[Congressional Record Volume 163, Number 111 (Wednesday, June 28, 2017)]
[Senate]
[Pages S3818-S3821]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Healthcare Legislation
Mr. BLUMENTHAL. Mr. President, over the last 10 days, I have
conducted
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emergency field hearings, giving my constituents in Connecticut an
opportunity to be heard, a chance for their voices and faces to be part
of considering the Republican healthcare or really, more accurately,
wealth care bill. Indeed, that label or characterization of the bill
came from one my constituents who said: This plan is not healthcare, it
is wealth care because it produces a massive transfer of wealth from
the poor and middle-class Americans, whose healthcare would be deeply
harmed, to the richest Americans, who would enjoy the benefits of
hundreds of billions of dollars in tax cuts.
That kind of voice and criticism deserves to be heard here. Yet my
Republican colleagues and their leadership have gone from total secrecy
to total chaos. They are in chaos because they have refused to heed the
voices and faces of ordinary, average working people--middle-class
people, the most vulnerable people--who would be deeply harmed by this
proposal.
One woman at one of my hearings in Connecticut, knowing what would
happen under this bill, said to me:
Do the right thing. Save the Affordable Care Act and save
our lives.
She was not exaggerating when she said lives are at stake. She is
right. This very eloquent woman, Amy Etkind, knows all too well what
this bill means for Americans like her, and the man she described,
literally, as the ``love of her life.'' She told me about him during a
hearing in New Haven Friday afternoon--about how he has struggled with
addiction, mental health issues, and now diabetes. He is alive today
because of Medicaid, and he has access to the services he needs. As she
said, ``If Medicaid were to go away, he would be literally dead in a
very short period of time.''
When we say the Republican plan would cost lives--it would kill
people--it is no hyperbole, no exaggeration. It is plain, simple fact.
As Ronald Reagan said, ``Facts are stubborn things.'' The fact is, this
bill would cost the State of Connecticut nearly $3 billion in Federal
funding over the next 10 years. These cuts, mainly to Medicaid, cannot
and will not be replaced, as the CBO has predicted. It would leave
States like Connecticut in an impossible position: either raise taxes
to pay the difference or cut Medicaid enrollment to insurers, putting
people like Amy's husband at risk, literally, of death; putting out on
the streets the senior citizens living in the Monsignor Bojnowski Manor
in New Britain, where they are enjoying great care--a high-quality
environment because of Medicaid. Many of them are middle-class folks
who worked hard, played by the rules, and exhausted their savings. They
are vulnerable now because of the cost of healthcare and their care, in
particular. The focus ought to be on them, on the people who are
affected, not so much the numbers, but we know from the numbers that
the Republican plan would disastrously raise premiums by 20 percent and
would cut enrollment impact on the individual market--premiums and
enrollment, apart from Medicaid, on the individual market. These
numbers are from the Center on Budget and Policy Priorities. They are
fact. Facts are stubborn things.
We know also what the effects would be--what the numbers are for
people who are middle income. The elimination of the tax credits for
middle-income people paying their premiums would be nothing short of
disastrous.
We focused on Medicaid. I talked to you about Amy and the love of her
life and what the effects would be of the decimation of Medicaid, but
here we are talking about the elimination of tax breaks that help
middle-income people. I don't need to explain this graph. For someone
with $26,500 in income, their premiums under the Senate plan would jump
to $6,500 from the present $1,700. For somebody earning in the
midfifties, the jump is even greater, and it is true even for people
who are earning $68,200. They will have to pay more, a larger share of
their income, and receive less. It is not only that the Senate plan is
disastrous because it is more costly, it is also going to impact the
quality of care by reducing the standards; eliminating the strict
requirements on preexisting conditions, the protections on annual and
lifetime caps for coverage, defunding Planned Parenthood, continuing
the war on women's healthcare. The long and short of it is that this
measure is bad for America.
Tia spoke to me at these hearings about the opioid epidemic. If there
is one example that breaks our hearts and wrenches our guts, it is the
effect on people who are trying to recover from opioid addiction and
abuse. Their recovery would be shredded--maybe stopped--by gutting
Medicaid coverage.
Another woman who spoke at my hearing, Donna Sager, called herself
``the perfect example as to why our healthcare plans must include
preexisting conditions and not punish people like me with high
premiums.'' Donna, as she told me, is 63 years old and not yet eligible
for Medicare. When she was 36, she was diagnosed with a rare form of
hereditary colon cancer. For 27 years she has been undergoing major
surgeries, constant screening, doctor visits to make sure she can
remain as healthy as possible. Then she told me about her husband, a
man in his seventies, and she said this:
He would like to retire, but how can he with all my medical
expenses? I am frightened what I will do if the Republican
healthcare bill gets passed. Changes to preexisting coverage
will be extremely damaging to me, how will I pay these costs
and high premiums? The republican healthcare plan wants to
punish me for having cancer.
She closed by saying:
It is as though Washington wants to punish me again for
having cancer and being older. . . . I never would have
expected that the greatest country in the world would treat
me like this.
There is a path forward, and it requires our Republican colleagues
very simply to start over, to work with Democrats, to abandon this
misguided, myopic effort to repeal, repeal, repeal. That mantra simply
is not a policy for American healthcare.
What is needed is to build on the Affordable Care Act, to improve it,
to correct its defects. We can do it if we work together and if we
focus on the rising costs of medical care and try to bring them down,
if we focus on the regulatory barriers to entering insurance markets
and seek to eliminate them, if we focus on the FDA drug approval
process and seek to responsibly and safely expedite new drugs coming to
market, if we enable Medicare to negotiate drug prices as the VA does.
Those examples of improving the present system are doable. They require
leadership, which has been lacking and most particularly lacking at the
White House.
Yesterday, we saw a picture that is worth a thousand words: the
President of the United States sitting with Members of this body, but
only Members of this body from the other side of the aisle--only
Republican Senators. It was almost the entire membership on the
Republican side. Not a single Democrat was invited, not a single
Democrat consulted, not a single Democrat involved in the continuing
process now of producing yet another plan behind closed doors in
secrecy.
The majority leader announced it just today. The effort is to have
another version to be submitted to the CBO by Friday, but that process
simply continues the present fatal flaw in my Republican colleagues'
thinking, which is that they can do it with only one party. I want to
give credit to our Republican colleagues who had the courage and
strength to say no because they saw it was bad for America.
In closing, I want to say that my Republican colleagues will be going
home this weekend. They have been looking at themselves in the mirror,
at their consciences, and they have been seeing something they don't
like--a moral failing in this bill, not just a political failing or a
policy defect but a real moral failing.
Healthcare is a right, and even if my Republican colleagues disagree
on that point, they have to recognize that taking away healthcare,
decimating Medicaid, waging war on women's health, depriving children
of the preventive care they need so they can go to school and learn
properly, evicting seniors from nursing homes, putting the burden of
billions of dollars on my State of Connecticut and every State
represented in this body, and other grotesque, cruel, costly impacts of
this bill are the wrong ways to go. They know that when they look in
the mirror, but they will know it even more powerfully when they look
in the eyes of their constituents this week--if they have the guts and
courage and heart to do so.
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This wealth care plan is doomed to failure. Even if it passes, it is
doomed to fail America. It is a moral failing, not just a policy
failing. The health of our consciences, as well as our physical well-
being, hangs in the balance.
Thank you.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. UDALL. 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. UDALL. Mr. President, I rise to defend the essential healthcare
that 300,000 New Mexicans and millions of Americans depend on.
Leader McConnell calls his TrumpCare bill the Better Care
Reconciliation Act, but actually the bill will mean worse care for
seniors, children, the disabled, rural communities, and working
families all trying to make ends meet. It will mean no care for 22
million people, according to the latest Congressional Budget Office
report. The bill cancels health insurance and slashes Medicaid funding,
all so Republicans can give big tax breaks to the richest Americans.
President Trump called the original House bill mean. The Senate
Republicans' healthcare bill isn't just mean; it is cruel. It is cruel
to take away nursing home care that seniors depend on, cruel to take
away necessary medical services from disabled children. Make no
mistake, this bill will cost lives.
This version of TrumpCare is a massive redistribution of wealth from
working families, seniors, and the disabled to the wealthy. But the
Republicans' bill is not Robin Hood in reverse. TrumpCare doesn't just
take money away from the poor to give to the rich; it takes away
people's healthcare and robs families of their health and ability to
work, care for their families, contribute to society, and lead happy
and healthy lives.
This bill was drafted in secret. Only a handful of Republicans and
their lobbyist friends got to see the bill. It is no wonder the
American people hate what TrumpCare would do to them and to their
families. TrumpCare is cruel; there is no doubt about it.
It is good that Leader McConnell decided not to call a vote this week
on this terrible bill, but I am by no means satisfied. We need to hear
from the Republican leadership that they are ready to work with
Democrats to improve the Affordable Care Act, not gut it, and to truly
improve our healthcare system. This is what the American people are
demanding, and this is what we in Congress should be working toward on
a bipartisan basis.
We created Medicaid in 1965 to serve a critical need. Since then,
Medicaid has become one of the most successful programs for making sure
low-income people get the healthcare they need. People get treatment
for illnesses that once were a death sentence.
The American people support a government that doesn't leave its most
vulnerable to suffer and die, but the current Senate bill cuts Medicaid
by more than $770 billion. Let's be clear, these cuts have nothing to
do with better healthcare. They are a ruthless tactic to fund tax cuts
for the wealthy.
On the campaign trail, the President vowed not to cut Medicaid. He
said it a number of times. Last week, he tweeted that he is ``very
supportive'' of the bill. Yesterday, he met with the Republican caucus
and told them to pass the bill. By supporting this bill, the President
breaks the promise he made during the campaign.
Medicaid expansion has allowed millions of Americans and over 265,000
people in my State to see a doctor. Many of these folks work but don't
have health insurance through their jobs or can't afford private health
insurance. Medicaid expansion is literally a lifeline, but TrumpCare
wipes this out. I can't believe that our Republican friends are doing
this to New Mexico children and families.
Take 1\1/2\ year old Rafe--this is Rafe. Rafe is here with his mom
Jessica and his dad Sam, a veteran. They are from Albuquerque, NM. Rafe
was born with cortical visual impairment--a kind of legal blindness--
and significant developmental delays. He faced monumental medical
challenges. But Jessica and Sam have been able to access the intensive
medical care, early intervention services, medical equipment, and
therapies he needs through a combination of their military insurance
and Medicaid.
Now Rafe's parents are scared he will lose his Medicaid services.
Their military insurance alone doesn't cover all the services and
equipment Rafe needs. They need Medicaid. Without it, Rafe's chances
for a better life are threatened. They worry about--and this is their
quote--``dealing with insurance, finding healthcare, tracking down
specialty doctors, keeping up with therapy appointments and doctor's
appointments.'' They worry whether Rafe will be able to walk, feed
himself, graduate from high school, and get a job. Now they must worry
whether he will get the medical care he needs to give him the
opportunity to do all of those things.
Let's talk about Carmen and her three children. Carmen is a single
parent. She serves Native American students as a teacher, a coach, dorm
parent, and higher education administrator. The small nonprofit
organization Carmen works for doesn't offer health insurance. For the
past 4 years, Medicaid has helped pay for the healthcare for her two
sons.
Her kids are healthy, but two have nut allergies and need EpiPens at
school and at home. According to Carmen, ``When I renewed their EpiPen
prescription for school this past fall, I was astounded that the price
sky-rocketed to $741 to fill one prescription!''
Now Carmen is worried; she doesn't know whether her kids will lose
Medicaid or how she will pay for prescriptions. She asked me: ``Please
continue to fight for the Affordable Care Act because you are fighting
for me and my family's well-being.''
It is cruel to threaten Rafe's chances for a healthier life, cruel
that Carmen might not be able to pay for EpiPens for her kids.
TrumpCare threatens these two families and millions more.
TrumpCare will hurt seniors, so it is not surprising that AARP
strongly opposes it. AARP opposes the TrumpCare age tax that allows
insurance companies to charge seniors up to five times more for their
premiums. The age tax, combined with reducing tax credits for premiums,
will price seniors out of health insurance needed to supplement their
Medicare. AARP is calling on every Senator to vote no on the Senate
Republicans' bill.
Medicaid pays for an astounding 62 percent of all nursing home care.
By cutting Medicaid, the Republicans threaten our mothers, our fathers,
and our grandmothers and grandfathers in nursing homes. States can't
bear the burden of these costs. Republicans want to shift them.
I know the State of New Mexico can't handle this. This cost-shift
sets States up to cut reimbursement rates and reduce eligibility for
services at nursing homes. Medicaid pays 64 percent of nursing home
care in my State. New Mexico's 74 nursing homes will be impacted by
these cuts.
Many of the folks in nursing homes are middle-class Americans who
worked all their lives, paid taxes, and saved for retirement. They did
everything right, but because skilled nursing care is so expensive,
they have outlived their life savings, and now Medicaid pays the cost
of care at the end of their lives, allowing them to live with dignity.
Senate Republicans may say that one improvement in their bill over
the House bill is it protects people with preexisting conditions, but
the American people shouldn't be fooled. People with preexisting
conditions are not protected under the Senate bill the way they are now
protected under the ACA.
The Senate Republican bill still allows States to waive the essential
health benefits that all insurance companies must now provide under the
ACA. These benefits include prescriptions, hospital stays,
rehabilitative services, and laboratory services. If States waive these
benefits, people with serious illnesses would have to pay out of pocket
for these services or buy additional insurance, or if these services
are covered but are not essential health benefits, insurance companies
can put annual or lifetime limits on the services, and people with
serious illnesses could end up with no coverage or be priced out of
services.
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All this sends us back to the time when people faced not getting care
or going bankrupt if they got sick. We passed the ACA because the
American people agreed no one should go broke to pay for lifesaving
care and that insurance companies shouldn't be able to place limits on
the care someone could get in their lifetime. Why do Republicans want
to take us back?
Finally, the steep cuts to Medicaid would devastate hospitals,
especially rural hospitals. Make no mistake--rural hospitals are
already struggling. Medicaid cuts will force some to close their doors
if TrumpCare becomes law.
In New Mexico, our rural hospitals are often an economic anchor for
the community. Hospital administrators in my State are very worried.
Medicaid has helped the Guadalupe County Hospital cut its uninsured
payer rate from 14 percent to 4 percent from 2014 to 2016. Its
uncompensated care decreased 23 percent in the same period. The
hospital's administrator, Christina Campos, fears what might happen if
TrumpCare becomes law. She is urging me to protect access to care in
rural areas.
I will fight hard to keep residents in our rural areas insured and to
keep rural hospitals open in New Mexico and across the Nation.
The President and congressional Republicans want to take us back to
the days when healthcare was a privilege for those who could afford it.
The American people do not support the Republicans' cruel plans.
Congress should listen to the pleas of our constituents. The American
people reject the framework of TrumpCare. They reject gutting Medicaid
and the Medicaid expansion. They reject making seniors pay more for
healthcare. They reject making healthcare inaccessible for those with
fewer resources.
The Republicans need to go back to the drawing board and begin to
work with Democrats. I say to my colleagues across the aisle, do not
take healthcare and the opportunity to lead a productive and happy life
away from millions of Americans. Together, we can make affordable
healthcare a reality for all.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The Senator from North Dakota.
Ms. HEITKAMP. Mr. President, one of the things that the healthcare
law changes here have demonstrated is that partisanship in Congress has
reached a new high--or I would say a new low. I am tired of reading
about who is to blame for what, and I know Americans and North Dakotans
are too. Most importantly, it certainly doesn't do anything to help
American families' healthcare get any better.
We should all want to improve our healthcare system so it works
better for families and for businesses. It should be a bipartisan
discussion, not a political exercise. I am here, as are many of my
colleagues, because that is what we hope to accomplish.
For years, I have been offering reasonable reforms to make the
current health reform law work better. I want such reforms to be
bipartisan. I want to have a larger conversation about healthcare in
this country. But the Republican Senate bill, the Better Care
Reconciliation Act, is simply not the way to have those discussions.
Frankly, this bill is a nonstarter.
I have heard from so many North Dakota children with disabilities,
seniors in nursing homes, men and women with preexisting conditions in
my State, and hospitals, doctors, and nurses, especially in rural
communities, who are deeply concerned--in fact, I can tell you, deeply
panicked--about how this bill would make care less available and less
affordable.
There are commonsense actions we can and should take right now to
make sure American families aren't hurt in the near term. That is why
we are here today.
Action and uncertainty caused by the administration, as well as House
Republicans, exacerbated instability in the insurance markets,
threatening significant cost increases for consumers in 2018. The
administration has been unwilling to commit funding for cost-sharing
reduction payments, and some Republicans have been working to dismantle
the health reform law by not funding critical reinsurance programs.
These actions make it extraordinarily difficult for insurers to plan
and make business decisions for 2018--yes, 2018, the year we are
talking about today. If insurers can't rely on these funds to support
healthcare programs that make it possible for health insurance costs to
remain affordable for families, the health insurance premium filings
for the next term year will reflect that uncertainty. Health insurance
rates for 2018 that have already been filed in some of our States
demonstrate that fact.
Let's talk about the facts. Independent reports from the
Congressional Budget Office and Standard & Poor's have said that the
insurance markets were expected to stabilize this year and could
stabilize this year unless the administration causes disruption. If you
look at the numbers from last year, you will see that health plans were
offered in every county in this country.
Today, we are here to offer a few bills that will make an immediate
and real difference for families to address health insurance rate
increases that we expect in 2018. These are commonsense bills that
should be bipartisan.
We hope our colleagues across the aisle will work with us in a
bipartisan way so we can provide immediate relief and guarantee
stability for the individual market--stability that will enable
individuals and families in all of our States to avoid serious
increases in their health insurance rates.
No family should face bankruptcy to cover their healthcare costs
because in Washington, DC, we can't implement the bill that we have and
instead continue to stall and play the game of politics against the
interests of the American people and, certainly in many cases, some of
sickest among us and people who have a whole lot of healthcare
insecurity. This is politics. We cannot continue to play politics with
people's health.
Some of the issues we are working to address were included,
interestingly enough, in the Senate healthcare bill--a clear
acknowledgment from the Republicans that these changes are necessary
for the health market to function in 2018.
Right now, we are standing here because time is of the essence. I
hope our colleagues will join us in this effort. We want to work with
them. We hope they will work with us. We hope we can at least at a
minimum get together and solve the problem for 2018 while we are
debating the future of healthcare delivery in this country.
I will call on my friend, the great Senator from New Hampshire,
Senator Jeanne Shaheen, to offer what I think is a terrific idea and to
talk about a bill on which I am a cosponsor.
The PRESIDING OFFICER (Mr. Lee). The Senator from New Hampshire.