[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Page 4522]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     CRITICAL PUBLIC HEALTH ISSUES

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Maryland (Mr. Brown) for 5 minutes.
  Mr. BROWN of Maryland. Mr. Speaker, I rise today to oppose the 
Republican plan to repeal the Affordable Care Act and to address two 
critical public health issues that are important to the families of 
Maryland's Fourth Congressional District.
  Nearly 26 million Americans are estimated to have chronic kidney 
disease. 700,000 people, including 3,000 in my district in Prince 
George's County, have irreversible kidney failure or end-stage renal 
disease often because of complications of diabetes and high blood 
pressure, where you cannot survive without a kidney transplant or 
dialysis treatment. And 70 percent of those patients are on dialysis 
treatment at least three times per week.
  This is a serious issue for us to consider today because nearly 50 
percent of all end-stage renal disease patients rely on Medicaid. If we 
pass the Republican plan to gut Medicaid, we are making life-and-death 
choices for these patients who are disproportionately seniors, 
minorities, and some of our most vulnerable neighbors.
  I saw the potential impact of these brutal cuts on my constituents 
when I toured a DaVita Dialysis facility in my district. Nearly half of 
all people with end-stage renal disease in Prince George's County are 
being treated at a DaVita facility. There I got to speak to several 
patients receiving lifesaving treatment, and I heard how important it 
was for them to have access to dialysis.
  Many of these patients simply would not get care if it wasn't for the 
Medicaid expansion, subsidies to afford quality health coverage, and 
the consumer protections under the Affordable Care Act that prevent 
health plans from denying coverage because of preexisting conditions 
and prohibiting insurers from dropping people from plans when they 
become ill. These are real people who will suffer the consequences of 
our actions if we pass this pay-more-for-less bill.
  As Republicans rush to pass this bill to repeal the Affordable Care 
Act and replace it with more expensive and worse care, we are also 
turning a blind eye to the impact on the opioid crisis that is ravaging 
many of our communities. In my district in Anne Arundel County, the 
number of people killed by heroin and opioid overdoses in 2016 was more 
than the prior 2 years combined.

                              {time}  1100

  Records show there have been more overdoses in the first 3 months of 
2017 than all of 2016. And last week alone, over a 24-hour period, 
there were 16 overdoses and 3 fatalities in Anne Arundel County. The 
Republican bill offers no solutions for this drug crisis. In fact, it 
makes it worse by dramatically cutting Medicaid and ending the 
requirement that addiction services and treatment be covered by States.
  Because of the Affordable Care Act, 1.3 million people are receiving 
treatment for substance abuse disorders or mental illnesses under 
Medicaid expansion. In Maryland, Medicaid pays for nearly 40 percent of 
all addiction treatment medication.
  Without this expansion, the clear majority of those people would 
either fall into the treatment gap, unable to receive substance abuse 
treatment because of a lack of insurance or public funds, or be forced 
to wait months or years to get into publicly-funded treatment programs.
  The so-called flexibility Congressional Republicans want to give 
States would only mean less funding for substance abuse. This is a step 
in the wrong direction, at a time when we are facing this urgent public 
health crisis.
  Reducing access to addiction treatment would lead to more drug 
overdose deaths and more trips to our emergency rooms. We know that 
untreated addiction leads to more crime and more homelessness. Again, I 
worry that the proposals being offered in this House could cost the 
lives of thousands of people in my State and around the country.
  The GOP plan for repeal will hurt a lot of people: the 24 million 
Americans who will be uninsured; the millions of middle-income 
families, especially the elderly, who will pay thousands of dollars 
more for care; the 33 million children and 10 million people with 
disabilities impacted by Medicaid cuts; the 390,000 women who will lose 
care if Planned Parenthood is defunded.
  But these aren't just numbers in a CBO report, they are the dialysis 
patient in Upper Marlboro, or the family whose son is finally getting 
the addiction treatment he needs in Severna Park.
  Mr. Speaker, let us think about all of these families before we vote 
on this ill-conceived and ill-advised bill. Let's not put partisanship 
before patients.

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