[Congressional Record Volume 163, Number 116 (Tuesday, July 11, 2017)]
[Senate]
[Pages S3893-S3895]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Healthcare Legislation

  Mr. NELSON. Mr. President, I want to speak on behalf of a group of 
Floridians I have met with who would be tremendously hard-hit by the 
healthcare bill, whether it be the one that has already been published 
by the majority leader or some of the iterations that are being 
discussed.
  I want to talk on behalf of and be the spokesperson for these people 
who have cried out to me. I want to say that people are crying out. It 
is not just the group of four families I assembled in my Tampa office 
last week, but it also includes walking down the street, being in an 
airport, or going into a public building. Constantly, folks are walking 
up to me and saying: Please, don't let them take away my healthcare.
  Just this past week, I was in--it shall remain nameless--a Republican 
Senator's State. It happened in the airport there as my colleague, the 
Republican Senator in that State other than mine--the travelers, the 
constituents of that Senator in the airport as we were waiting for the 
airplane walked up to that Republican Senator and begged: Please don't 
take away my healthcare.
  What we have seen in this Republican bill is that it takes health 
insurance away from millions of Americans. That is not my conclusion; 
that is the conclusion of the Congressional Budget Office. According to 
CBO, it also cuts back some $800 billion out of Medicaid over a decade, 
and it allows insurance companies to hike rates for older Americans.
  Under the bill, 22 million people would lose their insurance by 2026. 
Over 2 million of these folks are in Florida. In fact, the bill would 
increase the uninsured rate in Florida by 62 percent. That is not what 
I want inflicted on the folks in Florida.
  This bill lets insurance companies go back to the days when they had 
annual and lifetime limits on coverage and refused to cover basic 
health benefits, such as prescription drugs, mental health services, 
and even maternity care. This Republican healthcare bill, which has 
been so much the subject in the news and the center of the debate here 
for the past innumerable weeks, really does cut Medicaid. According to 
CBO--again, not my words; CBO's words--funding will be 26 percent lower 
in Medicaid by the year 2026 than under the existing law.

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  My home State of Florida is projected to lose $5.7 billion in Federal 
Medicaid funding from 2020 to 2026 under the bill that is proposed by 
the majority leader. If that is not enough, the Senate bill would 
dramatically increase healthcare costs for Americans between the ages 
of 50 to 64 before they turn that magic age of 65 when they are 
eligible for Medicare. It dramatically increases those costs. That 
dramatic rise in cost is due in large part to a provision that would 
allow insurance companies to charge older Americans up to five times 
what younger people are charged. The current law, the Affordable Care 
Act, has a differential of 3 to 1. This bill as proposed has a 
differential of 5 to 1. So if you are not on Medicare because you 
haven't turned 65 and you are an older American in those ages--which 
increasingly seem very young to me--up to age 64 when the differential 
from what the insurance company charges the young person is five times, 
not three times, as is the current law, this would especially be felt 
among those older individuals making between $42,000 and $48,000 a year 
who, after that point, no longer qualify for the tax credits under the 
Republican bill to make coverage more affordable.

  Remember, in the current law, up to 400 percent of poverty level, you 
are entitled to get tax credits according to what your income is to 
help you buy private health insurance from insurance companies on the 
marketplaces in each State. Even that is going to be reduced.
  This bill also includes a backdoor provision that undermines the 
protections that currently exist for people with preexisting 
conditions. In defending the bill, people will argue that it doesn't do 
that, but look what the bill says. It says that it can be left up to 
the States to determine that. What is a way that the State can lessen 
the cost of insurance premiums? Take away the guarantee that someone 
can get insurance if they have a preexisting condition.
  I have given a number of speeches. I have had some experience in this 
as the former elected insurance commissioner of Florida, when it was an 
elected position. It was also a constitutional position of the State 
treasury. I held that position for 6 years, and I have dealt with 
insurance companies. I have seen some insurance companies say: You have 
a preexisting condition. We are not going to insure you because you 
have asthma. I have even seen an insurance company cite: We are not 
going to insure you because you have a preexisting condition; you had a 
rash.
  Under the current law, an insurance company cannot deny you insurance 
because of whatever your preexisting condition is. Your preexisting 
condition may be that you have a weak heart, and you, of all people, 
would want health insurance. Before, you couldn't get it. Now, under 
the current law, you can.
  I don't want you to hear this plea over and over again from me. I 
want the pleas from several Floridians to reach out across the State 
lines and get to the Senators who are going to be voting on this. I 
want them to hear from some of my constituents. When I met with them 
last week in Tampa, I had many who said that they would be devastated 
if Medicaid were cut.
  I want to share with you how this has personally affected them and 
how apprehensive and plain scared they are right now that the 
healthcare they are getting will cease if this bill proposed by the 
majority leader is to become law.
  Take, for example, Michael Phillips. He is 36 years old, and he has 
spinal muscular atrophy. It is a genetic disorder that affects control 
of his muscle movement. He relies on a tracheotomy, a breathing tube, 
and uses assistive computer technology to be able to talk. The computer 
talks for him.
  Michael was supposed to join us on that day, but he wasn't feeling 
well, and, of course, there is always the added exposure to germs in 
his weakened immune condition. Instead came his two caregivers, his 
single mother Karen and his brother Brian. Michael relies on Medicaid, 
which allows him to live at home with his mom and have a personal care 
assistant. He benefits from the Medicaid home and community-based 
waivers. If the waivers are eliminated because of the whacking of 
billions and billions of dollars from Medicaid, he would ultimately end 
up in a nursing home, away from his mother and his family, being forced 
to compromise his level of care and quality of life.
  You may have seen this fellow and his mom interviewed by the national 
news networks. He is one and the same, Michael Phillips.
  The Senate healthcare bill ends Medicaid as we know it. Whether it is 
a cap on the amount of money going to the State or it is called a block 
grant, the effect is the same. It will put people like Michael at risk 
of losing critical services, and it will certainly take away his 
independence and his quality of life.
  I have already said that the bill certainly takes away the guarantee 
of coverage with a preexisting condition. Let me tell you about another 
Floridian who was in that meeting. Elizabeth Isom is from St. 
Petersburg, and she told me that the Affordable Care Act saved her life 
and allowed her to purchase insurance for the very first time. If it is 
taken away, she doesn't know how she is going to be able to afford 
coverage because of lifetime caps. An insurance company cannot put 
those lifetime caps on what they pay out. For example, in the old days, 
before the existing law, an insurance company would say: I'll pay you 
as long as it doesn't exceed, say, $25,000 or $50,000. That was all 
figured into their insurance payment and their premiums. In the current 
law there are essential health benefits. There are about a dozen of 
them.
  Elizabeth was a social worker before she developed a sinus tumor. She 
went without insurance for 3 years, during which time her health was 
deteriorating. Because she did not have health insurance, she could not 
afford to have that tumor operated on. What I do not know is if she 
knew this at the time--because she hadn't had the operation--or if she 
thought it was cancerous. As it turned out, later, when she was able 
under the Affordable Care Act to get health insurance and to have the 
operation, thank the good Lord it was benign. But her health had 
deteriorated to the point that as this thing started to grow into her 
sinus passages and into her brain cavity, she actually thought she was 
approaching death. She ended up having vital organ damage and reached 
the point of complete disability. The mass in her sinus had extended 
into her skull.
  After the ACA became the law of the land, she purchased insurance 
through healthcare.gov. She says that it is the best insurance she has 
ever had because it covered essential health benefits like preventive 
services. It certainly provided for her to go on and get the operation, 
and it saved her life.
  If this Senate bill passes, services that Elizabeth relies on may no 
longer be covered, and she likely will never be able to afford a decent 
health insurance package again. She obviously has a preexisting 
condition. She would be one of the 22 million people whom the 
Congressional Budget Office estimates would lose their health insurance 
if the bill proposed by the majority leader, Senator McConnell, were to 
become law.
  Let me tell you about another Floridian. Regina Hebert is from Tampa. 
She is a small business owner. She was diagnosed with stage IIB breast 
cancer at the age of 57. She, too, told me that the ACA saved her life. 
Without the ACA, she would not have received health insurance because 
her cancer is considered a preexisting condition--57 years old, 
preexisting condition, stage II breast cancer. She obtained health 
insurance through the ACA. She had two surgeons, months of chemo and 
radiation, and she told me that if her cancer comes back and she 
doesn't have insurance, then she is going to have to choose between 
going bankrupt--not through what she is doing now with her small 
business. She is paying taxes. She is contributing to society.
  What is her other choice? Her other choice is to give up. Take away 
her insurance and those are her choices: bankruptcy or giving up. I 
don't think we want to put Americans in that position. The Senate 
healthcare bill allows States to waive the essential health benefits--
the dozen I talked about that are listed, like those needed if they 
have a preexisting condition.
  There was another lady I met named Olivia Babis. She is from outside 
of

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Tampa, a place called Lutz. She also has a preexisting condition. She 
told me that she uses the essential health benefits guaranteed by the 
existing law. She is scared that insurance companies would take away 
the coverage of treatments for her disability and also reinstate annual 
and lifetime limits on coverage.
  Let me tell you about this young lady. She is just amazing. She was 
born without arms. She uses her feet and her toes to be able to 
function in the place of hands and fingers. She had to have a total 
knee replacement in one leg by the time she turned 30. She works as a 
community organizer. She doesn't qualify for Medicaid in Florida 
because her income is considered too high. She actually has an income. 
Olivia purchased health insurance through healthcare.gov with the help 
of tax credits to help her afford health insurance.

  This young lady, now in her midthirties, is just amazing. With no 
arms, she uses her feet and her toes, and she is capable of getting 
around in her wheelchair. She is capable of driving a car. She has a 
business. She has an income, and she is paying taxes. She is able to 
function because she has health insurance.
  Now, thanks to the ACA, people like Olivia benefit because there are 
bans on lifetime limits in insurance policies, and, thanks to the ACA, 
she lives an active life. She goes snorkeling, hiking, and even 
skydiving. Her legs are good, except for the knee replacement that she 
had so that she can walk. Then, when she has to do the normal functions 
with hands and arms, she sits down, and she uses her legs, her feet, 
and her toes. She told me that, without the ACA, she is trapped.
  I told you about this unnamed Republican Senator who was in an 
airport in another State--that of the Republican Senator's. What 
happened to that Republican Senator happens to me back in Florida with 
people coming up and begging me: Please do not take away my healthcare.
  We should not continue to waste our time with this healthcare bill 
that only takes away healthcare and charges more for less coverage. We 
have said--so many of us out here on this floor--that we should be 
looking for ways to improve the existing law, the Affordable Care Act, 
not to undo all of the good that it has done. We have Floridians and 
folks across the country who are grateful for it. They want us to fix 
it, not repeal it, and they say that over and over: Why can't you guys 
get together in a bipartisan way and fix it?
  These are the personal stories of Olivia, Michael, Regina, and 
Elizabeth, along with the hundreds of people who have come up to me in 
the street or in the airport and have begged me: Do not take it away. 
They do not want us to get rid of this. As you have heard, several of 
them claim that they would not be alive today without the ACA. 
Alternatively, they would be bankrupt if it were not for Medicaid in 
the ACA.
  In order to truly improve our healthcare system, why don't we work 
together to make it better? We need to look at real solutions. I am 
happy to say that this Senator has been talking to Republican Senators, 
and we have talked about specific things. I told some of these Senators 
about my experiences as the formerly elected insurance commissioner of 
Florida.
  When I had a problem after the monster Hurricane Andrew in the early 
1990s and we had a paralyzed marketplace in which you could not get 
homeowner's insurance in Florida from insurance companies because they 
were scared to death that the next big one was coming and that the 
losses were going to be so great that they would have to price the 
premiums so high, what did we do? We created a reinsurance fund called 
the Florida Hurricane Catastrophe Fund, which builds up the reserves 
that would reinsure the companies if they were to have a catastrophic 
loss.
  The same principle with hurricanes can apply to health insurance, 
which is that of creating a reinsurance fund that will insure the 
health insurance companies against catastrophic loss, which, 
occasionally, they will have. Do you know something? I costed that out 
in Florida, and it would reduce the premiums from the marketplace in 
Florida by 13 percent. Now, that is a real savings, and that is just 
one solution for a fix. We ought to be looking at approaches like this.
  I welcome all of our colleagues on this side and on that side--and I 
have been talking to some on that side--to join together and do 
something productive, like getting behind ideas just like the one that 
I suggested.
  I heard our colleague this morning. One of our favorite colleagues 
out here is Joe Manchin from West Virginia, and I heard him being 
interviewed on one of the morning shows. He was terrific. He said: We 
need to be working together. We should not be divided by party over 
this, and we should not be divided ideologically on this. We ought to 
be openly trying to work together to figure out how to drive down 
healthcare costs and increase coverage for more Americans.
  That is what those folks in Tampa, FL, told me last week with whom I 
met. That is what those hundreds of folks are telling me who come up to 
me in the airport, on the airplane, on the street corner, in the public 
buildings, in the hospitals--wherever I am: Please, get together, and 
work it out. They are asking us to fix what needs fixing. That is what 
the American people are asking us today, and that is what I beg of the 
Senate.
  As the good Lord says: Come. Let us reason together. Let us use some 
of our common sense.
  I yield the floor.