[Congressional Record Volume 163, Number 123 (Thursday, July 20, 2017)]
[Senate]
[Pages S4102-S4103]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mr. MURPHY. Mr. President, I thank the Senator from Georgia for the 
recognition.
  Colleagues, the new CBO score is out on, I guess, version 4.5 or 
5.5--it is hard to keep track of the bill to repeal the Affordable Care 
Act--and nothing has changed. This proposal, which is a moral and 
intellectual dumpster fire, is still a disaster.
  Here is what the CBO says about the bill that is currently being 
reworked behind closed doors by my Republican colleagues. The CBO says 
that, immediately, 15 million people would lose coverage by next year. 
That is a humanitarian catastrophe. It is something this country has 
never witnessed before--that number of people losing coverage in that 
short a period of time. Our emergency rooms would be overwhelmed as 
they would be unable to deal with the scope of that kind of 
humanitarian need. Ultimately, the number would rise to 22 million at 
the end of the 10-year window. We know it will be far bigger than that 
in the second 10 years because that is when the worst of the Medicaid 
cuts will happen, but 22 million is a lot of folks. It is no different 
than in the previous version, which was 23 million, or in the House's 
bill, which somehow got a majority vote in that place despite 24 
million people losing health insurance, according to the CBO.
  Today, 90 percent of Americans are covered by health insurance. The 
CBO says that number will go all the way down to 82 percent. I have 
heard my friend Senator Cornyn complain on this floor year after year 
that the ACA still leaves millions of Americans uncovered. This would 
make it even worse.
  When you get down to look at what happens to individual Americans, it 
gets even more frightening. Let me give an example of how this bill 
would dramatically increase premiums on individuals who are currently 
insured through the private market.
  A lot of the coverage losses happen because of this assault on 
Medicaid, but lots of folks who have private coverage would not be able 
to afford it any longer. If you are a 64-year-old who is making, let's 
say, $55,000, that is over three times the Federal poverty level. In a 
lot of places, you can live on $56,000. Today, that individual is 
paying about a $6,700 premium. Under the Republican healthcare bill, 
that individual would be paying $18,000 in premiums. That is an 
increase of 170 percent. That is just one individual.
  The bottom line is that, if you are older and you are less wealthy, 
you are going to be paying a whole lot more under this proposal.
  Despite all of the guarantees made by Republicans and this President 
that under their plan, costs would go down, that deductibles would go 
down and premiums would go down, the CBO says the exact opposite. It 
says that, especially if you are sort of middle-income and are 50 or 
older, your premiums will go up dramatically.
  This is a terrible bill. It does not solve a single problem that the 
Republicans said they were trying to fix. More people lose insurance, 
costs go up, and quality does not get better. This is a terrible piece 
of legislation.
  We are at this very frightening time in the negotiations when changes 
are being made to this bill not to improve policy but to try to win 
individual votes. That is what is happening as we speak. Behind closed 
doors, small changes are being made to this bill to try to win the 
votes of individual Senators, giving them specific amounts of money for 
their State, and their State alone, in order to win their vote. That is 
shameful, and it is no way to reorder one-fifth of the American 
economy. We are talking about 20 percent of the U.S. economy. And 
changes are being made to this bill right now that have nothing to do 
with good healthcare, that have only to do with winning individual 
votes to try to get to 50, because Republicans refuse to work with 
Democrats--refuse to work with us. So instead of building a product 
that could get big bipartisan support, Republicans are now down to a 
handful of their Members and are trying to find ways to deliver amounts 
of money to those Members' States in order to win their vote.

  There is a special fund in the latest version of the bill for 
insurance companies in Alaska that was not in the previous version of 
the bill. Now, all of these provisions get written in a way that if you 
are an average, ordinary American who decides to take a couple of hours 
of your time to read the bill, you would never know that it was a 
specific fund for Alaska because it doesn't say ``Alaska.'' It sets up 
a whole bunch of requirements that a State has to meet to get this 
special fund for insurance companies, and only one State fits that 
description, and it is Alaska.
  There is a change in this bill from previous law that addresses 
States that were late Medicaid expanders, States that expanded into the 
new Medicaid population allowed for under the Affordable Care Act but 
did it late in the process. The previous version didn't give those 
States credit when establishing the baseline for the new Medicaid 
reductions, but miraculously this new bill has a specific provision to 
allow for two States that were late Medicaid expanders to be able to 
get billions of additional dollars sent to their State. Those States 
are Alaska and Louisiana--two States.
  There is a new provision in the latest version of the bill that makes 
a very curious change to the way in which DISH payments are sent to 
States--that is the Disproportionate Share Hospital Program that helps 
hospitals pay for the costs for people without insurance. Not 
coincidentally, it is a change that was advocated by one Senator from 
one State: Florida. The change will disproportionately benefit the 
State of Florida, and it is now in the new version.
  These are not changes that help the American healthcare system. They 
are not changes that benefit my State or

[[Page S4103]]

the State of the majority of Members here. Some of these changes don't 
benefit 98 of us; they only benefit 2 of us. And they are in this 
version of the bill in order to win votes, not to make good policy.
  We heard word this morning of a new fund that was invented in the 
middle of the night last evening that would supposedly help States that 
are Medicaid expansion States transition their citizens who are 
currently on Medicaid to the private market. Now there are reports that 
it is a $200 billion fund, and that is a lot of money. It sounds like a 
lot of money, and it is a lot of money, but it would represent 17 
percent of the funds that are being cut to States, and it would only be 
a temporary bandaid on a much bigger problem. Why? Because CBO says 
definitively that the subsidies in this bill for people who want to buy 
private insurance are so meager that virtually no one who is kicked off 
of Medicaid will be able to afford those new premiums. That is why the 
numbers are so sweeping in their scale--22 million people losing 
healthcare insurance.
  So even if you get a little bit of money to help a group of 
individuals in a handful of States transition, when that money runs 
out--and it will--they are back in the same place. All they are doing 
is temporarily postponing the enormity of the pain that gets delivered. 
And once again, this provision being delivered to only States with 
Medicaid expansion populations is being targeted in order to win votes, 
not in order to improve the entirety of the healthcare system.
  Senator Corker called out his colleagues today. He said that he was 
willing to vote for the motion to proceed, but he was growing 
increasingly uncomfortable with a bill that was increasingly--I think 
his word was ``incoherent.'' That is what happens when you get to the 
point where you have a deeply unpopular bill that everybody in the 
country hates and you need to put amounts of money in it to get a 
handful of additional votes. It becomes incoherent. And this was an 
incoherent bill to begin with. It is hard to make this bill more 
incoherent, but that is what is happening when these individual funds 
are being set up for Alaska, Louisiana, and Florida.
  We could solve all of this if Republicans decided to work with 
Democrats. If we set aside the big tax cuts for the wealthy and the 
pillorying of the Medicaid Program, if we try to fix the real problems 
Americans face today, we could do it on a bipartisan way. And wouldn't 
that be great.
  I get it that there is enormous political advantage for Democrats to 
sit on the sidelines and watch Republicans vote for a bill that has a 
15-percent approval rating, just like there was political advantage for 
Republicans to sit on the sidelines and not do anything to help 
Democrats provide insurance to 20 million more Americans. Healthcare is 
a very thorny political issue, but it doesn't have to be that way. We 
could sit down together and own this problem and the solution together, 
and we could end healthcare being a permanent political cudgel that 
just gets used every 5 to 10 years by one side to beat the other side 
over the head.
  We are Senators too. We got elected just like our Republican friends 
did. Why won't Republicans let Democrats into the room, especially 
after this bill has failed over and over again to get 50 votes from 
Republicans? We don't have a communicable disease. We aren't going to 
physically hurt you if you let us into that room. We are not lying when 
we say we have a desire to compromise.
  Democrats aren't going to walk into a negotiating room and demand a 
single-payer healthcare system. We understand that we are going to have 
to give Republicans some of what they want; maybe that is flexibility 
in the benefit design that is offered on these exchanges. But 
Republicans are going to have to give Democrats some of what we want, 
which is the end to this madness--an administration that is trying to 
sabotage our healthcare system and destroy the healthcare our citizens 
get. But that could be a compromise. It is not illegal to meet with us. 
There are 48 of us; there are not 12 of us. My constituents in 
Connecticut deserve to have a voice in how one-fifth of the American 
economy is going to be transformed.
  I know a lot of my Republican friends want to do this. I have talked 
with Republican Senators who say: Well, when this process falls apart, 
we want to work with you. It is falling apart, because the only way 
Republicans are going to get the 50 votes is by making these shameful 
changes--specific funding streams for specific States in order to get a 
handful of votes--and that is not how this place should work. Maybe 
that is how things happened here 100 years ago, but it is not how 
things should happen today.
  So once again I will beg my Republican colleagues to stop this 
partisan closed-door exercise and come and work with Democrats. We can 
do this together. We can own it together. We will have plenty of other 
stuff left to fight about if we find a way to agree on a path forward 
for America's healthcare system.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Cassidy). The Senator from Oregon.
  Mr. WYDEN. Mr. President, before he leaves the floor, I want to 
commend my colleague from Connecticut for a very thoughtful speech. I 
think he has made the case that the challenge ahead is really a two-
part drill--first, to stop something that is especially ill advised, 
and second, to then move to a better way that really focuses on 
sunlight and bipartisanship. So I thank my colleague for his very 
thoughtful comments.