[Congressional Record Volume 163, Number 105 (Tuesday, June 20, 2017)]
[Senate]
[Pages S3621-S3624]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Healthcare Legislation
Mr. MERKLEY. Mr. President, on May 4 of this year, there was a party
at the White House, a celebration--a celebration that the House had
passed TrumpCare. Indeed, the President wanted to invite people over
and say what a great job they had done and what a great bill they had
passed. He called it a ``great plan.'' He said the House plan was
``very, very incredibly well-crafted.''
That was on May 4--a party at the White House, a celebration--but
what a difference a month can make. A week ago, on Tuesday, June 13,
the President had another gathering, and at this gathering he said that
the bill from the House was ``mean,'' and he went on to use a very
derogatory phrase to describe it.
So what happened between May 4 and June 13? Did the bill change in
some way? Absolutely not. It had already been passed out of the House.
Apparently what happened is that someone explained to the President
what was in it, and he said: That is terrible. We can't do that. It is
a mean bill. And he used other vivid language to say just how bad it
was.
What feature of the TrumpCare bill did the President get briefed on
that made him say that it was mean? It certainly is a mean-spirited
bill. It certainly is a hard-hearted bill. It certainly is destructive
to the quality of life of millions and millions of Americans. So which
aspect of the bill was he referring to?
I asked that question of the Secretary of Health and Human Services,
Tom Price, when he came to the Senate for a hearing last week. I asked
the Secretary if he shared the President's opinion that the TrumpCare
bill was a mean bill. He didn't have an answer for that. He wouldn't
say whether, as a leader in the administration on healthcare, he shared
the President's opinion.
I asked whether he thought the President thought it was a mean-
spirited bill because it ripped healthcare from 23 million Americans.
The Secretary of healthcare didn't answer.
I asked whether it was mean because it eliminated essential health
benefits like emergency care and rehabilitation services and mental
health and addiction treatment and maternity coverage for women having
a child. The Secretary again refused to answer.
And he proceeded to say things like ``Well, I wasn't in the
meeting,'' and that he hadn't talked to the President about why the
President didn't like the bill. One would think that the Secretary of
Health and Human Services, upon hearing that the President thought that
the bill he had advocated for was terrible, would actually go to him
and say: What is it you thought was so terrible? That might inform the
conversations here in the Senate. But he said that he hadn't talked to
the President about it. The Secretary of Health and Human Services
didn't want to know why the President disliked this bill.
I asked if the President thought that this was a mean bill because it
has vast premium increases for older Americans. An individual in their
mid-sixties, prior to the age for Medicare, a 64-year-old earning
$26,500--how much would they pay under current law and how much would
they pay under TrumpCare? Under current law, the answer is about $140 a
month. And under TrumpCare from the House, the answer is $1,200 per
month--an eightfold increase. How can anyone earning a little over
$2,000 a month spend $1,200 on health insurance? It is an impossible
situation.
So, of course, those Americans in that situation would not be able to
buy health insurance, would not be able to access healthcare. Is that
why the President thought it was mean? Did the President get briefed on
the damage it would do to our older Americans? Or was the President
concerned about the impact on our older Americans who need to have care
in a nursing home? Is the President finally aware that Medicaid pays
for more than 6 out of 10 individuals who are in a nursing home because
they need a level of care that can't be provided in the home?
I went and visited a nursing home over the weekend in urban Oregon
and then visited one in rural Oregon, in Klamath County. In Klamath
County they told me that almost 100 percent of their citizens in long-
term care are paid for by Medicaid. Nationally, it is a little more
than 6 out of 10, but in this rural community, almost 100 percent. I
thought about the residents there and what happens to them. Under this
bill, when Medicaid is slashed massively and 23 million folks lose
access to it, what happens to them? One woman, Deborah, said: Senator,
Medicaid pays for my bill and if it doesn't exist for me--if it is
taken away--I am on the street, and that is a problem because I can't
walk.
So picture an older American, a senior American who needs an
intensive level of care that can't be provided in the home being thrown
into the street in a wheelchair, unable to walk, and, by the way, no
support structure because in order to qualify for Medicaid to pay your
bill, you have to have spent down all your own resources, so it isn't
like somebody has a backup plan. Maybe there are family members who
will take them in and provide an intensive level of care. Maybe a few
will have friends who will take them in and provide an intensive level
of care. But for the vast majority, that support structure isn't there,
and that means they are going to be on the street. Is that why the
President said it was mean?
Was it because the bill said States can charge more, allow insurance
companies to charge more for individuals with preexisting conditions?
That is certainly a huge problem. Community pricing has given access to
insurance at the same price to everyone in America, regardless of
preexisting conditions, but, unfortunately, TrumpCare changes that.
I think we need to recognize that now, here in the Senate, 13
Senators are working to craft a Senate version of TrumpCare, and they
are terrified--terrified of the public seeing their bill. It is a
vampire bill. It is afraid of the sunlight--the sunlight of public
commentary, input, even a public discussion from experts. They are
afraid of their citizens. They are afraid of the expert commentary. And
they want to hide it until the last second so they can bring it to the
floor--next Thursday, a week from this Thursday--and try to pass it in
a moment's time, less than a day.
I was fascinated that our Secretary of Health and Human Services--
after there were more than 100 hearings and roundtables and walk-
throughs of the healthcare bill in 2009, after consideration of more
than 300 amendments in the Senate, after more than 100 Republican
amendments that were adopted,
[[Page S3622]]
minority amendments adopted, after more than 25 days of debate on the
Senate floor--complained that the bill and the process were not
transparent. If that wasn't transparent, how do you score the
transparency of a bill where there have been zero committee meetings,
zero chance for legislators to weigh in, zero chance for public input
by experts, zero chance for the citizens of the United States to see
this bill and share their feelings, zero chance for us to go back to
our own States and have townhalls and ask for input? Well, you give it
an F. It is a process completely out of sync with the responsibilities
that every Senator took when they took the oath of office to be a
Member of a legislative body--not a secret body, a legislative body,
which implies deliberation in committee and deliberation on the floor
and deliberation with constituents back home.
There is a phrase for the Senate--probably not merited; in fact, I am
sure it is no longer merited--that the Senate was the world's greatest
deliberative body. But crafting legislation in secret that affects the
quality of life of millions and millions of Americans, with no
deliberation, that is not a legislative process. That is not what was
envisioned under our Constitution, our ``we the people'' Constitution.
It wasn't a ``we the secret group of powerful folks accommodating
powerful special interests, government by and for the powerful.'' That
wasn't the introduction to our Constitution. Perhaps Members might read
the first three words of the Constitution. Perhaps folks might go back
and look at our history of why we have this floor to debate the issues,
because that is what a system of government of, by, and for the people
is all about.
In my home State, the elimination of Medicaid expansion--that is, the
Oregon Health Plan expansion--would throw 400,000 people off of
healthcare. Stretching that timeline from a couple years to 7 years
doesn't change the fact that 400,000 people lose healthcare. That is
mean-spirited. That is hard-hearted. That is terrible healthcare
policy.
It is not just those individuals who are affected. The uncompensated
care rate has dropped enormously in Oregon, from 15 percent to 5
percent. The result is that there is much more income to our clinics
and to our hospitals, and the result is better healthcare for
everyone--everyone in our rural communities, everyone in our urban
communities. Nonetheless, the majority persists in wanting to destroy
this improvement.
I am hearing from people like Elizabeth from Portland, who wrote to
say that the Oregon Health Plan saved her life. The Oregon Health Plan,
or Medicaid, saved her life. She was in school, and she had some health
problems that were getting worse because of stress. But she didn't have
a job and didn't have insurance, and things were getting bad. Then the
Affordable Care Act came around, and it extended coverage. Since then,
she has gotten her health problems under control, finished school, and
was able to get a job. In Elizabeth's own words:
I am once again contributing to society. I just need a
little bit of time and help and I'm back on my feet.
Isn't it the right thing to provide a foundation for every single
American to have access to quality healthcare, so that when they get
sick, it helps them get back on their feet?
Ask yourself: What is your value? Is it your value that every
American should have access to affordable healthcare? That is my value.
That is what I am fighting for. What are you fighting for? Are you
fighting to destroy healthcare for millions of Americans? Is that your
value--to make life difficult and hard and mean-spirited and hard-
hearted and terrible and painful for millions of Americans? Is that
your value? If so, then keep up with this secret plan to destroy
healthcare for millions of Americans. But if you value your
constituents' quality of life, if you value their peace of mind, then
put a stop to this abomination, this anti-democratic process. Insist
that there is at least a month of consideration of the bill so that
citizens can weigh in, so experts can weigh in, so committees can
deliberate, so committees can propose amendments and improvements.
Insist on that.
We just need three Members of the majority party to believe in the
responsibility of this Chamber to hold a public debate and insist that
they will not vote to proceed to the bill unless we have at least a
month of opportunity. That is only one-ninth of what we had in 2009. It
is only a fraction of the committee meetings, roundtables, and walk-
throughs we had in 2009. It would be only a fraction of the amendments
offered in 2009. It would only be a fraction of the time here on the
Senate floor we had in 2009. Don't you believe we should have at least
a fraction of the public deliberation we had just 8 years ago before
jamming this through and destroying healthcare for millions of
Americans? What does peace of mind mean to you?
I will tell you what it means to my constituents. It means that when
their loved one gets sick, their loved one will get the care they need.
It means that when their loved one gets sick, they won't go bankrupt.
That is the peace of mind we are talking about, and that is the peace
of mind that is so profoundly disturbed when you have a secret group
meeting with powerful special interests, devising a bill they are
afraid to show to the public of the United States of America. I would
never want to have to vote on such a major bill without being able to
hear what my citizens in Oregon think. I don't think any Member of this
Senate should agree to vote on a bill with no deliberation and no
public hearing.
So we need three champions. Just three out of 52. It should be 52 out
of 52 who insist on a quality public process. We have heard the
comments in the hallways, many Members of the majority dislike the fact
that there is a secret process that their majority leader is insisting
on. We have heard that they don't like it. It is not right. But do you
know what? Every Member here has a chance to say no to the secret
operation, the secret committee of 13, and the last-second presentation
of such a bill on the floor.
The issue of the changes in healthcare without public deliberation
terrifies folks like Deborah from Hillsboro, OR. She was diagnosed with
Crohn's disease 8 years ago and has to take regular injections and
medications to keep it under control. She does a lot of things right.
She doesn't smoke, she exercises, and she follows her doctor's
recommended diet. Other than her regular medications, she lives a
normal, healthy life, and she is looking forward to retiring in the
near future with her husband. They have been working hard their whole
lives. They have been saving up for it. It is so close that they can
almost taste it. But it is a dream that could be shattered by the
Republican healthcare plan--the TrumpCare plan--being concocted
secretly by 13 Members of this body. As she says:
Without affordable coverage for pre-existing conditions I
cannot even switch jobs easily. If Medicare is reduced or
eliminated, as the GOP is trying to do, I may never be able
to retire . . . we should not now, or ever, eliminate
coverage for pre-existing conditions (or price that coverage
such that most of us will never be able to afford it).
She is worried that changes that refer to Medicaid and the Oregon
Health Plan will ruin her ability to retire and her ability to access
healthcare.
I don't know exactly what the President was briefed on that made him
call TrumpCare ``mean'' and then speak in a very derogatory fashion
about the bill from the House. I don't know exactly what he learned. I
don't know if it was because he learned that folks on long-term care
could lose that long-term care and Medicaid pays for more than 6 out of
10 Americans who are in long-term care. I don't know if it was because
he learned about preexisting conditions. I don't know if it was because
he learned it would throw 23 million people out of the healthcare
system. I don't know if it was because he learned this would have
devastating consequences to rural healthcare because of the impact on
the finances of clinics and hospitals.
Whatever he meant, he was right. He was right to make that transition
from a month earlier when he held a celebration at the White House
because this terrific, wonderful bill had been passed by the House, and
when he sobered up and discovered that it was a mean-spirited, hard-
hearted bill. But for all these reasons, no healthcare should be
crafted and jammed through without deliberation. No significant bill
affecting
[[Page S3623]]
the lives of Americans should be pushed through in this manner.
Americans deserve better. They expect more from this Chamber than such
a secret, callous, poorly informed process. They don't like that
powerful special interests are meeting with the Senators in private--
those private 13--to develop a plan, because here is what they have
heard:
They know this bill gives huge tax breaks to powerful parts of the
healthcare industry, that it gives huge amounts of money away to those
who make medical equipment and huge amounts of money away to health
insurance companies, meanwhile stripping healthcare from millions of
Americans. They know it also gives a massive tax break to the richest
Americans.
So here we are with a bill that Trump has called ``mean,'' giving
away the Treasury to powerful special interests, meeting in private
with my colleagues, giving away the Treasury to the richest Americans,
while on the other hand lowering the boom on our seniors in long-term
care, lowering the boom on struggling and working families, lowering
the boom on 20 million or so Americans who would lose healthcare, and
lowering the boom on the clinics and hospitals that provide care for
everyone.
That is what they see: special favors for the powerful and thrown
into the street the working and struggling families. That is morally
wrong. That is wrong from a policy point of trying to improve the
quality of life of Americans, and it is why every Senator here should
absolutely say no to moving to this bill on the floor without a full
month, at least, for committee deliberations and for the citizens of
the United States to weigh in.
That is the difference between what happens in a dictatorship with no
deliberation and a democratic republic with a legislative process that
values deliberation and openness. That is the difference. Which model
do my colleagues support?
Let's fight for the ``we the people'' vision of our Constitution, and
let's fight for quality healthcare for every American, and let's say no
to moving to any bill that hasn't had public deliberation and at least
a full month of deliberation in this Chamber.
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.
Mrs. MURRAY. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mrs. MURRAY. Mr. President, I ask unanimous consent to speak for 6
minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mrs. MURRAY. Mr. President, I want to thank all of my colleagues for
their comments today on the damage TrumpCare would do. Democrats,
patients, and families have been fighting back against TrumpCare and
Republican efforts to jam it through Congress for months.
I want to take a moment and recall some of the promises President
Trump and Republicans made at the very beginning of this process
because there truly is a Grand Canyon between President Trump's
promises and the TrumpCare bill he has now admitted himself is
``mean.''
At the start, President Trump promised to provide insurance for
everybody that was both cheaper and higher quality. When TrumpCare was
introduced in the House, Secretary Price said that ``no one would be
worse off financially'' under the law. And when Speaker Ryan was asked
whether millions of people would lose their insurance coverage under
TrumpCare, he said ``no.''
Families were told again and again that TrumpCare would lower costs
and keep people covered. As we know, TrumpCare would do the exact
opposite. It will raise healthcare costs for people across the country,
astronomically for those with preexisting conditions and for seniors,
who could pay as much as 850 percent more in premiums. Medicaid would
be gutted. Women and men would be unable to get care from the providers
they trust and choose at Planned Parenthood. New mothers would pay as
much as $1,000 more a month just to get maternity care. Tens of
millions of people would see their healthcare coverage taken away.
I could continue. And I want to be clear that those facts came from
the nonpartisan, independent Congressional Budget Office.
Unfortunately and unsurprisingly, when TrumpCare passed the House,
President Trump ignored those facts and doubled down on his broken
promises. He championed TrumpCare, calling it ``very, very well-
crafted.'' He promised to get TrumpCare through the Senate, predicting
that it would be an unbelievable victory. His Secretary of Health and
Human Services called this bill--which would take healthcare coverage
away from 23 million people--a victory for the American people. Which
people? Maybe President Trump. Maybe special interests who are going to
get these massive tax breaks. But not the hundreds of thousands of
people in Washington State who are rightly scared of TrumpCare or
millions more across the country.
Democrats have come to the Senate floor with story after story about
how our constituents would suffer under this legislation, workers who
would not be able to make ends meet between jobs without losing health
insurance, seniors who know they will go bankrupt if TrumpCare becomes
law, moms who stay up at night worrying about whether their child who
has a preexisting condition will be priced out of coverage, patients
fighting for their lives who are afraid that TrumpCare will kill them
and who are literally begging Congress not to do this.
To these patients and families, President Trump's decision to finally
admit the incredibly obvious--that TrumpCare is ``mean''--doesn't begin
to cover it. To them, that bill is a gut punch. It is the bottom
dropping out. It could be a death sentence. And this is especially true
because, as hard as Senate Republicans have tried to keep their version
of TrumpCare secret, behind closed doors, and in back rooms, as often
as some have made promises just like those President Trump and House
Republicans were making to try to reassure their constituents somehow
that the Senate version of TrumpCare would be somehow less mean, the
truth is, we know the Senate version of TrumpCare will be just as
damaging.
Senate Republican leaders have already admitted that they expect
their TrumpCare bill to mirror 80 percent of the House's. We have House
conservatives writing letters to Senate Republicans making demands even
meaner than many Senate Republicans want. And we all have a good idea
how this is going to end up. ``Mean'' doesn't even begin to cover what
TrumpCare would do to my constituents in Washington and to people
across the country, but it is a start.
I haven't said this often, but I hope Senate Republicans listen to
President Trump. This is a man who knows about mean--from making fun of
a reporter with disabilities, to belittling our friend the junior
Senator from Florida, to even impugning the senior Senator from
Arizona, a war hero. When President Trump says something is mean, that
certainly means something.
Mr. President, I hope they think about why he had to make that
comment. They realize just how hard it will be to defend this truly
appalling legislation, especially after it has been jammed through
Congress, hidden from patients, and hidden from families without seeing
the light of day. I hope they do what we tell preschoolers to do when
they do something mean--apologize and make sure to do better next time.
In Senate Republicans' case, that means dropping this effort to
undermine families' healthcare once and for all and then joining with
us to continue fixing healthcare for the people we serve by making
healthcare more affordable, getting more families covered, and
maintaining quality of care.
Democrats have ideas. We are at the table. We are ready to get to
work as soon as Republicans are. It is not too late to make the right
choice. The wrong choice is far more than mean. If my Republican
colleagues do continue down this deeply harmful path, they should know
they will own every bit of the hurt they cause, and they will be held
fully accountable.
Mr. President, I yield the floor.
[[Page S3624]]
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