[Congressional Record Volume 164, Number 200 (Wednesday, December 19, 2018)]
[Senate]
[Pages S7847-S7849]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 UNANIMOUS CONSENT REQUEST--S. RES. 734

  Mr. MANCHIN. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of S. Res. 734, submitted 
earlier today; that the resolution be agreed to, the preamble be agreed 
to, and the motions 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, whether 
you support ObamaCare or oppose it--and I clearly oppose it--it remains 
the law. The decision in the Texas case is being appealed, and I expect 
it will eventually end up before the Supreme Court.
  Regardless of what happens in this legal process, our commitment has 
always been to protect people with preexisting conditions. As a doctor 
and husband of a breast cancer survivor who has had three operations 
and who has been through chemotherapy twice, I know the importance of 
making sure that patients can get access to quality healthcare at an 
affordable cost. Since ObamaCare passed, this has not happened for many 
families I speak to in Wyoming. They keep telling me that ObamaCare has 
made their insurance unaffordable, whether it is premiums, copays--all 
of it. It has made it more difficult to get the care they need.
  Simply put, they know ObamaCare has failed because they personally 
have experienced the law's sky-high premiums and few choices.
  It has taken Washington Democrats a little longer to figure this out. 
Now they are clamoring for a federally mandated, single-payer system. 
They want a healthcare system dominated and controlled by Washington.
  As a doctor, my focus is on making healthcare better for patients, 
period. It shouldn't take a judge to force us to get it done. We need 
to reform healthcare to give American families better care at a lower 
cost, which ObamaCare failed to deliver.
  The question is whether Washington Democrats are interested in 
solving problems or playing politics. I am ready to work.
  Therefore, Mr. President, I object.
  The PRESIDING OFFICER. Objection is heard.

[[Page S7848]]

  The Senator from West Virginia
  Mr. MANCHIN. Mr. President, I respectfully disagree with my friend 
from Wyoming. First of all, the reason I asked for a live unanimous 
consent request on my resolution was to protect the 800,000 West 
Virginians with preexisting conditions, along with millions and 
millions of Americans.
  We have tried. We have come to an agreement on how to fix the high 
cost of third-party and individual payer. It has been lying on the 
majority leader's desk for a year with no movement or action.
  People say that we all have sympathy and empathy for people with 
preexisting conditions. If you want to protect that, then remove your 
lawsuit or at least allow us to move forward on a unanimous consent 
request so that we can fight and have a fighting chance, as this will 
be appealed to the higher courts.
  It is absolutely wrong that people who have insurance for the first 
time, now have the threat of having it taken away from them.
  As a former Governor, let me tell you how this system works. If you 
think people are not deserving of insurance or should not be able to 
have affordable access to insurance, then you are paying anyway, 
because the people who don't have that or didn't have it before go to 
the emergency room at the highest cost. They go right to the emergency 
room. They don't pay. That cost is then distributed on to the Governor, 
and the Governor of each State has to come up with supplemental 
payments to keep hospitals and rural clinics open. That is the way the 
system works.
  If you work for a company and couldn't afford the copayment, if you 
work for a company that didn't offer insurance--a small company that 
didn't have insurance at all--what you would do if you got hurt at home 
or got sick, you would hobble into work and make a workers' comp claim. 
That is the only access to insurance.
  If you want to go back to those draconian days, that is where we are 
headed if this lawsuit succeeds. What we have asked for is simply the 
ability to fix what we have in front of us.
  I haven't supported the single-payer system; we are not talking about 
a single-payer system. We are not talking about anything but fixing the 
existing Affordable Care Act.
  The President of the United States, Donald Trump, could do this very 
easily, taking this up. I will be happy to call it Trump RepairCare. I 
think it would be a fitting name because he can fix it. He can bring us 
together so that we can basically look at a bipartisan solution to 
bring down the high cost of premiums. We can also look at a bipartisan 
solution to fix the runaway costs, teaching people how to take care of 
themselves, keep themselves healthier and be preventive in the care 
they receive.
  This resolution allows the Senate and legal counsel to intervene and 
defend West Virginians and Americans with preexisting conditions from 
this inhumane lawsuit. If you believe in that, there should be no 
consideration for objections. We should be able to sit down and let the 
legal staff that we have here in the Senate intervene on our behalf and 
the people we represent. That is all we have asked for.
  Millions of Americans with preexisting conditions have been trusting 
us to defend their rights. Now they are hearing the political rhetoric. 
They hear it every day when anybody goes on the campaign trail. The 
last thing I heard from my colleagues on the Republican side--and these 
are my friends--they said: Oh, yes, Joe, we want to make sure that 
people with preexisting conditions have access; they cannot be denied.
  But guess what the proposal is that they were going to come forward 
with. It would say simply this: We will make sure insurance companies 
offer you affordable insurance, but, basically, they will not have to 
protect you or insure you for an existing condition you have had. So we 
will basically insure your entire body, except for the cancer or the 
heart condition that you might have had prior to that. That made no 
sense whatsoever.
  So they are really not sincere about coming up with allowing people 
with preexisting conditions to have access to affordable care. That is 
all we are doing today.
  Right here and right now we have the opportunity, and we have heard 
the objection, and I am so sorry for that. We could have done the right 
thing and directly been involved in defending the lives of Americans.
  I believe that the Texas judge was wrong in his ruling because we 
never removed--even those who voted for the tax cuts, and I think a lot 
of people begrudgingly did that, looking back on that--but, with that, 
it said they removed the mandate. The mandate did not remove the 
language of the code of the law. It removed the money from it, but it 
didn't take the language away. So I think anybody with any type of 
background in the legal process understands that will not hold up in 
court. All we have asked for is the right to defend the people we 
represent.
  So I am very sorry for the decision to object. I really thought that 
we could get a unanimous consent agreement and move forward, and then, 
really, you could go out and talk to your constituents and say: I truly 
am fighting to make sure that any of you all who have preexisting 
conditions--800,000 West Virginians who have a preexisting condition--
will have affordable access and cannot be denied and cannot be 
overcharged. That is all. Give them a chance.
  I don't know where you come from, but where I come from, before we 
had any access to healthcare, before there was a law that forbade 
insurance companies to charge outrageous prices or cut people off to 
say that, basically, you have hit your cap and you are no longer able 
to be insured--you are too sick for us to invest any more into you--
they would say: I don't want to be a burden to my family.
  What a person is telling you, if they have a preexisting condition is 
this: I don't want to be a burden to my family because I don't want to 
put them in a position that would be absolutely ruinous for them, put 
them in bankruptcy; one of my illnesses could put my family in 
bankruptcy because I cannot buy nor will the insurance company sell me 
insurance, nor can I afford what they want for it.
  That is what we did away with, and that is where we are going back. 
We want to intervene so we do not go back to those dark ages.
  With that, I hope my friends on the Republican side will reconsider 
this, and, as a body, let this move forward to protect the people of 
America.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I rise to join in the remarks of the 
Senator from West Virginia, who worked very hard to make sure we had a 
resolution that would allow us to direct the Senate legal counsel to 
intervene in the lawsuit.
  Of course, the lawsuit is beyond the district court. We await what 
might happen in an appellate court. But the best way for anyone in this 
body to express their disagreement with the removal of the protections 
for those who might have a preexisting condition, if you believe that 
those protections should remain the law of the land as they are now, 
then you should, as a Member of the House or the Senate--even if you 
wanted to be in favor and voted in favor of repealing the Affordable 
Care Act, you could still argue that in the interest of preserving 
those protections, without question, in the interest of providing 
certainty to not just tens of millions of Americans but many millions 
more than that who have these protections in law right now--did not 
have those protections before the Affordable Care Act--if that is what 
you believe, you could very easily say: Let's preserve them and make a 
different argument in this court case, file a brief, and try to 
intervene, as you could in this case.
  But for some reason around here, some people think they can have it 
both ways. They do television ads and campaigns or give speeches back 
home saying: Oh, don't worry, I want to protect and I want to preserve 
the protections for preexisting conditions, but at the same time do 
nothing about it.
  There is no third way here. You are either in favor of those 
protections, maintaining in law the protections for those who have a 
preexisting condition, or you are not. You are either for that or you 
are not. If you are for it, I think you are dutybound to take action to 
preserve it.
  Right now, these protections are at risk. They will be in greater 
jeopardy if

[[Page S7849]]

an appellate court were to agree with the district court. So I think 
folks here have to make a decision: You are either for maintaining 
these protections, which carries with it a responsibility to take 
action to make sure that those protections are in law--are kept in law, 
remain a part of our law--or you have to go to the other side, which is 
you throw up your hands and say: Either I am not for those protections 
or I am not going to do anything about it.
  So you have to take action or not. I think that is true of people in 
both parties and both Chambers, but when you consider what is at stake 
in a State like Pennsylvania, we have a huge portion of our 
population--more than 3 million people--who live in rural communities. 
With 67 counties in Pennsylvania, 48 of them are rural.
  A couple years after the Affordable Care Act passed we saw in 
Pennsylvania--this is only maybe 2 years ago now, and I am sure the 
numbers haven't changed that much--we had about 280,000 people who got 
their healthcare through the Affordable Care Act but lived in those 48 
rural counties. Of the roughly 280,000 who got coverage, 180,000 were 
in rural communities. Lots of folks in rural areas are worried about 
the protections they got because they were benefited by Medicaid 
expansion, and the balance of those got their healthcare through the 
exchanges.
  If you are in a rural community and you got healthcare most recently 
through the exchanges or even if you had healthcare prior to 2010 or 
prior to the last several years, you have protections that you didn't 
have before. Of course, in rural communities in Pennsylvania, you have 
even higher incidents in many cases of those who have an opioid 
problem. These healthcare decisions, these healthcare votes that we 
cast, these healthcare court cases have even greater significance in 
rural communities--whether it is preexisting condition protections, 
whether it is having the coverage of Medicaid that allows you to get 
treatment and services for an opioid problem, or whether you are just 
dependent on healthcare because of your own health or that of a family 
member, especially children.
  I would just make a couple more points because I know we are limited 
in time. Here is some data on the impact of the Affordable Care Act and 
what could happen in some communities in a State like Pennsylvania that 
have a high significant rural population.
  We are told in one study that since 2010, 83 percent of rural 
hospitals have closed, and 90 percent of these rural hospitals that 
closed have been in States that have not--or have not as of that time 
period--expanded Medicaid when the hospital closed. So we are talking 
about a court case that would, in essence, invalidate the Affordable 
Care Act. We are talking about not just healthcare loss or coverage 
loss in a rural community, we are talking about job loss and 
devastation.
  In our State, we have something on the order of 25 rural counties 
where the No. 1 or No. 2 employer is a hospital. If that hospital is 
badly undermined, if they can't make the margins work because of cuts 
to Medicaid or the elimination of Medicaid expansion, as some around 
here want to do--not just cut it but eliminate it--you are going to 
have economic devastation in those communities in addition to 
healthcare devastation.
  The staff of the Joint Economic Committee has estimated that if the 
Affordable Care Act were struck down, which is the effect of this 
Federal court case of just last week, 17 million people would lose 
coverage next year--17 million people in just 1 year.
  What we should be doing around here, in addition to urging a court--
or any court--not to strike it down, is to have bipartisan hearings for 
a long time on lots of ideas. We need at least weeks of that, if not 
longer. If there is one area or one place of consensus around here, it 
is that healthcare costs for too many Americans are too high. We have 
to get costs down, and people in both parties have a lot of work to do 
on that.
  The second thing we hear back home and across the country is 
prescription drug costs especially are too high for too many families. 
Neither party has done enough on that issue. We have to get those down 
as well.
  If we focus on the priorities of most Americans, which is not 
repealing this law; it is not throwing out or ending Medicaid 
expansion, which helps with the opioid crisis and helps a lot of our 
rural communities especially--what we would do is focus on the 
priorities of the American people: get the cost of healthcare down, get 
the cost of prescription drug costs down, and deal with any other 
issues that have been brought to the table for those who care about 
improving our healthcare system.
  If the American people see only a battle about one side wanting 
repeal and the other side working every day to try to stop that, we are 
not going to advance very far on their agenda. Their agenda is not that 
fight. Their agenda is to protect the gains we have, make sure people 
don't lose coverage, and make sure a much larger portion of the 
population--virtually everyone you know--doesn't lose protections that 
were put into law a couple of years ago.
  If we do that and focus on those priorities, I think the American 
people will believe we are beginning to do our job in both parties on 
healthcare. The worst thing we can do is go back to the days when 
someone with a preexisting condition was denied coverage or was charged 
a higher rate because of that preexisting condition. We don't want to 
go back to those dark days. We should insist that we never reverse 
course on this issue.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Arizona.

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