking out my family.
  We are finally at a point we are going to do something about it, but 
I have colleagues who are now spreading fear all over the country that 
suddenly everyone is going to be thrown off their insurance and we are 
going to have people living out on the streets without coverage.
  I have heard on the floor of this Senate that 30 million people could 
die if we repeal ObamaCare. I have heard 20 million people will lose 
their insurance. I have heard there is no replacement plan, and people 
will get sick because their coverage will be gone.
  Well, let me just go through a couple of those because there are 
people calling my office and writing me who are very concerned. They 
are cancer patients, they are diabetics, they are people with long-term 
blood diseases, they are people who have difficulty getting insurance, 
and they are being told: All those mean Republicans up there don't like 
you and don't care about you, and all they want to do is throw you out 
on the street. When people say that, it couldn't be further from the 
truth. It may make for good politics, but it is using people who are in 
a very vulnerable spot in a negative way.
  First, let me get a couple of facts straight. This ``30 million'' 
number that is being thrown around--even past President Obama doesn't 
agree with that. It is not 30 million; in fact, it is not 20 million. 
It is 14 million people who gained access to health care coverage, if 
you count the people who have actually gained coverage and paid for 
their premiums through the course of the year or have been a part of 
the expansion of Medicaid. Of those 14 million people, 11.8 million 
gained additional coverage from Medicaid, not from the exchanges, and, 
of that, almost 12 million people got expanded coverage from Medicaid. 
Jonathan Gruber, as one of the architects of ObamaCare, made the 
statement that from their own studies, the vast majority of those 
people who were added to Medicaid weren't added to Medicaid because of 
expanded coverage; they were added to Medicaid because of promotions 
through advertising. They were already eligible for Medicaid.
  So we are talking about 6 million people or so that have been added 
to it. I am not belittling those 6 million people; that is a lot of 
people. But it is not 20 million, and it is not 30 million.
  So now what? As people address this to me, they ask about what just 
happened on January 6 when the Senate and later when the House voted to 
start the legislative process to repeal ObamaCare. What happened was we 
just actually started the process. It wasn't a total repeal. No one has 
been thrown out. It starts a legislative process.
  As we start that legislative process of what is called reconciliation 
and as we work through that process, it is a very simple process. It 
starts the opening conversation to work through committees, to work 
through debate on the floor so that in the days ahead we will bring a 
full repeal of ObamaCare and a replacement. But that replacement is not 
going to be a 2,700-page bill to replace the previous 2,700-page bill. 
It will be a series of solutions, and it will deal with things on a 
long-term basis.
  There was no vote to suddenly end people's health care in one day. 
This begins a transition point to make sure that we are watching out 
for those individuals, such as those cancer patients, diabetics, and 
individuals who are in very vulnerable situations and over the next 
couple of years will be able to transition to other care. We are 
watching to make sure this is not some sudden shift for those 
individuals. There are very vulnerable people who are in health care 
options right now and need to know that there is still that safety net 
there for them and that moving forward, we will continue to be able to 
watch for them.
  We want to be able to move a lot of those decisions back to the 
States. Quite frankly, that is where those decisions were before. And 
we want to be able to allow those individuals who are in very 
vulnerable situations to seek out the doctor they want, to get the 
options for health care coverage they want, and to have greater access 
to health insurance, not less.
  The people in my State who had been added and who received those 
subsidies are grateful to be able to have health care, but there are 
also individuals in my State who can now literally no longer afford to 
have health care because they have been priced out of the

[[Page S432]]

market, and they are stuck. ObamaCare moved the system from one 
uninsured group of people to now another uninsured group of people.
  Let me read a statement coming from a person from Oklahoma who said:

       My wife and I will be going without health insurance next 
     year! I do not resent anyone who is able to afford 
     healthcare, I just resent a government system that causes 
     [us] to be priced out of the reach of working people.

  Why is it we can argue about ObamaCare and people can say those 
individuals got coverage and people are not paying attention to a whole 
new group of Americans who no longer have coverage because they 
literally have been priced out of the market?
  Why is it that for the sake of 6 million people, we have affected the 
cost of health care for millions and millions of other Americans?
  We can do this transition. We will do this transition. It will take a 
couple of years. It is not going to be rapid, and there will be a large 
debate that will happen nationally in the process. That is appropriate, 
but allow us to be able to walk through this process together.
  One quick illustration and then I will be done. I have a friend who 
discovered last year that she had mold in her house. Initially, there 
were some treatments that were done. She had been very sick for a while 
and didn't know why. They did treatments to the house and such and 
thought that would settle it. It didn't. Eventually, she had to move 
out of her own home.
  Now they have had to actually strip out the walls and take out all 
the sheetrock. They are literally replacing studs and everything in the 
house. It will be a long-term issue to be able to get it all right.
  I tell that simple story to say that anyone who says replacing health 
care is going to be some simple ``spray everything down and that will 
fix it'' strategy just doesn't understand the difficulties of the 
American health care system. This will be much like my friend who is 
having to do a pretty radical transition that is going to take a long 
time, but that will actually get her house whole and healthy again.

  If we want to have a healthy nation again with people who have access 
to health care, regardless of what class they are in, it is going to 
take a while to make this transition, and it will be difficult in the 
process. But I can assure my colleagues that this Congress is watching 
out for all people, of all ethnicities, of all neighborhoods, of all 
diseases, to make sure that we are paying attention to this one simple 
thing: When ObamaCare was put into place, it punished people. We should 
encourage people to be able to get health care, and we should be able 
to walk through it with people in their most vulnerable moments and 
make sure they are able to make personal decisions, have access to 
their own doctors, have access to hospitals that can afford to stay 
afloat, and to provide the ability for people to choose their own 
health care. Why is that so radical? It used to not be.
  There are things that need to be fixed, but it begins with giving the 
power of the decision back to the patient and back to people, where it 
needs to be.
  With that, I yield the floor.
  The PRESIDING OFFICER (Mr. Sullivan). The majority leader.

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