[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Pages 4619-4620]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1030
      LISTEN TO THE PEOPLE CONCERNING THE AMERICAN HEALTH CARE ACT

  The SPEAKER pro tempore. The Chair recognizes the gentlewoman from 
Texas (Ms. Eddie Bernice Johnson) for 5 minutes.
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, the American Health 
Care Act, or TrumpCare, does one simple thing: This shortsighted 
Republican plan forces Americans to pay more to get less. It is nothing 
more than a tax break for the wealthiest at the expense of the most 
vulnerable.
  Today, joining every major responsible group for providing health 
care to Americans--including the American Hospital Association, the 
AARP, the National Physicians Alliance, the American Medical 
Association, the Association of American Physicians and Surgeons, and 
the National Nurses United--a group representing over 150,000 
registered nurses wrote to Congress urging us to oppose the American 
Health Care Act.
  Registered nurses care for Americans in our most difficult hours. 
From our first breath of life to our final, nurses are integral to the 
delivery of health care in our country. More than any other profession, 
nurses see the personal effects of a flawed healthcare system in the 
hospital every single day.
  I know, Mr. Speaker, because I was the first former registered nurse 
in the House. I have a firsthand, valuable perspective and insight that 
nurses have into our healthcare system. We should take their heed 
alongside the public outcry about the danger of this so-called 
replacement bill.
  These are not paid protesters going to townhall meetings across this 
country. These are our constituents, participating democratically, 
telling their Representatives that they want to keep and improve the 
current law, not repeal and replace.
  This proposed plan replaces nothing for the 24 million Americans who 
would lose coverage as a result of this ill-derived legislation.
  In my district alone, President Obama's Affordable Care Act brought 
the uninsured rate down from 27.3 percent to 20.8 percent, and insured 
over 265,000 individuals who did not have coverage before. While the 
main safety net provider in my district, Parkland Memorial Hospital, 
provided $1 billion in uncompensated care in 2015, Parkland and the 
other safety net providers face severe financial burdens in the House 
GOP proposal.
  One of my main concerns with this bill is that it punishes people who 
get their coverage through Medicaid by capping and slashing the 
program. With 70 million Americans and 5.2 million Texans who currently 
rely on Medicaid, per capita caps on the program

[[Page 4620]]

would not meet the needs of the population, and the people would 
suffer.
  People will live or die as a result of our decisions here on this 
floor, Mr. Speaker. There is no reason for the Republican leadership to 
rush this legislation without careful consideration, including the 
input of those who actually provide health care.
  We need to listen to our constituents, our nurses, our doctors, our 
long-term care aides, and our hospitals. We must listen to the people. 
This bill will force Americans to pay more for their premiums, more for 
their care, more for their medicine, more out-of-pocket expenses and 
deductibles, all the while giving tax breaks directly to the wealthy.
  Mr. Speaker, I urge my colleagues to consider the harmful effects of 
this bill. Your constituents are asking you to work with us to repair 
the Affordable Care Act, and we are ready to work.
  Mr. Speaker, I include in the Record correspondence from National 
Nurses United.

                                           National Nurses United,


                                Silver Spring, MD/Oakland, CA,

                                                   March 21, 2017.
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of the 150,000 Registered 
     Nurse members of National Nurses United, we urge you to 
     oppose the American Health Care Act when it comes to a vote 
     on the floor of the House of Representatives.
       Registered Nurses care for Americans in their most 
     difficult hours. More than any other profession, we see the 
     personal effects of a flawed healthcare system in the 
     hospital every single day. Our primary responsibility is to 
     protect the health and wellness of our patients by providing 
     care at the bedside.
       The American Health Care Act poses a mortal threat to the 
     health and well-being of our patients, and to the health 
     security of our country. Last week, the Congressional Budget 
     Office reported that 24 million Americans will lose insurance 
     coverage under the original legislative text. The plan would 
     increase the number of uninsured people by 78% in 2020, and 
     by 86% in 2026. This reality is in stark contrast to one of 
     the key campaign promises made by the President this past 
     year--instead of providing ``insurance for everybody'', this 
     healthcare bill will dramatically reduce the number of 
     insured Americans. The President also promised not to cut 
     Medicaid or Medicare, but the AHCA includes drastic cuts to 
     both programs.
       There is not a single aspect of this legislation that will 
     benefit our patients who lack the health care services that 
     they need. Specifically, the legislation will:
       Eliminate the Prevention and Public Health Fund, which will 
     worsen the health of our communities, spread infectious 
     disease, and increase health system costs;
       Phase out coverage for Medicaid expansion in Medicaid 
     expansion states beginning in 2020, while preventing new 
     states from receiving enhanced Federal Medical Assistance 
     Percentage in order to expand Medicaid;
       Institute a per capita cap for Medicaid, along with the 
     option for states to use a block grant instead. Both options 
     will reduce coverage for the most vulnerable, shift care from 
     clinics to emergency rooms, increase system costs for the 
     chronically ill as they defer treatments because of cost, and 
     unfairly shift the burden of costs to the states;
       Empower individual states to determine eligibility, scope 
     and benefits for Medicaid as per their own discretion, but 
     there will be no increase in federal monies to cover expanded 
     eligibility;
       Eliminate funding to Planned Parenthood which will worsen 
     women's health, and create burdens for women, families and 
     society from unsafe pregnancies and other health conditions 
     no longer treated;
       Eliminate the definition of ``essential benefits''--a move 
     that makes all patients vulnerable to the distortions and 
     marketing games of insurance companies;
       Repeal the cost-sharing subsidies of the ACA, and destroy 
     the ability of 80% of people currently buying insurance on 
     the Exchanges to maintain coverage;
       Open the door for junk insurance. The bill includes a 
     penalty for lack of continuous coverage, creating a big 
     incentive for patients to buy low-cost, no-coverage plans;
       Fail to encourage low-cost coverage, because the 
     legislation shifts thousands of dollars in spending from 
     insurance company spending to the individual's out of pocket 
     costs;
       Reproduce the failed ``high-risk pools'' of the 1990's and 
     2000's, through the ``Patient and Stability Fund''. It is 
     inevitable that the number of eligible patients will 
     overwhelm the resources of these high risk pools;
       Repeal the Medicare Hospital Insurance Tax, which will 
     reduce funding and destabilize for the Medicare program that 
     our nation's seniors rely on;
       Allow insurers to charge seniors five times the amount of a 
     younger person. This revision will prove to be deadly for our 
     nation's seniors, and it reveals the extent to which this 
     reform will benefit the profit margins of insurance 
     companies, at the expense of patients' lives.
       Our experience at the bedside, coupled with analysis from 
     health policy researchers, confirm our conclusion that this 
     bill does not address the primary concerns of our patients: 
     getting the care they need when they need it, without 
     overwhelming financial burdens.
       Over many years, with the notable exception of the passage 
     of Medicare in 1965, the United States has built a patchwork 
     health system around private insurance access, rather than 
     genuine access to health care. This legislation, if enacted, 
     will perpetuate this system while undermining gains made in 
     the Affordable Care Act. Given the ultimate reductions in 
     Medicaid, and the other reversals in the bill, there is 
     literally nothing in this legislation that provides our 
     patients with the care they need.
       In order to effectively address the health system problems 
     in this country, legislators must move beyond a private 
     health insurance company dominated system. Health policy 
     research, and the experience of every other wealthy nation, 
     shows that a single-payer health care system is the most 
     successful model to use. In the United States, Medicare is an 
     example of how successful such a system can be. If the goal 
     of our health system is to provide quality care for all 
     Americans at the lowest cost possible, then we must 
     transition to a single payer healthcare system--or Medicare 
     For All.
       The principal effect of the American Health Care Act, on 
     the other hand, will be the loss of existing health coverage 
     for tens of millions of people without any restraints on 
     healthcare industry pricing practices. This legislation will 
     result in overwhelming health insecurity for the American 
     people.
       On behalf of registered nurses across the country, we urge 
     the rejection of this flawed, and deadly, proposal. We urge 
     you to instead support guaranteed healthcare for all, through 
     an improved, expanded Medicare for All program.
           Sincerely,
     Deborah Burger, RN,
       President, NNU.
     Jean Ross, RN,
       President, NNU.

       

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