[Congressional Record Volume 166, Number 134 (Wednesday, July 29, 2020)]
[Senate]
[Pages S4572-S4574]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                   Unanimous Consent Request--S. 585

  Mr. JONES. Mr. President, I rise today amid what we all know to be a 
global health and economic crisis that we are in. I rise to propose a 
solution that has been in front of us all along from the very 
beginning. It is a solution that has existed for 55 years tomorrow--55 
years.
  Medicaid has brought millions of people to better healthcare. It has 
brought billions of dollars into States. That is important when we have 
both a healthcare crisis and an economic crisis, but for 55 years, 
Medicaid has lifted the health outcomes of people all across this 
country and especially in so many States that need it--States like 
Alabama that are poor States, that are unhealthy States.
  But we can do better. A solution of Medicaid would bring billions of 
dollars into my home State of Alabama along with about a dozen other 
States. It would create thousands of new jobs. It would help shore up 
rural hospitals that are facing financial struggles, a condition made 
worse by this pandemic. It would provide healthcare coverage in Alabama 
alone to between 300,000 to 400,000 Alabamians who do not have it right 
now. Some didn't have it before this pandemic. Others don't have it now 
because they have lost their jobs. They have lost their employer-
sponsored healthcare.
  Expanding Medicaid would generate $935 billion, with a ``b,'' in new 
tax revenue for the State of Alabama. It would help local economies 
across the State by creating good jobs and ensuring workers and their 
families have good healthcare.
  In our rural areas, especially, healthcare is dependent on Federal 
dollars. Folks, expanding Medicaid was the right thing to do before 
this pandemic and some 37 States or so did just that. In fact, two 
States did that fairly recently. Conservative States of Oklahoma and 
Nebraska are both in the process of expanding Medicaid. It was 
important before the pandemic, but it is vital that we do it now. It is 
absolutely vital, especially, as so many people have lost their jobs, 
lost their employer-sponsored healthcare through no fault of their own.
  Alabama didn't take that step back in 2011 when it should have. 
Alabama

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held back. There is little doubt that the main reason--not the sole 
reason--but the main reason that they held back was purely political. 
The Alabama Legislature and the Alabama Governor refused to legitimize 
the Affordable Care Act and put their name on anything having to do 
with it. The people of Alabama--hundreds of thousands--have suffered 
because of it.
  That excuse is waning thin today, especially when so much is needed 
to provide healthcare to the people of my State. Just this morning, a 
new poll came out from Auburn University that showed that a majority of 
the people of Alabama, including a majority of Republicans and a 
majority of Democrats, favor expanding Medicaid. Our hospitals and 
healthcare professionals have long advocated for this all across 
Alabama.
  We did a program just recently. The American Hospital Association has 
been begging for this for years to keep our hospitals open. They 
advocated for an understanding that without this, more and more of our 
hospitals will have to close their doors. They are working on either 
thin margins or they are underwater already, and the pandemic has made 
it worse. More than a dozen of our hospitals, rural and urban, have 
shuttered while Alabama has refused to expand Medicaid.
  Today, we have a chance to save the ones we still have and perhaps 
even revive some outpatient services that have lost their provider. 
Every pregnant mother who has to drive hours for a round trip for 
prenatal appointments or a rural Alabamian who lives 45 miles from the 
nearest emergency room or the workers who are employed would benefit 
from this. Those who still do not have good healthcare and have to take 
their children to an emergency room for routine healthcare, it is for 
those people that I am committed to finding a way to expand Medicaid.
  Today, I stand with my colleague Senator Warner from Virginia to once 
again call for the passage of our proposal to incentivize States to 
expand Medicaid. Our bill, the SAME Act, States Achieving Medicaid 
Expansion Act, would restore the financial incentives for States that 
expanded late and would give them the same fair shot at Federal support 
as the early expanding States.
  The legislation would have the Federal Government cover 100 percent 
of the costs for the first 3 years, then would scale back to eventually 
cover 90 percent in perpetuity.
  I want to make sure folks understand this bill does not mandate an 
expansion of Medicaid; it still gives States the choice. If the 13 or 
14 States, including Alabama, choose not to expand Medicaid, even with 
a second bite of the apple, then they don't have to. Shame on them for 
not doing so, but they don't have to do it. More importantly, if they 
were to do that, thousands of people would get this healthcare 
coverage, including a very important point for the State of Alabama, 
which is expanded mental health coverage. So many places that I have 
been to in the State of Alabama are begging for mental health coverage 
that they cannot afford in their communities. Expanding Medicaid would 
do just that.
  Let me be clear. Even without this bill, I still believe Alabama 
should take this step. We literally can't afford not to. We need to be 
investing in our citizens' health the same way we invest in trying to 
bring businesses into Alabama. We need to try to invest in our people's 
health because it will lift all boats.
  If this incentive is what is needed to get us over the finish line, 
let's just do it. Again, it is not mandated. States don't have to do 
it. But for those States that do, they will see better health outcomes 
for their citizens and better economic advantages in areas that need 
it. Millions of Americans in these remaining States are struggling, and 
we can no longer allow politics to get in the way of their access to 
quality healthcare.
  I urge my colleagues to please let my State have the chance. Let us 
have the opportunity to right the wrong that we did in 2011 by refusing 
to expand. Give me that opportunity to go back and try to convince the 
folks in Montgomery, AL, that this is the right thing to do. It is a 
commonsense solution. Let's not stand in the way of more Americans 
getting healthcare amid a global health crisis.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Blackburn). The Senator from Virginia.
  Mr. WARNER. Madam President, I want to thank the Senator from Alabama 
for his partnership on the SAME Act. I am going to repeat some of the 
same arguments he made because I think they are quite compelling.
  We are talking about healthcare, which is an issue that is weighing 
on too many American families at this point--and not just healthcare 
but access to healthcare coverage. I think we would all agree that 
regardless of what we feel about this issue, we are in the midst of the 
greatest public healthcare crisis in generations. In this unprecedented 
time, I think it calls for unprecedented action from Congress.
  Today, in a couple of moments, I am going to ask that this Senate 
take up and unanimously pass legislation I introduced along with 
Senator Jones from Alabama and several of my colleagues--legislation 
that could provide access to quality and affordable healthcare coverage 
for millions of Americans. To be clear, the SAME Act is the bill I have 
been pushing for more than 3 years. This bill was a good idea before 
the pandemic, but the need for it has become even greater in light of 
the COVID-19 outbreak.
  The SAME Act would ensure that States like Virginia--and we did pass 
Medicaid expansion, but we passed it later than other States--that 
States that have expanded their Medicaid Program to serve more 
Americans can get their fair share of Federal matching dollars.
  It would also incentivize additional States--like the State of 
Alabama which hasn't yet expanded Medicaid--to expand this critical 
program to millions of more Americans. I can think of no better time to 
pass this legislation than right now, when more than 5 million 
Americans find themselves having lost their healthcare coverage in the 
last 3 months alone.
  In fact, some reports actually estimate that nearly 27 million 
Americans have lost their employer-sponsored health insurance and are 
now in jeopardy of becoming uninsured.
  Our legislation would provide much needed financial support to States 
that are seeing an increase in Medicaid enrollment as folks face the 
fallout of this crisis. For those millions of people, the SAME Act 
would provide a significant lifeline. Estimates show that if every 
State were to expand its Medicaid Program, about 3 million additional 
Americans would have healthcare coverage.
  I don't believe this is a political argument nor a philosophical 
exercise. This legislation has a real-world impact, and it is clear 
that Americans want and need this legislation to pass.
  As my colleague just mentioned, there are a number of States--Red 
States and Blue States--which have taken advantage of this opportunity, 
including, just recently, Oklahoma. A few weeks ago, Oklahomans went to 
the polls and voted to expand their Medicaid Program to provide broader 
access to coverage. We have seen similar actions from citizens in Utah, 
Maine, Idaho, and others. Across our Nation, Americans are making it 
clear that they want expanded access to healthcare coverage, and I 
believe Congress needs to listen.
  With all due respect to my Republican colleagues, you can't say you 
want to help Americans in this devastating time and simultaneously 
oppose this bill, which would actually provide that help.
  As we stand here in this Chamber, we have the privilege of knowing 
that we and our families have access to the healthcare coverage we need 
so that, if something were to go wrong, we would be covered. So why 
shouldn't we ensure the same access for more Americans? The median cost 
of a hospitalization due to COVID-19 is $14,000. For Americans without 
health insurance--the nearly 30 million and growing--that could mean 
losing their homes or their cars. For many, it could put them into 
bankruptcy.
  Now, I know that my colleagues on the other side of the aisle want to 
do right by their constituents and the millions of other Americans who 
need help. So I ask us to come together today to support the SAME Act. 
No one should go bankrupt because one

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got sick and sought medical care, but more importantly, no one should 
go bankrupt when this legislative body has the opportunity to act.
  As if in legislative session, I ask unanimous consent that the 
Committee on Finance be discharged from further consideration of S. 
585, the States Achieve Medicaid Expansion Act; that the bill be 
considered read a third time and passed; and that the motion 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 Florida.
  Mr. SCOTT of Florida. Madam President, in reserving the right to 
object, I appreciate we all want to help Americans get the healthcare 
they need, but what my colleagues are proposing is a Federal bailout 
that will help a handful of States but do little to directly help 
patients. That is not fair to Americans across the Nation who need 
better access to affordable healthcare.
  We have seen that a government takeover of healthcare does not work. 
ObamaCare was sold on a lie, plain and simple. Let's remember, when 
ObamaCare passed, they promised it would save $2,500 per family. Not 
true. Costs and premiums went up. They promised that you could keep 
your doctor. Not true. Provider networks got narrower, and people lost 
their doctors. They promised, if you liked your plan, you could keep 
it. Again, this was not true. The promise of ObamaCare didn't happen. 
Actually, the opposite happened. Under ObamaCare, costs skyrocketed, 
and families lost the doctors they liked.
  The American people don't want more lies. Actually, they want more 
solutions. The solution is not to create more inequity in the system. 
What we need is to take concrete steps to make sure we help all 
families across the Nation actually get the healthcare they need. My 
colleague's bill does nothing to help patients. States will make their 
own decisions on Medicaid. Giving certain States free Medicaid is 
nothing more than a bailout for State budgets.
  In June, I wrote to all 50 Governors and requested information on how 
their States have allocated the trillions of dollars in taxpayer 
funding from the Federal coronavirus response measures that had been 
passed by Congress. Unfortunately, a majority of the States simply 
chose not to respond, including Virginia and Alabama.
  The Federal Government already allocated $1 trillion to States and 
local governments to respond to the coronavirus, but these States are 
refusing to tell us how they are spending these extra funds, including 
the estimated extra $50 billion in Federal Medicaid dollars they 
received in the Families First Act. Since the Families First Act has 
passed, Medicaid costs have actually gone down, but the States don't 
want to tell us that because they simply want bailouts.
  Instead of pursuing a partisan bailout of a select number of States, 
I want to use this opportunity to propose a commonsense solution that 
would use bipartisan principles to help every single American in this 
country. Though ObamaCare was a failure, I support protecting people 
with preexisting conditions and ensuring that young adults can stay on 
their parents' health plans until age 26. I think my colleagues would 
also support these principles.
  I have been working with Senator Tillis on the PROTECT Act, which 
would directly assist Americans by, one, guaranteeing coverage for 
preexisting conditions and prohibiting insurance companies from 
excluding coverage of treatment for a patient's preexisting condition; 
two, prohibiting insurance companies from charging Americans higher 
premiums due to their preexisting conditions; and, three, guaranteeing 
the availability of health insurance coverage in the employer or 
individual market regardless of one's preexisting condition. My 
amendment builds on the PROTECT Act and adds protections to allow young 
adults to stay on their parents' health insurance plans until they are 
26.
  We could pass this amendment, which I believe has bipartisan support, 
and ensure that every American with a preexisting condition is 
protected no matter how the Supreme Court rules on ObamaCare.
  The American people and, certainly, the people of Florida, Virginia, 
and Alabama want us to get something done that would actually reduce 
healthcare costs and increase access to care. That is what my proposal 
does. Protecting Americans with preexisting conditions is a commonsense 
step we can and should take today to lower the costs of healthcare for 
all Americans. I hope my colleagues will join me in supporting these 
bipartisan healthcare reforms
  Therefore, I ask the Senator to modify his request to include my 
substitute amendment, which is at the desk; that it be considered and 
agreed to; that the bill, as amended, be considered read a third time 
and passed; and that the motion to reconsider be considered made and 
laid upon the table with no intervening action or debate.
  The PRESIDING OFFICER. Does the Senator so modify his request?
  Mr. WARNER. Madam President, in reserving the right to object, I have 
great respect for my friend, the Senator from Florida. I know he has a 
long and deep background in healthcare, but I have some news. The 
Affordable Care Act already provides strong protections for millions of 
Americans with preexisting conditions.
  I believe, unfortunately, the legislation my colleague is proposing 
would allow insurance companies to, once again, impose arbitrary annual 
and lifetime cap limits on care, and it would allow insurance companies 
to refuse to cover essential health benefits, like mental health 
coverage, substance use disorder, or maternity care.
  I don't believe we can go back to the days when a certain number of 
companies held all the power and consumers were routinely denied access 
to healthcare. I do believe the SAME Act--again, sponsored by my good 
friend, the Senator from Alabama--would simply continue to extend the 
right to have the same level of Federal subsidies for all States. We 
are seeing voters across the country, as they have a chance to weigh in 
on this, agree to this principle, which is that those same rights ought 
to be extended to States like Alabama, which has chosen not to move 
forward, and to States like Virginia, which has moved forward but a 
little bit late. I still strongly believe that the SAME Act, which 
would equalize and level the playing field, is the appropriate action.
  Respectfully, I object to the unanimous consent request of the 
Senator from Florida to pass this bill.
  The PRESIDING OFFICER. Objection is heard.
  Is there an objection to the original request?
  The Senator from Florida.
  Mr. SCOTT of Florida. Madam President, in reserving the right to 
object, first of all, I thank my colleagues, and I hope to work with 
them to figure out how we can drive healthcare costs down because, as 
we know in all of our States, healthcare costs are too high, and as my 
colleagues have said, we have people who are being impacted because 
they can't afford the cost of healthcare.
  I am clearly disappointed. My colleagues don't want to protect those 
with preexisting conditions and ensure that young adults can stay on 
their parents' plans until age 26 if ObamaCare is actually ruled 
unconstitutional by the Supreme Court. Whether by figuring out how to 
bring drug prices down or just the whole cost of healthcare, I hope 
that we can figure out how to work together because the costs shouldn't 
be this high.
  Therefore, respectfully, I object.
  The PRESIDING OFFICER. Objection is heard.
  Mr. WARNER. I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. RUBIO. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.