[Congressional Record (Bound Edition), Volume 163 (2017), Part 6]
[Senate]
[Pages 8500-8501]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               TRUMPCARE

  Mr. VAN HOLLEN. Mr. President, as our colleagues know, just yesterday 
we received the Congressional Budget Office's analysis of the most 
recent version of the Republican health care bill, the bill that passed 
out of the House of Representatives, also known as TrumpCare 2.0.
  I encourage all of us, every one of our colleagues, to read the CBO 
report and to read it carefully. For those who are interested, it can 
be found online at www.cbo.gov. On the front page you can link to the 
report, which I have here in my hand.
  I think it is worth reminding our colleagues that the Congressional 
Budget Office is composed of professionals, budget experts, and the 
current Director of the Congressional Budget Office was selected by the 
Republican chairman of the House Budget Committee and the Republican 
chairman of the Senate Budget Committee. Without an umpire on budget 
issues, this Senate would be in absolute chaos when it comes to 
determining the impact of many of our major decisions, so it is very 
dangerous when people start attacking the umpire when it comes to these 
important issues that can have literally life or death implications for 
our constituents.
  What you will find in this most recent Congressional Budget Office 
report is that the most recent House Republican plan is even worse than 
the original plan, which also was the subject of a Congressional Budget 
Office report. What this CBO report tells us is that, like the earlier 
version, this so-called health bill is really a massive transfer of 
wealth from working-class and middle-income Americans to the top 1 
percent of the wealthiest in our country and some very powerful special 
interests. Its title would much more fittingly be ``wealthcare,'' not 
healthcare.
  Let's take a look at some of the findings that are in this report 
that can be found online. I turn to page 4 of the report, where the 
Congressional Budget Office reaches the conclusion that if we adopt 
this House proposal, if the Senate votes for the House Republican bill, 
there will be 23 million fewer of our fellow Americans who will have 
access to affordable healthcare when it is phased in than today. So if 
we were to adopt this, if this becomes law, we are saying to 23 million 
of our fellow Americans: Sorry, we are going to take away your access 
to affordable healthcare. It is right there on page 4. That is because 
what this so-called healthcare bill does is take away some of the 
supports that provide access to affordable healthcare. It reduces for 
millions of Americans the tax credits they use for their premiums in 
the Affordable Care Act exchanges.
  As you will find on page 3 of this report, it also cuts Medicaid by 
$834 billion. Now some people will say: Hey, no problem; that is just 
going to be sent to the States, and States are going to have more 
flexibility.
  The Congressional Budget Office is very clear that when you are 
talking about Medicaid cuts of this impact, one of two things happen: 
Either a lot fewer people get access to affordable healthcare or States 
have to raise taxes on the people in their States to ensure continued 
access. But this notion that somehow there are all these extra funds 
floating around and that greater flexibility will allow fewer dollars 
to go further with no negative impact is a fairytale.
  In fact, Medicaid already has lots of provisions for flexibility. 
They have a whole suite of waiver provisions. Our State of Maryland 
exercised lots of waivers under the Medicaid program to allow it to be 
creative and flexible.
  This $834 billion cut we found out about yesterday with the 
President's budget is just the first round of cuts. They are proposing 
another almost $610 billion cut to Medicaid. Total cuts are $1.4 
trillion to Medicaid.
  I would remind my colleagues that in addition to helping working-
class Americans get access to healthcare, two-thirds of Medicaid money 
goes to help seniors in nursing homes, and 60 percent of seniors in 
nursing homes use Medicaid to help pay the bills. Two-thirds of it goes 
to those seniors and people with disabilities.
  The Congressional Budget Office is telling us that this TrumpCare 
2.0, this latest version of the Republican healthcare bill, is going to 
result in 23 million fewer of our fellow Americans having access to 
healthcare. It is going to cut Medicaid, and this is just the first 
round, by $834 billion.
  Why do this? Who is benefiting from this? Well, let's look at the 
very first page of the Congressional Budget Office report. It reduces 
revenues by $992 billion. There are cuts to Medicaid by $834 billion, 
and it reduces revenues coming in by $992 billion, essentially 
transferring revenues that are going to help tens of millions of our 
fellow Americans get access to healthcare and transferring that to tax 
breaks. Those tax breaks go overwhelmingly to the very wealthiest 
Americans--to the top 1 percent, in fact.
  One of the things we did when we put together the Affordable Care Act 
to help pay for it was--we said: You know what, we think wealthier 
households should have to pay a small fee on their unearned income to 
be devoted to the Medicare trust fund.
  Everyone in the country knows when they get that pay stub, it tells 
them how much is taken out for Medicare--3.4 percent. We said: Look, 
that should not just apply to earned income from hard-working people. 
If you're in the top 1 percent, if you are a higher income earner, you 
should also be contributing some of your capital gains revenue to help 
strengthen Medicare. That is what we did.
  Yet this bill provides all those households with a tax cut. In fact, 
for millionaires, the average annual tax cut as a result of this bill 
will be $50,000--a $50,000 tax cut to millionaires while cutting access 
to affordable care for 23 million of our fellow Americans.
  Why all these tax cuts are in something masquerading as a healthcare 
bill, I don't know, but we now know certainly who benefits the most 
from this legislation. Beyond those top 1 percent income earners, you 
also have insurance companies and the pharmaceutical industry. They get 
some tax breaks, as well, under this legislation.
  Finally, I said at the outset that this TrumpCare 2.0, the most 
recent Republican healthcare bill, is worse than the original one. The 
original one was rotten to the core. The original one had most of the 
provisions I am talking about. So what got added that makes this one 
even worse? To find that, people should look at page 5 of this report 
and see what happens to people in States that decide to get rid of the 
patient protection provisions in the Affordable Care Act.

[[Page 8501]]

  We have heard a lot of talk about how that House bill isn't really 
going to hurt people with preexisting conditions like diabetes and 
asthma. We have heard all that, but here's what the Congressional 
Budget Office report says. This is what the referee, the umpire, has to 
say about that with respect to those States. It says: ``Community rated 
premiums would rise over time, and people who are less healthy,'' and 
then they state ``including those with preexisting conditions or newly 
acquired medical conditions,'' right? So people who have had any kind 
of preexisting condition or prior health condition that an insurance 
company will argue makes them a much greater risk--people who are less 
healthy and those with preexisting conditions ``would ultimately be 
unable to purchase comprehensive nongroup health insurance at premiums 
comparable to those under current law, if they could purchase it at 
all.'' They go on to say ``despite the additional funding that would be 
available under H.R. 1628.''
  That is the House bill. Despite that additional funding to help 
reduce premiums, they go on, and I hope our colleagues will pay 
attention to this conclusion: ``As a result, the nongroup markets in 
those states would become unstable for people with higher-than-average 
expected health care costs.'' Translation: People with preexisting 
conditions, people who, because they had diabetes or asthma as a child 
or they have a congenital disease--any preexisting condition will make 
it much harder for them to afford any kind of coverage at all, and 
ultimately the nongroup markets in those States will become unstable 
for those people. That is why this TrumpCare 2.0, this House healthcare 
bill, this Republican bill, took a really rotten bill and actually made 
it worse.
  It is not enough, colleagues, for people to make a few cosmetic 
changes to this, to put couple of bandaids on it in the Senate, and say 
``Hey, we made this thing better'' because this is rotten to its core.
  If people really want to address healthcare reform, let's work 
together to improve the exchanges. There are commonsense things we can 
do to improve the exchanges, but you don't improve the exchanges by 
cutting Medicaid by $834 billion. That has nothing to do with the 
exchanges. You don't improve the exchanges by giving a windfall tax 
credit to the wealthiest Americans. That has nothing to do with 
healthcare.
  TrumpCare 2.0, this Republican healthcare bill, is rotten to the 
core. Let's throw it out, and let's focus on the question of fixing the 
exchanges. If people want to do that, we can actually get something 
done. But let's not pretend we are doing healthcare when really what 
the goal so far has been is ``wealthcare.''
  Thank you.
  The PRESIDING OFFICER. The majority leader.

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