[Congressional Record Volume 163, Number 154 (Tuesday, September 26, 2017)]
[Senate]
[Pages S6154-S6157]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTHCARE, THE DREAM ACT, AND TAX REFORM
Mr. VAN HOLLEN. Mr. President, we had some good news--or I should say
the American public had some good news today in the announcement from
the Republican leader that the Senate will not be proceeding to debate
what is known as the Graham-Cassidy legislation, the latest version of
TrumpCare, which would have had a devastating impact on our healthcare
system and created harm throughout the country and in my State of
Maryland. In fact, I know millions of Marylanders will be breathing a
sigh of relief as a result of this decision.
Mr. President, I ask unanimous consent to have printed in the Record
the personal testimonials of Marylanders who, in the last few days,
have sent to me their very powerful stories about how the Graham-
Cassidy legislation would have harmed their loved ones.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Van Hollen Constituent Healthcare/ACA Stories
9/19/2017
``I am a Registered Nurse who specializes in perianesthesia
care. Please do not wind back the clock and make it harder
for people to seek care during an illness. I am heartbroken
that I have cared for patients who delayed care for weeks and
months because they were more afraid of medical bills than
dying. When people are ill and do not seek care, they
jeopardize their lives--and in the case of communicable
diseases they jeopardize the lives of others by delaying care
and treatment.''--Beth
``My 14 year old daughter is a leukemia survivor. She has
multiple serious long term side effects from her chemotherapy
regiment. By repealing Obamacare, she becomes uninsurable due
to her preexisting conditions and the fact that she has met
her life time maximum many times over.''--Caroline
``I have a neuromuscular autoimmune disease called
Myasthenia Gravis. It affects my voluntary muscles, muscles I
use to walk, carry my groceries, see, swallow and breathe. I
already have to fight with my insurance to get them to pay
for my immunoglobulin infusions, which most of the time they
deny, which sends me to the emergency room because I can't
breathe. If for any reason I have to find a new insurance,
such as my husband getting a different job, it could be a
death sentence for me. Just one month of outpatient
immunoglobulin therapy is $27,000. My immunosuppressants I
have to take daily can run up to $2000 for a 3 month supply.
Then couple my health issues and the cost of medications and
I would probably die within a month or less. I didn't ask to
get sick. I never imagined at 41 I would be facing my
mortality.''--Chrissy
``My older sister has been profoundly disabled by mental
illness for the last 50 years. She is 62 now. She has severe
behavioral issues She cannot work. . . . She has been one
step from living on the street if it weren't for Medicaid and
SSDI. She is not getting rich from these safety nets by any
means. If these go away the republican congress and this
presidential administration will be responsible for making
challenging lives that much more miserable We don't treat our
most vulnerable as if they are disposable.''--Cat
``My son, 6, has a complex congenital heart defect called
Hypoplastic Left Heart Syndrome (HLHS). He has had four open
heart surgeries and several cardiac catheterizations. A
transplant could be needed one day. I worry every day about
how he will have heart care should something happen and when
he is too old to be on our plan.''--Dara
``I am a nurse practitioner and worked for the VA
Healthcare System for 15yrs. While this system is not without
its challenges, without it, many of our veterans would not be
receiving the healthcare and support they need to remain
healthy and productive members of society They would not be
able to work and support their families and as a result,
would likely not seek healthcare until they needed emergency
services. By then their previously untreated condition may
already have worsened to the point of permanent disability or
death, leaving their families to fall into poverty, despair
and having to rely on Gov't. Assistance. If they do not die,
their disability care costs far more than the early and
maintenance treatment they should have been receiving even if
they needed this maintenance treatment for a lifetime!''--
Becky
``My 25 yr old son has Crohn's disease. His entire large
intestine was surgically removed when he was 17. He must get
a remicade infusion every 6 weeks to keep his immune system
from attacking his intestines. No hospital ER will administer
his remicade infusion as this is considered maintenance of
his disease. When his situation becomes life threatening and
he needs the Intervention of the ER . . . the damage is
already done. Why don't our republican senators get this?
Shouldn't they be aware of this. . . . if they think they are
the experts, representing us? Trey will lose his insurance
next June when he turns 26.''--Darlene
``Deep Medicaid Cuts would be devastating to the millions
of people with disabilities. The Home and Community Waivers
would be in jeopardy. Because of the Community Pathways
Medicaid Waiver, Our 32 year old son is able to live in his
own apartment, volunteer in the community, hold a 30 hr week
job in Gaithersburg, and have a social life. Without the
supports he would lose his independence. . . . Please don't
make deep cuts to Medicaid.''--Reda
``We have 14 year-old twins, both of whom have Cerebral
Palsy. . . . It isn't their fault that they have a disability
and they should not be punished for it.''--Danica
``I work with medically fragile children with disabilities.
Without Medical Assistance, these children and their families
cannot afford the equipment, supplies & therapies that help
them grow and thrive.''--Carmel
``I'm 48. I was diagnosed with scoliosis at age 13, and I
had spinal fusion surgery to save my life from it at age 21.
The surgery saved my live, but also had lifelong
consequences. I have had this pre-existing condition for most
of my life. My parents, and then me when I came of age, have
always had to be careful to make sure that pre-existing
conditions were covered. I once turned down a job in part
because their insurance didn't cover pre-existing conditions.
The ACA meant I no longer had to worry. Today, I work as a
contractor for the US military, helping defend US cyberspace.
I wouldn't be here, doing important work and being a
productive member of society, if I couldn't get coverage for
my pre-existing conditions.''--Bruce
``Obamacare saved my roommate's life. He was a server at a
very popular restaurant, hardworking, got good tips but could
not afford health insurance. He got prostate cancer.
Obamacare got him the care he needed.''--Deborah
``I had a mitral valve prolapse. It was discovered when I
was a little girl, and basically that means that one of the
valves in my heart never fully closed. I was followed
annually by a cardiologist, and she told me to expect to have
it fixed in my 30s. She also told me to have children in my
20s because if I needed to have it replaced (not just
repaired), I would need to take blood thinners that would not
allow me to be pregnant. I had my heart repaired four days
after my 30th birthday, when my kids were 5 and 9 months. It
was not fun, especially being a mom with little ones, but I
am as good as new five years later. Only my health insurance
doesn't think so. Prior to the ACA, I was rejected by the
BCBS policy my husband's company was providing for us and his
employees. They told us they were happy to offer coverage for
my family but would not include me on our plan. Everyone gets
sick. Everyone gets old. You can do everything right and
take care of yourself--and still have a preexisting
condition that makes you more expensive to cover. And
without the ACA, I may find myself having to fight for
health insurance again.''--Justine
``My daughter was diagnosed with a rare Autoimmune disorder
at age 18 . . . . Thanks to Obamacare, she was able to stay
on our insurance until age 26 then purchase her own through
her employer. Preventative care keeps her in remission.
Losing the ability to afford insurance means she cannot
afford care. One medication alone costs over $2,000/
month!''--Cheryl
``I am the first to acknowledge that there are major
problems under the ACA. Premiums and deductibles are far too
high and increasing far too much annually. I am self-employed
and the individual market is getting exceedingly worse each
year. CareFirst proposed a 50% rate hike for 2018 for plans
that already have a $6500 deductible. This is not
sustainable. However, prior to the ACA, I was denied coverage
by every insurer in the State of Maryland. The reason for the
denial was that I was prescribed Lovenox, an injectable blood
thinner, when I was pregnant with my three children. The
letters denying coverage said I was at increased risk for
thrombosis, despite the fact that I had medical documentation
stating otherwise because my particular blood clotting
concerns exist only in pregnancy. Before the three children
in my profile picture were born, our first daughter was
stillborn and I had two miscarriages. Initial pathology
following her stillbirth showed that the placenta was badly
clotted and blood testing showed that my Protein S levels
were low. Following the two miscarriages and substantial
blood work, my doctors concluded that my protein S levels dip
to deficient levels in pregnancy and that I needed blood
thinner in order to maintain a pregnancy. I find it ironic
that the ``pro-life'' Republican party wishes to punish me
and my family because of medication I took to ensure that my
children were born alive and well. We need to fix the ACA,
but this is not it.''--Kim
``I have been a type I diabetic for 25 years. When my
husband and I had health insurance coverage through his
employer, my prescription for life-sustaining insulin cost us
$300 each month. After he began working for a new employer
who did not offer health insurance, we were encouraged to
shop for our healthcare on the Maryland Exchange. With our
ACA plan, my insulin is now much more affordable at $50 a
month. If I have to go back to paying exorbitant amounts of
money for a medication I need in order to survive, I will be
forced to cut corners. If I do not take the necessary amount
of insulin, I face a host of complications including kidney
failure, neuropathy, blindness, and so much more. My husband
and children should not have to watch me suffer the
preventable side-effects of this disease. Like all other
[[Page S6155]]
Americans, I deserve affordable health insurance coverage and
the Affordable Care Act provides that for me!''--Katie
``I am a 55-year-old humorous, fun-loving, and fiercely
idealistic daughter, sister, friend, 5th grade teacher,
volunteer, advocate, and 9 year breast cancer SURVIVOR.
Please!! Do not allow them to change the words ``breast
cancer survivor'' into something I loathe and fail to
celebrate!! If the GOP is successful, which I CANNOT bear to
consider, I become no more than a ``preexisting condition and
cancer VICTIM'' in the eyes of our government, insurance
companies, and the healthcare system. If the GOP is
successful, I become a 55-year-old angst-ridden daughter,
sister, friend, 5th grade teacher, volunteer, advocate, and
SCARED AS HELL breast cancer VICTIM who fears bankruptcy and
spends countless hours contemplating my mortality. Please!!
Keep fighting for all of us. I sincerely believe that
EVERYONE IS A SURVIVOR--NOT A VICTIM--OF SOMETHING IN THIS
LIFE!! Please!! Do not let the GOP take control of our
narrative. We all have people who count on us. If we cannot
take care of ourselves because of sky-rocketing medical costs
. . . If we cannot function in our jobs properly because of
constant fear and worry . . . . How can we possibly take care
of our beloved family, friends, and those in our care both
professionally and in our volunteer endeavors???''--Carla
``Thank you for fighting this. I am a 7 1/2 year cancer
survivor, but could be prohibited from coverage if my
previous diagnosis is included in pre-existing condition
exemptions.''--Pat
``My daughter is medically fragile, and dependent on a
ventilator, due to a genetic condition (Neurofibromatosis
type 1, also known as NF). She also has a rare
cerebrovascular disorder, called Moyamoya Disease that caused
her to suffer two strokes at age 15 months old. Daphne has
been through heart surgery, neurosurgeries, chemotherapy, and
countless hospitalizations. She also suffers from epilepsy.
Because of her vast health issues, she requires 24 hour care
and receives in-home nursing through Medicaid for 16 hours a
day. Cuts to Medicaid coupled with allowing insurers to deny
for pre-existing conditions, and bringing back high-risk
pools would put the most vulnerable people at risk . . . .
Every ACA repeal bill that has come forward has been a threat
to my daughter's wellbeing, and this one is no exception.
This is not the right path forward. The Senate should be
working hard to make sure every American has access to
healthcare, every Senator should be looking out for the most
vulnerable Americans. There are measures needed to improve
our healthcare system; but cutting access to healthcare to
the people who need it most is not an improvement. For
families like mine, it would be devastating.''--Jenny
``In 1994, I was 24 years old and working at Dartmouth
College in New Hampshire, when I suddenly got very sick and
was hospitalized. I was diagnosed with acute pancreatitis of
unknown cause, and spent 11 weeks in the hospital and had 2
surgeries. I did have health insurance, but the final costs
from that initial illness that were billed to insurance
totaled over $250,000. Two years later I experienced a
recurrence of the pancreatitis, and I was told that I now was
almost assuredly going to have what is known as Idiopathic
Recurrent Acute Pancreatitis. This time I was only
hospitalized for 30 days, but the costs were mounting, and I
began to be afraid that I was going to easily hit the one
million dollar lifetime limit that was currently part of my
policy. I also was unable to consider moving away from New
Hampshire (to be closer to family resources and support, for
example), because of the strict Pre-existing Conditions
clauses at that time. In 1998, when President Clinton signed
the bill that forbade insurance providers from denying
coverage for preexisting conditions, I was able to change
jobs and move back to my hometown of Baltimore, Maryland.
Now, after working for The Johns Hopkins University for 15
years, I have been forced by necessity to leave my job and
obtain Social Security Disability benefits, and now I am also
being covered primarily by Medicare. I am already living on a
fixed income, at age 47, and I am not making enough money to
even live without a roommate, let alone enough money to face
increasing premiums as well as decreasing coverage for my
medical care. Please, please, please do not let Congress pass
this bill!! I would be honored for you to tell my story, and
I hope that maybe it could be eye-opening for some of the
representatives who seem to believe that if you are a well-
educated, younger, tax paying citizen these changes won't
have a big impact. This kind of unexpected medical
disaster could happen to anyone.''--Nicole
``11 months ago, I had to consent to a C-section at 28
weeks pregnant due to pre-eclampsia. The only thing worse
than having to put my tiny son's health in jeopardy to save
my life was the fear of my dying and leaving my husband to
raise a 4 year old and a potentially medically-fragile
infant. Now I worry, will his prematurity and my high blood
pressure come back to haunt us? I got through his 142 day
stay in the NICU by dreaming of what his life could be. I
dream of him running when he is two, arms outstretched, of
when he is 22 and graduates from college, maybe to be a NICU
nurse, of when he gets married and I dance with him . . . .
My nightmare is that this will affect our ability to have
that future I dreamed of, mostly that I won't be there for
him. We have fought so hard to get our own ``normal'', please
keep fighting for us.''--Rachel
``I am a Montgomery County Maryland resident and have an
aged severely disabled aged brother in a nursing home who
depends on Medicaid and an adult daughter with Crohn's
disease and a preexisting condition she acquired as a
teenager and both of their lives will be put in jeopardy if
they lose their current . . . medical coverage and I am
worried and angry at the cruel and heartless Republican
attempt to reduce or eliminate their life saving health
coverage.''--Richard
``My husband and I have both have had life threatening
medical conditions. To lose our health insurance due to pre-
existing conditions will be a death sentence when we run out
of options. I worry most though for our medically fragile
children and seniors.''--Val
``Twelve years ago, before the Affordable Care Act, I was a
single parent of two school age children and was denied
health insurance coverage because of pre-existing conditions.
I frantically searched for employment where I could have
coverage in an employer plan. I was fortunate to find this .
. . . In 2014 I had to leave employment to become a care
giver for my husband who was diagnosed with Parkinson's
disease. I considered myself fortunate to be able to do this
because the Affordable Care Act would allow me to purchase
health insurance without worrying about my pre-existing
conditions. My premiums and deductibles have been very
expensive, but at least I could obtain coverage. I remember
the stress and fear from being previously denied
coverage.''--Roberta
``My 25 year old daughter is about to hit her 90-day
sobriety date, thanks to her hard work, and the treatment she
is receiving at a great rehab in PA. She is still going to
outpatient, and she is living in a sober house with
roommates. My health insurance has covered her treatment.
Thank God she is still able to be covered under our family
plan. Please do not take the chance for a life in recovery,
and addiction treatment services away from our children It is
saving lives.''--Deb
``It would be a death sentence for me. As it is now I am
fighting to get on disability now. I have 4 serious pre-
existing conditions. The ACA saved my husband's life no joke
as he had cancer life threating cancer and without it he
would NEVER had survived period. He also has 3 other
preexisting conditions. Our medical bills as it stands now
are more then all our other bills combined per month. In the
middle of an opiate epidemic as well OMG addiction and or
mental health issues are considered pre-existing conditions
what are they thinking and ripping millions of people safety
net away from them in the middle of this crisis is not
human.''--Jean
``I have asthma, which was and is a pre-existing condition.
Early in my twenties when I was in college but not able to be
on my parent's insurance, I would put off going to the doctor
because I couldn't afford it when I got sick. Consequently,
this meant I ended up in the ER for asthma related problems.
Every 6 months I would come down with pneumonia because there
was no vaccine for it then, and each time it meant a visit to
the ER for intensive breathing treatments because I could not
breathe. This happened so many times I eventually had to
declare bankruptcy to get out from under the bills. Today my
asthma medicine is covered with a nominal co-pay, I can see
my doctor before a case of bronchitis becomes something
worse, and I do not need to go to the ER for treatment. Now I
have a twenty year old in college who has pre-existing
conditions, unlike me she is still covered under our health
insurance and her prescriptions are affordable. What happens
to me, my daughter, and my husband who all have pre-existing
conditions if our insurance is allowed to go back to the old
days of charging more for our coverage? What happens to my
daughter if she can no longer be on our policy? Surely the
Republicans can't think that repealing these protections and
replacing them with nothing is something good for our
country? Are they that out of touch with the middle class?
Please do not pass this, you will be hurting many, many
people.''--Pamela
``As a type 1 diabetic, I used to skimp on my insulin to
make the bottles last longer. Keeping my blood sugar levels
higher than they had to be is catastrophically unhealthy.
Please don't make people with chronic illnesses have to
choose between food and medicine!''--Sandra
``My sister who has Cerebral Palsy and is able to live at
home at the age of 41 with my parents would lose the medical
coverage and supports that ensures her wellbeing. My father
who is 87 years old would now be subject to pre-existing
condition exclusions. This is a man who served in the army
and retired from the Postal Service in his 70's. He grew up
in the Great Depression and worked tirelessly his entire
life. Name me one person who does not have a pre-existing
condition by the age of 87.''--Bonnie
``My daughter has had pre-existing conditions since she was
22 months. She is now 23, still with developmental delays and
chronic medical conditions. She will need good care and
Medicaid and a Medicaid waiver program the rest of her life.
She will never be able to work. If there are cuts to Medicaid
and she gets denied private insurance for pre-existing
conditions, our government is basically telling me and
telling her, ``We really don't want her to live. We really
only want healthy and non-disabled people living in America.
We would like her to die.'' That is exactly what their plan
sounds like to me.''--Kimbell
[[Page S6156]]
``I am guilty of being born with an autoimmune condition.
For much of my young adult life I was not insurable because
of the pre-existing condition clause, and arthritis caused by
my autoimmune condition left me stuck in bed more days than
not. Since the ACA, I am insured and as a result have been
able to start a treatment for my condition which is literally
life-changing. I can leave the house, I can have a normal
life, and I'm even fostering a dog for a rescue that took
dogs from the Harvey shelters before the storm, to make room
for displaced pets. He needs a walk every day, at least once
a day, and I can do that. The repeal makes no sense--if I can
buy insurance I can work and contribute to the community. If
I can't get insurance I can't get healthcare, and without
healthcare I can't work, I can't contribute to society
through volunteering--how do people benefit from making sure
people like me can't get the healthcare we need to be able to
have lives? Even if you don't care about us as people,
society benefits when more people can work and pay taxes and
volunteer.''--Kris
``In 2006 at age 41, I was diagnosed with a rare, incurable
and life-threatening disease. I had insurance through a
Health Savings Account, which had a $3,000 annual deductible
and monthly premiums that increased 400% in 5 years. I've
been disabled by this illness and many complications and rely
on Medicare and Medicaid to survive. If either is cut I won't
be able to afford the highly specialized medical care this
rare disease requires. I will die as a result. Please do
everything in your power to protect all of us whose lives are
at risk.''--Sangye
``My Wife's Father, Dennis, passed away a little over two
years ago of congestive heart failure. He wasn't even 60. He
was a CT Native that lived alone in SC with just his beloved
German Shepheard Bobbi at his side. While his medical issues
were great, he managed to hide most of them from the family .
. . . Had he gotten treatment early his conditions could have
been easily managed but because he went untreated for years,
his issues became fatal. There was eventually nothing that
could be done. The saddest part of this is that we fought
with him for years to sign up under the Affordable Care Act.
He refused because he felt this was a hand out and he was too
proud for that. When he eventually became too weak to carry
out even the most basic tasks, which included hiding his
condition from the family, he finally agreed to sign up.
While he did sign up, he would never see his first
appointment. He passed in his sleep before it could even be
scheduled . . . . Dennis should have lived. He could have
lived. If he simply had access to the care he needed all
along then he would still be with us. But we don't get to
have that. Instead my Wife has a hole in her heart that may
never be repaired. Tormented with the ``what ifs'' that can
never be answered. The only thing we can be thankful for in
this is that we were able to claim Bobbi, the dog he lived
for. She has become a truly beloved member of our family.''--
Jason
``Thank you for fighting for us. If pre-existing conditions
aren't covered I will quickly go bankrupt. I will lose my
house that I just purchased. I have a good, steady job and a
Master's degree but this would quickly bankrupt me.''--
Rebecca
``People need to understand how easy it is to feel like a
relatively healthy person, then be saddled with a ``pre-
existing condition''. I work in a field where it is difficult
to get employer sponsored health insurance. Before the ACA,
when I was applying for my own policy . . . . I had to go
through underwriting. They called every doctor I ever had.
They requested that my entire file be sent to the insurance
company. It was very invasive . . . . Finally, I received a
letter. I do not qualify for insurance due to pre-existing
conditions. I have never been seriously ill, never been
hospitalized. I use an asthma inhaler as needed and I take
one generic pill every day for another condition. This was
enough to deny me. I had to go on a high risk plan which cost
me almost as much as our ACA plan for a family of three.
There was no drug coverage whatsoever. I had to pay list
price for drugs . . . . I had a well-paying job with no
dependents and I still needed help from my parents to pay for
all of this . . . . With this new bill, these are the days we
are going back to. We can't. We just can't.''--Hilary
Mr. VAN HOLLEN. Now that we have decided not to vote on that
legislation, it is essential that this Senate move forward
expeditiously to take up bipartisan legislation that has been in the
works through Senator Alexander and Senator Murray. Those conversations
were bearing fruit. They were productive until the Senate decided to
veer off, once again, to try to pass legislation that would have
destroyed the Affordable Care Act. But now that we have decided not to
go down that path, we have to quickly come back to those bipartisan
talks and adopt some commonsense measures to strengthen the insurance
system in a smart and targeted way.
There were many commonsense ideas that are part of those discussions,
including making more permanent the so-called cost-sharing provisions,
which help to lower the costs of healthcare and help to reduce the
premiums, the copays, and the deductibles, and the reinsurance
provisions that also have that effect, as well as discussions about how
we might be able to streamline waivers within the Medicaid system
without sacrificing or jeopardizing the important principles and
protections that Medicaid provides on a national level.
We know we have to move quickly on this front because insurance
companies all over the country have already started or are on the brink
of starting the process of announcing their premiums. Unless this
Senate takes action, we are going to see many high premiums. So we have
to move quickly. As we do, the White House needs to stop their efforts
to undermine and sabotage the Affordable Care Act.
On day one of his Presidency, President Trump adopted an Executive
order that began to sabotage that program. We are already seeing the
impact when it comes to some of the early premium announcements we have
seen from insurance companies that offer insurance in the exchanges.
That decision--that early Executive order--has created a big spike. So
the President needs to act right away to assure the folks who provide
healthcare throughout the country that he is going to stop the sabotage
and begin to make sure that we stabilize those markets. It is under his
control to say today, if he wanted, that he will continue those cost-
sharing payments until the Senate and the House adopt permanent
legislation to address those issues.
So it is really important that the Trump administration take those
actions now to avert increasing premiums in the exchanges in the days
to come. It is also essential that the Senate move forward on that
legislation.
I hope we will also move forward with the continuation and some
strengthening and modifications of the Children's Health Insurance
Program. Again, there is bipartisan agreement on that proposal. We need
to move forward right away with the support for community health
centers because that authority will also expire.
I hope we will then get on with the business of putting into law the
agreement in principle that was reached by President Trump and the
Democratic leaders in the House and the Senate to provide protections
for the Dreamers. As we all know, the President lit the 6-month fuse on
these young people who were brought here through no fault of their own,
and it is incumbent on all of us to make sure that these young people,
who have grown up knowing only America as their country and who have
grown up pledging allegiance to the flag, not face the threat of
deportation 6 months from now. That is what they are facing as of this
moment. The Senate should act quickly to pass the bipartisan Dream Act.
I hope we will also move forward in a bipartisan way on the important
issue of tax reform because I think all of us agree that our Tax Code
could be simplified. There is a lot of junk in our Tax Code that has
been put there by powerful special interests who were able to hire
high-priced lobbyists to exempt themselves from certain tax provisions
that all other Americans have to pay. We need to clear out that
underbrush and make other important reforms, and we can simplify the
Tax Code.
As we do that, I was very much hoping that we would take the advice
of our colleague, Senator McCain, who said we need to get back to the
regular order. We need to get back to the Senate conducting its
business in a transparent manner. We need to have hearings. We need to
bring witnesses from all different perspectives and points of view to
testify as to the impact of tax reform proposals.
We short-circuited that process when it came to healthcare, and the
result was a healthcare bill that the overwhelming majority of the
American people rejected, including every single patient advocacy
organization that weighed in on that bill--from the American Cancer
Society to the American Heart Association and the American Diabetes
Association. We have seen that very long list, with all of the
healthcare providers, from the nurses to the doctors to the hospitals.
Hospitals in rural areas, suburban areas, and urban areas all said that
the healthcare bill that did not go through the regular process and did
not go through the regular order was deeply flawed and would hurt
America.
[[Page S6157]]
We should learn a lesson from that. The lesson we should learn is
that tax reform, which also has an incredibly wide-reaching impact on
our economy and on our country, should go through the regular order of
debate. It is very alarming to see that, as of now, it appears that the
process on tax reform is going to go through the same short-circuited
effort as we saw with respect to healthcare, because what we have seen
is that the Senate Budget Committee, on which I am proud to serve, will
soon--maybe as early as next week--be taking up a budget bill that will
include what are known as budget reconciliation instructions, which
would provide for a tax cut that would be deficit-financed. What does
that mean? It means that we would be cutting taxes and not paying for
them. We would be cutting taxes and putting it on the American credit
card and, as a result, dramatically increasing our debt. In fact, the
reports indicate that the proposal will actually green-light a $1.5
trillion increase in the Federal deficit.
Now, I have heard our Republican colleagues in the House and in the
Senate for years talk about the fact that the debt is a huge burden
overhanging on our economy. The debt is a big problem, and we need to
deal with it. In fact, a few months ago, Leader McConnell said that any
tax overhaul plan would ``have to be revenue-neutral'' because of the
``alarming $20 trillion Federal debt.'' Yet, just months after that
statement, we are told that we are probably going to get a proposal
that would actually green-light--open the door--to increasing the
Federal debt by $1.5 trillion in order to provide a tax cut.
Now, the Democrats have put forward some principles for tax reform
that I believe reflect the views of the American public. What we have
said is this. No. 1, tax reform should be there to help the middle
class and working families with some relief, and we should not be
providing millionaires in the top 1 percent with yet another tax cut
windfall. That should not be the priority of the country. In fact,
Secretary Mnuchin, when he was testifying during his confirmation
hearings, put forward something that we called the Mnuchin rule, which
said that there should be no net tax cut for the very wealthy. So we
have adopted that as one of our principles for tax reform.
We have also said what Leader McConnell said a few months ago, that
tax reform should not add to the deficit and debt. We shouldn't pass
that burden on to taxpayers and future generations to pay the interest
on that debt.
Finally, we have said that it should go through the regular order, as
Senator McCain indicated, where we have that debate in an open forum so
that everybody can understand the impact and have their say before
people try to rush it through the Senate in a short period of time. So
I hope that is what we will do. These reports that we are talking about
short-circuiting the process are alarming.
Then, we just heard within the last few days that, in addition to
creating a process that would fast-track tax cuts that could go
overwhelmingly to the wealthy and add to our deficit, this
reconciliation bill will be written in a way that might allow us to try
to fast-track the destruction of the Affordable Care Act again. We have
finished this debate for this fiscal year, but suggestions are that it
will open the door to destroying the Affordable Care Act through that
fast-track, so-called reconciliation process in the months ahead.
So we would have in one piece of legislation a proposal that says:
Let's cut taxes for very wealthy people, and it will add to the
deficit, but we are also going to try to reduce the deficit a little
bit by cutting healthcare for millions of Americans.
We thought we just had that debate, and we thought the American
public just weighed in on that debate. The result of the American
public's weighing in was very clear, and that is why we are not voting
on that this week in the Senate. We should not open the door again to
that kind of fast-track process that could do such grave harm to the
healthcare of the American people.
So I hope that when it comes to tax reform, we will take a different
path. As I indicated, there are things we can and should do to simplify
our Tax Code. What we should not do is what we have seen in the past.
What we saw in the past in the early 2000s was this fast-track
procedure used to pass tax cuts that went overwhelmingly to the
wealthiest Americans. In fact, after that tax cut was put in place,
what went up was the income of the top 1 percent. What went up was the
deficit and the debt, and everybody else was left flat or sinking. So
that would be a terrible mistake.
For example, we are told that part of this will be eliminating
entirely the so-called estate tax. Right now, the estate tax only
applies to estates over $11 million, for couples--over $11 million. So
0.2 percent of Americans are impacted by the estate tax, and they are
the wealthiest of the very wealthy. Yet this proposal says we are going
to actually increase the debt by $1.5 trillion in order to make room
for tax cuts that benefit the top two-tenths of 1 percent of the
American public.
That is heading in the wrong direction. I am pretty confident that,
at least, in my State of Maryland, the overwhelming majority of our
citizens would be very much opposed to that effort. What always happens
is that, when it comes to cutting taxes for the very wealthy or for
powerful special interests, many of our Republican colleagues here
forget about all the talk about the importance of the deficit and debt.
It is OK to run up a $1.5 trillion debt on top of our already high debt
in order to provide tax cuts. But then, when those debts go up, always
the conversation comes around to cutting--cutting our investments in
education; cutting Medicare, turning it into a voucher program, as
various Republican budgets in the House and Senate have proposed over
the years; cutting Medicaid, which is what the Graham-Cassidy bill
would have done and, according to the Congressional Budget Office, it
is over a $1 trillion cut, and that is before it went over a total
cliff in the outyears.
So let's, please, colleagues, learn the lesson from how this
healthcare fiasco unfolded. When it comes to things like tax reform,
let's proceed in a bipartisan way. Let's begin in the coming week to
get back to the bipartisan discussions on healthcare, so that as we
head into the fall, people are not going to experience wounds that are
inflicted by the lack of action by this Congress--by this Senate and
this House.
I thank you, Mr. President. I hope we can get back to regular order
at some point in time and really do the people's work the way it is
intended to be done--in an open, transparent, and bipartisan way.
The PRESIDING OFFICER. The Senator from Iowa.
Mr. GRASSLEY. Mr. President, I ask unanimous consent to speak for
approximately 6 or 7 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
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