[Congressional Record Volume 163, Number 107 (Thursday, June 22, 2017)]
[House]
[Pages H5101-H5107]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           PROGRESSIVE CAUCUS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2017, the gentleman from Maryland (Mr. Raskin) is recognized 
for 60 minutes as the designee of the minority leader.


                             General Leave

  Mr. RASKIN. Mr. Speaker, I ask unanimous consent that all Members 
participating in this Special Order hour with the Progressive Caucus 
have 5 legislative days to revise and extend their remarks and include 
any extraneous material on the subject of this Special Order, which is 
healthcare.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Maryland?
  There was no objection.
  Mr. RASKIN. Mr. Speaker, I am delighted to be here tonight on behalf 
of the Progressive Caucus to manage this Special Order hour along with 
my colleagues, who I will be introducing. Several of them will be 
joining me tonight to discuss what is going on in the Senate today with 
the GOP finally unveiling their closely guarded secret plan to repeal 
the Affordable Care Act, a plan they are unveiling that has had the 
legislative benefit of no hearings, no witnesses, no expert testimony, 
no testimony by the public, and, again, no Congressional Budget Office 
score so far, which is the same way that the legislation passed out of 
the House side.
  So does all of this sound familiar? It should, because this is the 
same clandestine, in-the-dark process that led to the plan which 
emerged here in the House of Representatives on the barest of margins 
with every manner of power play and power ploy engaged by leadership to 
produce the final result.
  That bill, by the way, now stands at a whopping 9 percent in the 
polls, which means it is even more unpopular than Congress itself. And 
even though my friends across the aisle rented buses and vans to take 
them over to the White House to go and celebrate and exult in their 
dubious victory and uncork the champagne and drink beer with the 
President and his staff after they pushed the bill through the House, 
today, President Trump now calls the bill that he celebrated and he 
campaigned for mean. He says it is a mean bill today.
  And there is no question he is right about that. We said that at the 
time, mean as a rattlesnake, that bill, which would have thrown 24 
million people off their health insurance plans and destroyed 
preexisting health insurance coverage for people with preexisting 
health conditions.
  The Senate version, though, is just as mean. It is downright mean. It 
may even be meaner than the House version. It not only strips health 
insurance coverage from tens of millions of our fellow American 
citizens; it not only forces American families to pay higher premiums 
and deductibles, increasing out-of-pocket costs, all to pay for a tax 
cut for the wealthiest of our citizens; it forces Americans, ages 50 to 
64, to pay premiums five times higher than everyone else, no matter how 
healthy you are.
  That is right. If you are in the age bracket of 50 to 64, your 
premiums, under their bill, will be five times higher than everybody 
else in the population, no matter how healthy you are. It reduces the 
life of the Medicare trust fund and robs funds that seniors depend on 
to get the long-term care that they need. It blocked grants, Medicaid 
to the States, and then, astonishingly, for the first time ever, places 
a per capita cap on Medicaid payments for all recipients, including 
disabled Americans and senior citizens.
  That is just unconscionable. Think about it. For the first time ever, 
under Medicaid, the Federal Government would not commit to pay for all 
of enrollees' health bills. So if your illness or your injuries are too 
severe or too complicated, your treatment too long, tough luck for you, 
buddy; you are on your own, Jack. That is the new proposal that is 
coming out from the Senate today.
  The people that railed about death panels before passage of the 
Affordable Care Act, panels that never materialized and were proven to 
be an absolute

[[Page H5102]]

fiction and fantasy, now seek to throw millions of people off of their 
health insurance, roll back the Medicaid expansion in the Affordable 
Care Act, which benefitted millions of our countrymen and -women, and 
then cut the heart out of the Medicaid guarantee by placing a per 
capita cap on payments to beneficiaries.

                              {time}  1730

  And this particular assault on the health and well-being of the 
American people doesn't even claim to be a response to any alleged 
problems with the Affordable Care Act, or with ObamaCare as they call 
it. It is, instead, a sweeping change to Medicaid that so-called free 
market conservatives have been trying to make for years.
  This Senate legislation, cooked up in secret and seasoned with 
slashing cuts to Medicaid, is one fine mess. It does nothing but make 
our healthcare system more expensive, dangerously throws tens of 
millions of people off of their insurance, and eviscerates the core 
protections of Medicaid.
  And why? What is the public policy being advanced here? All for a tax 
cut for the wealthiest Americans. It takes a special kind of single-
minded focus to turn a healthcare bill into a massive tax cut for the 
people who need it the least in America.
  Now, I heard some of my friends, my distinguished colleagues on the 
other side, say that other colleagues should not have been talking 
about how the bill was ``mean,'' or ``mean spirited,'' or ``mean'' 
because we have a renewed spirit of civility in this Chamber, which we 
do; and I praise it, and I celebrate it. Ever since the terrible attack 
on our colleague Steve Scalise and other colleagues and the Capitol 
Police officers who rose valiantly to defend them, we have really tried 
to put aside a lot of the partisan rancor. But my friends, we have got 
to talk honestly about legislation which is threatening the well-being 
of our own citizens.
  The word ``mean'' comes not from my colleagues who were speaking 
before. The word ``mean'' comes from the President of the United States 
himself, who said that the legislation that passed out of the House, 
looking back on it, was ``mean.'' Now, all of that was in order to say 
he likes the Senate version instead, but we think that the Senate 
version is even meaner than the bill that the President has already 
described as ``mean'' that came of the House.
  So to describe more of the specific terms of this legislation and why 
it is a threat to our public health, why it is a threat to the basic 
values of solidarity and justice and community that defines us as 
Americans, we have invited a number of our colleagues to come up and 
participate, beginning with the Congresswoman from Seattle, Washington, 
Pramila Jayapal, who used to co-chair the Progressive Caucus hour with 
me.
  She has now been replaced by someone because she is moving on to an 
even bigger assignment right now, but please welcome a great 
Congresswoman, Pramila Jayapal, from Washington.
  Mr. Speaker, I yield to the gentlewoman from Washington (Ms. 
Jayapal).
  Ms. JAYAPAL. Mr. Speaker, I thank the gentleman from Maryland, 
Representative Raskin.
  Mr. Speaker, it is great to have you presiding over the Chamber as 
well. It is all of our new Members here, and Representative Khanna from 
California, who is going to be taking over as co-chair of this Special 
Order hour for the Progressive Caucus.
  Mr. Speaker, we have to make sure that the American people understand 
exactly what is going on. This is a bill that the Senate has been 
negotiating in private. It has been 13 men discussing healthcare for 
all Americans across this country in a secret room. That is really what 
has been happening.
  Today we saw a draft of this bill, and the prevailing wisdom, when 
the bill passed the House, was that the Senate would completely revamp 
the bill. But according to The New York Times, it said: The Senate bill 
``once promised as a top-to-bottom revamp of the health bill passed by 
the House . . . instead maintains its structure, with modest 
adjustments.''
  It is the same bill. It is the same bill. And in fact, in some ways, 
it is a little bit worse because the cuts to Medicaid, while they don't 
take effect as quickly and they are more gradual, they are actually 
deeper than the House cuts to Medicaid.
  There are other things in the bill that have been done, really, in 
part, to affect how the American people see the bill but don't change 
the basic provisions of this bill.
  Part of the reason they delayed the cuts to Medicaid is so that they 
hope that they can get a better CBO score, Congressional Budget Office 
score, which the American people should know the last time around, the 
second time around after the first time the bill was about to come to 
the floor and then it got pulled from the floor because there weren't 
enough votes in the House, the second time when it did pass, it passed 
without a CBO score. It was not scored.
  The reason it was not scored was because there was a belief that that 
very narrow passage in the House would not happen if Republicans and 
Democrats found out that the bill, as ``revised,'' was actually just as 
bad.
  So the bill that passed the House still took away health insurance 
from 23 million Americans. This is where we are today: a bill that has 
been crafted in secret but is essentially the same bill.
  I have received more than 9,000 calls and letters from constituents 
who have been very clear that Congress needs to do all it can to 
protect our seniors, to expand Medicaid, and to defend the gains that 
have been made over the last 7 years.
  And you know what is really ironic about this whole situation is 
that, if you think about some of the things that Republicans said about 
the Affordable Care Act when it was being passed--here is a quote.
  In 2010, Speaker Paul Ryan said: ``After months of twisting arms, 
Democratic leaders convinced enough members of their own party to defy 
the will of the American people and support the Senate health bill 
which was crafted in secret, behind closed doors.''
  Senate Majority Leader Mitch McConnell said: ``When it comes to 
solving problems, Americans want us to listen first, and then, if 
necessary, offer targeted, step-by-step solutions. Above all, they're 
tired of a process that shuts them out. They're tired of giant bills 
negotiated in secret, then jammed through on a party-line vote in the 
middle of the night.''

  That is what Speaker Ryan said and Senate Majority Leader Mitch 
McConnell said when the Affordable Care Act was being debated.
  But here is the thing: When the Affordable Care Act was being 
debated, Democrats actually threw open the doors in Congress. They held 
over 100 Senate hearings. I wasn't here. This is based on actual 
reports and documents and files from Congress. There were over 100 
Senate hearings, 25 consecutive days of consideration, and 161 
amendments from Republicans. Many of those amendments were accepted 
into the bill.
  This is a completely different process. We didn't have a single 
hearing on this bill. The bill came to the House floor, and there was 
some debate, but it certainly wasn't 100 hearings. It wasn't 25 days of 
consideration. There weren't 161 amendments. There weren't any 
amendments that were accepted from Democrats because there was no 
amendment process.
  And now, in the Senate, we are going through the same process where a 
bill that is about the healthcare of hundreds of millions of Americans 
across this country is about to come to the floor, and they are not 
going to accept any amendments, certainly not from the Democratic side. 
Maybe they will take a few amendments from the Republicans before it 
comes to the floor. I don't know. We will have to see. But there is no 
debate on this.
  How can we talk about the process of democracy and even of civility 
and the ability to work together if we didn't offer the other side a 
chance to weigh in?
  This bill will take away health insurance from millions of people, 
and it will make it less affordable for those who still have insurance 
because it is not very different from the House bill, and we already 
know that that is what the House bill does.
  It would raise out-of-pocket costs for middle class families with 
higher

[[Page H5103]]

deductibles and cost sharing. It would essentially defund Planned 
Parenthood by blocking people with Medicaid coverage from accessing 
preventive care at Planned Parenthood health centers for birth control, 
cancer screenings, and STD treatment and testing. And it would cut the 
essential health benefits protections.
  Now, what are the essential health benefits protections? We talk 
about that phrase, but a lot of Americans don't know exactly what that 
means. So here is what it means.
  It means that if you buy insurance, then you can be assured that that 
insurance is going to cover certain things. It will cover, for example, 
hospitalization. It will cover if you get cancer. It will cover some of 
your treatments that you need for cancer, certain things that are 
included in that. Mental healthcare is part of that essential health 
benefits coverage.
  That is what it means. Otherwise, an insurance company can sell you 
something, and it can even say we cover, you know, X, Y, and Z, but 
when you get to the hospital because you are sick, you will find out 
that it doesn't actually cover hospitalization.
  So this was an attempt to say, there is sort of an essential 
understanding, an essential set of things that would be covered. We 
will guarantee you that they will be covered if you buy insurance.
  Now, I want to talk about Medicaid for a second, because this is one 
of the biggest travesties of the bill that is being proposed by the 
Republicans in the Senate.
  This bill would literally decimate Medicaid. And between the Medicaid 
cut of over $800 billion in the healthcare bill in the Senate and the 
budget cut that is proposed of over $600 billion, let me be clear that 
we are talking about almost a $1.5 trillion cut to Medicaid through 
these two mechanisms.
  I want to talk about what Medicaid is because a lot of people might 
think that Medicaid just covers poor folks, which, frankly, I think we 
should cover poor folks. Let's be clear about that. But I want to tell 
you what Medicaid actually covers.
  It covers half of all the births in the United States. It covers 
insurance for one in five Americans. It covers treatment for 220,000 
recovering people with drug disorders, including those who suffer from 
opioid abuse. It covers 1.6 million patients, mostly women, who get 
cancer screenings, and STD testing. It covers 64 percent of all nursing 
home residents. It covers 30 percent of all adults with disabilities. 
It covers 39 percent of all kids in this country and 60 percent of kids 
with disabilities.
  So if you cut half of Medicaid, which is what a $1.5 trillion cut to 
Medicaid would include--it would be half of what we spend on Medicaid 
today--a program that covers 74 million Americans across this country, 
38 million Americans would lose their coverage.
  No wonder, as Mr. Raskin said, this healthcare bill has had such low 
approval ratings in the House, and now it is the same bill in the 
Senate.
  Americans understand that whether you live in blue America or red 
America, whether you live in rural America or urban America, whether 
you are a man or a woman or a child, whether you are young or old, one 
of the great things about this country is that we are a country that 
believes in trying to provide for people when they get sick.

  Now, we have been trying to do that for a long time, and until the 
Obama administration and the Congress passed the Affordable Care Act, 
we weren't doing that. But in Washington State, my home State, when we 
passed the Affordable Care Act, Medicaid expansion allowed us to cover 
an additional 600,000 people across our State. We cut the uninsured 
rate in half, and we created over 22,000 jobs across the State, 
including in rural areas.
  So what we need to do now is to stop this bill from moving forward 
because it would be bad for the American people. It is that simple. It 
is going to kick Grandma out of her nursing home. It is going to stop a 
kid with asthma from getting an inhaler. It is going to put a premium 
on being an elder American. If you are an older American, you are going 
to pay four to five times as much as anybody else. Why? You just have 
to ask why.
  So who benefits from this bill? This bill is a transfer of wealth 
from middle class Americans to the wealthiest Americans, corporations 
in this country. So this is about tax cuts for the richest. Sheldon 
Adelson, who is a Republican donor, casino magnate, he will get, if the 
Senate bill passes, he will get a $44 million tax cut in 2017 alone.
  How are they paying for that? By cutting Medicaid, taking away 
protections for preexisting conditions, for seniors, for average 
Americans.
  Mr. Speaker, that is just not right. It is not right if you are a 
Democrat. It is not right if you are a Republican. It is not right if 
you are an Independent. It is just not right.
  And, yes, the President is correct on this point: It is a mean bill. 
It is mean; it is cruel; it is unjust. And I hope we defeat it.
  I thank the gentleman for yielding.

                              {time}  1745

  Mr. RASKIN. I thank the gentlewoman, Ms. Jayapal.
  We have next with us Congressman Ro Khanna who is from California. He 
is an economist, and he is a lawyer. He has taught economics at 
Stanford, and he has taught law at Santa Clara. He was a Deputy 
Assistant Secretary of the Commerce Department under President Obama. 
He is a well-known author who has written a very good book about 
manufacturing and economic competitiveness in the United States.
  Mr. Speaker, I yield to the gentleman from California (Mr. Khanna) 
who is going to be taking over for Congresswoman Jayapal as my co-
convenor of this Special Order hour from here on in.
  Mr. KHANNA. Mr. Speaker, I thank Congressman Raskin. It is a real 
honor to be able to co-chair this Special Order hour with the 
gentleman. The gentleman is one of the most brilliant Members of our 
body on constitutional issues and constitutional law, really 
understanding our role in Congress as a check on the executive branch, 
and I look forward to working with the gentleman. I appreciate Liz 
Bartolomeo's and my staff's help in organizing this.
  Mr. Speaker, I want to echo what Congresswoman Jayapal said about 
this bill and the impact it is going to have on middle class families 
and on jobs, because here is one of the things that Congresswoman 
Jayapal said that folks don't understand: this bill is going to affect 
almost every family that has someone that goes for eldercare, to a 
nursing home.
  The average cost at a nursing home is about $80,000 a year. Most 
families can't afford that. Most middle class--most upper middle class 
families can't afford that.
  So what do they do when their savings run out?
  Medicare, by the way, doesn't cover nursing home costs. They rely on 
Medicaid.
  What this bill does, in a shocking way, is say: we are going to cut 
Medicaid funding. Of course, we are going to conveniently cut it 
starting 7 years from now, coincidentally, after everyone has faced 
reelection, because we don't want people to know that we are going to 
cut these programs that they rely on. We are going to start these cuts 
7 years from now, and we are going to make sure that people no longer 
have access to funding to be able to go for eldercare.
  Now, here is what is so problematic about this from an economic 
perspective. One of the biggest job creators, according to McKinsey and 
according to every economic study, is in healthcare, is for eldercare. 
Medicaid creates more jobs for working class families and middle class 
families at a time of globalization and automation than probably any 
other significant government program.
  So not only are we hurting middle class families and the elderly, we 
are eliminating the very jobs that we ought to be creating at a time of 
automation. We are eliminating jobs of people who are going to take 
care of folks who are sick or folks who are elderly, service jobs, jobs 
that should be paying more.
  At the same time, we are coupling this with drastic cuts in a budget 
for Alzheimer's research and for research on diseases that are 
affecting middle class families.
  Congressman Raskin said what the bill's motivation is. It is to 
really save money for tax cuts for the well-off--not for the well-off 
talking about people

[[Page H5104]]

making 70 grand or 80 grand or $100,000. Those are folks who are going 
to need Medicaid. We are talking about tax cuts for people who are 
making over $1 million, over $1.5 million.
  Now, let's put aside the President that he said it is mean. Let's 
just see what is their philosophy. Give him the benefit of the doubt. 
Why do they want to do this? Because they think that giving these tax 
cuts to these multimillionaires is going to somehow fuel more 
entrepreneurship and more growth.
  I ask people who are listening to this: Is that the problem in our 
country? Is that really the issue, that we think millionaires and 
corporations aren't making enough profits? Is that really what is the 
issue about why we aren't creating jobs? Or is the issue that, for half 
this country, their wages have stagnated for the past 30 years, and 
that people can't afford a decent place to live, college, and 
healthcare, and they are having trouble getting jobs?
  If you believe that the problem is we need more corporate profits, we 
need more speculation on Wall Street, and we need more economic breaks 
for the investor class, that that is really what America needs at this 
moment in our economy, then I suppose you could look for the Republican 
bill. But if you believe that the real problem in our economy is that 
the middle class and the working class are getting squeezed by the 
economic concentration of power, by the excess on Wall Street, that 
ordinary folks are having a hard time getting jobs, and that what we 
really need to be doing is providing more jobs in healthcare for people 
so that they can have a decent middle class life, that what we really 
need to be doing is providing middle class families with basic economic 
security so they know that when they retire they will have some dignity 
for them, or their spouses when they fall sick, that they know that 
they won't be bankrupt because they have to bear the cost of the care 
for their parents; if you believe that we ought to be on the side of 
middle class families--working class families--then it is such a no-
brainer that you would oppose this bill.
  I will just end with this: People often say, Well, what can we do?
  Well, I think you can speak out. I believe you should speak out and 
hold every Member in this body and in the Senate accountable because 
this bill is about our fundamental values. It is about what type of 
country we want to be. Are we going to be a country that gives power to 
the elite and believes that that is the ticket to American success? Or 
are we going to bet on middle class families and working class families 
like we have throughout our history?
  Mr. Speaker, I thank Congressman Raskin, and I am looking forward to 
co-chairing this with the gentleman.

  Mr. RASKIN. Mr. Speaker, I thank Congressman Khanna for his very wise 
and insightful words.
  Mr. Speaker, I yield to the distinguished gentlewoman from Illinois 
(Ms. Schakowsky).
  Ms. SCHAKOWSKY. Mr. Speaker, I thank Congressman Raskin for yielding 
to me.
  I am very proud and excited to be here because we have so much at 
stake right now.
  I wanted to point to this incredible photo that we blew up from 
today's news. Fifty people with disabilities were forcibly removed and 
arrested outside Senator Mitch McConnell's office today. They were 
there to protest what could happen to them and the 10 million Americans 
who rely on Medicaid to live a life--often still struggling, but a life 
with more dignity because they have Medicaid.
  I want to take some time to thank them for so passionately but 
peacefully resisting against the cruel Republican bill to repeal the 
Affordable Care Act. People were pulled out of their wheelchairs and 
ejected at the order, I presume, of the leader of the Senate to make 
space in front of his office. They were exercising their freedom to 
protest for themselves and for others in their situation. As I said, 10 
million Americans with disabilities rely on Medicaid.
  The Affordable Care Act incentivizes States to offer home and 
community-based care under Medicaid. The Republican bill would undo 
that. It would make it very likely that States would eliminate that 
home care and community-based care.
  Now, I have worked for years with people with disabilities, and I 
know some of them have struggled to get out of nursing homes and to be 
able to live in the community which, by the way, is actually less 
expensive than taxpayers paying for people to be in nursing homes. This 
has been a tremendous battle for the disability community to be able to 
live independently.
  That ability is threatened. By the way, even the amount of money that 
would go to nursing homes would be cut dramatically, or could be.
  Right now, one-half of the cost of nursing homes and home care and 
community-based care is paid for by Medicaid, and $800 billion was cut 
out of the House bill. I hear that the Senate bill is even worse. So 
this monstrosity of a bill would do a countless amount of harm to 
millions and millions of Americans. Just about everyone will be 
affected.
  So, today, I want to focus on the damage it would do to two groups in 
particular: Americans age 50 to 64 and people with disabilities whom we 
saw represented by the courageous protesters today outside Senator 
Mitch McConnell's office.
  This bill would impose a crippling age tax on people 50 to 64 years 
old, which means that they will be either unable to afford insurance 
altogether or be forced to pay thousands more for it every year.
  This is the same age tax that was in the House's version of the bill. 
The nonpartisan Congressional Budget Office gave this example: It 
estimated that a 64-year-old who makes $26,000 a year could see his or 
her premiums rise by over 800 percent. That would be in the area of 
about $14,000 a year. How does that work? There is simply no way she 
would be able to keep her insurance.
  The Senate bill would allow individual States to undermine the 
essential health benefits package that is in the Affordable Care Act 
that ensures older Americans have insurance that actually covers the 
services they need. Without those essential benefits, insurance 
companies could end coverage for prescription drugs, for cancer care, 
for emergency care, and much more.
  On top of those attacks on Americans age 50 and older, the bill also 
guts--as I pointed out--the Medicaid program which is absolutely 
essential for people with disabilities, both young and old.
  Medicaid pays for nearly half of all long-term care in our country, 
and that includes, as I said, not just care provided by nursing homes, 
but home and community-based and personal care services that allow 
people with disabilities to live independently, sometimes to even 
travel to Washington, D.C.
  We fought really hard to provide those home and community-based 
services. We expanded access to them in the Affordable Care Act. This 
mean bill not only undoes the progress, it moves us backwards by 
slashing Medicaid funds and turning it into a capped program, capping 
the amount of money that may go to every person. The Senate bill is 
even meaner than the House. Caps would rise more slowly and cause even 
more damage.
  So it is no wonder that the AARP, the Alliance for Retired Americans, 
the National Committee to Preserve Social Security and Medicare, the 
National Council on Independent Living, the Consortium for Citizens 
with Disabilities, the American Medical Association, and the American 
Nurses Association, really all the providers of healthcare, say no to 
this disastrous bill.
  It spells disaster for anyone who depends on Medicaid. That includes 
pregnant women, infants, children, people with disabilities, and 
adults--including low-income seniors. The bill is also devastating for 
women's health. It defunds Planned Parenthood. Let's remember Planned 
Parenthood is often the only clinic within driving distance of people 
in rural areas.

                              {time}  1800

  Sometimes it is the only clinic available in medically underserved 
areas for things like cancer screening, primary care, birth control, 
testing men and women for HIV/AIDS, et cetera. It defunds Planned 
Parenthood and targets private insurance plans that would cover 
abortions.
  So we really have to ask ourselves: Who benefits from this bill? Who 
wins if TrumpCare were to pass?

[[Page H5105]]

  Well, there is an answer. The ultrawealthy individuals who get a 
massive tax break from this bill--that is why they want to cut all 
those hundreds of billions of dollars out of Medicaid--they are the 
winners.
  Insurance, prescription drug, and medical device companies also get a 
huge tax break in this so-called healthcare bill.
  Yes, they call it a healthcare bill that benefits only the healthy 
and the wealthy. I know which side and whose side I am on.
  Mr. RASKIN. Mr. Speaker, I want to pause from our analysis of the 
specific terms of the bill that was unveiled today to ask the question: 
What is the value that is really at stake in healthcare policy in the 
United States?
  When we were debating on the House side, I heard a colleague get up 
on the floor and say something to the effect of: Under ObamaCare, under 
the Affordable Care Act, healthy people are having to pay insurance to 
take care of sick people.
  It took a second for that to register with me. Then I turned to the 
person I was sitting next to and said: Yes, that is what insurance is. 
The whole point of insurance is that all of us pay money in, knowing 
that people get sick in the course of life.
  We hope that we are not going to be one of them. We hope we won't get 
injured. We hope we won't get sick or ill or come down with a terrible 
disease, God forbid, but we know it can happen, so we all pay in. When 
it does happen to some people, that is what insurance is for. So the 
value there is one of solidarity among everybody together.
  In the richest country on Earth, at its richest moment in our 
history, there is another value at stake here, which is the value of 
justice.
  Forgive me, but I want to speak personally for a moment here, because 
I have what we call a preexisting condition. So this issue of 
preexisting condition coverage is important to me and my family. I 
understand it is important for tens of millions of families across the 
country.
  If you are having a great day, and you have got not one, but two jobs 
you love--I have been a professor of constitutional law at American 
University for 27 years now, and I was serving in the Maryland Senate. 
But if you wake up and it is a beautiful day and you have got two jobs 
you love, a family you love, great kids, and constituents you are 
committed to, and a doctor tells you that you have got stage III colon 
cancer, that is what I immediately took to be a misfortune.
  It is a terrible misfortune, but we have to remember that it happens 
to people across the country, all over the world, every single day, 
where people get a diagnosis of colon cancer, lung cancer, Alzheimer's 
disease, autism, bipolar disorder, depression, multiple sclerosis, 
cystic fibrosis, you name it. It is a misfortune because it can happen 
to anybody.
  But if you are told that you have colon cancer, for example, and if 
you can't get health insurance because, for example, before marriage 
equality, if you loved the wrong person and you couldn't get health 
insurance through your spouse, or if you can't get health insurance 
because you lost your job and you are without health insurance, or if 
you are too poor to afford it, that is not just a misfortune. That is 
an injustice.
  We can do something about that. Life is hard enough with all of the 
illness, sickness, accidents, and injuries that people receive without 
government compounding all of the misfortune with injustice. Life is 
hard enough without government doing the wrong thing. So the Affordable 
Care Act added more than 20 million Americans to the rolls of people 
who have health insurance.
  The bill that came out of the Senate today wants to strip health 
insurance from tens of millions of Americans and jack up everybody's 
premiums and make healthcare more inaccessible for people. They want to 
compound the normal difficulties and misfortunes of life with the 
injustice of distributing healthcare in a radically unequal and unjust 
way.
  We can't go back. It is too late for that. The great Tom Payne once 
said that it is impossible to make people un-think their thoughts or 
un-know their knowledge. We have come too far as a country to turn the 
clock back.
  I know there are people on the Senate side, like Rand Paul, who I saw 
on TV speaking about this, who think we should get rid of all forms of 
public attempts to get people health insurance. Rand Paul takes a 
perfectly principled position. He says the government shouldn't be 
involved at all. I don't know how he feels about Medicare or Medicaid. 
He certainly hates the Affordable Care Act. He just wants to outright 
repeal it, which is what the GOP said they would do.
  So he is going to vote against that bill because it keeps the 
remnants of the system that we voted in with the Affordable Care Act. I 
understand that. I understand his position. I disagree with it 
completely because I think, as Americans, we have got to have 
solidarity with each other and we have got to take care of each other 
through insurance because the misfortunes of life can happen to 
anybody. So we have got to stand together.
  He says that is not part of the social contract. Okay. That is fine. 
I get it. But what I don't understand is people are saying: Well, we 
said we would just get rid of it, but we will get rid of some parts of 
it. We will throw millions of people off their health insurance. We 
will make insurance more expensive for everybody. We will cut the heart 
out of Medicaid.
  Why? What is the public policy that is being advanced here?
  It doesn't make any sense. Countries all over the world have arrived 
at the point of universal single-payer plans, like in France, the 
United Kingdom, Germany, and Canada. The countries that can afford it 
overwhelmingly have said: healthcare for everyone.
  That is why I am a proud cosponsor of a bill, which is proudly 
cosponsored by a majority of the people in the Democratic Caucus. It is 
Congressman Conyers' Medicare for All bill.
  I think that is where we need to go. I am convinced we are going to 
get there sooner rather than later. Winston Churchill once said: You 
can always count on the Americans to do the right thing, once they have 
tried everything else first.
  We have tried some other stuff in between, but we are on the way to 
taking public responsibility for the healthcare of our people. My 
healthcare is connected to your healthcare because my health is 
connected to your health. We want the families whose kids go to school 
with our kids to be in a relationship with a primary care doctor. We 
want them to get their shots. We don't want them coming to school sick.
  Public health dictates that everybody be in the system. A lot of 
young men, for example, think that they are too tough to go see 
doctors. That becomes a danger for everybody else. We need everybody to 
be in a relationship with a doctor. We owe that not just to ourselves 
and our families, but we owe it to everybody.
  Everybody in the system, everybody covered. That is where America 
needs to go. But understand that what is coming out of the Senate has 
nothing to do with that. The Senate plan is all about rolling back the 
progress that we made under the Affordable Care Act, like the ban on 
throwing people off of healthcare because they have a preexisting 
condition or denying people insurance in the first place because they 
have a preexisting condition.
  The fact that someone has got a preexisting health condition is the 
reason that they need health insurance. It is not a reason to deny them 
health insurance. What they are doing is perfectly backwards.
  The Affordable Care Act also said that young people could stay on 
their family's plan until age 26. Thank God we have had that provision. 
Even the GOP doesn't want to mess with that, at this point. We got 
millions of people into relationships with doctors. We could show you 
dozens of emails and letters and calls that we are getting from people 
who say: The Affordable Care Act saved my life. I would have had no 
access to healthcare without it.
  The whole idea of turning the clock back and moving in the opposite 
direction is completely antithetical to the direction of American 
history. We are moving forward. We want universal coverage for 
everybody.
  By the way, we spend more on healthcare than most of those countries 
that have single-payer healthcare. I think we may spend more than 
anybody else on Earth on healthcare, but

[[Page H5106]]

we don't get the best results because we leave so many people out and 
we are spending lots of money on insurance. The last I looked, it was 
around 30 or 31 cents on the dollar we are spending on the insurance 
companies, on bureaucracy and red tape, instead of getting people 
healthcare.
  That is the direction we need to be moving in, not dismantling and 
savaging the healthcare protections that we have in place right now.
  I want to close with some thoughts just about the process that is 
going on. Back when the Affordable Care Act was being debated, my dear 
friends across the aisle complained about how fast things were going 
and how they thought the legislation was being rushed.
  I don't want to embarrass anybody by calling out specific statements 
made, but we have got voluminous statements made by people on the other 
side of the aisle saying: This is too fast. You're trying to sneak it 
through. You're trying to ram it down the throats of the American 
people. All of this is happening too fast.
  Well, Mr. Speaker, the debate over the Affordable Care Act spanned 
more than 12 months. It took more than a year. The Senate bill was 
unveiled today with no hearings, no witnesses, no professional 
testimony, no opportunity for the public to testify for nurses or 
doctors or patient advocates or any of the groups that are interested; 
none of them.
  In the Affordable Care Act, there were 79 hearings that I was able to 
find in Congress. That is 79 hearings. Not zero hearings, which is what 
they are proposing to do now. There were 79 hearings. There were 181 
witnesses, both expert witnesses and ordinary citizens, who came to 
testify before Congress, in public. So far, there has been zero 
testimony on what the ramifications and consequences are of the bill 
that was unveiled in the Senate today.
  We had multiple Congressional Budget Office scores that analyzed the 
costs and the impact of different proposals that were part of the ACA. 
By contrast, the House was forced to vote on the GOP healthcare repeal 
plan in this body with no CBO score at all, no estimate on how much the 
bill would cost the taxpayers, no estimate on how many Americans 
precisely would lose their health insurance. We have learned later the 
CBO estimate of $23 million, but that was after we voted on it.
  So the people who were saying that the debate moved too fast back 
then--a year of debate, with dozens of hearings and witnesses, and so 
on--now seem perfectly content with a process where a bill comes out on 
Thursday, and then they are going to vote on it next Thursday with no 
hearings, very little public debate, no opportunity for people to come 
and testify, and no real opportunity for the public to process what is 
going on.
  What is the urgency?
  If it is such a great bill, then we should be out trumpeting it and 
advertising it. And everybody should have at least one townhall meeting 
back in their congressional districts to explain how they feel about it 
so that everybody's constituents can ask us about the bill.
  Is it going to improve America's healthcare? Is it going to improve 
the health and well-being of the people, or reduce the health and well-
being of the American people? Is it going to drive our premiums, 
copays, and deductibles even more?
  Those are questions we should have to face with our constituents.
  Regardless of what your political party or ideology is, everybody 
should tell their Member of Congress: At the very least, let's have 
some public discussion about it. Let's have the opportunity for 
townhall meetings across the country before we completely rewrite the 
healthcare plan for the American people.

                              {time}  1815

  I urge my colleagues to slow down, take a step back, and work across 
the aisle for the best possible results. There are things we can do 
together to help.
  For example, I heard the President of the United States come to our 
body and make a speech in which he said that prescription drug prices 
were out of control and we needed to give government the authority to 
negotiate lower drug prices. I agree 100 percent with the President of 
the United States about that.
  There has been no action on that by my friends across the aisle in 
the House or in the Senate, and I beseech the President of the United 
States, before you advance 1 centimeter further on this extremely 
controversial bill, which I understand four Republican Senators have 
already announced their opposition to today, before you go any further 
on this, let's get to something we can agree on for once. Let's find 
the common ground. And the common ground has got to be prescription 
drug prices are out of control for Americans.
  Let us give the government the authority to negotiate for lower drug 
prices in Medicare the way that we have got it for VA benefits or for 
Medicaid prescription drugs. We have got that authority, but there was 
a special interest provision slipped into Medicare part D, and the 
government doesn't have that authority. That is authority we should 
have.
  Mr. President, we agree with you about that. Why don't you put a 
pause on trying to demolish the ACA and Medicaid, and let's see if we 
can get some prescription drug legislation that will bring prices down 
for all Americans. We are ready to work with you on that.
  There are reports that there is some effort to come up with a phony 
plan on prescription drug prices that wouldn't actually give the 
government the authority to negotiate lower prices. I hope that is not 
true, but let's have a real plan to bring people's prescription drug 
prices down.
  There are things we can do together across the aisle. In fact, the 
President of the United States said repeatedly during the campaign that 
his plan would be a magnificent plan that would cover everybody. He 
said everybody would be part of it. And a lot of people, including me, 
took him to be invoking the single-payer universal health plans that 
work all over the world, that work in Canada and that work throughout 
Europe and so on.
  Mr. Speaker, let me ask, would it be possible for us to get together 
with the President in order to come up with a single-payer plan, the 
kind that he invoked over the course of the campaign? Let's seize upon 
the new spirit of civility and community in this body and in Congress 
to come up with plans that bring us together, that don't drive us 
apart.
  The plan that passed out of the House of Representatives is standing 
at 9 percent in the public opinion polls. I can't imagine that the 
Senate plan is going to be any more popular. If this was a mean plan, 
as the President said, the Senate plan looks meaner, or at least as 
mean as the House plan is.
  But even if you doubled it and said 18 percent of the people would 
support it, that is still a tiny fraction of the American people. The 
overwhelming majority of Americans are not sold on this idea of turning 
the clock back and throwing millions of people off their health 
insurance plans.
  Let us work together, and we can do it. In the societies that have 
universal health coverage, it is accepted now by people across the 
political spectrum. If you go to France or the United Kingdom or 
Canada, the conservatives are not agitating to throw people off of 
healthcare. The conservatives support a universal payer plan. And there 
are lots of conservative arguments for it.
  For example, let's liberate our businesses, especially our small 
businesses, from the burden of having to figure out people's 
healthcare. Let's take that completely off of the business sector, and 
let's make that a public responsibility the way they have done in so 
many countries around the world. Wouldn't that be good for business? 
And doesn't it enhance feelings of community, solidarity, and 
patriotism for everybody to be covered by the healthcare system of the 
country that they live in?
  We can do this as Americans. We are the wealthiest country that has 
ever existed. This is the wealthiest moment in our history. Let's come 
up with a real plan for health coverage that eliminates as much 
insurance bureaucracy and waste as possible and gets people the 
healthcare coverage that they need.
  Mr. Speaker, I want to thank you for the opportunity to have this 
Special

[[Page H5107]]

Order hour on behalf of the Progressive Caucus, which has advanced the 
Medicare for All plan, and I encourage everybody to check it out.
  But in any event, we are not retreating 1 inch from defending the 
Affordable Care Act and the progress that has been made under it, and I 
hope that we will have maximum transparency and scrutiny of what came 
out of the Senate today, because we think that the only possible 
outcome is that bill will go down; then we can come together, find the 
commonsense solutions, find the common ground, and make progress for 
the American people.
  Mr. Speaker, thank you very much. I yield back the balance of my 
time.

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