[Congressional Record Volume 164, Number 200 (Wednesday, December 19, 2018)]
[Senate]
[Pages S7890-S7891]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               HEALTHCARE

  Mr. CARDIN. Mr. President, I take this time to talk about the recent 
court decision concerning the Affordable Care Act.
  I see that Senator Flake is on the floor. I was listening to my 
colleague, Senator Klobuchar, talk about the four colleagues on the 
Republican side who will be leaving. I have already had a chance in the 
Foreign Relations Committee to talk about Senator Flake, but I want him 
to know, and I want the American people to know, that there is no finer 
Senator than Senator Flake. He has shown great integrity on foreign 
policy issues, on decency issues, and on his principles.
  I will never forget our visit to the southern part of Africa, where 
Senator Flake was a missionary when he was a little bit younger, and 
his passion for the people and their needs has never stopped. That is 
just one example. I can name many more examples of how Senator Flake 
has inspired all of us. The courage that he has shown has been an 
inspiration. I wish him the best as he moves on to the next chapter in 
his life.
  I rise today to discuss America's access to healthcare and the 
patient protections that are currently being threatened by President 
Trump and his administration; specifically, his decision to not uphold 
the Patient Protection and Affordable Care Act, the law of the land.
  Last week, Judge Reed O'Connor of the U.S. District Court for the 
Northern District of Texas ruled that the Affordable Care Act is 
unconstitutional and that the law is not severable from and cannot 
stand without the individual mandate penalty, which Republicans 
eliminated in their December 2017 tax bill. While this ruling is being 
appealed, President Trump has the opportunity to stand up for the 
American people.
  Over and over again, we have heard President Trump promise to lower 
prescription drug prices for seniors, end the opioid epidemic, and 
improve the availability and affordability of health insurance. Yet, 
for any of his proposed policies to succeed, President Trump needs the 
Affordable Care Act, even though he will not admit it.
  Without the Affordable Care Act, which closed the doughnut hole for 
seniors, many older Americans would likely spend around $2,000 more in 
out-of-pocket costs for prescription drugs each year. Rather than 
helping our seniors lower costs, with the loss of the protection under 
the Affordable Care Act--the benefits--they will end up paying more.
  Furthermore, the Affordable Care Act created the Centers for Medicare 
and Medicaid Innovation, which is the basic infrastructure for the 
Trump administration to test the recently released drug-pricing 
proposals. Without the ACA, the Centers for Medicare and Medicaid 
Innovation would not exist, and President Trump would need 
congressional approval to implement such a sweeping national test on 
drug prices.
  We all should be committed to reducing the cost of prescription drugs 
in this country. The President ran on that when he was Candidate Trump.
  We know that as Americans we pay so much more than people from other 
industrialized nations for the same drugs, many of which are 
manufactured right here in America. The ACA--the Affordable Care Act--
helped us move in the right direction. We need to build on that. Let us 
work together to preserve the progress we have made under the 
Affordable Care Act and to pass additional legislation allowing us to 
use the collective bargaining power of our consumers so that we can pay 
lower prices than our friends from Canada because we have a bigger 
market. We should be paying lower--not twice as much.
  President Trump says that he wants to end the opioid epidemic. By 
getting rid of the Affordable Care Act, he will cause millions of 
Americans to lose their current health insurance. This is because any 
rollback in Medicaid coverage, the biggest payer for behavioral 
healthcare, would result in roughly 1.2 million people with addiction 
and mental health issues losing access to affordable treatment.
  If you don't have insurance protection for behavioral health or 
addiction, you are going to be much less likely to be able to get 
access to that needed treatment in order to deal with your addiction.
  We know we need a comprehensive approach to deal with the opioid 
crisis. Yes, we want to stop the dangerous drug fentanyl from coming 
into this country. Yes, we want to stop the distribution of illegal 
drugs. But we also

[[Page S7891]]

have to deal with the reality of people who have addictions, and they 
need to be able to get help. Part of that is having access to care and 
having coverage. The elimination of the Affordable Care Act will move 
us in the wrong direction.
  We need to continue to build on legislation we have worked on 
together--bipartisan--that provides additional resources to our State 
and local governments to deal with the opioid crisis. Part of that is 
the expansion of coverage under the Affordable Care Act.
  Scrapping the healthcare law will not only leave Medicaid expansion 
enrollees high and dry; it will also hurt very vulnerable populations 
that were unable to buy affordable, comprehensive coverage before the 
Affordable Care Act, including more than 130 million women, children, 
and other people with preexisting conditions.
  Let's remember that prior to the Affordable Care Act, many 
Americans--millions of Americans--were denied full coverage because of 
preexisting condition restrictions. The Maryland Health Benefit 
Exchange estimates that in Maryland, there are approximately 2.5 
million non-elderly Marylanders with preexisting conditions, 320,000 of 
whom are children. They are at risk with this court decision in Texas.
  Undoing current law would also eliminate strong patient protection. 
Insurers would once again be able to impose annual and lifetime limits, 
discriminate against women, and charge higher out-of-pocket costs. 
Young adults would no longer be able to stay on their parents' 
insurance until they turn 26.
  We are talking about tens of millions of Americans who are at risk by 
this court decision. It is absurd to move back and tell these people 
they are going to lose the protection they now have under our 
healthcare system.
  It is simple. President Trump must take this opportunity to stand up 
for the American people and defend the law. That is what the President 
of the United States should be doing. That is why I joined Senator 
Manchin and many of my Democratic colleagues in a letter urging 
President Trump to direct the Department of Justice to defend the law 
of the land. Yes, we should defend the law. It is our responsibility to 
make sure we protect the people of this Nation.
  Let's build on the progress we have made together. We know we need to 
improve our healthcare system. We know the cost of prescription drugs 
is too high. We can do something about that. We know the individual 
marketplace needs improvement. We want to make sure there is 
affordable, quality insurance for everyone in this country.
  Yes, we need to build on the progress we have made to make 
improvement, but what I urge all of us to do--let's maintain the 
protections we have today. Let's not go back to the time when being a 
woman was a preexisting condition and you couldn't get full coverage. 
Let's not go back to the days when, if you had a heart ailment and you 
tried to buy an insurance policy, you were not going to get coverage 
for what you need. You were going to get those exclusions. That is 
where we were before we passed the Affordable Care Act.
  Let's build on the Affordable Care Act. Let's work together as 
Democrats and Republicans. Let's defend the progress we have made. I 
hope the President will join us, but let's take that responsibility and 
build on that and work together, Democrats and Republicans, to build a 
stronger system for all.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Boozman). The Senator from Montana.

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