[Congressional Record Volume 163, Number 102 (Thursday, June 15, 2017)]
[Senate]
[Pages S3532-S3533]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. President, I rise today to talk about the healthcare debate and 
in particular not just the issue of healthcare but the effort underway 
by Senate Republicans in their attempts to repeal the Patient 
Protection and Affordable Care Act.
  I have grave concerns about the substance of the legislation--what we 
know about it. It has been kind of a secret process. We don't know a 
lot, but we have some general sense of where they are headed. I also 
have grave concern about the lack of transparency employed by the 
Republican majority around the development of this healthcare plan.
  Like millions of Americans, I oppose this secretive process--and I 
have to say it is a partisan process as well--that could result in 
major legislation that would harm children who will lose their 
healthcare, especially by way of the cuts to Medicaid. It could harm 
individuals with disabilities--and by one recent estimate in 
Pennsylvania, that means over 720,000 Pennsylvanians with a disability 
who rely upon Medicaid; and, of course, seniors--a lot of seniors 
across the country cannot get into a nursing home absent the full 
support of the Medicaid Program, and we are concerned about them as 
well; and finally, middle-class families who may not be able to afford 
healthcare if the House bill were to become law or a substantially 
similar bill passed by the Senate.
  In 2009, the legislation passed the Senate after a yearlong, open 
process that included a total of 44 bipartisan hearings, roundtables, 
and summits. That was in the Committee on Health, Education, Labor, and 
Pensions, of which I was a member at the time and remember well those 
hours and hours and days and days of hearings. The Committee on Finance 
at that time also had many hearings over many months. This whole 
process by two committees led to the consideration of some 435 
amendments offered by both parties, majority and minority, and a full 
debate on the Senate floor that lasted over 25 consecutive days. In 
fact, a number of Republican Senators were able to offer and get a vote 
on their amendments, some of which passed and became part of the 
Patient Protection and Affordable Care Act.
  Yet, in the last 5 months, there have been no Senate hearings on this 
proposed legislation, no hearings on the House proposal, and certainly 
no hearings on what is being developed here in the Senate. If that is 
the case--if that remains the case over the next couple of days and 
weeks--then I believe we should institute a very basic rule: If you 
have no hearings, you have no vote. In other words, you can't have a 
vote on the Senate floor on a bill that will affect so many tens of 
millions of Americans and will change dramatically and, I would argue, 
adversely, to the detriment of a lot of people, our healthcare system. 
I hope the majority will agree with that--that if you don't have a 
hearing, you shouldn't have a vote on the Senate floor.
  There have been no relevant bills considered in executive session by 
any of the committees of jurisdiction. Every indication is that the 
Republican majority will jam this legislation through with minimal 
opportunity for debate. This is unacceptable to me, but I also believe 
it is unacceptable to people across the country in both parties.
  We know, for example, the reason--or one of the many reasons--folks 
would want a hearing before a vote, and that is because we are getting 
a sense of what the substance is. Just to give one example, I won't 
enter this whole report into the Record, but I am holding a full copy 
of the Congressional Budget Office cost estimate. This estimate is 
dated, May 24, 2017, analyzing H.R. 1628, the American Health Care Act 
of 2017. This is the bill which passed the House. Page 17 of the CBO 
report says:

       Medicaid enrollment would be lower throughout the coming 
     decade, culminating in 14 million fewer Medicaid enrollees by 
     2026, a reduction of about 17 percent relative to the number 
     under current law.

  That is quoted directly from page 17 of the CBO report, that over the 
decade, 14 million people will lose their Medicaid coverage.
  I know some here and across the city who were commenting on this 
legislation--either members of the administration, Members of Congress, 
or otherwise--are refuting this, but I think when you have a 
Congressional Budget Office report which is an independent entity that 
both parties have relied upon--and it is not only the CBO. This is a 
report authored by not just the Congressional Budget Office but also 
the Joint Committee on Taxation.
  So 14 million fewer people on Medicaid--why is that relevant to the 
Senate debate if the CBO report was analyzing the House bill? Here is 
what one think tank, which has analyzed healthcare policy for years, 
the Center on Budget and Policy Priorities--they put forth a report 
this Monday, June 12. In that report of just a couple of pages, they 
had a chart--I am holding it. I do not expect people to see it, but 
here is what it says. It has four columns. The first column has the 
major provisions of the House bill; and then what are likely, based 
upon reporting and information we can ascertain so far, major 
provisions of the House bill; what happens if the House bill passes; 
and then major provisions of the Senate bill.
  There is a section entitled ``Medicaid Expansion.'' When the Center 
on Budget and Policy Priorities analyzed and compared the House bill to 
what we know so far about the Senate bill being proposed or at least 
the development of it, basically the Center on Budget says there is no 
long-term impact on any reported changes from one bill to the other. 
The Medicaid per capita cap--another very disturbing development that 
is being considered--when they compare the Senate bill to the House 
bill, they say no major changes.
  So we are very concerned about what happens to Medicaid. I am very 
concerned because of the 1.1 million children in Pennsylvania, the 
disability number I mentioned before of over 722,000 people with 
disabilities who get Medicaid, and of course the seniors who depend 
upon Medicaid. So we are concerned about the elimination, even over 
time, of the Medicaid expansion. We are also concerned about the 
Medicaid Program itself.
  In addition to those numbers, I want to highlight a few individual 
stories of people to get a sense of what is at stake when it comes to 
this bill and when it comes to Medicaid.
  This past Friday, I met with German Parodi from Philadelphia. Here is 
his story:
  In 2001, he was a victim of a carjacking and was shot in the neck, 
leaving him paralyzed and unable to use his legs and having limited use 
of his arms. He was nursed back to health by his grandmother and has 
worked for the past 16 years to be a full citizen, going to school, 
working, owning his home, now caring for his grandmother who once cared 
for him. German, who now uses a wheelchair to get around, has worked to 
achieve what every American wants--to be a successful student, to own a 
home, and to care for his family. He can do this because of his 
knowledge, skills, and perseverance, and he has been able to achieve 
these goals because he gets direct care services paid for by Medicaid. 
His direct care professional helps him get out of bed in the morning, 
get showered, dressed, breakfast, and get to work. Medicaid and the 
services it provides makes it possible for him to use his skills to be 
successful.
  German told me that without Medicaid, ``I would end up having to live 
in an institution. This would dramatically affect my life and my 
grandmother's life.''
  While talking with me, he said: ``Please do everything in your power 
to protect my life and the lives of millions like me.''
  I am short on time but here is another example. Latoya Maddox, whom I 
met at the same meeting, is from the Germantown section of 
Philadelphia. She was born with arthrogryposis multiplex congenital, a 
disability that limits the use of her limbs. Latoya also uses a 
wheelchair to get around, including getting to school and getting to 
work. She is smart, energetic, and the mother of a soon-to-be 6-year-
old. She is now a junior at West Chester University working on her 
bachelor's

[[Page S3533]]

degree in social work and works part time at Liberty Resources, 
Incorporated, one of Pennsylvania's independent living centers.
  Like German, Latoya is a successful young professional because she 
works hard and takes advantage of the opportunities presented to her. 
She has support from Medicaid in the form of direct support 
professionals who help her with her daily tasks. Without Medicaid, the 
wheelchair and other medical equipment she needs and her direct care 
workers, Latoya would not be able to work, attend school, and care for 
her son.
  While I was talking with Latoya, she told me: ``Medicaid makes it 
possible for me to live a regular, full, productive life, to be a 
parent, to go to school, and to be a reliable employee.''
  While talking with her, it was clear that Latoya was proud of her son 
and proud to be his mother. She was clear that the support she receives 
from Medicaid makes it possible for her to be that proud parent.
  She closed her remarks by saying that Medicaid ``makes it possible 
for me to be me.''
  My last example is Karen Stauffer. Karen Stauffer is from Bucks 
County, PA. She is a small business owner. She operates the River of 
Life Natural Foods store. Karen purchased her healthcare policy from 
the Pennsylvania Affordable Care Act exchange. She said to me that 
prior to the passage of the ACA, she saw her healthcare premiums 
increase from $300 a month in the late 1990s to $1,300 in the mid-
2000s. She said to me that because of preexisting conditions such as 
high blood pressure and a long bout of Lyme disease, she was worried 
she would lose her healthcare. She said passage of the ACA was both an 
emotional and financial relief for her. Her premiums were reduced to 
$500 a month after being as high as $1,300, and she knew she had the 
protection of the law when it came to nondiscrimination because of her 
preexisting conditions.
  As she spoke, she shared her fears from what she has been hearing 
about the House bill and what might come out of the Senate; that, at 61 
years of age, her premiums could be five times that of younger 
policyholders and that the meager subsidies proposed by the Republican 
majority would make healthcare unaffordable for her. She said to me: I 
am frankly terrified about what could happen to me in the next 4 years. 
My income has gone down, I have preexisting conditions, and instead of 
making adjustments and improvements to the ACA, legislators are causing 
insurers to become concerned about the future.
  Karen was distraught when talking about the future and reminded me 
that ``we all could be one accident or illness away from disaster.'' 
That is what Karen said.
  So German, Karen, and Latoya, I think, give us a lot to think about. 
I hope the majority, when they are making the final edits to their 
bill, will make sure that any American with Medicaid, for example, who 
has it now--a child who comes from a low-income family, an adult or 
child with a disability or a senior trying to get into a nursing home--
if they have Medicaid today and need it in the future, that there would 
be a guarantee that they don't lose their Medicaid, that they don't 
lose it this year or 5 years from now or 10 years from now, or longer. 
Stretching it out over many years and eliminating that coverage year 
after year, a little bit each year, is going to be just as bad in the 
long run.
  I hope the majority would think of those families and the families in 
their own States when they are considering healthcare legislation in 
the Senate. We should have a vote only if there is a hearing on this 
legislation or, frankly, more than one hearing to consider something 
this complicated.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.


prayers for the Victims of the Congressional Baseball Practice Shooting

  Mr. MERKLEY. Mr. President, yesterday we had a horrific tragedy here 
in the capital area. I know I speak for all of my colleagues who are 
holding the victims of that attack in their hearts and in their 
prayers: Congressman Steve Scalise, still in critical condition; Zack 
Barth, legislative correspondent who works for Congressman Williams of 
Texas, who was injured; Matt Mika of Tyson's Foods, who represents them 
here on the Hill; and two of our police officers, David Bailey and 
Crystal Griner of the U.S. Capitol Police. Without those two police 
officers present, this could have been a much more tragic event.
  We have to reinforce the understanding that we are blessed to have 
the opportunity to raise our voices in our democratic Republic. We are 
able to raise them by speaking to our members who are elected in local 
and State and Federal Government, by writing to them, by meeting with 
them in townhalls. In my State, you can call them up, and they will sit 
down with you in a cafe. We have an opportunity to weigh in through 
writing letters to the editor, by protesting in the streets, by 
overflowing the email lines and flooding the phone lines. We have all 
kinds of ways to weigh in, in America, but violence is absolutely 
unacceptable. We have to try to diminish and eliminate the hate speech, 
which so often becomes the foundation for hate violence.
  We have had a very divisive 18 months here in America, where various 
folks have sought to increase the divisions between groups of 
Americans, to attack women, to attack African Americans, to attack 
Hispanics, to attack Muslims, to attack LGBT citizens. We need to 
eliminate that strategy of division.
  Here, in America, we are a tapestry of talents from all over the 
world, of different cultural backgrounds who come together to make this 
Nation incredibly strong. Unless you are 100 percent Native American, 
you are either an immigrant yourself or the son or daughter of 
immigrants. We bring that diversity to bear and we make this Nation 
powerful in ways few other nations could even come close to having.
  Let's take this as a moment in which we seek to encourage public 
participation in all the legitimate forms of free speech but put hate 
speech out of bounds and hate violence out of bounds.