[Congressional Record Volume 163, Number 81 (Wednesday, May 10, 2017)]
[Senate]
[Pages S2859-S2861]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        American Health Care Act

  Mr. KING. Mr. President, I rise to speak briefly about the American 
Health Care Act that was passed last week in the House of 
Representatives. I thought a lot about this bill over the past few days 
and over the weekend. I talked to friends, I read about it, and I did 
as much analysis as I possibly could, given the fact that we don't have 
a Congressional Budget Office analysis of this complicated and 
important piece of legislation. I have concluded that it is the most 
ill-conceived, damaging, and downright cruel piece of legislation that 
I have ever seen a legislative body pass in my adult life.
  It drastically cuts support for Americans' ability to obtain health 
insurance. In Maine--again, as near as we can tell, because we don't 
have the final analysis--the preliminary numbers are this. Maine, under 
the Affordable Care Act, through the payments to individuals and other 
support, is receiving about $354 million a year coming via the 
Affordable Care Act. After this bill, it appears that the number is $80 
million a year--$364 million to $80 million. That is almost an 80-
percent cut. No one can tell me the people of Maine are going to have 
better healthcare with an 80-percent cut in the funds going to support 
their ability to do so. It just doesn't make sense.
  The way this bill works is, it is a tax on the elderly. Under the 
Affordable Care Act, there is a rule that policies for older people, 
50, 55, 60, cannot exceed three times the rate of policies for younger 
people. We all know that younger people's policies do in fact cost 
somewhat less because they tend to be healthier, but the rule was no 
more than 3 to 1. Under the bill that was passed by the House last 
week, it is now 5 to 1. That is an elder tax, and Maine happens to be 
the most elder State in the United States. If they had taken a blank 
sheet of paper and said: We want to write a bill to harm the people of 
Maine, it would have been this bill.
  There also is a massive cut to Medicaid--$880 billion--and the 
sponsors to this bill claim that they are helping the deficit. How are 
they doing it? By

[[Page S2860]]

shifting the cost to the States--shift and shaft. Balancing the Federal 
budget by simply taking costs that are now borne by the Federal 
Government and passing them off to the States is not responsible fiscal 
policy.
  Why don't we just have the States fund the U.S. Air Force? That would 
save us billions of dollars a year--probably $100 billion a year. Shift 
that to the States--and $880 billion shifted to the States.
  Then there is what I call the figleaf--the preexisting condition 
provision which talks about the Maine plan, which was a plan that 
preceded the Affordable Care Act, which did give protection for 
preexisting conditions, but it was adequately funded. It cost about $64 
million a year to fund our preexisting plan. Again, because we don't 
have the precise figures--but it looks like under this new bill, that 
$64 million would be $20 million, one-third as much, a two-thirds 
reduction. It is not a real preexisting condition plan; it is a 
figleaf. It is to say to people: We are covering preexisting 
conditions--nonsense, not true.
  Of course, the final piece of this bill is a massive tax cut for the 
top one-tenth of 1 percent of people in this country. They will not 
even notice it, but the people who lose their healthcare will notice.
  Now, under the Affordable Care Act, there is a list of essential 
benefits which includes mental health and substance abuse. That is a 
big deal. That allows and assures people to have coverage for these 
very damaging and dangerous, in the case of substance abuse, 
conditions. Under this bill that passed in the House, States can waive 
those provisions and the waiver is very easy. The standards for the 
waiver are very easy, and if the Federal department doesn't respond in 
60 days, the waiver is automatically provided. In those States when 
they have a waiver, mental health and substance abuse services could be 
covered under a specialized plan which would be very expensive. By the 
way, this waiver covers both the individual market and employer-based 
coverage. How many people will be impacted? We do not know because we 
do not have an analysis from the Congressional Budget Office.

  I want to talk for the remainder of my time about opioids and what 
this bill would do on that.
  We are in the midst of a crisis in Maine and across the country. It 
is the most serious public health crisis in my adult life. In Maine, 
with regard to substance abuse and overdose deaths, you can see what 
has happened in the last 5 years. More than one person a day is dying 
of an overdose. Across the country, it is four an hour. We have turned 
ourselves inside out in this country in order to deal with the threat 
of terrorism, for example, which was entirely appropriate. Yet what if 
we had a terrorist attack that was killing 37,000 people a year across 
our country, and we were just sort of going along, business as usual?
  I have been working on this issue since I got to the Senate. I have 
been meeting with people throughout Maine--in hospitals and in 
recovery--and meeting with families and parents and law enforcement. 
The one thing that comes through loud and clear is that treatment works 
and that we need it and that we do not have enough available beds in 
Maine and across the country.
  This is a terrible disease, but the most tragic thing of all is when 
someone finally reaches the point at which he is ready to ask for help 
and he is told ``Sorry, there is a 3-week wait'' or ``There is a 3-
month wait.'' That is when lives are lost and families are destroyed.
  Treatment does work. I have met with people for whom it has worked 
and changed their lives. I have a friend in Portland named Andrew 
Kiezulas, who I believe is graduating this weekend from the University 
of Southern Maine. He has been through this. He has been to the bottom, 
and he is now on the mountaintop. He knows treatment works, and it has 
made a difference in his life. Without it, he would not be where he is 
today. Justin Reid, another young man from Southern Maine, was in the 
throes of addiction and escaped. He now runs a sober house and 
volunteers for a program with his local police department.
  Access to treatment is much easier with health insurance and with 
sufficient Medicaid support. The House bill simply makes it more 
difficult to access treatment. It penalizes the very people who have 
taken the hard step to say that this is what they need.
  Let me tell you a story. Matt Braun is from Cape Elizabeth, ME, right 
outside of Portland. In 2009 Matt entered treatment for opioid 
addiction. His parents, who were strong, middle-class, professional 
people, purchased what they thought was good health insurance for their 
family. After 5 days of treatment, they received a call that the 
insurer was not going to pay for any more. We have decided your son 
only needs 5 days. His parents argued, and the medical staff argued. 
They finally won. They got 7 days of treatment. Those extra 2 days made 
a difference.
  The insurance company said that it was not going to help, that he was 
going to be a chronically relapsing, drug-addicted person, so they were 
going to stop at 7 days. They said he would not make it. His parents 
did not give up.
  Matt stayed in treatment and has been sober ever since 2009. He is 
successful. He is getting ready to take the MCAT. He wants to go to 
medical school. His goal is to approach addiction from the perspective 
of a health professional and offer care and support to people who are 
struggling in the way he did.
  ``It is frustrating how insurance companies dictate what treatment 
looks like and what a life is worth,'' said Matt.
  Getting treatment for substance abuse disorder is not easy, but this 
bill, the American Health Care Act, which is a misnamed bill--it should 
be the American Take Away Health Care Act--only makes it worse.
  On top of all of this, the administration has recently indicated that 
it is talking about essentially dismantling the Office of National Drug 
Control Policy--the highest level to be working on this problem in a 
coordinated way in the Federal Government. Here we are, in the midst of 
the most serious drug crisis in the history of this country, and the 
administration is talking about gutting the very office that is 
supposed to lead the fight. It would have been as if, in the middle of 
World War II, we had abolished the Department of Defense. It makes no 
sense. It is moving in absolutely the wrong direction.
  By supporting this healthcare bill--or non-healthcare bill--in the 
House of Representatives, which will drastically cut Medicaid, 
drastically cut reimbursements for health insurance, drastically limit 
the availability of coverage for preexisting conditions--by the way, 
drug addiction could be one--and drastically eliminate the essential 
benefits provisions of the Affordable Care Act, we are just making it 
worse.
  The Office of National Drug Control Policy has things like the Drug-
Free Community Support Program, which administers small grants to small 
towns. That can make a real difference. Last fall, 18 Maine programs 
each received $125,000, and the DFC's 2014 national evaluation report 
said that there was a significant decrease in the 30-day use of 
prescription drugs for youth in communities with one of these programs.
  Prevention is one of the things we need to work on, and it is one of 
the things we need to understand. Yet talking about this problem is not 
going to solve it. Treatment is going to solve it. Money for treatment 
is going to solve it. Beds for treatment are going to solve it. Detox 
centers are going to solve it. More resources to law enforcement are 
going to solve it. More resources to the Coast Guard, in order to 
interdict drug shipments coming into this country, are going to solve 
it.
  There is no single answer, but at the core is commitment. Passing 
this bill from the House, which drastically undermines all of those 
elements of treatment and prevention, and then talking about 
dismantling the office that has led this fight in the entire Federal 
Government, is beyond comprehension in the midst of where we are.
  If this graph were doing this, if it were going down, I would be OK 
with it. But it is not going down; it is going up. It is getting worse, 
and we have to deal with it.
  As we work through this issue of healthcare--hopefully we are going 
to start with a blank sheet of paper over here--I hope we will bear in 
mind that one of the most serious health problems in the country today 
is opioid

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abuse. This is not all about ideology, and it is not about policy. It 
is about people. It is about Matt, and it is about Andrew. It is about 
the thousands and millions of people across this country who are 
struggling, who want to lead productive lives, and who want to 
contribute to their communities. All they need is to have that moment 
when treatment is available, when a helping hand is available, when 
caring is available to help them escape the throes of this terrible 
disease and rejoin their communities and their families. That is what 
we have to keep in front of us as we work here in this body. We can 
make a difference in people's lives, but in leaving them behind, we 
will certainly not do so.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mrs. Ernst). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. LEAHY. 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. LEAHY. Madam President, what is the parliamentary situation?
  The PRESIDING OFFICER. The Senate is considering the Lighthizer 
nomination.
  Mr. LEAHY. I thank the Chair.