[Congressional Record Volume 163, Number 104 (Monday, June 19, 2017)]
[Senate]
[Pages S3577-S3580]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. SCHATZ. Mr. President, we Democrats are here on the floor to take 
a stand against a bill that is a disaster for our Nation's healthcare--
Medicaid patients, families with loved ones in nursing homes, people 
who struggle with opioid addiction, women who rely on Planned 
Parenthood, and people who work in the healthcare industry. We stand 
with them and for them tonight, but we also stand for the American 
public, who is being left in the dark about what TrumpCare will mean 
for them.
  This is not the normal order of Senate business. The Republicans are 
going about this in a way that is so procedurally flawed that it is an 
embarrassment to democracy itself. They are hiding this bill. They are 
hiding this bill because people will be outraged when they find out 
what is in it.
  That is why a Republican aide said that they are not releasing the 
bill--because ``we aren't stupid.'' Think about what that statement 
means. First, it means that they have a bill. Second, it means that 
they think it is political suicide to make the bill public. So they are 
bypassing the normal and necessary process that is needed to make good 
legislation.
  The way you make legislation is to allow the Sun to shine in, and 
that starts with hearings. Every legislative body in the country--from 
a school board to a county council--has hearings because we have 
figured out over the centuries--for all of our flaws--that you need 
hearings, not just to placate the masses but to figure out whether your 
legislation is any good or not.
  Republicans have not held a single hearing on TrumpCare. No one who 
knows anything about healthcare is allowed to say anything about this 
bill because they are not even allowed to see it, but anyone who has 
ever tried to understand the American healthcare system knows that it 
is complicated. The President said so himself. You need expert 
testimony, public input, and time to talk to your home State. That is 
the way you get a good product, but Republicans have totally bypassed 
the two committees that exist in order to consider legislation like 
this.
  Think about it. Under normal circumstances, this legislation would be 
in the Finance and HELP Committees' jurisdictions. There would be 
hearings, and there would be a markup, but that is not the process that 
is being used. There is no markup. There are no committee hearings. It 
is just 13 dudes, and they are rushing to pass a bill without

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women, without Democrats, and without input from the American people. 
Here is the order of the people who get to see the healthcare bill: 13 
men in secret, Republican lobbyists, POLITICO, Republicans, Democrats, 
and, then, the American people.
  This is shameful. This is a violation of the way democracy itself 
should work. When they are done, the product will be the fruit from the 
poisonous tree. It will not be good because the process that will have 
produced it will have been so flawed.
  There are many, many Americans who do not support this bill, and I am 
going to highlight just three groups who stand to lose.
  First, you have people who are going to pay more for insurance, lose 
their insurance altogether, or lose the ability to choose their 
providers. Families will not be able to afford nursing home care for 
their loved ones or to pay the hospital bills for a parent after she 
has had a heart attack. Americans who have preexisting conditions will 
struggle to buy insurance because insurance companies will be able to 
charge more for conditions like diabetes or cancer or asthma. Women 
will be blocked from getting annual checkups or cancer screenings at 
their local Planned Parenthood clinics. All of these people stand to 
lose if the bill moves forward.
  Second, you have people whose jobs may be at risk. Healthcare makes 
up about one-sixth of the American economy, and it does not exist in a 
vacuum. It is an industry that impacts millions of workers, and you can 
bet that those jobs will be affected by this bill. One study found that 
TrumpCare will take away nearly 1 million jobs by the year 2026. We are 
supposed to be helping American workers, not taking away their jobs or 
making it harder for them to get healthcare.
  Finally, this bill hurts the working poor. These are the people who 
will struggle even more under TrumpCare, and I do not know why we would 
punish them. Why would we leave them with nowhere to turn? I know that 
millions of Americans feel the same way that I do. They care deeply 
about the poor, the vulnerable, and the sick among us, because they 
have made news in standing up for their neighbors.
  One woman named Jessie went to a town hall to make her voice heard on 
TrumpCare, and I want to read what she said:

       It is my understanding the ACA mandate requires everybody 
     to have insurance because the healthy people pull up the sick 
     people, right? And as a Christian, my whole philosophy on 
     life is pull up the unfortunate. So the individual mandate, 
     that's what it does. The healthy people pull up the sick. If 
     we take those people and put them in high-risk insurance 
     pools, they're costlier and there's less coverage for them. 
     That's the way it's been in the past, and that's the way it 
     will be again. So we are effectively punishing our sickest 
     people.

  Look, we may not agree on policy, but I hope we can agree on the 
process. So what will it take? What will it take for this process to be 
restored and for TrumpCare to be considered in the way that it ought to 
be considered?
  The answer is actually very straightforward. We need three 
Republicans. It only takes three Republicans, and you can be a person 
who hates the Affordable Care Act or has mixed feelings about the 
Affordable Care Act or anywhere in between. It only takes three 
Republicans in the U.S. Senate to restore the U.S. Senate itself--to 
restore the hearing process, to restore public confidence, and to 
restore bipartisanship.
  All we need are three Republican Senators to say: I will not vote for 
anything if there hasn't been a public hearing. I will not vote for 
anything that is being jammed down Americans' throats. I will not vote 
for anything without being able to go back home and figure out how it 
will impact my State's hospitals.
  This is not an unreasonable task. We are just asking for three 
Republicans to say: Let's be a Senate again. Let's restore order and 
transparency and do things the right way because that is the only way 
this bill will not be a total disaster.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. BOOKER. Mr. President, I am grateful for the recognition. I am 
grateful for my colleague from Hawaii and for my colleagues from across 
the country who are going to be coming to the floor tonight.
  This is going to be a long evening because there are a lot of folks 
who are frustrated. There is frustration not just about the actual bill 
itself, a lot of this frustration right now is building because of the 
brokenness of this process. It is a process that is right now about 
secrecy. It is a process that has been conducted behind closed doors in 
back rooms. It is a process that is not reflective of our history, of 
our traditions, or of the many calls from both sides of the aisle, in 
my short time in the Senate, hearing echoes of a chorus from my 
colleagues on both sides of the aisle who talk about regular order, 
regular order, regular order.
  Several of my colleagues and I earlier were asking for unanimous 
consent--trying to use the process of the Senate to bring about a 
better process--a process that would bring this legislation out into 
the light of day and create an opportunity reflective of the Affordable 
Care Act, where we would have people able to put input into this 
process. A debate would happen. Discussion would happen. Actually, we 
would come forward with a bill the American public would see go through 
the debates.
  In fact, through the process, the very Constitutional Convention of 
this country--perhaps some of the biggest issues of humanity--were 
debated in an open forum. We have records of those discussions, records 
of those deliberations. Everything from the representation that each 
State should have to issues as profound as slavery were right there, 
out in the open. Tonight, it is remarkable to me, it is almost tragic 
to me, to see a process that is so broken, a process that is so 
secretive, a process happening in back rooms--everything Americans 
dislike about politics of old--people working in secret on a bill they 
are going to try to force through Congress with no public input, no 
hearings, no meetings, no markups, no debate, no public accountability.
  So there will be a lot of voices tonight speaking about the realities 
of this legislation. I am one of those folks. I came from a children's 
hospital this afternoon with parents and with children who suffered 
accidents--car accidents and more--telling me how they were relying on 
Medicaid. I think it is one of the most terrifying things that is about 
to happen because people look at the House bill--a bill our President 
even called mean--and they are fearing for their own communities, 
fearing for families like theirs.
  I understand the substance of this bill should have many people 
afraid about what kind of country we are going to be when we look at 
the House version of the bill and see that it violates our common 
values and ideals as a nation--to give massive tax breaks worth 
hundreds and hundreds of thousands of dollars to the wealthiest and, at 
the same time, cut the social safety net to a degree we haven't seen in 
my lifetime. The substance of this is frightening, but the process, to 
me, violates the values I know so many of my colleagues hold and that 
any of us, watching this happen in an objective way, would criticize.
  We know the starting place in the House. We know the details of that 
bill--23 million Americans losing health insurance, the gutting of 
Medicaid by $800 billion, throwing one-sixth of our economy into 
crisis, but it is the process that is fundamentally at odds with the 
principles and the values of especially this body, the Senate. When I 
was running for this office, I had so many people come to me and say: 
This is the greatest deliberative body on the planet Earth--the 
Senate--which slows things down, the saucer that cools the tea as our 
ancestors said. This body has a history of grappling with issues. This 
process is so at odds with everything I believe about this body and how 
it is supposed to operate. The Senate is meant to be a place of 
powerful consideration of debate, of discussion.
  Now, the history of this body and its debates and discussions is 
really interesting. The longest consecutive session in Senate history 
was a debate during the First World War about whether to arm merchant 
ships. That is the record. By the way, issues of war and peace I would 
hope would bring about substantive, deliberative debate, discussion, 
open air. This body is probably--in fact, the elder statesmen and

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women in this body I have spoken to on both sides of the aisle, 
sometimes the most difficult decisions they have made are involving war 
and peace. What is interesting, if you look at the history of the body, 
the longest consecutive session debate was about war and whether to arm 
merchant ships in the First World War.
  What was the second longest debate? The second longest consecutive 
session in Senate history was actually healthcare, or, more 
specifically, it was the healthcare debate in 2010 about the Affordable 
Care Act or so-called ObamaCare. In fact, here we are looking at a 
process that seems to be screaming something to the floor: No hearings, 
no markups, no committee sessions--screaming to the floor in the shadow 
of the second longest consecutive session of debate. That, to me, is a 
contrast that speaks volumes about the wrongness of this moment in 
history. Anyone objectively standing back would agree and concur that 
for something that is so deeply at the core of what our country is 
about--we literally founded this Nation because of life, liberty, and 
the pursuit of happiness--life. What more fundamental aspect of life is 
there?
  A critical constituent part of that has to be how we preserve life, 
how we embolden life. What is the state of our healthcare? For this 
great, historic, deliberative body to be doing that without so much as 
a pause, with the brilliant minds on both sides of this aisle, with the 
thoughtful people on both sides of this aisle, people who have come 
through portals and processes where they expose themselves and their 
lives to public discussion, public debate--that is what a democracy is, 
and that is what this Republic was founded upon, not secrecy, not back 
rooms.
  This body reflects the best of what democratic principles are. Now we 
are rushing something through that fundamentally affects life, and we 
are pushing it to the floor with an insult to our history, an insult to 
our values.
  It has been said before, but I remind my colleagues that the 
Affordable Care Act had a lengthy process before that near 
recordbreaking consecutive days of session. The Senate's HELP Committee 
held 14 bipartisan roundtables, 13 bipartisan hearings, 20 bipartisan 
walkthroughs, and considered nearly 300 amendments. The Affordable Care 
Act actually accepted over 160 amendments--160 Republican amendments to 
shape the bill.
  The Finance Committee held 17 roundtables, summits, and hearings; 13 
bipartisan Member meetings and walkthroughs, 38 meetings and 
negotiations, and then a 7-day markup on the bill--the longest markup 
in over 20 years. That is our history. In the end, the Affordable Care 
Act went through a lengthy process, through which the policy experts, 
market experts, medical professionals, health nonprofits, insurers, 
hospitals, and families all came to this Senate and put forward their 
input and their ideas.
  This wasn't a Republican bill or a Democratic bill by the politicians 
themselves. America was invited to the table. Hours and hours of 
hearing records show that people--whether the bill ended up reflecting 
their ideas or not--had their say. That is what is beautiful about this 
democracy, is that the dignity and the voice and the opinions of others 
is brought into the process.
  I was mayor of Newark during the time that this process was going on. 
People in my community were riveted by it. They knew that issues that 
would affect their lives were going on here in the U.S. Senate, at a 
time when the No. 1 reason for personal bankruptcy in my State was 
because people were declaring bankruptcy because of their healthcare 
bills--something that is not happening now at those levels.
  People were caring and concerned about what was going on, and 
representatives from my community came down. I saw how that process 
shaped the bill. I saw how Republican ideas shaped the bill. I saw how 
hospitals and insurers and advocates and doctors and nonprofits, the 
AARP, and others let their voices be heard, shaped the process, had 
input, had voice, and their dignity and perspectives were respected.
  Mr. MERKLEY. Mr. President, will my colleague yield for a moment? The 
majority leader has returned to the floor to hear a unanimous consent 
request--actually two of them--which we will make very brief and then 
yield back to the Senator from New Jersey.
  Mr. BOOKER. I fully yield to the majority leader.


                 Unanimous Consent Requests--H.R. 1628

  Mr. MERKLEY. Mr. President, this weekend, I was out doing townhalls 
in rural Oregon. I was in Klamath County and Lake County--counties that 
on any map would be described as solidly red. At my townhalls, people 
were turning out with one huge anxiety; that is, the healthcare bill 
that might be considered next week, with no consideration in committee, 
no consideration for amendments, no opportunity for experts to weigh 
in, and, most importantly, no opportunity for the citizens of America 
to weigh in.
  So two veterans came up to me after one of the townhalls, at the 
Paisley Saloon, and they asked: Does DC understand the despair, the 
anxiety in rural Oregon over this healthcare bill plan? The answer, of 
course, at this point is no, but we hope the answer will be yes.
  Then I was visiting a nursing home, and two different individuals I 
spoke to noted that virtually everyone on long-term care was there 
through Medicaid. They said: You know, if we lose Medicaid, we are out 
on the street. As one woman said: I will be out on the street, and I 
can't walk so that is a problem. Well, yes, it is a problem for folks 
on long-term care to be dumped onto the street.
  That is why, at this moment, I am asking for our normal process for 
any bill, any modest bill, but certainly a major bill to get thorough 
democratic consideration in this beautiful, ``we the people,'' 
democratic Republic, and that means committee hearings, that means 
experts testifying, and that means input from citizens.
  Mr. President, that is why I ask unanimous consent that no motion to 
proceed to Calendar No. 120, H.R. 1628, the American Health Care Act, 
be in order until the bill has been the subject of executive session 
meetings in the Committee on Finance and the Committee on Health, 
Education, Labor, and Pensions, during which amendments from the 
majority and the minority have the opportunity to be presented and 
considered, and the American people have the chance to weigh in, and 
the bill has been reported favorably from the committee.
  The PRESIDING OFFICER. Is there objection?
  Mr. McCONNELL. I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from Massachusetts.
  Mr. MARKEY. Mr. President, when I was home in Massachusetts this 
weekend, I constantly had people coming up to me and asking me about 
the secret Republican healthcare bill--what is in it and how it is 
going to affect their families--because, to use Donald Trump's words, 
they are afraid that it is going to increase premiums, and that would 
be mean; that it is going to make it possible for insurers to deny 
coverage for preexisting conditions, and that would be mean; that it 
would create an age tax for older Americans, and that would be mean; 
that it would cut Medicaid coverage for grandma and grandpa to get a 
nursing home bed if they had Alzheimer's, and that would be mean.
  So the question that kept coming to me all weekend was, is this 
secret bill really meant to cut all of the funding that goes for the 
poor, the sick, the elderly, and the disabled so they can give tax 
breaks to the wealthiest people in America? Can we get that out so 
people can see that?
  They also said to me that they didn't want to be fooled, because 
their fear is that TrumpCare is as much a healthcare bill as Trump 
University was a college institution and that there really isn't any 
healthcare in it and that it is cruel, inhumane, and immoral.
  So we are demanding that the Republicans show us the bill so the 
American people can see the bill and understand what is in it because 
the consequences for their family's health are so dramatic.
  As a result, I ask unanimous consent that Calendar No. 120, H.R. 
1628, the American Health Care Act, be referred jointly to the 
Committee on Finance and the Committee on Health, Education, Labor, and 
Pensions with instructions to report the bill with changes to eliminate 
provisions that, No. 1, increase health insurance costs;

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No. 2, reduce coverage; No. 3, make healthcare less affordable for 
those with preexisting conditions; and No. 4, reduce tax liabilities 
for corporations and individuals with incomes over $1 million.
  The PRESIDING OFFICER. Is there objection?
  Mr. McCONNELL. I object.
  The PRESIDING OFFICER. Objection is heard.
  The Senator from New Jersey.
  Mr. BOOKER. Mr. President, I recognize my more senior Senator is here 
from Delaware, so I suspend at this time in deference to an opportunity 
for the senior Senator from Delaware to have a few words.
  The PRESIDING OFFICER. The Senator from Delaware is recognized.
  Mr. CARPER. Mr. President, I thank my friend for yielding. I take the 
train back and forth from time to time to my home State. I am going to 
try to get on a train later tonight to go home. Thank you for letting 
me have a few minutes.