[Congressional Record Volume 165, Number 114 (Tuesday, July 9, 2019)]
[Senate]
[Pages S4717-S4723]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Affordable Care Act

  Mr. MURPHY. Madam President, I am going to be joined on the floor 
over the next 45 minutes or so by a number of my colleagues to talk 
about an exceptional court case that is being heard today in New 
Orleans, LA.
  This is a court case the Trump administration, along with a number of 
Republican attorneys general, has brought to obliterate the Affordable 
Care Act, all of it, overnight. The case, if successful, would result 
in a humanitarian catastrophe in this country.
  Why do I say that? Because the plaintiffs in the case, backed by the 
Trump administration, are arguing that the court should throw out the 
entire Affordable Care Act, with nothing to replace it, despite the 
fact that for almost a decade now, I have listened to this President 
and my Republican colleagues in the Congress object to the Affordable 
Care Act on the premise that they will have something better to replace 
it with--in President Trump's words, a replacement that will insure 
more people, at lower cost, with all the protections the Affordable 
Care Act has. That plan has not materialized yet because it doesn't 
exist. It has never existed. It will never exist.
  The choice today is between the Affordable Care Act, which insures 
over 20 million Americans, which guarantees that people with 
preexisting conditions cannot be discriminated against, and nothing--no 
protections, no expansion of Medicaid, no subsidies--for individuals to 
buy private insurance.
  Right now, with the support of Republicans in Congress, the Trump 
administration today is making the argument that the entire Affordable 
Care Act should be struck down, with nothing--nothing at all--to 
replace it.
  This is my friend John from Middletown, CT. I had breakfast with John 
last week. That is a picture of John in his younger years. John was 12 
years old when he started to have flulike symptoms but was diagnosed--
coincidentally, on the day of the tragedy in Sandy Hook, CT--with a 
rare form of soft-tissue cancer in the back of his throat.
  The treatment process for John was, in his words, horrendous, 
bringing him to as little as 70 pounds for a period of time, rendering 
him unable to speak, eat, or drink. He was out of school and in and out 
of the hospital for almost 2 years.
  Six years later, he can only open his jaw a small fraction of the 
normal range of motion; he can only chew foods out of one side of his 
mouth; and he has very limited healing ability for any jaw injury.
  These issues will never go away for John. He has become an advocate 
for the Affordable Care Act because he knows--he knows that if the 
Trump administration's lawsuit is successful, his life as he knows it 
is over because, once again, insurance companies would deny him 
treatment. No insurance company would provide John Carlson with 
insurance, knowing his history of cancer, if they were allowed to make 
decisions for themselves on who gets coverage and who doesn't. The only 
reason John gets coverage is that we have said, through the Affordable 
Care Act, we are not going to hold you responsible for your childhood 
cancer. We are going to make sure you get insurance no matter what.
  These are the stakes right now. These are the stakes for millions of 
Americans like John whose lives will be upended if this heartless, 
thoughtless, cruel lawsuit proceeds. We should be talking about how to 
make the healthcare system better. We should be talking about ways to 
lower costs. We shouldn't be talking about going backward with no 
safety net.
  What if this lawsuit is successful? I haven't heard a single 
Republican in the Senate talk about what they would do. I haven't heard 
the President talk about what his plan is if his lawsuit is successful.
  What happens to John? What are you going to do to make sure he still 
gets the treatment he needs? The answer is, you don't know. The answer 
is, you are jumping without a net, and you are playing with the lives 
of millions of Americans.
  John is a remarkable young man also because his eyes were opened when 
he was in the hospital. I want to read you his words. He said this to 
me a couple of weeks ago, and I asked him to write it down because it 
is really remarkable the capacity of young people to see beyond their 
own suffering. He said:

       I wanted to take this opportunity today to tell one more 
     story about an experience I had in the hospital during my 
     cancer treatment. This is a story about a young boy who 
     received cancer treatment the same time as me. During my 
     daily physical therapy walks around the childhood cancer 
     floor, I started to notice a pattern. There was always one 
     room--directly across from the nurses station--with the same 
     patient inside. A small

[[Page S4718]]

     boy, no older than three years old. I can remember asking my 
     parents and nurses, ``Why are that baby's parents not with 
     him?'' I felt so angry that such a tiny child was left alone 
     and forgotten in a hospital room while going through cancer 
     treatment. I remember seeing the tiny chemotherapy port 
     embedded in his head through the glass door.
       ``Why would they abandon him like that?'' I asked the nurse 
     walking with me that day. She explained to me that he had not 
     been abandoned at all, he was not forgotten nor neglected. 
     She explained that he was left alone due to pure necessity 
     and desperation.

  This is John talking. He said:

       I learned that both of his parents were working day and 
     night to be able to afford his cancer treatment. Nobody 
     deserves to go through this alone, especially not a three-
     year-old infant. I shared my story so that his story will not 
     continue to take place in America. I shared my story so that 
     patients fighting for their life will no longer be taken 
     advantage of by the hospitals and insurance companies.

  What a miracle that this young man, going through his own cancer 
treatments, would think of a 3-year-old child who has no parents there 
with him because his parents are working multiple jobs in order to 
afford the cancer treatments for their son.
  Before the Affordable Care Act went into effect, 750,000 people in 
this country went into bankruptcy because of medical costs. That does 
not happen any longer. It doesn't mean our healthcare system is 
perfect. It doesn't mean it doesn't need more improvement, but why 
would we want to go back to the day in which a family lost everything 
simply because their 3-year-old son got cancer? Why would we take this 
chance with these people's lives?
  I, once again, come to the floor to beg my colleagues to stand with 
us, to stand with us and oppose this lawsuit--this careless, 
thoughtless lawsuit. At the very least, if you support it, then come to 
the floor with a real plan for how you are going to take care of John 
and the millions of Americans who rely on the Affordable Care Act for 
coverage.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Madam President, I am very pleased to follow my 
colleague from Connecticut and to continue his thoughts about the utter 
chaos and catastrophe that would be caused by the success of this 
lawsuit now before the court of appeals--chaos and catastrophe that 
would, in effect, turn back the clock to days that I remember well 
because I was attorney general when preexisting conditions were used as 
a ruse to deny lifesaving medical care and coverage to people with 
cancer, brain tumors, and literally lethal diseases.
  In those days, as attorney general, I took their fight and made it my 
own, even sometimes calling presidents of insurance companies over 
weekends to go to bat for those individuals.
  Those bad old days--the days of no protection against preexisting 
conditions--are over now, but they will come back if this lawsuit is 
successful. If this lawsuit wins, young people who are now covered by 
their parents' policies up to the age of 26 will be without it. If this 
lawsuit wins, the annual and lifetime caps on benefits will come back. 
If this lawsuit is successful, preexisting conditions again will come 
back to haunt people who need and deserve coverage. If this lawsuit 
wins, millions of people--tens of thousands in Connecticut--will be at 
risk.
  One of them is a young man, Conner Curran, an 8-year-old boy in 
Ridgefield. His picture is right here. I met Conner 3 years ago when he 
was 5, and his parents noticed he was lagging behind his twin brother. 
They brought him to a doctor, expecting maybe a simple diagnosis. 
Instead, they were told that Conner had Duchenne muscular dystrophy. 
That is a degenerative, terminal disease. It has no cure. It is life-
threatening. In fact, most people with the disease don't survive past 
their midtwenties.
  Conner's family wrote to me, telling me that their beautiful, young, 
sweet child, at the time just 5\1/2\ and full of life, would slowly 
lose his ability to run, to walk, to lift his arms. Eventually, they 
said, he would lose his ability to hug them.
  Conner needs care--complex care--from multiple specialists, costing 
tens of thousands of dollars per year. Thanks to the Affordable Care 
Act, there is no denying him coverage. There is no denying him coverage 
because of his illness, and he will receive the care he needs.
  His family also wrote to me that the reinstatement of lifetime caps 
or elimination of essential health benefits will hinder his family's 
ability to access the care Conner needs. In fact, if this lawsuit wins, 
there will be virtually insuperable obstacles to Conner receiving that 
vital lifesaving care. If this disease progresses, as seems very 
possible, he will need access to Medicaid in offsetting costs of living 
with that disability.
  For his family, the question is, Will Medicaid even be there? If that 
devastating day comes, will he receive the care he needs?
  Conner's family shared their concern over what would happen if the 
repeated and reckless attempts to undermine healthcare succeed and if 
repeal of the ACA becomes a reality. He and his family are not giving 
up. They have come to my office since he was diagnosed to fight for a 
cure and for the Affordable Care Act. They have demonstrated strength 
and courage, sometimes with tears in their eyes. They raise awareness 
and fight for their son. I know they would do it a million times over 
if it meant Conner could have a long and healthy life.
  Connor and millions like him are the reasons I am here to fight back 
against any attempts to repeal the Affordable Care Act. Whether it is 
in Congress or in the courts, make no mistake, this effort in the 
courts is another means of repealing the ACA. The people of Connecticut 
get it. They understand the agenda here. They want all of us--and I 
think most of our constituents do as well--to make sure this kind of 
care is there for Connor and for all of us because all of us will be at 
risk if the ACA is repealed, whether it is in Congress or the courts.
  In Connecticut, there are 1.5 million people living with preexisting 
conditions. That includes 182,000 children like Connor. If this 
Republican-backed lawsuit against the Affordable Care Act succeeds, 
their protections will be eviscerated; they will be lost, not just for 
a year or two but likely for their lifetime.
  The Affordable Care Act ban on lifetime coverage caps is so important 
to kids like Connor. If the Republican-backed lawsuit against the ACA 
is successful, he will be one of the more than 1.2 million people in 
Connecticut who would meet a lifetime coverage limit and be forced to 
worry about how and if they can pay for their necessary medical care.
  In Connecticut, about 25,000 young people get their healthcare 
coverage under their parents' plans, thanks to the Affordable Care 
Act's requirement that children can be covered until the age of 26. If 
the Republican-backed lawsuit against the ACA succeeds, these young 
adults will be left without coverage.
  In Connecticut, over a quarter of a million people have healthcare 
coverage because of the ACA's Medicaid expansion. Another 110,000 have 
coverage through the Connecticut ACA exchange. If the Republican-backed 
lawsuit against the Affordable Care Act succeeds, their healthcare 
coverage will be gone.
  If the Republican-backed lawsuit succeeds, the uninsured rate of 
Black Connecticut residents would likely double. One in five Latinos 
under 65 will go uninsured.
  All of these people, like Connor, represent our Nation--the best of 
our Nation--with their dedication to the people they love, and they 
deserve to be heard. Their voices need to be heard here. They are the 
true faces of the Affordable Care Act. Every one of them, like Connor, 
is a life that will be enhanced by continuing the Affordable Care Act. 
If this Republican-backed lawsuit succeeds, their lives will be at 
risk, and we will be a lesser nation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. MANCHIN. Madam President, I come before this body, I come before 
all of those in America to explain a little bit of what we had before 
the Affordable Care Act and where we are today.
  I wasn't here in 2009 when they passed the Affordable Care Act. I was 
the Governor of the State of West Virginia, my beautiful State. I can 
tell you about the type of healthcare in a rural State--a rural, hard-
working

[[Page S4719]]

State--where people have worked hard all their lives. They have been 
challenged, but they really have given so much to this great country. 
Most of them did not have insurance. A lot of people across America had 
some really good insurance, but a lot of working people--hard-working 
people or people of less means, poor people--did not have access.
  Let me tell you what they used. They used the emergency room--the 
highest cost of entry with no preventive care, nothing at all to 
maintain health or wellness--but they would go there in an emergency. 
That is what most people who didn't have any insurance used.
  Let me tell you about the people who basically were working and could 
not afford the copays where they worked or weren't afforded insurance 
at places where they worked. If they were ill or if they got hurt at 
home, working, they would go into work on Monday and make a worker's 
comp claim, again, at a very high cost to all of the States.
  At the end of the year, and I think this is in most States, they 
would come to you--every hospital, every rural clinic would come to 
their Governor and their legislature; we would call them DSH payments, 
disproportionate share--and say: Governor Manchin, if you don't help me 
with $10 million or $12 million--I have given away $20 million in 
charity care--we are going to have to close.
  We had to scramble around, using taxpayer dollars to keep every rural 
clinic and hospital open for the people. People forget about all of 
that.
  For those who had wonderful access to insurance or were offered 
insurance, that was wonderful. We want to make sure they still have 
that opportunity.
  Guess what. We have a way to fix this. There have been two bills 
sitting on Senator McConnell's desk for almost 3 years that would 
reduce the cost--what we know is wrong with the bill--the Affordable 
Care Act.
  Let me tell you what is right with the Affordable Care Act. I wasn't 
here in 2009. I would like to have seen changes, but now that I am 
here, I know what I had before, which wasn't working, and I know what 
we have now can be a lot better.
  In a bipartisan way we have tried to fix this. We have tried to find 
ways to make sure that people who had good insurance are not going to 
be exorbitantly charged out of the market or priced out of the market. 
We are doing everything we possibly can.
  I am asking everybody, please, for the sake of humanity, if a person 
for the first time has ever gotten insurance--and I have told people 
this. We gave people the greatest wealth card you could ever get, which 
is a health card, but we didn't give them one shred of evidence as far 
as information about how to use it--the instructions.
  I compare it to this: If you bought a box of Cracker Jacks, you would 
get the prize inside, and they would show you how to use that little 
prize. We never took the time, but now they want to throw it out. Let's 
make an effort to basically teach people how to live a healthier 
lifestyle, how to use preventive care, how to have a more productive 
and a healthier life. We haven't done any of that.
  For the first time, we know, scientifically, if a person is addicted 
to drugs--if they are addicted--it is basically a health problem. It is 
an illness. An illness needs treatment. For the first time, in a State 
that has been inundated with opioid addiction and drug addiction, 
people are able to get treatment, get back into a productive lifestyle 
and get their lives cleaned up. For the first time they want to take 
that away. Out of 1.8 million people who live in my State, there are 
800,000 West Virginians who have some form of preexisting condition 
because they have worked in the mines and the factories. They were hard 
workers. Those people, if you have ever talked to them, if you have 
ever talked to rural Americans in any State, you can ask: How are you 
doing?
  I am OK. I am OK.
  How is your health?
  Well, I don't want to be a burden to my family.
  Let me tell you what they are telling you when they say ``I don't 
want to be a burden to my family.'' They are saying: I can't afford 
insurance. I don't have insurance. I am not going to break my family 
and put them in bankruptcy to try to keep me alive. So whatever the 
good Lord has planned for me, I will accept.
  That is not who we are as Americans. It is just not who we are. This 
is what we are trying to change.
  We have 20 attorneys general, Republican attorneys general. These are 
people I know. I don't think they are mean-spirited, but to be this 
insensitive to the real world and what is going to happen--every 
hospital, every clinic, every provider is going to be in jeopardy of 
not having a job or being able to provide the services people need. 
This thing will come unraveled--unraveled.
  We are fighting and hoping and praying that this is not upheld in the 
court system. How it has gotten this far I do not know. I can tell you, 
reasonable people would not make this type of decision.
  When you look at what is going on--let me tell you, in a bipartisan 
way, my Republican colleagues have admitted that millions of Americans 
will lose their health insurance if the Republican attorneys general 
succeed. They have admitted this. It is bipartisan because we all have 
the same challenges. Senator Tillis from North Carolina and nine other 
Republicans stated that oral arguments in Texas v. United States will 
begin September 5, and if a judge rules in favor of the plaintiffs, 
protections for patients with preexisting conditions could be 
eliminated. We know that.
  My good friend Senator Murkowski from Alaska said, in her own words, 
that this lawsuit will take away healthcare coverage from people with 
preexisting conditions. Senator Murkowski said: ``With the uncertainty 
of the outcome in the upcoming Texas v. United States case, this 
legislation is needed now more than ever to give Alaskans, and all 
Americans, the certainty they need that protections for those with pre-
existing conditions will remain intact.''
  My Republican colleagues know that if these attorneys general win, it 
will devastate households, our economy, and millions and millions of 
Americans' health. That is why I have been working with them to fix the 
problems of the Affordable Care Act. I introduced the Premium Reduction 
Act with my Republican colleague and dear friend Senator Susan Collins 
from Maine. It would reduce the cost of health insurance in the 
individual market by supporting and expanding State-based health 
insurance.
  We owe it to every West Virginian with a preexisting condition to fix 
our healthcare system.
  I would like to introduce you to Aiden Jackson Williams. This is 
Aiden Jackson Williams right here. Aiden is a 6-year-old cancer 
survivor from West Virginia. At 9 months old, he was diagnosed with an 
optic glioma and underwent chemotherapy for 16 months. At 2 years old, 
he was in remission. Aiden continues to get MRIs every 3 to 6 months, 
and there is a high chance of recurrence of other tumors in his body 
due to his condition.
  With that said, Aiden doesn't let it bother him. His parents are 
proud to say that today Aiden is doing great. He and his twin sister 
Reagan both enjoy sports, and he moves around just as well as anybody. 
To this day, Aiden is their hero and inspiration.
  Kids like Aiden have fought and beat cancer. They shouldn't also have 
to fight to keep their health insurance.
  What we are saying is that if the ACA goes away, Aiden will not have 
the certainty to be able to have health insurance, to have the MRIs to 
detect early enough to save his life. That is what we are talking 
about.
  This is life and death. This is life and death. This is not just a 
matter of the ideological differences that we have. We are going to 
fight and fight hard, and that is why I am here--for Aiden and all West 
Virginians with preexisting conditions. They are trusting us to do the 
right thing, along with my colleagues, the Republicans, in a bipartisan 
way, to fix what, basically, we have to know and what we do know that 
can be fixed with the bill before us, the Affordable Care Act, but not 
throw the baby out with the bath water.
  I hope that each one of my colleagues will take this seriously and 
that they will work with us in a bipartisan way to fix the healthcare 
for Americans that is so needed.

[[Page S4720]]

  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Madam President, today President Trump and Republican 
attorneys general are explaining in court why they think people who got 
their healthcare through the exchanges or Medicaid expansion should 
have it ripped away. They are explaining why limits on patients' out-
of-pocket costs should go away while limits on their annual and 
lifetime benefits should come back and why protections for people with 
preexisting conditions should be struck down.
  In other words, Republicans are, once again, fighting to take us back 
to the bad old days to give big insurance companies all the power, to 
leave millions of people without any hope of getting the quality 
affordable care they need and to leave patients and families with fewer 
protections and higher bills--patients like Lily from Gig Harbor, WA, 
in my home State.
  Lily is a rising high school sophomore. She is a rising soccer star, 
and she is a patient living with cystic fibrosis. To stay healthy and 
stay on the field, Lily needs to take several prescriptions a day. She 
needs to keep expensive medical devices on hand and visit specialists 
every other month, not to mention the hospital a couple of times a 
year. Even on a good month, her healthcare can cost thousands of 
dollars.
  For families like hers, the stakes could not be higher. If 
Republicans win their blatantly partisan lawsuit, insurance companies 
could kick patients like Lily off their parents' insurance before they 
turn 26, meaning that instead of worrying whether Lily will continue 
her soccer career at Gonzaga or UW or somewhere else, her family could 
spend her senior year worrying how to make sure she can get the 
healthcare she needs.
  If Republicans win, insurance companies could also avoid covering 
essential health benefits patients need--things like prescription drugs 
or emergency care. They could remove limits on how much patients have 
to pay out of pocket and put limits on patients' annual and lifetime 
benefits, which is particularly challenging for patients, like Lily, 
who need expensive drugs to treat chronic preexisting conditions.
  If Republicans win, insurance companies could discriminate against 
patients who have preexisting conditions, like cystic fibrosis, by 
charging them more, excluding benefits, or even denying them coverage 
completely.
  Let's be clear. Lily is just 1 of 30,000 patients in our country with 
cystic fibrosis and 1 of over 100 million patients in our country 
living with a preexisting condition.
  Like the woman who wrote to me about her severe arthritis, which 
could be debilitating without treatment, or her husband whose high 
blood pressure could be deadly without medication, or the mom who wrote 
to me about her son's rare form of epilepsy and how, without insurance, 
the medical costs would crush her family. For these families and so 
many other patients living with a preexisting condition, the lawsuit 
Republicans are bringing today is a matter of life and death.
  People are watching closely, and they are not going to forget who 
kept their word to fight for their healthcare, to fight for protections 
for people with preexisting conditions, and who on the other side 
blatantly broke that promise by championing a partisan lawsuit that 
would throw the healthcare of millions of people out the window.
  Democrats are not going to stop fighting for families like Lily's; we 
are not going to stop holding President Trump accountable for his 
ongoing healthcare sabotage; and we are not going to stop pushing for 
commonsense steps that help women and families get quality, affordable 
healthcare or pushing Republicans to work with us to get the train back 
on the track and stop pulling up the rails.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Madam President, I both concur and applaud the senior 
Senator from Washington State for her comments. We saw Senator Manchin 
here. I know Senator Kaine was here. Senator Murphy was here. Senator 
Blumenthal was here. I know there are probably a dozen others, all of 
whom know people and have talked to people, who get out and, as Lincoln 
said, listen to people and get their public opinion baths.
  They meet people like Susan Halpern from Columbus, whom I will talk 
about in a few minutes. They talk to them. They meet. They see that 
what we do here actually matters to people's lives.
  They can play games with the Affordable Care Act. They have been 
doing that for a decade now, literally almost a decade, putting 
people's healthcare at risk, scaring people, and alarming people, 
trying to take their healthcare away. These are real people, as these 
pictures show and as these stories show.
  Let me back up for a minute. A Federal judge is hearing arguments in 
a case that would literally yank health coverage away from millions of 
Americans.
  I know what that means in my State. There are 900,000 people in Ohio 
who have insurance today because of the Affordable Care Act. There are 
100,000 Ohio seniors who have gotten major savings on their 
prescription drugs through the Affordable Care Act. One million Ohio 
seniors have had osteoporosis screenings, diabetes screenings, 
physicals with no copay and no deductible, and preventive care so they 
don't get sick, saving the healthcare system money, saving taxpayers' 
dollars, and making their lives better. Yet my colleagues on the other 
side of the aisle, all of whom have good insurance paid for by 
taxpayers, want to take it away from them.
  Almost any day you could look down the hall--you can open this door 
and walk down the hall, look down the hall, and you will see the 
healthcare lobbyists, the drug company lobbyists, the tobacco 
lobbyists, and the gun lobbyists. You will see one after another going 
to the Republican leader's office, Senator McConnell. Every one of 
those lobbyists causes us to spend more dollars on health insurance. 
The health insurance lobby, the gun lobby, the tobacco lobby, the 
alcohol lobby, the spirits lobby coming out of Kentucky--all of them 
cost taxpayers more because it means people's health gets worse because 
they don't stand up to these interest groups.
  We know what is happening in Texas. A partisan judge, an absolutely 
partisan hack of a judge, ruled in December to strike down the Ohio 
healthcare law. I know Justice Roberts said we don't talk about Obama 
judges or Bush judges or Clinton judges or Trump judges. Yes, that is 
what they say, and that is what Supreme Court Chief Justice Roberts 
says, but we know what has happened here. We know how Senator McConnell 
is looking for the most extreme and young judges possible to put on the 
court to go after labor rights, to go after voting rights, to go after 
healthcare, costing our citizens their health and costing citizens 
billions of dollars.
  We know the President wants to get rid of the entire Affordable Care 
Act. If President Trump gets his way, if the court decides to wipe it 
off the books, to take away the entire healthcare law, here is what 
happens: tax credits to help you afford your health insurance--gone; 
protections for preexisting conditions--gone.
  Right now, 5 million Ohioans have a preexisting condition. Most of 
the rest of us will have a preexisting condition at some time in our 
lives. It is called aging, when people are more likely to develop 
illnesses and get sick.
  So consumer protections built in by Obama, built in by the Affordable 
Care Act so insurance companies can't deny you coverage, and they can't 
say: ``Sorry, we are not going to insure you'' or ``You already have 
insurance''--and they will take the insurance away if you just happen 
to get too sick and you cost the private insurance companies too much 
money--gone. Republicans in this body and President Trump want to take 
those protections away.
  The ability to stay on your parents' health insurance until you are 
26--gone. We know what that has meant to so many families. If my 
colleagues would leave this building, leave their foreign travel, leave 
their nice homes that most of us have in our States and get out and 
listen to people, they will hear people say: Well, this is really 
important to my 26-year-old sister or my 26-year-old daughter or my 24-
year-old son.
  Ohio's entire Medicaid expansion that Republican Governor Kasich 
did--

[[Page S4721]]

gone. Limits on how much you pay out-of-pocket each year--gone. Many 
more affordable prescription drugs for seniors through closing the 
doughnut hole under the Affordable Care Act, if they get their way--
gone.
  Free preventive services, like mammograms and bone density screenings 
for Medicare beneficiaries--millions of them in my State and tens of 
millions of them in the country--gone. The list goes on.
  There are 5 million Ohioans under 65 who have preexisting conditions. 
That is half the population of our State.
  I am not being an alarmist. We know this is what so many of you who 
were in the House earlier voted on time and again to try to repeal the 
Affordable Care Act. You had no replacement. You said you did, but 
there was no replacement for the Affordable Care Act. It was the repeal 
of the Affordable Care Act, taking away all of these benefits that tens 
and tens of million Americans benefit from.
  These Ohioans have been able to rest a little easier knowing they 
can't be turned down for healthcare coverage or have their rates 
skyrocket because a child has asthma, because a husband has diabetes, 
or because a wife was diagnosed with breast cancer, but this case 
intentionally puts all of that at risk.
  President Trump has thrown the whole power and all of the attorneys--
the battery of lawyers--in the Justice Department into this case to try 
to take the away the Affordable Care Act. That is what he promised in 
his campaign; that is what all these Republican Members of the Senate 
promised; and that is what all the Republican Members of the House 
promised. Do you know what? A lot of them lost last year because they 
want to take their insurance away. They are not doing it through 
Congress because that might be politically risky. They don't want to do 
that. They are trying to do it through the court system and then blame 
who knows what for this.
  In Columbus, I met Susan Halpern. Ms. Halpern is a cancer survivor. 
She is pictured here. She told me this:

       As a breast cancer survivor and self-employed small 
     business owner in Ohio--

  Creating jobs--

       I depend on the ACA for my healthcare. I am aware that 
     without the ACA, I would not be able to purchase health 
     insurance for any price. Even though my cancer has been in 
     complete remission for 12 years, I would still be 
     uninsurable.

  These stories from Michigan that Senator Stabenow tells, from 
Washington State that Senator Murray just told, that Senator Kaine 
told, that Senator Murphy has told, and that Senator Blumenthal has 
told go on and on. These are all cases where people have insurance, and 
a bunch of people in this body--all of whom get insurance paid for by 
taxpayers--are trying to take it away from them. All of these benefits 
are gone, thanks to the lobbyists lining up in Senator McConnell's 
office from the gun lobby, the tobacco lobby, the insurance lobby, the 
spirits lobby, and all the rest.
  Last week, in Cleveland, I met Maya Brown-Zimmerman, who pointed out 
to me that I had met her many years before when she was a student in 
high school. She went to high school with my daughter. I met her at a 
school event once. She has a rare genetic disorder that one of her four 
children also inherited. Here is what she said:

       I cried the day the ACA was passed because it meant a 
     safety net for my family. No lifetime caps on medical 
     coverage, and the guarantee of being able to get health 
     insurance even if something were to happen to my husband's 
     job.

  She went on:

       Whether or not my family loses these protections literally 
     keeps me awake at night.

  Think about that. Think about the selfishness of my Republican 
colleagues, of President Trump, and of the people in this 
administration--all the Justice Department lawyers and all these 
judges. Think about their selfishness. They have a political agenda, 
and they are keeping Ms. Brown-Zimmerman awake at night because she 
worries about her insurance. Think about the selfishness. Think about 
the morality of that.
  She said:

       I want our elected officials to remember we can't predict 
     when we will need to access the healthcare system and so 
     access to healthcare is an issue that is going to affect us 
     all.

  There are not too many people who are not able to sleep in this body. 
There were not too many people who were not able to sleep in the House 
as they were all voting to repeal the Affordable Care Act. That doesn't 
seem to cross their mind, but it crosses the minds of millions of 
people in Detroit, in Ann Harbor, in Cleveland, and in Mansfield.
  Today, tomorrow, and the day after, 14 Ohioans will die of an 
overdose. Medicaid is the No. 1 tool we have to get people into 
treatment. Ohio is in the throes of an addiction crisis, like much of 
the rest of the country but only worse in many cases. We know Medicaid 
expansion has been a lifeline to so many Ohioans.
  Sometime ago, I was at Albert House in Cincinnati, one of the best 
addiction treatment centers in the country. I sat with a man and his 
daughter. He put his hand gently on his daughter's arm. He looked at 
me, and he said: ``Senator, my daughter would be dead if it were not 
for Medicaid.'' He said: ``My daughter would be dead if it were not for 
Medicaid.''
  Yet Federal judges--Trump-appointed judges and Bush-appointed 
judges--and Republican Senators, all of whom get health insurance from 
the Federal Government, from taxpayers, are apparently willing to have 
that on their conscience. They are willing to work to repeal the 
Affordable Care Act with no real replacement. That matters in the life 
of Ms. Halpern. That matters in the life of Ms. Brown-Zimmerman, whom I 
just talked about. That matters in the life of the gentleman in 
Cincinnati who talked to me about his daughter.
  The President wants to make it harder for Ohioans to get that care. I 
don't know how Members of this Congress and this President--all with 
good insurance that is paid for by taxpayers--can support dismantling 
this lifeline that so many Americans rely on.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Ms. STABENOW. Madam President, I first want to thank my friend and 
colleague from Ohio for his passion and for caring so deeply, as we all 
do in our caucus, fighting for people's healthcare.
  It seems every week I am down on the floor saying exactly the same 
thing: Healthcare is personal; it is not political. Healthcare is 
personal to every single person in Michigan; it is not political.
  Whether a senior is able to afford the medication she needs to treat 
her chronic condition, that is personal. Whether a single dad is able 
to take his children to a trusted doctor when they get sick or hurt and 
keep them on his policy until age 26, that is personal. Whether a woman 
is charged more for the health insurance coverage she needs to detect 
cancer early enough so it can be cured, that is personal.
  Unfortunately, the law that helps seniors afford their prescriptions, 
ensures children can remain on their parents' insurance until age 26, 
requires health insurance policies to charge women the same as a man 
and to cover lifesaving, preventive care, that law is currently in the 
intensive care unit on life support.
  As we know, since 2010, Senate and House Republicans have voted to 
repeal or undermine the Affordable Care Act more than 100 different 
times--100 different times. That didn't sit right with families across 
Michigan and across the country. They stood up with us, they fought 
back with us, and together we won.
  What Republicans couldn't do in Congress, they are trying to do 
through the courts. Today, literally, the Fifth Circuit Court of 
Appeals begins hearing arguments in a case brought by 18 different 
Republican attorneys general and Governors.
  In short, these 18 Republican attorneys general and Governors, backed 
by the Trump administration and President Trump, are trying to take 
away your healthcare. If they win, healthcare reform could be 
completely overturned and healthcare taken away. That would take 
everything away, including Medicaid expansion, which we call Healthy 
Michigan. In Michigan, we have about 700,000 people getting healthcare 
now who don't have to pick between working a minimum wage job and 
getting healthcare. They can do both. Children staying on their 
parents' insurance plans until age 26--

[[Page S4722]]

gone. More affordable drugs for seniors--gone. Protections for people 
with preexisting conditions--gone.
  In other words, it would put insurance companies back in charge of 
your healthcare, and we all remember what that was like.
  Women could once again be charged more for coverage and have to get a 
rider if they want to get maternity care coverage and prenatal care 
coverage. Remember when being a woman was considered a preexisting 
condition? I do. Members of my family do.
  Families could once again face yearly or lifetime caps on care when 
they need it the most, when you think about it.
  If the Affordable Care Act is repealed through the courts, the 
insurance companies would once again be able to say to your doctor: You 
know, I don't think she really needs 10 cancer treatments or 12 cancer 
treatments, so we will pay for 5. If addiction treatment or mental 
health treatment is needed, they could say: I don't think you really 
need to have more than two sessions if you are an addict. Come on. 
Today, the doctor decides, with you, what you need in terms of number 
of treatments, and that is the way it should be.
  As I mentioned, nearly 700,000 people in my State are getting 
healthcare through Healthy Michigan or Medicaid expansion, and they 
could lose that. In fact, they will lose that.
  Our uninsured rate has fallen from 12 percent before the Affordable 
Care Act to 5 percent. So 12 percent of people were not insured at all, 
and now it is 5 percent. I would call that a success. Is there more 
that should be done? Yes. But that is positive, not negative.
  The number of people without insurance who have been treated has 
fallen by 50 percent in Michigan--50 percent. And that is great for all 
of us. It is certainly great for hospitals that were treating people 
without insurance before. Someone walks into the emergency room and 
gets care in the most expensive way, and they don't have insurance. 
What happens? Everybody else's insurance rates go up. That is what 
happened. When people were able to get their own insurance coverage, 
insurance rates went down. In fact, we had over $400 million in 
Michigan that was put into the State government as a savings as a 
result of not paying for people going to the emergency room without 
insurance.
  A record 97 percent of Michigan children can see a doctor now when 
they get sick--97 percent. I would argue that is a great success, not 
something to be taken away or something to play politics with.
  Michigan seniors are saving money on their prescription drugs through 
the Medicare Part D Program--something called the doughnut hole, the 
gap in coverage that we closed.
  More than half of our families in Michigan, which includes people 
with preexisting conditions, are now able to get coverage. The 
insurance companies can't say no, and they can't say: When you get 
sick, you are going to be dropped. They can't deny you from getting the 
coverage you need if you have a preexisting condition.
  One of those people in Michigan is Heidi, who lives in Cedar Springs. 
She wrote to me in May. I thank Heidi for doing that. Heidi had bought 
health insurance for years and almost never needed it because she was 
healthy. In fact, she only used it, she said, when she gave birth to 
her daughter. That all changed in 2004 when Heidi was diagnosed with 
breast cancer at the age of 45. She has since had multiple tests, 
multiple surgeries, and multiple rounds of chemotherapy, all at least 
partially covered by insurance.
  Heidi wrote this:

       My fear every day is that I won't have insurance if these 
     changes are made. There is no way any company would insure 
     me. My husband has a life insurance policy that he bought 
     before we were married. . . . We asked about me. The salesman 
     nicely said that I am not insurable. So my plan B is, if I 
     lose my health insurance, I will take that money and save it 
     for my funeral (since I can't even get a life insurance 
     policy for enough for a funeral).

  Heidi added this:

       I am lucky that I thought insurance was a good thing, and, 
     therefore, paid for it for years through my job.

  Heidi depends on protections for people with preexisting conditions. 
Heidi didn't ask to get breast cancer. It could happen to any of us. 
Any day, something could happen to any of us or someone in our family. 
And if you have or will have what is called a preexisting condition, 
your health insurance will be taken away if this court case, supported 
by President Trump, his administration, and Republicans, succeeds.
  A couple of months ago, I spoke at the Detroit Race for the Cure, 
which raises money for breast cancer research. It is a wonderful event. 
We had a beautiful, sunny day. As I stood on the stage and looked out 
over a crowd of over 10,000 people, mostly women and many wearing pink, 
I saw women living with preexisting conditions. I saw people like 
Heidi.
  One woman who was standing on the stage near me asked me a question 
that I will never forget: ``Why is it that I have to worry about 
whether or not I will be able to get insurance in the future? Why?'' 
She added: ``Why don't President Trump and other Republicans understand 
that this is my life? This is my life.'' It is a very good question. It 
deserves an answer.
  Why don't Republicans in Congress, why don't those 18 attorneys 
general and Governors, and why doesn't President Trump believe that 
people like Heidi deserve to have healthcare coverage? Why don't they 
believe that seniors deserve access to more affordable prescription 
drugs? Why don't they believe that women should pay the same for their 
health insurance as men? Why don't they believe that young people 
should be able to stay on their parents' insurance until age 26? And 
why don't they believe that families, not insurance companies, should 
make healthcare decisions? Families, with their doctors, should be 
making health decisions, medical decisions, not an insurance company. 
If this lawsuit succeeds, we are going to go right back to putting your 
medical decisions in the hands of the insurance companies.
  Healthcare isn't political; it is personal. It is time to stop 
playing politics with people's health. For each of us, it is our life.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Madam President, I ask unanimous consent that I be 
permitted to speak for 5 minutes, followed by Senator Cortez Masto for 
5 minutes, prior to the series of votes we will have.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WYDEN. Madam President and colleagues, at Fourth of July picnics 
and parades, it is likely that complicated healthcare policy debates 
are not exactly a central topic of conservation. I am pretty sure that 
is the way the Trump administration wanted it to be.
  Today, lawyers representing the Trump administration and a number of 
Republican Governors are attempting to have the Affordable Care Act 
ripped up and thrown out by a Federal court. They were unable to do 
that in the Congress, so now they have headed off to try to get it done 
in the courts. The case is happening in the Fifth Circuit in Louisiana. 
This is not some theoretical exercise; this is an immediate threat to 
the healthcare of millions and millions of Americans.
  I want to be clear at the outset of these remarks what the bottom 
line is. The bottom line is that eliminating protections for 
preexisting conditions is now the official position of the Republican 
Party. That is the centerpiece of what this court case attacks--the 
ironclad, airtight guarantee at the heart of the Affordable Care Act 
that insurance companies cannot discriminate against those with a 
preexisting condition. The fact is, the Republican Party wants that 
eliminated.
  This attack on Americans' healthcare goes way beyond preexisting 
conditions. What about prescription drug costs? Prescription drugs are 
outrageously expensive right now, and the problem is getting worse 
under the Trump administration. Prices are up more than 10 percent just 
in the past 6 months. Americans are forced to make life-threatening 
choices where they really have to balance their food bill against their 
medicine bill and medicine against other necessities, like shelter. In 
effect, Americans self-ration because their prescriptions just cost too 
much.
  If this lawsuit succeeds, prescription drug costs are going to 
skyrocket even higher. If the Affordable Care Act is

[[Page S4723]]

thrown out, that will be the end of the requirement that health 
insurance companies have to cover prescription drugs. Patients will be 
forced into junk insurance plans that don't cover the care they 
actually need. Millions of people of limited means would be kicked off 
their Medicaid coverage. Millions of seniors would face higher drug 
costs.
  The bottom line: If this case is successful, it will launch a forced 
march back to the days of yesteryear when healthcare was for the 
healthy and the wealthy. The reason I say that is that is the way it 
used to be. If you had a preexisting condition in the past, you were 
just out of luck unless you had an enormous amount of money. The only 
people who really could benefit were people who were healthy and people 
who were wealthy. The Affordable Care Act changed that. More than 100 
million people got a lifeline protection against discrimination if they 
had a preexisting condition.
  If the lawsuit succeeds, the biggest winners are going to be the 
largest of the insurance companies and the drug manufacturers. They 
would get the power they need to once again walk all over the American 
people.
  Here is the kicker: There is no replacement plan if the Affordable 
Care Act is wiped out. The President keeps saying he has a big, 
beautiful healthcare plan, and we always get the sense--it reminds you 
of the movie house in the old days where it would say: Coming soon. 
Movie coming soon. But it never actually gets there. There is never a 
grand unveiling, and that is because there isn't a backup plan. This is 
just an ideological crusade to make winners out of the most powerful 
corporations and losers out of millions of working Americans.
  Democrats in this Chamber have proposals ready to go to take a better 
path, a better approach, and to protect the healthcare of our people, 
blocking Trump's lawyers from using taxpayer dollars to destroy the 
Affordable Care Act, banning junk insurance, which isn't worth much 
more than the paper it is written on, and standing four-square behind 
protecting people with a preexisting condition.
  That is what the Senate ought to be working on so the Trump 
administration can't bring on a healthcare nightmare for millions and 
millions of Americans.
  One of our most valuable members of the Senate Finance Committee has 
joined us now, Senator Cortez Masto, and I am happy to yield to her to 
close our time before the vote.
  The PRESIDING OFFICER. The Senator from Nevada.
  Ms. CORTEZ MASTO. Madam President, I want to talk today about Kyle 
Bailey from Sparks, NV. Kyle is 27 years old, and he is an amazing 
success story. He was born with cystic fibrosis, a genetic condition 
that affects the lungs and digestive system, making it hard to breathe 
normally or absorb nutrients.
  Cystic fibrosis has no cure, so patients like Kyle spend hours every 
day on treatments to keep themselves as healthy as possible. With good 
medical care and lifesaving medications, he has been able to live a 
full life, creating music and artwork. He is engaged to be married.
  Yet Kyle lives in fear. He is afraid he will lose his health 
insurance and coverage for treatments that keep him alive. That could 
happen if the Republican Party succeeds in its latest attempt to use 
the courts to attack the Affordable Care Act and to end its protections 
for preexisting conditions.
  Just today, a Federal appeals court has heard more arguments about 
whether the ACA is constitutional. On one side are patients like Kyle; 
on the other side are the Trump administration and 18 Republican State 
attorneys general, who all want the court to strike down the Affordable 
Care Act.
  We have seen it before. The Republicans have tried to defeat the ACA 
in Congress and in the courts over 100 times, and each time they have 
failed because the American people have raised their voices and said: 
Stop. We want our healthcare coverage.
  But just because the ACA survived those attacks doesn't mean it is 
safe. It is especially scary for those who gained coverage and peace of 
mind thanks to the Affordable Care Act's strong safeguards for 
patients.
  One of the most important parts of the ACA is its guaranteed 
protections for people with preexisting conditions. Insurers used to be 
able to discriminate against people because of their medical history. 
They would weed out people who were born with genetic conditions, like 
Kyle, or people who had gotten seriously ill, like Ivy Batmale from 
Incline Village. At 5 years old, Ivy was diagnosed with acute 
lymphoblastic leukemia, one of the most common childhood cancers. Ivy 
beat leukemia, but the years of harsh therapy triggered a reaction that 
affected her legs. Ivy was told that she would never walk again. She 
spent years in wheelchairs undergoing surgery and other treatments.
  With costly therapies, Ivy got better. This spring, she and her 
family marched into breakfast with me right here on Capitol Hill to 
advocate for childhood cancer research. But Ivy, like other childhood 
cancer survivors, has had lingering health conditions over the course 
of her life and will need careful monitoring until she is 40 years old. 
That is why if Republicans give insurance companies the choice, 
insurers will either refuse to cover people like Ivy and Kyle or they 
will charge sky-high rates. The ACA keeps the insurance companies from 
doing that. If judges strike down the ACA, people like Ivy and Kyle 
will be endangered through absolutely no fault of their own.
  Some people may hear stories about Kyle and Ivy and think, well, that 
is very sad, but it can't affect that many people. That is wrong. In 
Nevada alone, in 2015, 1.2 million people under 65 had preexisting 
conditions. That is half of the nonelderly residents of the State.
  A preexisting condition could be as rare as childhood cancer or as 
common as pregnancy. That means every other Nevadan can face increased 
insurance rates if the ACA is struck down.
  I have met families at roundtables across the Silver State whose kids 
are some of the 44,000 Nevada children with asthma. Just last week in 
Las Vegas, I talked to 12-year-old Joey Douglas. Joey's asthma often 
keeps him from school and sometimes lands him in the hospital for days. 
He told me that even when he is struggling to breathe, his biggest 
concern is whether his mom will be able to pay his medical bills. These 
kinds of worries are the reason that when Kyle wrote to me, he asked me 
to speak out for people who don't have a voice in healthcare policy in 
this country--people who are afraid that losing the ACA could mean 
losing protections that have allowed them to grow up, start a family, 
follow their passions, and live their lives to the fullest.
  Today and every day I am here to fight for people like Kyle and Ivy 
and countless Nevadans like them. I have repeatedly urged the President 
and Department of Justice to come down on the side of patients in the 
Texas case. I have cosponsored legislation to get rid of junk 
healthcare plans that let insurance companies make an end run around 
ACA protections for people with preexisting conditions, and I am 
committed to protecting and strengthening the ACA for all Americans but 
especially for people like Kyle, Ivy, and Joey.
  So I am calling on this President and Republicans in Congress to do 
what we can to make sure that the Affordable Care Act is not repealed 
and that we are fighting for healthcare insurance for everyone.
  I yield the floor.