[Congressional Record Volume 163, Number 111 (Wednesday, June 28, 2017)]
[Senate]
[Pages S3818-S3823]
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

[[Page S3819]]

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.

[[Page S3820]]

  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.

[[Page S3821]]

  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.


                   Unanimous Consent Request--S. 1462

  Mrs. SHAHEEN. Mr. President, I am very pleased to join my colleague 
from North Dakota, Senator Heitkamp, and appreciate all of the efforts 
she is making to try to address the challenges we are facing in the 
healthcare markets across this country. Like her and like so many of my 
colleagues who are going to be here, I have come to the floor this 
afternoon because we want to take urgent steps and we can take steps 
today to address the uncertainty in our health insurance markets. We 
can take steps today that can hold down premiums.
  I have heard Senators on both sides of the aisle who have expressed 
concern about looming premium increases in the Affordable Care Act 
marketplaces. We all need to understand, as Senator Heitkamp pointed 
out, what some of the causes of these premium increases are.
  Insurers regularly cite the Trump administration's refusal to commit 
to making cost-sharing reduction payments, also known as CSRs. These 
CSR payments were included in the Affordable Care Act in order to help 
Americans afford insurance once they had it. The ACA requires insurers 
to reduce deductibles and copayments for working families who are 
buying insurance in the marketplace. Because of the cost-sharing 
reduction payments, the CSRs, patients pay less for their care and the 
government reimburses the insurers.
  These reductions and payments are built into the rates insurers are 
charging for 2017. Yet the Trump administration has refused to commit 
to paying these reimbursements because of a partisan lawsuit that has 
been brought by House Republican leaders.
  Because of the radically uncertain landscape insurers are facing 
right now, many of them are doing one of

[[Page S3822]]

two things: Some are pulling out of the ACA marketplaces altogether, 
and others are dramatically increasing premiums. The end result is 
fewer choices and higher costs for American families.
  Last year in my State of New Hampshire--and Senator Hassan is here. 
We represent New Hampshire, and we have been very concerned about what 
is happening right now. Last year, the insurance markets were stable, 
and health insurance premiums increased an average of just 2 percent--
the lowest annual increase in history. Today is a radically different 
story, in large part because of the uncertainty this administration is 
causing by refusing to guarantee insurers cost-sharing reduction 
payments. What we are seeing is that those insurance companies are 
protecting themselves by raising premiums on patients.
  The same thing is happening in other States. In some cases, insurers 
are filing two different sets of rates--a set that is premised on the 
administration continuing to make cost-sharing reduction payments and 
an alternative set with higher premiums to account for continuing 
uncertainty and the possibility that this administration will stop 
making those payments.
  Unfortunately, the Trump administration continues to send mixed 
signals to insurers, and of course it has threatened to stop paying 
cost-sharing reduction payments altogether. If this were to happen, 
insurers could immediately exit the markets for breach of contract.
  So we are kind of in this perverse limbo situation. The 
administration creates uncertainty by refusing to commit to continuing 
the CSR payments, and the insurers protect themselves by exiting the 
markets or raising rates. And it is the premium holders, the families 
out there, who are hurt by this political football that the 
administration seems to be intent on continuing.
  That is why I have introduced the Marketplace Certainty Act, which is 
a bill to appropriate funding for the cost-sharing reduction payments 
in order to make good on our commitment to help working families with 
their deductibles and cost sharing.
  I believe that the House Republican leaders' lawsuit has no merit but 
that the chaos it has caused by allowing the Trump administration to 
waver on these promised payments requires that we act now.
  I am pleased to be joined in this legislation by Senators Baldwin, 
Blumenthal, Cardin, Carper, Coons, Kaine, Hassan, Heitkamp, Cortez 
Masto, King, Leahy, Markey, Wyden, Stabenow, and I am sure that by 
tomorrow, we will have even more Senators on this bill.
  We could pass it right now. Right now, we could end this manufactured 
crisis. We could immediately restore certainty and stability to the 
health insurance markets for all of our constituents. That would be 
good for the Republicans, and it would be good for the Democrats. 
Mostly, it would be good for the families out there who are 
experiencing this uncertainty.
  We could do this. It would give us the breathing space we need to 
come together on a bipartisan basis to improve the law, to strengthen 
what is working and to fix what is not. In poll after poll, that is 
what the American people want us to do. They want us to stop the 
partisan bickering. They want us to work together. They want us to make 
commonsense improvements so that this law works for every American.
  Mr. President, at this point, I ask unanimous consent that the Senate 
proceed to the immediate consideration of S. 1462, the Marketplace 
Certainty Act; that the bill be considered read a third time and 
passed; and that the motion to reconsider be considered made and laid 
upon the table with no intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Wyoming.
  Mr. BARRASSO. Mr. President, reserving the right to object, I just 
had an opportunity to read the legislation of the Senator from New 
Hampshire. It appears that the legislation was just filed today. 
Instead of giving the American people time to read the bill, the Senate 
is being asked to pass the legislation now. At a minimum, shouldn't the 
American people have at least a day to read the proposal?
  Putting that aside, this bill seeks to address another major failure 
of ObamaCare. That is what they are trying to do here. As a doctor, I 
want insurance to be affordable for patients all across the country. 
This bill confirms what we all know--that ObamaCare is not affordable.
  The Senator is well aware of the large premium increases in her own 
State. It is not just the premiums that are skyrocketing. This week, I 
spoke to a woman in Wyoming. She told me that the deductible under her 
ObamaCare plan is so high that her husband refuses to go visit the 
doctor. She said that it is $6,500 for her and $6,500 for him and that 
he will not go to a doctor with that kind of a deductible. According to 
supporters of ObamaCare, this person is actually covered under 
ObamaCare, but as a doctor, I see things differently in that healthcare 
must be more affordable for everyone.
  The Senator's proposal seeks to throw more money at a systemic 
problem with ObamaCare. Instead, we should be passing bills that 
actually bring down the cost of care.
  When the Senator mentions the CSRs, I will point out that absolutely 
every payment has been made--every one--all the way up until today.
  People also talk about the sabotaging of the market. To me, the 
sabotaging of the insurance companies and the insurance market in this 
country has been because of ObamaCare's mandating that people buy 
insurance--buy more than they want, more than they need, and more than 
they can afford in so many cases, and it is insurance that provides 
very hollow opportunities to actually use the insurance.
  Again, I appreciate the acknowledgment that ObamaCare is clearly not 
working; however, our focus should be on policies that make healthcare 
more affordable to all Americans.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  The Democratic leader.
  Mr. SCHUMER. Mr. President, I ask unanimous consent that we get our 
full amount of time and that the time my friend from Wyoming uses be 
from the Republicans' time at some point later.
  The PRESIDING OFFICER. There is no order for divided time.
  Mr. SCHUMER. Oh. So we have as much time as we need?
  The PRESIDING OFFICER. There is no order.
  Mr. SCHUMER. I thank the Presiding Officer.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, while I am disappointed, I am not 
surprised that my colleague from Wyoming has objected to our effort to 
move forward. He is objecting to ending the uncertainty we have 
experienced, which is forcing insurers to raise rates because of the 
uncertainty with which this administration is administering the 
Affordable Care Act. They have been very clear that they want 
marketplaces to implode so that the act does not work for people. 
Senator Barrasso is objecting to a commonsense step to stabilize the 
insurance marketplaces.
  This is not going to be the last word because this is a commitment we 
made to American families. The instability here in Washington is what 
is causing the instability not only in insurance markets but in the 
country at large.
  We are approaching the Fourth of July, which is next week. When our 
Founders declared independence on July 4, 1776, Benjamin Franklin 
warned that we must all hang together or we will all hang separately. 
It is no different today. We all need to come together. We need to work 
across the aisle. We need to improve the healthcare system so that it 
works for all Americans. That is our goal. That is why we are here on 
the floor today, and we need to start by making sure the insurers have 
some certainty so that they can keep rates low for American families. 
We will be back, have no doubts about that.
  The PRESIDING OFFICER. The Senator from Missouri.
  Mrs. McCASKILL. Mr. President, I have to say that there are a lot of 
things my friend from Wyoming could have said in his objection, but to 
lecture us about bringing out a bill that people have not had a chance 
to read or study is rather rich at this moment in our legislative 
journey on healthcare. I do not know if he thought that through before 
he said it, but I can assure you

[[Page S3823]]

that when it came out of his mouth, all of us on this side were saying: 
You have got to be kidding me. Really? It was just a little much.
  I know we are all talking around the obvious, and that is that we 
need to fix the healthcare system in America so that people do not have 
to go into their pockets as often, so that insurance is reliable, and 
so that the markets are more stable. We are going to have a lot of 
opportunity, I hope, to come together and do just that. I hope my 
friend from Wyoming and my other friends on the other side of the aisle 
will be part of that.


                   Unanimous Consent Request--S. 1201

  We have a very simple solution to the bare counties, and I hope 
people will think this through before they just object. I am going to 
have 25 bare counties, mostly as a result of the sabotaging of the 
exchanges by this administration. People in those counties are looking 
to me for an answer, and I do not blame them for being worried. How can 
we solve that problem today? S. 1201, the Health Care Options for All 
Act, which I have introduced, will solve that problem today.
  All we have to do is say to anyone who is in a county in America--and 
I know my colleague from Ohio, Senator Brown, has some counties, and I 
know my colleague from Indiana has some counties--if you do not have an 
insurer in your county, you can come with your subsidy and buy 
insurance from the same places our staffs buy it and most Members of 
Congress buy it. Those are national plans. They are in every State in 
the Union because Members of Congress have staff members in every State 
in the Union. There is no need to attract more plans. There is no need 
to do anything complicated. You just take the subsidies that you are 
entitled to and you buy insurance at the same place Congress buys it.
  We can do that today. If we do not do it today, do you know what we 
are saying to the people who live in Ohio and Indiana and Missouri? We 
are saying that we are entitled to something better than they have and 
that they should not be allowed to buy what we can buy. Now, that takes 
some nerve. If we are not willing to take this simple, basic step, 
people in these counties should be angry and take up pitchforks--
metaphorically, of course.
  The national plans that are out there that my staff uses that are in 
Springfield, Cape Girardeau, Columbia--and I am sure my colleagues 
could talk about their staffs using these plans all over the country--I 
would like to make those available to regular folks in my State who 
want to be able to lay their heads on their pillows tonight and not 
worry about whether they are going to have insurance next year.
  Mr. President, I ask unanimous consent that the Committee on Finance 
be discharged from further consideration of S. 1201, the Health Care 
Options for All Act; that the Senate proceed to its immediate 
consideration; that the bill be considered read a third time and 
passed; and that the motion to reconsider be considered made and laid 
upon the table with no intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Wyoming.
  Mr. BARRASSO. Mr. President, reserving my right to object, before 
coming to the Senate, I practiced medicine in Wyoming for over 20 
years. That is why I am passionate about improving the quality of care 
and lowering the cost of healthcare. Unfortunately, we know healthcare 
is in a crisis. Premiums and deductibles are skyrocketing, and 
insurance is unaffordable.
  It is interesting to hear the comments when we are talking about the 
sabotaging of the marketplace. It is ObamaCare that has sabotaged the 
marketplace. The Presiding Officer knows fully well, as do I, that when 
you look at the co-ops that were set up all around the country under 
ObamaCare, one after another went bankrupt--belly-up, shut down--and 
left people uncovered. That was before we even knew who the Republican 
nominee for President was going to be in 2016. That is ObamaCare. That 
was at a time when all there was out there was the Obama healthcare 
law. One co-op after another failed, and it cost the taxpayers billions 
of dollars--guaranteed loans that will never be paid back.
  Just like the bill we just discussed, this proposal is an important 
acknowledgment by the Senator from Missouri. It is the acknowledgment 
that ObamaCare's collapsing insurance markets are affecting people all 
around the country. In Missouri, 18,000 people in 25 counties will have 
zero options on the ObamaCare exchanges--zero. They have been promised 
that their preexisting conditions will be covered, and no one is 
selling insurance in those counties in that State. They have basically 
been misled by ObamaCare that they will be covered for preexisting 
conditions. In the Republican plan, what we are doing is covering 
people who have preexisting conditions.
  Let me say again that next year thousands of people in Missouri will 
have no insurance company that will be willing to sell insurance in the 
ObamaCare exchange. It is clear that insurance markets in Missouri are 
collapsing, as they are all around the country.
  This bill is not the solution. Instead of giving people more choices 
in Missouri, what does the bill do? It sends people to Washington, DC, 
to buy their health insurance--a typical solution from the other side 
of the aisle. Instead of empowering States with more flexibility and 
the authority at the State level, they think once again that Washington 
knows best. They think that the people they represent would rather call 
a bureaucrat who is hundreds of miles away than talk with local people 
who live and work in their communities.
  The simple fact is that ObamaCare is not providing patients with the 
increased choices they were promised. We need to rescue people in 
Missouri and across the country from ObamaCare. This bill is the wrong 
approach.
  I object.
  The PRESIDING OFFICER. Objection is heard.
  Mrs. McCASKILL. Mr. President, will the Senator yield for a question?
  The PRESIDING OFFICER. The Senator from Wyoming does not have the 
floor.
  The Senator from Missouri.
  Mrs. McCASKILL. Mr. President, the next time I will know, when he is 
giving a speech, before he objects, to start then.
  I am pretty sure that his staff in Wyoming is not coming up to 
Washington to buy their insurance. I am pretty sure that all of our 
staffs--I am pretty sure the Presiding Officer's staff, those who work 
for him in Utah--are not coming to Washington to buy their insurance. I 
am pretty sure Senator Manchin's staff and Senator Patty Murray's staff 
and all of our staffs who live all over this great country are not 
coming to Washington to buy their insurance. They are getting good 
health insurance plans.
  I just think it takes incredible nerve to lecture me about people in 
Missouri having no insurance while the Senator from Wyoming is 
objecting to letting them get the same insurance he has. Really? That 
is what this has come to, this partisan exercise?
  We don't have to fix this permanently this way, but we could do it 
just temporarily to give people peace of mind until we figure out the 
right way forward. But how dare Members of this Chamber tell people in 
my State they are not entitled to buy what we have, when they have no 
other options at this moment.
  Let's move forward together and fix it--all of it. But to get a 
lecture that people in my State don't deserve what my staff has or what 
Senator Barrasso's staff has--no wonder people are upset with 
Washington.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.