[Congressional Record Volume 163, Number 85 (Wednesday, May 17, 2017)]
[Senate]
[Pages S2986-S2988]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. KING. Mr. President, I rise to speak for a few minutes on the 
AHCA, which is the healthcare bill that was recently passed in the 
House.
  I believe the letters stand for ``anti-healthcare bill'' as there are 
many troublesome aspects of this bill--kicking something like 20 
million people off of health insurance and compromising essential 
benefits. It is what I call a ``fig leaf'' preexisting condition 
provision, which does not provide adequate funding in order to actually 
protect people with preexisting conditions.
  Yet what I really want to focus on today are two interrelated 
provisions--a massive cut to Medicaid and a massive tax cut for the 
wealthiest Americans. By the way, that tax cut gives a zero tax cut to 
anyone making less than $200,000 a year. I will talk about that in a 
moment.
  Let's talk about the Medicaid cuts, however. This is a part of the 
bill that has not gotten much attention. It is $840 billion over 10 
years. It will be about a 10-percent cut of Medicaid funds in Maine. It 
is hard to get an actual analysis of that, however, because the House 
bill was passed without any Congressional Budget Office analysis--none, 
zero. Unbelievably, the Members of the House voted for a bill that 
they, literally, did not know the financial effects of--how it would 
affect the States, how it would affect the people in their States. 
Maybe, next week, we will get that analysis. Certainly, this body will 
not act in that way with no Congressional Budget Office analysis.
  Let's talk for a minute about who is on Medicaid, as 34 percent of 
the people on Medicaid are children, 20 percent are disabled people, 
and 18 percent are elderly. In other words, almost three-quarters--75 
percent--are children, disabled, and elderly people. Many people talk 
about and think about Medicaid as some kind of welfare program. This is 
an essential lifeline for some of the most vulnerable people in our 
society--children, the disabled, and the elderly--75 percent--and 75 
percent of the funding goes to disabled and elderly people.
  The people who sponsored this bill and who are talking about it 
across the country talk about flexibility. Yes, there are some cuts, 
but we are giving the States flexibility. That is nonsense. They are 
giving the States flexibility to make decisions between funding 
programs for the elderly and programs for children, between cutting off 
programs for opioids and providing support for people who are disabled. 
That is not flexibility. That is just passing agonizing choices off to 
the States. I was a Governor, and I know about having to make these 
kinds of decisions. To cut this money by this huge amount--almost $1 
trillion over 10 years--and act as though it can all be made up through 
some kind of fake flexibility is just an unspeakably cruel way to shift 
this burden to the States.
  The bill talks about saving on the deficit. It saves on the deficit 
because $840 billion is shifted to the States. Let them pay it--shift 
and shaft. That is what it is--shift and shaft. Shift the cost and 
shaft the States, particularly the people in those States who depend 
upon these programs--those people being the disabled, the elderly, 
children, people with disabilities, and those who are struggling to 
defeat the scourge of opioids and opioid addiction.
  I want to talk about some people today. I want to talk about this 
guy, Dan Humphrey. He is 28 years old and lives in a group home in 
Lewiston, ME. He has autism and is nonverbal. He has some bipolar 
characteristics and a seizure disorder but is gentle and charming, and 
you can see his smile. He has very basic functional communication 
skills. He enjoys jumping on a trampoline and drumming. He performs all 
of his chores to care for himself, with prompting and guidance, such as 
laundry and grocery shopping. He is proud of his volunteer jobs. He 
serves Meals on Wheels to clients through the week, and he takes excess 
food from a nearby college to a local soup kitchen every Saturday.
  Daniel needs around-the-clock support in order to maintain this 
quality of life. When this level of programming was unavailable or is 
unavailable, he regresses and becomes aggressive. Even at current 
funding, Daniel is one of the lucky ones, as he is not on a waiting 
list. Although he qualified for services, it took him 8 years to get a 
home and a community-based service waiver for him to be able to live 
the life he does. He is in a group home in the wonderful city of 
Lewiston, ME, where he lives today. He is contributing. He has a decent 
life.
  By the way, this is all about people. It really bothers me that we 
talk about policy and ideology and free markets and flexibility. We are 
talking about people. We are talking about real people whose lives are 
on the line--people who are struggling with opioid addiction, elderly 
people who have no place to go, and disabled people like Dan and like 
Lidia Woofenden.
  Here is Lidia. She graduated from Mt. Ararat High School in June. She 
turns 21 in August. That is the high school my kids went to. I had two 
boys graduate from that high school. When she was 4 years old, she was 
diagnosed with a delayed growth of myelin on her brain, and, at 15, she 
began having seizures and was diagnosed with a rare genetic disorder. 
She lives with intellectual disabilities, seizures, and their side 
effects, as well as with a general lack of physical coordination. Yet, 
as her mom says, that is not who she is. She is charming and funny. Her 
mom calls her friendly and goofy and the stubbornest cuss.
  She was never expected to read but is now on her fourth Harry Potter 
book. She was never expected to ride a bike, but now she does. She even 
has a job. After years of volunteering at a local nursing home, she was 
offered a part-time job and is doing well. She is doing this because 
she had support from Medicaid. She cannot cross a street by herself, 
and she needs to be reminded to brush her teeth. She has no sense of 
money or danger. On the one hand, she is 20 years old; on the other 
hand, she is 6 years old. In other words, like most young people, she 
is complicated. Everything she has achieved has been accomplished with 
the help of dedicated teachers and therapists and has been almost 
exclusively funded through special education in the public schools and 
by Medicaid.
  By the way, Medicaid provides help to the tune of $26 million a year 
to children in Maine schools who need it. One of the amendments passed 
at the last minute in the House puts that funding through the schools 
in jeopardy. She has made monumental gains, but she will never be able 
to live alone.
  What happens when we make these cuts? What happens to Lidia? What 
happens to Dan?
  In the old days, they were warehoused. They were in facilities that 
were far away--out of sight, out of mind--or with their parents, who 
had to bear the burden, who themselves could not work because they had 
to take care of the children. These are just two people--two examples--
of what we are talking about here.
  Who will speak for them? Who will stand up for them?
  I will, and I hope this body will. We are the last bulwark between 
this terrible piece of legislation that was passed in the House and 
these people and millions like them across the country. Who will stand 
up for them?
  Why are we doing this? Why are we putting States through the ringer 
of having to make decisions to choose between Lidia and an elderly 
person in a nursing home and between a child and a young man who is 
trying to beat opioids? Why are we forcing them to make those choices?
  It is because we want to give a huge tax cut to the wealthiest 
Americans, and I am talking about a huge tax cut. It is the most skewed 
tax cut in history because it only goes to a few people. Seventy-nine 
percent of the benefit of this tax cut goes to millionaires, which is 
an average tax cut of $54,000 a year. Now, $54,000 a year to 
multimillionaires--the top one-tenth of 1 percent, those with incomes 
above $6 million--would receive tax cuts of more than $250,000 a piece 
in 2025 under this legislation.
  We are putting people like this at risk in order to have somebody buy 
another Maserati. It is unbelievable that

[[Page S2987]]

this body would even consider making that tradeoff. That is what we are 
talking about here. Let's be very clear. It is an equation of lost 
Medicaid benefits, a gigantic tax cut. That is what this bill is all 
about. If you make between $500,000 and $1 million, you will see a 
$4,000 tax cut, which is not so egregious as higher up, and if you are 
under $200,000 a year, you get zero.
  This doesn't even masquerade as a middle-class tax cut. This is one 
of the most inequitable, cruel, and unconscionable pieces of 
policymaking I have ever seen. I think we need to be clear about that. 
If we don't stand up for Dan, Lidia, and millions like them--old and 
young, living in the shadows of our society, asking for nothing more 
than the ability to do the slightest things we take for granted, like 
crossing the street, having a job, dressing, feeling they are 
contributing--to take that away, to force States to make those 
decisions--and make no mistake, they are going to have to make those 
decisions. You simply can't cut the amount of money that is proposed in 
this bill--which will expand over time, by the way--and still expect 
the services to be the same or better through some kind of flexibility. 
That is nonsense. It would be bad enough, except to do it because of a 
massive tax cut to the people who least need it--that is what really 
makes this unacceptable.
  I know that people in this body are working on an alternative to the 
bill in the House, and I hope this can be an open process where all of 
us participate, where we are able to contribute ideas and amendments 
and thoughts. Particularly, I want us to think about the fact that we 
are the last line of defense. We are the last line of defense for 
people who can't speak up. In the case of my friend Dan, he literally 
can't speak up. We are who they are counting on, between us, and if it 
weren't for us, they would have no one to think about and demand that 
they be treated fairly and respectfully in the richest society on 
Earth. I hope we can do better. I know we can.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Missouri.
  Mr. BLUNT. Mr. President, there is a reason we are talking about 
healthcare, and we should be talking about healthcare. We should be 
looking for the gaps and trying to find those gaps. I had a long 
conversation this morning about people who have disabilities, adults 
who have disabilities, and the challenges they have always faced in the 
insurance marketplace. They are people like Dan and Lidia who have a 
hard time working or are unable to have a full-time job, who may be 
covered by insurance through their parents until they are too old, or 
they may not be covered because their parents aren't covered. But 
normally, if that has been the case, where you were able to share 
whatever coverage your parents had--and certainly this is an area we 
should work on, how we deal with those who are disadvantaged. On the 
Medicaid front, our goal should be to look at the House bill and make 
it better.
  The people who were added to Medicaid under President Obama's 
healthcare plan, decided by the States--the very group who my friend 
from Maine said shouldn't be making these kinds of decisions--the 
States made these decisions because it was left to them to make them. 
And they weren't children and they weren't old people; they were single 
adults who traditionally had not been covered by Medicaid. We can talk 
all we want to about how these cuts are going to affect children and 
old people, but that is not who would be affected.
  There is a debate the States have already had. Some States added 
single adults for the first time, and others didn't. Many States 
believe they can make those decisions better in their own States, to 
have a healthcare home where somebody has a doctor they could go to. 
Having coverage doesn't matter if you can't get access to healthcare. 
Our debate here should be about access to healthcare, and it should be 
about people who, because of ObamaCare, are having problems with access 
to healthcare.
  President Obama promised that the new plan would bend the cost curve. 
He said it would bend the cost curve and bring healthcare costs down. I 
think the topic he was discussing was healthcare coverage costs coming 
down by $2,500 for the typical family. The cost curve got bent all 
right, but it didn't get bent down, it got bent up. In our State, just 
last year in Missouri, 25 percent was the average increase from one 
year to the next. The individual policies in many of our counties--84 
percent have only one insurance company that is willing to offer a 
plan. That should tell us something right there about whether the 
exchange idea worked, the way it was put together. It is clearly not 
working.
  We can continue to move forward and act as though that doesn't 
matter, but it matters a lot. We have 114 counties and the city of St. 
Louis, and our constitution functions as if it were a county. One-
hundred and fifteen of those entities, the county-like entities--97 of 
them have only 1 company willing to offer insurance. In all of them, 
the average increase statewide was 25 percent 1 year over the next, and 
that is just 1 year, and it is not even next year. Every estimate says 
that those individual policies will go up even more next year than they 
did last year.
  We can continue to act as though this system is working and not do 
anything about it, or we can do something about it.
  When ObamaCare was implemented, I came to the floor almost every week 
for the first year to share story after story of people and families 
who were affected, who couldn't have the kind of healthcare or the kind 
of coverage--either one--they had before, and I could share those same 
stories now. I will share a couple of them today. They haven't stopped 
coming in. Many people have just decided: We are never going to have 
the doctors we used to have. We are never going to have the insurance 
policy we used to have. The government has failed us.
  They had a policy on which they were paying maybe a third of what 
they are paying now and which had higher coverage. But after a while, 
you quit complaining and understand that your government has actually 
come up with a system that--for your family, at least--was worse than 
the system they had.
  We talk about cancellation notices being sent out by the thousands. 
Thousands of families and thousands of individuals got cancellation 
notices. Last year President Clinton, while campaigning for his wife 
for President, said: What a crazy system. The costs keep going up, and 
the coverage keeps going down.
  There is clearly something wrong here. We need to do something about 
it. We should be working together to do something about it.
  When I am home and talking to people about this or when people 
contact our office about this, they just continue to say over and over 
again that this has gotten worse. Now, we get some calls--and I am glad 
to get them--where people say: We want to be sure that you understand 
what happens to individuals like the two people my friend from Maine 
mentioned. And we are looking for ways to be sure they don't get left 
out. But let me tell you some of the people who have been left out.
  Thomas and Kathy, a married couple from Kansas City, told me that 
their out-of-pocket costs have jumped from $2,700 in 2014--that was the 
first year of this healthcare plan--to $5,000 in 2017. In addition, 
their copays have increased--in their case, they appear to be lucky--by 
only 20 or 30 percent.
  They are not by themselves. Tony, an insurance broker in Northwest 
Missouri, recently told me about a client who was shopping for 
coverage. The client realized that the only plan she could afford would 
force her to spend, for herself, almost $5,000 a year in insurance 
premiums on top of having another $5,000 deductible before that 
insurance she would be paying for every month would do any good. She 
said she would be spending almost $10,000 without receiving anything, 
and it made absolutely no sense. Well, her insurance broker couldn't 
help but agreed with her that in her case it didn't make much sense, 
and I think all of us can see why it might not.
  Yesterday at a press event here in the Capitol, I mentioned a farmer 
who called and said she had a $12,000 deductible for her family and she 
was paying $16,000 in annual premiums. So in her case, she could pay 
$28,000 before she had any coverage at all, and that $28,000 was 
money--she could be paying

[[Page S2988]]

$12,000 of it just for access to see a doctor because her insurance 
company didn't help with that.
  One final story I would like to share is from Rob, a small business 
owner in St. Joseph who pays half of his employees' medical, and his 
costs keep going up. His agent walks in every year, he told me, and 
says: Well, this year it went up 9 percent.
  He said: That might have been acceptable, except it also went up 9 
percent last year and 11 percent the year before that, and it was 9 
percent the year before that.
  Many of the losses in the individual market are being shifted to try 
to make the insurance market make up for what is happening on the 
individual side.
  Year over year, we see premium increases, skyrocketing deductibles, 
and higher out-of-pocket costs. That is the status quo under what we 
have now, and it is unacceptable. That is why Republicans have made 
clear that we are going to move forward to solutions that will address 
some of the major issues in our healthcare system and look for ways to 
bring down costs and expand access to quality, affordable coverage, but 
more importantly, quality, affordable care.
  I urge my colleagues to work with us and join in this effort to help 
us find solutions to be sure we don't leave people out who shouldn't be 
left out but that we also make access to healthcare more possible for 
more families and more individuals than it is today.
  Mr. 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. BARRASSO. 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. BARRASSO. Mr. President, Republicans have been warning for years 
now about the grave damage ObamaCare has done to the American 
healthcare system. We have pointed out how the healthcare law's 
regulations are destabilizing the health insurance industry. We have 
warned that the ObamaCare markets are unstable. We have talked about 
the death spiral which has already doomed ObamaCare.
  It seems like every day we get more proof that the collapse is well 
underway. Last week, the insurance company Aetna announced it was 
exiting the individual ObamaCare markets entirely. CNN did a story 
about this last Wednesday. The headlines said: ``Aetna to ObamaCare: 
We're Outta Here.'' It is interesting because Aetna as a company was 
one of the cheerleaders for ObamaCare early on; they jumped in and 
said: We are very involved. We want to make this work. Here they are 
pulling out, saying it has failed.
  Humana had already said it was quitting the exchanges, not just one 
place but everywhere.
  In the past month or so, we have seen big companies drop out of the 
markets in Virginia and in Iowa. There is now just one company left 
selling in the exchanges for Nebraska and for Delaware. There is just 
one company selling in Alaska, in Missouri, in Alabama, in Oklahoma, in 
South Carolina, and in my home State of Wyoming.
  For people living in all of these States, there is a monopoly for 
whom they get to buy their insurance from under the ObamaCare markets. 
That is not a marketplace, it is a monopoly.
  The Associated Press looked at all of these companies dropping out. 
It now found that 40 percent of America--4 out of 10 counties in 
America--will have just 1 company selling insurance in the ObamaCare 
exchanges for next year; 4 out of every 10 counties in America. That is 
what you get with an ObamaCare exchange.
  How is that supposed to bring down prices? Other companies have been 
saying how much they will need to charge if they are going to stick 
around for 1 more year under ObamaCare. It looks like we will have 
another year of incredible price increases. In Maryland, insurance 
companies are demanding average premium increases of anywhere between 
18 and 59 percent. In Connecticut, they are asking for 15 to 33 percent 
more next year.
  Democrats are desperate to blame the collapse of ObamaCare on 
President Trump. My question to the Democrats is this, What about all 
of the companies that dropped out of the marketplaces last year? What 
about the double-digit price increases Americans were paying year after 
year under ObamaCare?
  The premium for the average benchmark plan in the exchanges went up 
25 percent at the start of this year. Are Democrats going to try to 
blame that on someone else?
  In March, the Kaiser Family Foundation reported the results of a poll 
on healthcare in America. In this poll, 4 out of 10 American adults 
with insurance under ObamaCare said they have trouble affording their 
deductible. They have ObamaCare insurance, but 4 out of 10 adults in 
America with ObamaCare insurance are having trouble affording their 
deductibles. Three out of every ten with insurance under ObamaCare said 
they have problems paying their medical bills. One in four Americans 
with insurance under ObamaCare said the costs have forced them to put 
off healthcare they needed or skip it entirely.
  These people are suffering because of President Obama and the 
Democrats and what they passed. These Americans are struggling because 
of the flawed policies and regulations of the ObamaCare law that 
Democrats in Washington wrote.
  Republicans are saying what we have said all along: Healthcare reform 
should be about helping people get the care they need, from a doctor 
they choose, at a lower cost. We need to do something to rescue the 
people who are being crushed under this collapsing ObamaCare 
system. That is why Republicans are the ones talking about solving the 
problems that have been caused by ObamaCare. The House of 
Representatives passed a bill that includes some important things that 
could help stabilize the markets. It includes things to stop these 
double-digit premium hikes that have been occurring every year.

  In the Senate, we have already started mapping out the ideas. We are 
going to continue offering our ideas. We are going to continue debating 
them. I want to invite Democrats in the Senate to come to the floor and 
offer their ideas as well. It doesn't have to be a partisan fight. It 
shouldn't be a partisan fight that drags on for months and months. We 
need to find solutions for the American people who are suffering under 
President Obama's healthcare law.
  For all the Democrats who are now trying to redirect the blame away 
from themselves, the problems they caused, trying to pass the buck, we 
are trying to pass a bill. I can tell from listening at home in 
Wyoming, where I will be again this weekend and was last weekend, 
people know who caused the problems of ObamaCare. The American people 
are looking for solutions. They don't care who offers it. They want 
solutions. I think if we can get a bipartisan solution, all the better. 
I invite the Democrats to come to the floor to give us their best 
ideas.
  Mr. 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. SCHATZ. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Toomey). Without objection, it is so 
ordered.