[Congressional Record Volume 163, Number 41 (Thursday, March 9, 2017)]
[Senate]
[Pages S1714-S1716]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        American Health Care Act

  Mr. CORNYN. Madam President, this week the Senate continues to press 
forward on a number of congressional review actions; in this case, a 
disapproval that will roll back and repeal many Obama-era regulations 
that have hurt people across the country and strangled our economic 
growth.
  By doing away with excessively burdensome rules and regulations, we 
are delivering on our promise to the American people to actually do 
what we can to help the economy, to grow the economy, to create jobs 
and not hurt it with unnecessary, expensive, and burdensome redtape.
  Earlier this year, we began the legislative process to deliver on our 
biggest promise: repealing and replacing ObamaCare with more affordable 
and more accessible healthcare options, options that will work for all 
American families. The American Health Care Act, introduced in the 
House on Monday, is the first step in fulfilling that promise.
  ObamaCare is collapsing. It has already failed countless families 
across the country, and it has forced people off good insurance plans 
they liked and strong-armed them to sign up for plans that were more 
expensive, offered less care, and didn't even let them use the doctor 
of their choice. So we would be revisiting healthcare even if Hillary 
Clinton had been elected President of the United States because 
ObamaCare is in a meltdown mode.
  ObamaCare has also saddled our economy with more than a trillion 
dollars in new taxes. Most of those taxes are so hidden that most 
Americans are probably not aware of the fact that there is even a tax 
charged on the premium for their health insurance policy, for example. 
Well, all of these taxes end up being absorbed and have to be paid by 
American families.
  At its very core, the individual mandate of ObamaCare was a major 
power play and overreach by the Federal Government. Basically, what it 
said was, if you don't buy the government-prescribed health insurance 
plan, we are going to fine you; we are going to penalize you.
  The government should not be able to force anyone to spend their own 
hard-earned money for something they don't want but have to buy under a 
threat of financial penalty. The American people have spoken up loudly 
and clearly and rightfully demanded that Congress do better, and we 
will.
  Since the 2010 timeframe--when our colleagues on the other side of 
the aisle passed ObamaCare with 60 votes in the Senate, a majority in 
the House, and with the White House--they have lost the majority in the 
Senate, they have lost the majority in the House, and they have lost 
the White House. I think ObamaCare has been one of the major reasons 
why, because people, the more they learn about it, the less they like 
it, and they don't appreciate Washington forcing them to do things they 
don't want to do with their own money.
  About 2 months ago, one of my constituents in Texas wrote me about 
her skyrocketing healthcare costs. Before last year, her premium was 
about $325 a month. A short time later, that was revised to $436 a 
month. This same Texan later moved from one city to another and, 
because of her change of address, her premium jumped to $625 a month. 
It started at $325 and is now $625. In 2017, thanks to ObamaCare, her 
premium went up again to an astronomical $820 a month. It started at 
$325 before ObamaCare and is now $820 a month. I don't know many people 
who could absorb that kind of increase in their healthcare insurance 
premium.
  In about a year, her monthly healthcare payment jumped by more

[[Page S1715]]

than 150 percent--150 percent. That is hardly what I would call 
affordable; thus, the misnamed Affordable Care Act should be the un-
Affordable Care Act.
  To make matters worse, she then found that her provider would be 
putting a halt to individual plans in Texas, something that has been a 
recurring theme in my State and across the country. So while President 
Obama said: If you like your plan, you can keep your plan, as a result 
of ObamaCare, she was not able to keep her plan so she had to find a 
new plan and a new doctor, a plan ultimately with less care, less 
flexibility, and even a higher price.
  Suffice it to say, for this constituent of mine and for millions more 
like her, ObamaCare is not working. ObamaCare is not affordable, and it 
is hurting Texans. It is time for Congress to keep its promise that we 
have made in every election since that given the privilege of 
governing--of being in the majority, being in a position to change 
things--we would repeal and replace ObamaCare with options that fit the 
needs of all Americans and their families at a price they can afford.
  Mr. SANDERS. Will my friend from Texas yield for a question?
  Mr. CORNYN. I will not, not at this time.
  Fortunately, we now have a President in the White House who clearly 
sees the failure of ObamaCare and wants to do something about it. 
Republicans in Congress have introduced a bill, which is now being 
marked up in the House, that the President can actually sign, once it 
is passed, to get us out of this mess. The American Health Care Act is 
the vehicle to do just that, and I am glad President Trump endorsed the 
plan earlier this week.
  It is a work in progress. The House committees are marking it up as 
we speak. There will be changes along the way, but, ultimately, the 
House will pass the bill and send it to the Senate. Then we will have 
an opportunity to offer our amendments during the course of its 
passage. The important point to make, though, is that this legislation 
will actually put patients first so they are not forced into a plan 
that they don't want or that provides coverage they can't afford. It 
does away with the outrageous new taxes and the penalties that have 
made the economy worse off and have made life harder for American 
families.

  The legislation will also give families more flexibility so they can 
get the healthcare specific to their needs that actually works for 
them. If they decide, for example, to get a major medical policy that 
is relatively inexpensive and then use a health savings account to use 
pretax dollars to pay for their regular doctors' visits, they will have 
the flexibility to do that. So this legislation promotes sensible 
reforms to ensure that big ticket items like Medicaid are put on a more 
sustainable fiscal path.
  I have heard some suggestions that this legislation actually guts 
Medicaid. That is false. That is not true. It actually continues at 
current levels in this shared State and Federal program, but it is 
subject to a cost-of-living index that will actually put Medicaid on a 
more sustainable path. Just as importantly, it will also return the 
authority back to the States to come up with the flexible programs they 
need to deal with the specific healthcare needs of the people of their 
State.
  This legislation makes sure that Medicaid doesn't lose sight of its 
design, which is to serve the most vulnerable among us who can't afford 
access to quality healthcare. It provides them that access--and better 
access--by providing flexibility to the States.
  We know that the States and the Federal Government spend an awful lot 
of money on Medicaid. In Texas, for example, my State spent close to 
one-third of its budget on Medicaid last year--one-third of all State 
spending--and it is uncapped, so it goes up every year by leaps and 
bounds. Under the American Health Care Act, Medicaid will be tied to 
the number of people in the State using it, a per capita rate, which 
makes sense, and it represents the first major overhaul of the program 
in decades.
  ObamaCare left us with unchecked government spending, more taxes, and 
fewer healthcare options. This bill is the opposite of ObamaCare in 
every way. It will control spending in a commonsense way, it will 
repeal ObamaCare's taxes and the individual and employer mandate, and 
it will provide more flexible free market options for families across 
the country. That is not just a bumper sticker or advertisement; that 
is actually what is contained in the legislation.
  I look forward to working with my colleagues in the House, in the 
Senate, and in the Trump administration to get this done in the next 
few weeks.
  Madam President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MARKEY. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MARKEY. Madam President, here we go again, debating the 
nomination of a Trump candidate who is both unqualified and reflects an 
extreme ideology for the Department she will hope to lead. In this case 
it is Seema Verma, and the Department is the Centers for Medicare and 
Medicaid, or CMS, as it is often called.
  Why is CMS, an acronym for a department that most Americans don't 
even know about, so important that its nominee would make it to the 
floor of the U.S. Senate for debate? Because 100 million Americans 
receive health insurance coverage under one of our Federal insurance 
programs--Medicare, Medicaid, the Children's Health Insurance Program, 
and the health insurance marketplace created by the Affordable Care 
Act, all of which are under the jurisdiction of CMS.
  CMS is the traffic cop of our Federal Government healthcare system. 
It makes sure that Americans have access to affordable, quality 
healthcare by administering and overseeing all aspects of our Federal 
health program. It promotes healthcare innovation and works to reduce 
waste, fraud, and abuse throughout our healthcare system.
  Under the Trump administration and Republican leadership, which has 
vowed to repeal ObamaCare and get rid of Medicaid as we know it, the 
leader of CMS will be the person responsible for reducing Federal 
spending on public insurance programs, particularly for the poor, the 
elderly, and the disabled. Seema Verma is President Trump's nominee to 
try to meet that misguided and heartless challenge.
  Republicans have an ancient animosity toward Medicaid, and it would 
seem that Ms. Verma shares that prejudice. Ms. Verma is most well known 
for proposals that penalize and create roadblocks to coverage for low-
income Americans. She supports changes to Medicaid that would make it 
harder for those who need Medicaid to access it. This stance is 
fundamentally antithetical to the core principle of Medicaid, which is 
providing coverage for those who cannot afford it. For the most part, 
we are talking about poor people in the United States of America in 
2017.
  Despite the fact that research shows the onerous premiums or cost 
sharing for low-income individuals served as barriers to enrolling in 
and obtaining care, Ms. Verma supported a plan to require Medicaid 
enrollees to pay premiums through monthly contributions to a health 
savings account. Guess what. People who are poor enough to qualify for 
Medicaid rarely have enough money to dedicate to savings accounts of 
any kind. They are living day to day, week to week, month to month.
  She also supports putting in place restrictions that put more burdens 
on low-income Americans than even private insurance. It will be Grandma 
and Grandpa who will pay the highest price.
  Medicaid isn't just a line in our healthcare budget; it is a lifeline 
for millions of seniors in every State of the country. Here are the 
facts about the importance of Medicaid to our seniors. It is 
anticipated that by 2060, there will be more than 98 million Americans 
over the age of 65. The number of individuals over the age of 85 is 
expected to reach 14.6 million in 2040--triple the number in 2014. Of 
this population, 70 percent will likely use long-term services and 
supports, of which Medicaid is the primary player. Medicaid spent $152 
billion on long-term support services like nursing home care in 2014.

[[Page S1716]]

  Let me say that again. The entire defense budget is about $550 
billion. We spent as a nation $152 billion--a little less than one-
third of the defense budget--to take care of Grandma and Grandpa in 
nursing homes in 2014. They may have Alzheimer's, they may have other 
diseases, but, unfortunately, most families can't save $50, $60, 
$70,000 for year after year of nursing home coverage; that is Grandma 
and Grandpa.
  The anticipated growth rate for Medicaid beneficiaries over the age 
of 65 is four times the rate of growth for all Medicaid beneficiaries. 
The only thing growing faster than the need for Medicaid is the number 
of people who are opposed to repealing the Medicaid expansion under 
ObamaCare. Medicaid pays for nearly two-thirds of individuals living in 
nursing homes.
  Can I say that again? Medicaid pays for two-thirds of individuals 
living in nursing homes in our country. So if you know a family member 
who is in a nursing home who has Alzheimer's or some other disease, you 
can just assume that Medicaid is helping that family to ensure that 
Grandma or Grandpa is getting the care they deserve for what they did 
to build this great country.
  Fundamentally restructuring Medicaid will place additional strain on 
already strapped State budgets because nursing facility care is a 
mandated Medicaid benefit. States may offset the increased costs in 
covering this service by further cutting payments to providers or 
removing benefits that seniors want and need, like home- and community-
based services. It also puts more strain on working-class families 
because if Medicaid isn't picking up the cost of putting your grandma 
in a nursing home, that comes out of the pockets of other contributors 
to the family.
  Unfortunately, Republicans want to undermine the Medicaid expansion 
under the Affordable Care Act, which is benefiting millions of seniors. 
They want to force seniors to pay more out-of-pocket for healthcare or 
forgo coverage because they cannot afford it.
  What Republicans refuse to accept is that the Affordable Care Act is 
the most important program we have put in place for seniors since 
Medicare. The uninsured rate for Americans aged 50 to 64 dropped by 
nearly half after the passage of the ACA. The uninsured rate for this 
older population living in Medicaid expansion States was 4.6 percent 
while the uninsured rate for the same population living in a non-
Medicaid expansion State was 8.7 percent--almost double.
  Not only does the Republican proposal amount to an age tax by 
substantially increasing the amount an insurance company can charge for 
an older person, but it provides older Americans with fewer resources 
than what is available under ObamaCare to help cover their increased 
costs for care.
  Unfortunately, as Republicans attempt to repeal ObamaCare, CMS is 
authorized by President Trump's Executive order to ``minimize the 
unwarranted economic and regulatory burdens'' of ObamaCare. In simple 
terms, that means undoing and privatizing vital provisions of the 
Affordable Care Act as soon as possible under the law.
  CMS has also picked up a sledgehammer. It has already proposed new 
rules of slashing open enrollment times for the exchanges by over a 
month. It has proposed rules to relax the minimum standards for what 
qualifying health plans sold on the exchanges have to cover.
  Now, more than ever, we need a leader at CMS who understands and 
respects the fundamental need for healthcare for our seniors, and for 
so many of them, that need is met by Medicaid. Ms. Verma's disdain for 
Medicaid is simply an insurmountable problem for the millions of older 
Americans in this country who rely upon this fundamental program.
  Given her lack of experience and extreme views, several major groups 
that represent millions of working-class Americans have voiced strong 
opposition to her confirmation.
  This is what the American Federation of State, County and Municipal 
Employees of the AFL-CIO said:
  ``Leading CMS is too important a role to be held by an individual who 
is committed to policies so radical they would jeopardize the health 
and lives of ordinary Americans.''
  I could not agree more.
  Seema Verma is the wrong person to run CMS at a time when millions of 
Americans are relying on the dignity and coverage that Medicare and 
Medicaid provide.
  Instead of cutting funding for defense, Donald Trump wants to cut 
programs for the defenseless. The Trump administration would rather 
bestow billions more to the Pentagon to pay for new nuclear weapons, 
which we do not need and cannot afford, all the while supporting cuts 
to Medicaid and senior health. We should be cutting Minuteman missiles 
instead of Medicaid. We should be cutting gravity bombs instead of 
Grandma's prescriptions.
  The Trump administration's plan for Medicaid and our overall 
healthcare system would be a nightmare for Grandma and Grandpa and 
millions of middle-class Americans.
  I am opposed to Seema Verma's nomination, and I call on my colleagues 
to join me in voting no on her nomination when it is presented on the 
Senate floor.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sasse). The Senator from Colorado.