[Congressional Record Volume 163, Number 105 (Tuesday, June 20, 2017)]
[Senate]
[Pages S3627-S3631]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. UDALL. Mr. President, I am happy to be joined today on the floor 
by Senator Heinrich, who has been a real fighter for healthcare for New 
Mexicans, and I am looking forward to staying on the floor and hearing 
him talk about how he feels about this Republican healthcare bill as 
well.
  I rise today for the third time this session to oppose plans by 
President Trump and the Republicans to gut our healthcare system and to 
throw millions of Americans off their health insurance.
  On May 4 of this year, the day that House Republicans narrowly passed 
their TrumpCare bill, the President held a celebration at the White 
House in the Rose Garden and pronounced the bill a great plan.
  Well, TrumpCare may be a great plan if you are wealthy and healthy, 
because if you are wealthy you get big tax cuts and if you are healthy, 
your premiums may not go up, and may even go down--that is, until you 
are sick.
  TrumpCare is not a great plan if you are over the age of 62, if you 
are a hard-working family trying to make ends meet, if you live in a 
rural area, if you have or have not had an illness like cancer or heart 
disease or diabetes, or if you are a woman. Twenty-three million 
Americans will be left high and dry--out of health insurance by 2026. 
They don't think TrumpCare is a great plan. To them, it is a mean plan. 
Actually, those were President Trump's own words several weeks after 
the Rose Garden celebration. President Trump came clean with the Senate 
Republicans, admonishing them that the bill is ``mean'' and needs to be 
more ``generous, kind, and with heart.'' For the first time since his 
inauguration, I agree with the President on healthcare.
  Since day one of the 115th Congress, Republicans have had the 
Affordable Care Act in their sights, and so has the President. They 
have tried mightily to do away with the rights and benefits under the 
ACA. But there is good news. The American people have rallied. They 
have called, they have emailed, and they have gone to town halls. They 
have marched, they have made their views known, and they have shared 
their stories. So far, they have stopped Republicans from gutting our 
healthcare system.
  Just this past Saturday in my home State, simultaneous rallies in 
opposition to TrumpCare took place in 20 counties. I say to them: Keep 
up the fight, and I will continue to fight as hard as I can. We need to 
do all we can to stop this attack on healthcare.
  The consequences of upending our healthcare system are enormous. They 
are enormous for the 20 million Americans who now have healthcare 
because of the ACA through private insurance and through Medicaid 
expansion. TrumpCare hurts the most vulnerable--the elderly, the 
disabled, and those with fewer resources.
  The consequences of gutting the ACA and restructuring Medicaid are 
enormous for our economy, one-sixth of which is related to healthcare. 
They are enormous for hospitals that rely on third-party reimbursements 
under the ACA and Medicaid expansion. These hospitals need those 
revenues, and even more so for rural hospitals that keep their doors 
open thanks to the ACA, as well as the Indian Healthcare Service 
facilities, which have reduced wait times and added services because of 
the ACA.
  But the majority in Congress refuses to hold hearings, and they are 
blocking all public participation. This is unconscionable, and it is 
undemocratic.

[[Page S3628]]

  Before Democrats voted on ObamaCare, the Senate held 100 committee 
hearings, roundtables, and walk-throughs. The final Senate bill 
included 147 Republican amendments. The majority leader has missed an 
opportunity for political and moral leadership on one of the most 
important issues we face. Senator McConnell should have an honest and 
open process, including Senate committee hearings, with full public 
participation and a chance for patients to tell Congress how this 
proposal impacts them--not hidden meanings, not limited debate and a 
simple majority vote.
  Americans deserve an open process from their elected leaders. That is 
why I introduced a bill last week with my Democratic colleagues called 
the No Hearing, No Vote Act. This bill would require a public committee 
hearing for any legislation that goes through the fast-track budget 
reconciliation process, including the TrumpCare legislation.
  Members of Congress were elected to improve lives, not destroy them, 
and I believe we need bipartisan cooperation to ensure we don't do 
that.
  If we wanted to improve on ObamaCare, we could: No 1, make sure that 
all Americans have healthcare; and No. 2, make healthcare more 
affordable.
  So I will tell my colleagues what is really happening here. The 
American people don't want the benefits they have gained through 
ObamaCare to be repealed and replaced with an inferior plan. They do 
not support TrumpCare. Only 17 percent of Americans support the House 
Republicans' current bill. With this degree of public opposition, it is 
baffling that Republicans keep pushing the bill that kicks 23 million 
Americans off their healthcare.
  But the moral underpinnings of TrumpCare are as bankrupt as Trump's 
New Jersey casinos. The winners of TrumpCare are the wealthy, and the 
Republicans are plainly serving those interests. The Republicans can 
keep trying to hide TrumpCare, but Americans understand that it is just 
plain wrong.
  I want to talk about a few of the ways that it is just plain wrong. 
While women make up half of our population, no women serve on Senator 
McConnell's healthcare working group. Yet women are uniquely affected 
by TrumpCare. For example, the range of cost-free preventive services 
under the Affordable Care Act includes screenings for breast cancer, 
including mammograms, bone density screenings, cervical cancer 
screenings, domestic violence screenings and counseling, breast feeding 
counseling and equipment, contraception, and folic acid supplements. 
All of these services were critical to maintaining women's health and 
the health of their babies as well.
  New Mexico leads the Nation in the percentage of births that are 
covered by Medicaid at 72 percent of all births in the State. So these 
services that are now available to every woman are essential.
  TrumpCare would repeal the cost-free preventive care requirements for 
the Medicaid expansion population. Not only would this repeal risk the 
health of women and their babies, but it would result in increased 
medical care costs overall. Preventive medical services save money in 
the long run.
  The Affordable Care Act requires insurance plans to provide a range 
of essential health benefits. For women, these required services 
include maternity and newborn child care. But TrumpCare would allow 
States to apply for a waiver to define their own essential health 
benefits beginning in 2020. So States could choose to exclude maternity 
and newborn care, and women would end up paying more for this care. The 
result is women not getting the care they need.
  TrumpCare would cut Medicaid funding to Planned Parenthood for 1 
year. Planned Parenthood provides preventive medical and reproductive 
health services to women and men, and Planned Parenthood funding 
provides a safety net to low-income women. According to the CBO, 
cutting off Medicaid payments to Planned Parenthood for 1 year would 
mean a total loss of access to services in some low-income communities 
because Planned Parenthood is the only public provider in some regions.
  Take Elena from Albuquerque, NM. When she was 30 years old and in law 
school, Elena found out that she had the BRCA gene mutation, which puts 
her at a much higher risk for breast and ovarian cancer. The treatments 
for the BRCA gene mutation include a mastectomy and ovary removal--
treatments she couldn't afford.
  Thankfully, Elena qualified for Medicaid under the expansion. She got 
her breast cancer screenings and decided to have a mastectomy because 
of the cancer scare. Elena had three surgeries, costing thousands of 
dollars, covered by Medicaid, and now the chances of her getting breast 
cancer are very low. But Elena now worries that if she decides to have 
her ovaries removed and TrumpCare becomes law, she will not be able to 
have this potentially lifesaving surgery. If she has had a lapse in 
Medicaid coverage, her Medicaid expansion coverage will be gone, and 
because TrumpCare would end the ban against insurance companies denying 
coverage for people with preexisting conditions, she may never be able 
to get insurance or surgery.
  Public schools and schoolchildren will be hurt by TrumpCare. Schools 
are now eligible to receive Medicaid funds for necessary medical 
services for children with disabilities. Schools are reimbursed for 
vision, hearing, and mental health screenings. These services help 
children get services early so they can be ready to learn.
  Right now, New Mexico schools are reimbursed $18 million from 
Medicaid, but under TrumpCare, States would not have to consider 
schools' Medicaid-eligible providers, and the costs would be on the 
public schools. The problem is, New Mexico public schools cannot take 
on these kinds of costs. That might mean hundreds of schoolchildren 
each year will go without vision, hearing, and mental health treatment 
because no one else will be able to provide them.

  Dr. Lynn McIlroy, superintendent of the Loving Municipal Schools, a 
rural school district in Southeastern New Mexico, said:

       Medicaid funding is vital to our continuum of care and 
     service to the majority of our students. Often, our school 
     nurse is the only medical professional our students ever see.

  New Mexico has one of the highest percent Native American populations 
in the country, more than 10 percent of our residents. Even though many 
Native Americans receive healthcare through the Indian Health Service, 
IHS has not always been able to provide needed care due to a lack of 
funding. Medicaid expansion has changed that and changed that 
dramatically.
  Dr. Valory Wangler, who works with the Zuni Pueblo, says: Since the 
Affordable Care Act, patients of Zuni have access to special services 
that were once difficult to fund and often delayed or denied.
  An IHS physician working on the Zuni Reservation had a patient with 
severe arthritis that was making it difficult for her to stay 
physically active and work at a local school. She needed knee 
replacement surgery. Before Medicaid expansion, IHS had trouble funding 
knee replacements, and the surgery was denied for years because IHS 
could only afford to pay for life and loss of limb services. This 
patient is now on the Medicaid expansion. She was able to get a total 
knee replacement, is working full time, staying fit, and is no longer 
in pain.
  One of the ACA's most popular provisions is the protection from 
discrimination if you have a preexisting condition. This is one of the 
most mystifying parts of TrumpCare. Republicans would end that 
protection by allowing States to waive out and set up high-risk pools.
  All of us know someone with a serious illness or condition, like Kitt 
here. Kitt is 4\1/2\ years old and has type I diabetes that will 
require lifelong care. Her mother Dana is worried about TrumpCare. Dana 
says: It breaks my heart that elected officials are leaning toward 
dropping the Federal mandate to guarantee affordable health insurance 
for those with preexisting conditions. Sit down with a child who has an 
unbearable disease and be their warrior in DC to make everything 
possible for that special soul and their family to have an easier 
tomorrow.
  I hope we will all be those warriors to protect that healthcare 
program which has been put in place for them.
  I yield to Senator Heinrich.
  I suggest the absence of a quorum.

[[Page S3629]]

  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. HEINRICH. 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. HEINRICH. Mr. President, I want to start by thanking my colleague 
from New Mexico, Senator Udall, for his advocacy on behalf of the 
pieces and parts of our healthcare system that are so important to the 
State of New Mexico. Things like rural hospitals, opioid treatment, 
Indian Country, he has been an incredible champion on those. That is 
part of the reason why both of us come to the floor today, given what 
is at stake.
  Last month, President Trump and House Republicans rushed through a 
disastrous healthcare bill that would leave average New Mexico families 
paying thousands of dollars more for less healthcare coverage. It would 
destroy the Medicaid Program as it currently exists in our State and 
throw our entire healthcare system into chaos. Now Senate Republicans 
are drafting their own version of a similar healthcare bill in complete 
secret, behind closed doors, with absolutely no--none--bipartisan 
input.
  This lack of transparency and departure from regular order is 
unacceptable and deeply irresponsible, especially when every single 
American family's healthcare coverage is at stake if this bill ever 
becomes law.
  While we don't know for sure what the Senate Republicans' version of 
TrumpCare will look like, media reports say it is shaping up to look 
more and more like the train wreck of a bill that President Trump and 
House Republicans celebrated in the White House Rose Garden just a 
couple months ago, a bill President Trump reportedly said in another 
closed-door meeting with Republican Senators last week was, in his 
words, ``mean'' and cold-hearted.
  The House-passed TrumpCare bill is devastating to low-income 
families, to seniors, to Americans living with preexisting conditions. 
This isn't so much a healthcare bill as it is a tax cut for the 
ultrarich masquerading as healthcare reform. You don't have to take my 
word for it. You can look at how the nonpartisan Congressional Budget 
Office described its projected impacts of the House-passed TrumpCare 
bill.
  According to the CBO's analysis, TrumpCare would strip 14 million of 
their health insurance next year and 23 million by 2026, all to give 
tax breaks to the wealthiest of Americans. That is reckless, and 
frankly it is inexcusable by any measure.
  How would the bill do that? The House-passed bill, which again seems 
to be the baseline for the ongoing secret negotiations here in the 
Senate, would slash funding for the Medicaid Program by hundreds of 
billions of dollars and end the need-based tax credits for individual 
healthcare market plans under the ACA.
  I have heard from so many New Mexicans who have told me how access to 
healthcare coverage has helped their families and, in some cases, even 
saved their lives.
  I recently met with patients at the Ben Archer Health Center, a rural 
health clinic in Hatch, NM, and heard firsthand how important Medicaid 
coverage can be to families in Southern New Mexico. One of the New 
Mexicans I met there was Anna Marie, a Las Cruces native who worked for 
the Las Cruces public food service for 22 years.
  Anna Marie's husband passed away in 2008, and when she found herself 
unable to keep working following a minor stroke, she could not afford 
healthcare coverage on her own. When she reached out to my office last 
year, she had bronchitis and walking pneumonia. My staff helped her 
enroll in Medicaid, and now she is able to get access to the care she 
needs.
  I want to take a moment to explain why the Medicaid Program is so 
critical in my home State of New Mexico. As a Medicaid expansion State, 
New Mexico has seen dramatic gains over the last 5 years in coverage 
for the folks who need it the most. Stories like Anna Marie's 
illustrate just how important Medicaid can be for hard-working New 
Mexicans.
  Medicaid currently provides affordable healthcare coverage to over 
900,000 New Mexicans, including many schoolchildren, seniors in nursing 
homes and long-term care facilities, people with disabilities, and 
people who need treatment for mental health and addiction.
  Just one example of the wide-ranging consequences of the Republican 
healthcare plan's drastic cuts to the Medicaid Program would be the end 
to any possible progress we have made so far in fighting the opioid and 
heroin epidemic. The opioid addiction epidemic has been deeply felt in 
communities across the State of New Mexico. For years, without adequate 
treatment resources, our State has suffered through some of the highest 
rates of opioid and heroin addiction in the Nation.
  I would just note that today a story came out about how we 
hospitalized in the ER long-term care or hospital care 1.3 million 
Americans last year because of this epidemic. However, when provided 
with an opportunity to receive comprehensive treatment and 
rehabilitation, people who have suffered through the trials of opioid 
addiction can and do turn their lives around.
  Evidence-based treatment works, but it is only possible when we 
devote real resources to pay for it. So much of that comes directly 
through the Medicaid Program. As we can see on this chart, Medicaid 
pays for 30 percent of opioid medication-assisted treatment in New 
Mexico--30 percent. It is the foundation to build on for opioid 
treatment.
  In States like West Virginia, Ohio, and Kentucky, Medicaid pays for 
nearly half of opioid treatment payments. This came up just last Friday 
when the White House hosted its first meeting for President Trump's 
Commission on Combating Drug Addiction and the Opioid Crisis. The 
President's top advisers probably didn't hear what they would have 
liked to from the advocates who have been on the front lines of 
fighting the growing opioid crisis.
  For example, Dr. Joe Parks, the medical director for the National 
Council for Behavioral Health, told the President's Commission:

       Medicaid is the largest national payer for addiction and 
     mental health treatment. Since the majority of increased 
     opiate deaths and suicide occur in young and middle-aged 
     adults, which is the Medicaid expansion population, the 
     Medicaid expansions must be maintained and completed.

  It is nothing short of hypocrisy for the Trump White House to claim 
it is taking steps to address the opioid epidemic when it is helping 
Republicans in Congress push through legislation that would end the 
Medicaid Program as we know it. Slashing hundreds of billions of 
dollars in Federal funding from the Medicaid Program will ultimately 
pass all of those costs on to the States. Let me give a sense for just 
how big a burden that would be.
  In New Mexico, it is estimated that our State government would have 
to either come up with a way to raise $11 billion of new taxes over the 
next decade or cut the equivalent amount of coverage for the hundreds 
of thousands of New Mexicans who rely on the program. That is a hit to 
the State budget of 1 billion-plus dollars a year. This would have an 
especially hard impact on our State's rural communities.
  When you go to small towns in New Mexico, like Clayton, Raton, and 
Santa Rosa, as I did last fall on a rural healthcare listening tour, 
you see right away the vital role hospitals play in rural communities. 
In most cases, these hospitals are the only healthcare providers for 
many miles in any direction.
  Hospitals are also often the major employer in these small towns. 
Rural healthcare providers face enormous challenges because it is 
financially difficult to provide care to populations that live over 
vast spaces and are, on average, older, less affluent, and more prone 
to chronic diseases than those in more urban and suburban communities.
  Medicaid expansion and the need-based tax credits for individual 
healthcare market plans in the ACA have been critical financial 
lifelines for rural healthcare providers. Thanks to the coverage gains 
we have seen in New Mexico, instead of seeing uninsured patients coming 
to the emergency room during expensive medical emergencies, our rural 
healthcare providers are able to help New Mexicans live healthier lives 
with primary care and a preventive medicine approach.

[[Page S3630]]

  When medical emergencies do arise, New Mexicans have coverage that 
helps rural healthcare providers cover those expenses. If President 
Trump and Republicans in the Senate pass their healthcare bill, all of 
that could go away, and some of our rural healthcare providers may very 
well have to close up shop.
  Right now, more than one-third of rural hospitals are already at risk 
of closure. If you look at where the hospitals that have been forced to 
shut down in recent years are located, they are almost all in States 
that chose not to expand Medicaid. We should learn a lesson from that.
  I know for a fact that if hospitals shut down, healthcare delivery in 
rural New Mexico would be decimated and economic impact would be severe 
in these small towns. It is estimated that when a single hospital 
closes in a small rural community, nearly 100 jobs are lost, taking 
more than $5 million directly out of the local economy.
  A recent report by the Economic Policy Institute estimates that if 
Congress passes TrumpCare into law, New Mexico alone would see a loss 
of almost 50,000 jobs by the year 2022. Thanks in large part to the 
major coverage gains that we have seen under the ACA, the healthcare 
sector has been New Mexico's strongest area of job growth for the last 
5 years. New Mexico added over 4,000 healthcare jobs in 2015 alone.
  A couple of months ago, I met with students at Central New Mexico 
Community College, CNM, in Albuquerque, who were training for those 
healthcare jobs. These bright young people want to make careers out of 
making their communities healthier and safer. With this dangerous 
legislation moving through Washington, they are all worried about what 
it might mean for their future career plans.
  Why would we want to rip the rug out from under them by wreaking 
havoc on the Nation's healthcare system? Again, you really have to ask 
yourself why Republicans are so intent on rushing through a massive 
piece of legislation before we can even understand its potential 
harmful consequences.
  As I said earlier, I have heard from literally thousands of New 
Mexicans who have called in or written or come up to me on the street 
to oppose this legislation. Many of them have told me how it will 
directly impact their families. I could pick any one of these stories 
to demonstrate what is at stake in this debate, but I will leave you 
with just one.
  Brittany, from Aztec, NM, wrote me about her two young children who 
were diagnosed with a rare form of food allergies that created 
absolutely unaffordable costs through her husband's employer-provided 
healthcare plan.
  Brittany said that she and her husband were averaging three doctors' 
visits a week and were ``barely keeping [their] heads above water just 
from paying co-pays.''
  After applying for Medicaid, she and her husband have full coverage 
for their children's medical costs. Brittany wrote to me and said:

       For us Medicaid is literally lifesaving. Please do not take 
     away this program or any of the ACA! It may not be perfect 
     and could use some work, but taking it away altogether would 
     be catastrophic for so many people like my family.

  That is what she wrote to me.
  I want to urge President Trump and I certainly want to urge my 
Republican colleagues in the Senate to listen to that urgent message. 
It is time to turn the page on the disastrous policy path that is 
``repeal and replace'' so we can finally get to work on actually fixing 
those things in the current healthcare system that we all agree need 
work.
  Our common goal--regardless of whether we are Republicans or 
Democrats--that we should all be working toward is making quality 
healthcare more accessible, more affordable for all Americans.
  I would welcome a good-faith effort to tackle that challenge because 
healthcare policies shouldn't be a political football. It should be 
about giving peace of mind to the millions of Americans like Anna Marie 
in Las Cruces, like Brittany in Aztec, who are only one diagnosis away 
from a crisis if we don't get this right.
  I reserve the remainder of my time.
  The PRESIDING OFFICER. The Senator from Illinois.
  Ms. DUCKWORTH. Mr. President, over the past few years, the Affordable 
Care Act has made tremendous strides in expanding healthcare coverage 
for hard-working Americans and the families who need it. I thank my 
colleague for his stories, and I would like to add some of my own.
  While the law could certainly be improved, the way to do it is not by 
passing TrumpCare, which even President Trump has admitted is a 
``mean'' bill. Unfortunately, Republican Senate leadership has 
indicated whatever it is that the Republicans are crafting in secret, 
behind closed doors, is going to be very similar to the version of 
TrumpCare that has passed the House. That is simply bad news.
  The version of TrumpCare that passed the House could cost 23 million 
Americans, including 385,000 Illinoisans, to lose healthcare coverage. 
It would make it more expensive for older Americans and working people, 
especially those with preexisting conditions, to purchase insurance.
  TrumpCare would cause their premiums and their out-of-pocket costs to 
simply skyrocket. The premiums of the average Illinoisan would increase 
by $700.
  TrumpCare would also make critical services like maternity care for 
new moms and mental health and substance abuse services significantly 
more expensive, even though they are desperately needed. That is 
extremely mean-spirited.
  Making matters worse, it would also put veterans on the chopping 
block. Specifically, TrumpCare would prohibit veterans who are eligible 
for VA healthcare from receiving tax credits to help them afford 
insurance in the individual marketplace. However, there is a big 
difference between being eligible for VA healthcare and being enrolled 
in VA. Oftentimes, that is not even a choice you can make.
  According to the nonpartisan Congressional Budget Office, as many as 
7 million of our veterans are eligible for VA care but are not 
enrolled. Preventing them from receiving tax credits would amount to a 
massive tax hike that would force them to pay thousands of dollars 
extra each year. That is not just mean; it is unacceptable.
  There has been ample reporting indicating that Republicans knew 
exactly what they were doing. They could have included a fix to this 
but purposefully did not because that would have made their bill 
ineligible to be considered under the Senate's budget reconciliation 
process, which requires only 51 votes. That is because to remedy this 
huge flaw, the veterans tax credit language would need to be considered 
in committees of jurisdiction. That would entail holding public 
hearings and markups in committees, which would then reveal to the 
American people what exactly is in the Republican bill.
  Apparently, the cost of public scrutiny is too high for Senate 
Republican leaders who are willing to raise taxes on veterans so they 
can hide this bad bill from the American people. As a result, the 
appalling flaws in their bill remain unfixed, and up to 7 million 
veterans remain on the chopping block.
  That is not the only way TrumpCare would harm veterans either. Its 
massive cuts to Medicaid would have a direct impact on veterans, since 
nearly 2 million veterans across our country, including 60,000 veterans 
in my own home State of Illinois, rely on Medicaid for their healthcare 
coverage. That is 1 in 10 veterans.
  For nearly 1 million of these veterans, Medicaid is their only source 
of coverage. Many of them are eligible for VA care only for the 
injuries they sustained in the military but not for any of their other 
health needs.
  I shouldn't have to remind my colleagues that veterans are at a 
higher risk for serious health issues because of the sacrifices they 
made for our Nation. Yet, if TrumpCare becomes law, many of them will 
lose the coverage they gained from Medicaid expansion under the ACA.
  Right now, 13 Republican Senators are sitting behind closed doors in 
some secret room on Capitol Hill, gambling with the lives of millions 
of Americans and people who have honorably served their country. One of 
those lives belongs to Robin Schmidt, a veteran from the North Side of 
Chicago.
  Robin served during Desert Storm in Army military intelligence. Robin 
loved her job in the military because it had always been her dream to 
serve her country. As a 13-year-old girl, Robin

[[Page S3631]]

stood at the Vietnam Veterans Memorial Wall in Washington, DC. She knew 
that serving her country was her true calling. However, she was 
eventually forced to end her military career because, in her words, 
``the Army refused to allow my husband to come back overseas to live 
with me.''
  When she was pregnant with her child, she was forced to leave the 
military in order to return home to Arkansas to be with her husband to 
raise their children. When she was stateside, the VA denied her 
benefits because they were not service-connected, thus forcing her and 
her husband to pay the costs of maternity care and childbirth out of 
pocket.
  She faced medical complications and developed endometriosis, a 
preexisting condition, and had to have a Caesarean section during 
delivery. After she delivered her baby, she ended up with $500,000 in 
hospital debt.
  This enormous debt followed Robin and her husband throughout their 
marriage, and it eventually left them in divorce, medical bankruptcy, 
and with all of the repercussions that come from extreme financial 
hardship. She was also blocked from accessing affordable healthcare 
coverage because she now had a preexisting condition and could not 
afford good coverage on an $8.50-an-hour wage, so she went without 
care.
  Robin remained uninsured for a total of 22 years, until she remarried 
and gained healthcare coverage under her husband's insurance. This was 
especially devastating because in 2007, Robin was diagnosed with 
cancer. Even though Robin was covered by her husband's insurance, 
insurance companies were not required to cover chemotherapy in 2007, 
and chemotherapy was too expensive for Robin and her family to pay for 
out of pocket. Instead, she had to choose debilitating surgeries.
  After her cancer diagnosis, Robin developed severe autoimmune 
arthritis. Her autoimmune treatments started at $5,000 a month and soon 
increased to $14,000 a month. Insurance companies wanted Robin to pay 
for her medication upfront, with no guarantee of reimbursement.
  As her medical costs grew and grew, Robin had to choose between her 
medical care and her mortgage payment. After the Affordable Care Act 
became law, insurance companies were mandated to cover Robin's 
medications and treatments. They were no longer able to refuse her the 
medications she needed. Her insurance premium prior to the Affordable 
Care Act was $1,600 a month, which was more than her family paid for 
their monthly mortgage and household bills. Now she pays just $300 a 
month for her entire family. There was no more redtape, constant 
stress, or fear that she might not be able to work--or worse, might not 
be able to stay alive.
  Unfortunately, the coverage, relief, and peace of mind the ACA 
brought to Robin and her family is now under attack by congressional 
Republicans. Robin is afraid that if TrumpCare becomes law, she will 
once again become nothing more than an uninsurable preexisting 
condition. She is afraid she would be considered a high-risk pool 
patient who will be able to have insurance but will not be able to 
actually afford any of her treatments. She is afraid that if 
Republicans push through TrumpCare, she will not be able to walk, work, 
and will have absolutely no quality of life.
  Her dream was to serve her country in our Armed Forces. She took two 
oaths to serve this country, and she kept those oaths--promises that 
she would defend this great Nation.
  Robin may not be in uniform anymore, but she certainly deserves that 
we in Congress and here in the Senate defend her right to access 
quality healthcare.
  For Robin and for nearly 7 million veterans, middle-class families, 
our seniors, and some of our most vulnerable Americans, I urge my 
Republican counterparts to stop these secret negotiations, take repeal 
off the table, and work with Democrats to improve our healthcare 
system. Just like Robin, each of these Americans has a story, a family, 
and a valued place in society. Robin's family and all Americans deserve 
better than having their coverage stripped away from them behind closed 
doors.
  I yield back.