[Congressional Record Volume 163, Number 84 (Tuesday, May 16, 2017)]
[Senate]
[Pages S2944-S2945]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. CASSIDY. Mr. President, it is fair to say that Americans are sick 
of partisanship when it comes to issues of greatest concern. They are 
asking, if you will, that we in the Senate put party behind us--behind 
the needs of the people. This is especially true when we are speaking 
of those issues of greatest importance, and I would argue that the 
replacement of the Affordable Care Act is one of those issues of 
greatest importance.
  Whatever the excuse, no Senator of either party should sit on the 
sidelines. This is such an important issue that every Senator, whatever 
her or his personal views, should be engaged.
  We know President Trump's principles, if you will. He laid them out 
time and again on the campaign trail. He wants to maintain coverage, 
lower premiums, care for those with preexisting conditions, and 
eliminate the ObamaCare mandates upon individuals and businesses.
  At his inauguration speech, he spoke of the forgotten man and of the 
forgotten woman. In fact, we can see that just before his inauguration, 
he emphasized that with what he said during the campaign:

       We're going to have insurance for everyone. There's a 
     philosophy in some circles that if you can't pay for it, you 
     don't get it. That is not going to happen to us.

  He also emphasized the quality of the care, saying that people 
covered under the law that he would propose to replace can expect to 
have great healthcare. ``It will be in a much simplified form. Much 
less expensive, much better,'' he said to the Washington Post just 
before he was sworn in. These are his principles.
  When he was sworn in and gave his inaugural address, speaking of the 
forgotten man and the forgotten woman, I cannot help but think that he 
was influenced as he went through counties seeing folks with terrible 
tales of their child dying from opioid addiction or their spouse unable 
to afford insurance under ObamaCare.
  I will point out that there is a huge dimension to this that we 
sometimes forget, but we should not. Senator Jerry Moran from Kansas 
made the point that healthcare is like no other issue. It is an issue 
which touches us most personally. I think President Trump saw that on 
the campaign trail. He saw the parent of an adult child with mental 
illness, and she could not get a psychiatric bed for her child. We know 
the fate of that child if he does not have the care he needs. He will 
end up either in a homeless shelter, a jail cell, or the morgue. That 
is the human dimension to this, and that is why we need to help 
President Trump fulfill his pledge.
  Voters understand what we are speaking of; they understand the 
importance of it. But let me speak just a little bit more to the 
politics of this because we cannot separate what we do here in 
Washington, DC, from politics.
  There are researchers from Princeton who recently published a report. 
If you look at White males and females between 18 and 54 who lack a 
college education, their life span is decreasing. Now, for Hispanics, 
African Americans, and other minorities, it is improving, but for this 
group, it is decreasing.
  I have seen data which shows that in the population centers of the 
United States in which this phenomenon is being most seen--these Whites 
from age 18 to 54, noncollege educated, their life span is decreasing--
the counties in which this effect is most seen were most likely to vote 
for Donald Trump. Think about the politics of this. The politics are 
that a group of folks who understand that their life is materially and 
physically declining, with higher rates of suicide, addiction, liver 
disease, and other chronic illness, ending in premature death, voted 
significantly more for the President who swore that he would remember 
them, who spoke of the forgotten man and the forgotten woman. His 
pledge to them was a lifeline. Their vote for him was a cry for help.
  This is not just a human dimension; there is a political dimension 
leading to a policy necessity.
  Let's stop for a second. There is a key issue of cost. We understand 
that the Affordable Care Act was too expensive. We can save money. But 
let's not fool ourselves; it is still going to cost. We can save the 
$150 billion or so that the House suggested we have to save. We know 
the rules the Senate has to address to save at least that much money. 
On the other hand, we know that Congress has mandated people can get 
care; therefore, if Congress mandates that folks get care, then 
Congress should help provide the means by which to pay for it.
  There are some who think, oh, my gosh, Congress does not need to 
provide for the money for care, and everything will be good. I am a 
physician. I have been in the emergency room at 2 in the morning, and 
at 2 in the morning, when those emergency room doors are open, whoever 
comes in is treated. She may have heart failure, he may have a drug 
overdose, they might be a schizophrenic, or they might be somebody 
vomiting blood. Each one of them receives all the care that he or she 
needs to stabilize their emergency condition. And if they have to be 
hospitalized--think of a car wreck with multiple traumas--and they are 
in the hospital for 4 months, they still get that care because Congress 
mandates that. But, if Congress does not provide the means to pay for 
it, the cost of that care is shifted not to government; the cost of 
that care is shifted to the privately insured. All of those getting 
their insurance through their employer begin to pay higher premiums--
much higher premiums. Somebody pays. And if we do not fulfill our 
obligation, after mandating that those patients get cared for--we, 
being Congress--then society pays, and society is the person struggling 
to make ends meet and now finds out from her employer that her premium 
has increased 20, 30, sometimes 50 percent--all because of the cost-
shifting that occurs.
  It is not just the group market. Under ObamaCare, we can see that in 
the individual market, premiums have skyrocketed. It is not that the 
Affordable Care Act is working so well. Last week I communicated with 
someone who lives in San Francisco, and she and her young family are 
paying $20,000 a year for a premium, $6,000 deductibles; none of them 
is sick, none of them will meet their deductibles, but living in a very 
expensive city, having to struggle to pay their mortgage, groceries, 
and transportation, now they have to come up with $20,000 to pay for 
their healthcare. That is all because of the Affordable Care Act.
  Then I spoke with a person in Washington, DC, and someone in 
Washington DC--that person who is a consultant on insurance issues, 
knows insurance backward and forward, says that for his family, the 
premium is $24,000 a year, with a $13,000 family deductible. The 
insurance expert says: I will be out $37,000 in a single year before my 
insurance kicks in. Families cannot afford that.
  I will finish up lastly with a story from Louisiana. Folks never 
believe this because it seems too crazy, but I put it on my Facebook 
page. There is a couple back home, 60 and 61. They were quoted a 
premium of $39,000 for a premium of one year, with a deductible on top 
of that--$39,000. We can see that in the individual market, the 
Affordable Care Act is not working, it is becoming the un-Affordable 
Care Act. We have to address this.
  But let me say, we have to address it whether we are a Democrat or a 
Republican. We must respond to the cries for help coming from those 
folks suffering from addiction, mental illness, heart failure, or any 
other chronic disease for which they do not have coverage, but also to 
the cries for help from middle-class families who cannot afford these 
premiums, and if they don't sacrifice something in the budget to pay 
for it, under the Affordable Care Act, they will be fined.
  Let's return to the political side. The political side is that I have 
voters back home asking why Republican Senators

[[Page S2945]]

are not helping a Republican President fulfill his pledge--a pledge to 
all voters--but one that certain Republican voters specifically took to 
heart; that is, to fulfill his pledge of caring for those with 
preexisting conditions, continuing coverage, lowering premiums, and 
eliminating mandates.
  If you are a Democratic Senator, the forgotten woman and the 
forgotten man is in your State too. I can promise you, even if you are 
not a Republican but you are a Democrat, you have an opioid crisis in 
your State. So if we are now looking at addressing Medicaid expansion 
or the affordability of the individual market, and you are a Democratic 
Senator and you decide to sit on the sideline--if you are a voter in 
that State, you should be asking why.
  Let's face it. Speaking of my Democratic colleagues, many of you do 
not like President Trump. Some of you hate President Trump. Some of you 
like him, but you have to pretend that you hate him. Even though this 
is President Trump's pledge, this is not about President Trump. This 
about the voters--the patients, the people in our States who either 
cannot afford their insurance or who have an addiction or some mental 
illness or some other critical mental healthcare need that, if this 
ObamaCare replacement is not done well, will leave them far worse off.
  I have heard some of the excuses from my Democratic colleagues as to 
why they cannot participate. They say: Oh, we are using the word 
``repeal'' or, oh, we are not going through a normal committee 
process--oh, this, or oh, that. I concede it all. Who cares? If you are 
a voter right now, and your child is addicted to opioids, do you really 
care that there is a semantic issue regarding whether or not we are 
saying ``repeal'' or ``repair''? Do you really care that after 8 years 
of hearings, we don't have a few more hearings? Do you even understand 
the difference between reconciliation versus normal process? I would 
say no, because the principal thing that concerns you is that your 
child is desperate for help and you are not sure that the help will 
continue.
  So I say to my Democratic colleagues: Whatever the excuse, ignore the 
excuse, and please engage.
  Let me finish where I started. I think the average American right now 
wants every Senator, whether Republican or Democrat, to help President 
Trump fulfill his pledge to maintain coverage, lower premiums, and care 
for those with preexisting conditions, without mandates. Every Senator 
should listen to the American people as they ask us to put patients 
over party, to put the American people over partisanship.
  Mr. President, I ask unanimous consent that the time during quorum 
calls until 12:30 p.m. today be equally divided.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CASSIDY. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. BLUNT. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BLUNT. Mr. President, I ask unanimous consent to engage in a 
colloquy with my colleagues on the floor to talk about Police Week.
  The PRESIDING OFFICER. Without objection, it is so ordered.