[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[Senate]
[Pages 9640-9645]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTHCARE LEGISLATION

  Mrs. MURRAY. Mr. President, since the first day of this 
administration, I

[[Page 9641]]

have heard from women in my home State and nationwide who are fearful 
of what President Trump will do to their health and rights--from 
appointing a Supreme Court Justice who has made clear that he opposes 
the historic ruling in Roe v. Wade, to trying at every turn to 
undermine women's access to safe, legal abortion here in the United 
States and abroad, to proposing a budget that would defund Planned 
Parenthood and devastate investments in women's health. I know from 
letters, calls, emails, tweets, rallies--you name it--that across the 
country women feel under attack because of this administration's 
policies and the willingness of Republicans in Congress to make sure 
they are carried out.
  Women are worried and, unfortunately, they have a right to be, 
especially in this moment. In a matter of days, Senate Republicans 
could bring their version of TrumpCare to this floor. As many of us 
have said, this is the worst bill for women in a generation. It will 
cut off access to critical healthcare services at Planned Parenthood, 
our Nation's largest provider of women's healthcare. It will allow our 
insurance companies to go back to charging women more and interfere 
with women's constitutionally protected reproductive rights. In fact, 
at literally every stage of life, TrumpCare would stand in the way of 
women's access to the healthcare they need.
  Under this bill, young girls nationwide would lose Medicaid coverage. 
College students across the country who go to Planned Parenthood for 
contraception would find the centers they rely on shuttered. Women 
would pay $1,000 more a month for maternity care, and women battling 
cancer and women who are survivors would have to look ahead to being 
discriminated against for having a preexisting condition. Senior women 
would watch their premiums spike by as much as 850 percent because of 
the age tax Republicans have inexplicitly chosen to include in this 
bill.
  I could go on, but let me just say that since President Trump and 
Republicans first began trying to jam this bill through, I have heard 
from countless women who would be impacted by the cruel policies I have 
just described.
  One of them is Kelly. Her son has a developmental disability and he 
gets Medicaid coverage. There is Jennifer, who is fighting cancer tooth 
and nail and is now worrying about what is going to happen if the 
Medicaid expansion goes away. There is Tammy, whose congenital heart 
disease made pregnancy life threatening and who was able to afford safe 
and effective contraception because of her insurance coverage. Those 
are just a few examples. I am so grateful to them and to the many, many 
others who have spoken out and shared their stories.
  We might think that with so many women thinking about how this bill 
would impact them, with so much at stake for women's health, rights, 
and financial security should TrumpCare be signed into law, Senate 
Republicans would want to see what women thought of their version of 
TrumpCare. But they have made it abundantly and offensively clear that 
they do not.
  They put together a working group of 13 men to draft their version. 
They negotiated in secret. They wrote this bill in back rooms. Now 
Senate Republicans are keeping it under lock and key until the very 
last minute so that women have as little time as possible to see just 
how badly this bill could harm them and their families. Women aren't 
going to put up with that, and Democrats aren't either.
  I am proud to be here this evening with a number of my Democratic 
colleagues to call on Senate Republicans to stop hiding their bill from 
women and bring it out in the light for the scrutiny it deserves.
  My Republican colleagues are right, I think, to be ashamed of this 
version of TrumpCare. But that doesn't mean it should be hidden from 
view, and we are not going to stop until women across the country get 
to read the fine print, instead of taking 13 male Republican Senators' 
word for it.
  While this is a truly difficult and frightening time for anyone who 
believes that women should be able to make their own decisions about 
their own healthcare and who think politicians should not be able to 
interfere with those decisions, I have also been truly inspired by the 
response I have seen to the extreme agenda President Trump and 
Republicans are pursuing.
  Since the first days of this administration, when I was so proud to 
march with millions of women across this country and the world to stand 
up for women's health and women's rights, women have continued to lead 
the fight against this administration's constant efforts to take our 
country backward. That is exactly what TrumpCare would do.
  So let me be very clear. If Senate Republicans continue down this 
path, if they choose to jam a secret bill through Congress and get it 
signed into law instead of listening to people in this country and to 
us and working with us on real solutions to fix our healthcare system, 
you can be sure that women across the country--who will be forced to 
pay more for their care or lose it altogether--are going to be ready to 
make sure Republicans own every ounce of the harm they cause.
  So I am here tonight to urge Republicans to make the right choice, 
and I will join women across the country in holding them fully 
accountable if they don't.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Tillis). The Senator from Hawaii.
  Ms. HIRONO. Mr. President I join my colleagues, Senator Murray and 
others, and I thank Senator Murray for her leadership on this important 
issue.
  Right now, 13 of our male colleagues are sequestered away somewhere, 
plotting--and I use that word, and that is an accurate word because 
that is what it feels like to those of us who are shut out of the 
process of putting together the Senate bill. These 13 men are plotting 
how to deprive millions of women across our country access to essential 
healthcare--women all over our country. That is half of our population. 
Frankly, it is sad that we are having this debate about the need for 
openness and transparency that impacts half of our population and that 
is one-sixth of our economy.
  Sadly, it isn't surprising. Republicans in Congress have fought to 
deny women access to healthcare for decades. Now they have a willing 
and complicit ally in this crusade--Donald Trump. In their zeal to 
repeal the Affordable Care Act, the President and his allies in 
Congress don't appear to be concerned about the collateral damage they 
leave behind.
  For women, this means facing a return to a time when our gender--our 
very gender--was considered a preexisting condition. Before the 
Affordable Care Act, insurance companies could discriminate against 
women of child-bearing age. They could charge outrageous rates for 
birth control and contraceptives. Under the ACA, women have secure 
access to care before, during, and after their pregnancies. They can no 
longer be charged outrageous rates simply for having a child or be 
denied access to mental health services if they suffer from postpartum 
depression. Women can now receive free contraceptive care, like birth 
control pills and IUDs. But now the President and Republicans in 
Congress are determined to drag us backward, all in the name of giving 
the richest Americans a huge tax cut.
  Let's be really clear on this. The poorest, oldest, and the most sick 
people in our country are going to suffer so that the richest people in 
our country can get a huge tax cut under this bill. We need to do 
everything we can to fight against all these misguided efforts.
  Although we haven't seen the likely monstrosity currently being 
hatched in secret, we have a pretty good idea of what is going to be in 
this bill. In the House version of TrumpCare, States have the ability 
to opt out of the Affordable Care Act's essential health benefits, 
which include access to birth control, pregnancy, and mental health 
coverage.
  One Republican Congressman even had the audacity to say he shouldn't 
have to subsidize pregnancy care because he can't get pregnant. How the 
heck do you think he even arrived on this Earth? I really think this is 
outrageous. This is an outrageous statement that speaks for itself.

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  The bill also makes good on a longstanding Republican promise to 
defund Planned Parenthood, regardless of the cost in lives. Over the 
past few years, Republicans in Congress have tried everything they 
could think of to defund Planned Parenthood--passing stand-alone bills, 
attaching poison pills to must-pass bills, threatening a government 
shutdown, and passing TrumpCare in the House. In March, the majority 
leader held the floor open for over an hour to allow the Vice President 
time to travel to the Capitol to break a tie to repeal a regulation on 
title X funding meant to preserve access to Federal family planning 
services.
  I understand that many of my friends on the other side of the aisle 
have strong feelings about abortion, but I have never been able to 
understand how this translates into attacking an organization that uses 
no Federal funds to provide abortions. In fact, Planned Parenthood uses 
its Federal funding to provide low-cost healthcare to the people in our 
country who need it most but who can't afford it.
  In 2014 alone, Planned Parenthood provided over 600,000 cancer 
screenings and over 4 million tests and treatments for sexually 
transmitted infections. These are real facts, not alternative facts.
  I have heard from hundreds of my constituents over the past 6 months 
about how important Planned Parenthood is to them, and I would like to 
share a few of their stories.
  Tiffany from Honolulu made her first visit to Planned Parenthood when 
she was 21, under unexpected circumstances during a pregnancy scare. 
She felt that having a child at that time in her life would be 
extremely difficult and would have negatively impacted her ability to 
finish school. During her visit to the clinic, Tiffany took a pregnancy 
test and discovered she wasn't pregnant. Her caregivers were then able 
to counsel Tiffany about her sexual health without judgment. They 
walked her through the different options she had and administered an 
STD test. She left the clinic with a prescription for birth control.
  Kim, a young attorney from my State, recently wrote to my office to 
tell her story about turning to Planned Parenthood when she faced an 
unexpected pregnancy. After having a safe and open conversation with 
the staff at her local Planned Parenthood, Kim decided she was not 
ready to have a baby and ended her pregnancy. Planned Parenthood gave 
her the space and opportunity to make the best decision for her. As she 
recounted to us, ``You don't have to like someone's choice, but you 
don't get to take away their freedom to make it.''
  The fight against TrumpCare continues, but I am going to do 
everything I can to protect women's health and their right to control 
their bodies--to control our bodies.
  I urge my colleagues to oppose any measure in TrumpCare that takes 
women back to the days when our very gender was considered a 
preexisting condition.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. HASSAN. Mr. President, I thank my colleague from Hawaii for her 
words and Senator Murray for organizing this group of speakers.
  I rise today to join my colleagues in making clear that TrumpCare 
would be a disaster for women in New Hampshire and across the Nation.
  Right now Senate Republicans continue to meet behind closed doors on 
their TrumpCare bill, and the reason they have not been transparent is 
because they know they can't defend this dangerous bill to their 
constituents. Throughout the process in the Senate, it has been a group 
of 13 men--no women--writing a bill that will impact the healthcare of 
millions of American women. It is not just that a small group has been 
writing the bill behind closed doors. It is also that once we do 
eventually see the bill, it is going to be rushed to the floor without 
a hearing. So we will not have the benefit of feedback from our 
constituents, from stakeholders, from people who understand what the 
impact of this bill will be. This is simply unacceptable.
  To compete economically on a level playing field, women must be able 
to make their own healthcare decisions. They shouldn't have to pay more 
than men do for their healthcare. They should be able to visit 
providers of their own choice who understand and have expertise in 
women's healthcare needs. The health insurance that is available to 
women should be equal to that of their male colleagues. That means it 
should cover their basic healthcare needs.
  To fully participate not only in our economy but also in our 
democracy, women have to be recognized for their capacity to make their 
own healthcare decisions--just as men are.
  I have heard from many constituents whose lives have been changed by 
being able to get the healthcare they need from the providers they 
trust. One of those people is Carla from Newfields, NH. As a college 
student, Carla suffered from significant pain. She needed immediate 
medical care, so she went to her local Planned Parenthood.
  It turned out that her pain was caused by ovarian cysts, and the 
treatment for those cysts was birth control. As a college student on a 
limited budget, before the Affordable Care Act had passed, Carla 
couldn't afford birth control. Because she went to Planned Parenthood, 
though, she got the treatment she needed at a price she could afford. 
Her pain went away. She was able to graduate college and eventually 
start a family--something she might not have been able to do if her 
underlying condition had not been treated, caught when it was. That was 
the power of access to appropriate and affordable health care in her 
life at the right time.
  Carla's story is the story of the thousands of New Hampshire women 
who received primary and preventive healthcare services from Planned 
Parenthood.
  TrumpCare is a disaster for women. TrumpCare defunds Planned 
Parenthood, which would take away a critical source of care for women. 
This care includes birth control and breast and cervical cancer 
screenings. Defunding Planned Parenthood would leave many women in the 
Granite State and throughout the country without access to care, plain 
and simple. There aren't enough other providers, as I heard from 
medical providers throughout my State when I was Governor there, to 
absorb all of the patients Planned Parenthood cares for now.
  TrumpCare also includes harmful language that restricts women's 
constitutionally protected rights to access abortion services. 
Additionally, under TrumpCare, if you are a mother, giving birth could 
now be considered a preexisting condition that insurance companies 
could use to discriminate against you and charge you more.
  TrumpCare would increase the cost to women from maternity care in two 
ways:
  First, it would undermine the requirement that insurance companies 
must cover essential health benefits, including maternity care. In 
fact, the Congressional Budget Office says that the House-passed 
TrumpCare bill would increase out-of-pocket spending for maternity care 
for women who have private insurance by thousands of dollars per year.
  Second, TrumpCare slashes Medicaid funding. Medicaid pays for nearly 
one-half of all births in the United States, meaning, with the 25-
percent cut in expenditures over the next decade that is called for in 
the TrumpCare bill, that at least some of this maternity coverage would 
also be cut.
  Any cut to Medicaid would disproportionately affect Granite State 
women, as 62 percent of Medicaid recipients in New Hampshire are women. 
These cuts would also strain at-risk families because Medicaid covers 
nearly one in three children across our country and nearly 30 percent 
of the children in my State of New Hampshire.
  It is clear that TrumpCare would continue efforts to play partisan 
games with a woman's right to make her own healthcare decisions and 
control her own destiny.

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  It is critical that people in New Hampshire and across our Nation 
continue to speak out and share their stories about how TrumpCare would 
impact their lives, and I am going to continue to work with my 
colleagues to defeat this bill.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, I am very pleased to follow my colleague 
from New Hampshire, Senator Hassan. She said it very well. This is an 
extraordinarily important part of the debate.
  A Senate vote on TrumpCare is now days away, and that is the case 
even though the bill remains hidden in the Senate shadows. I am here 
tonight with my colleagues to try to shine some light on the 
extraordinary harm TrumpCare is going to do to women's health across 
the country and also to call on the American people to stand up and 
say, and say loudly, that this is wrong--wrong because it would be a 
partisan process that takes away important healthcare rights from women 
across this country.
  First, TrumpCare says that health insurance in America ought to be 
based on what men need and what women need ought to cost extra. You 
look back a few years to when the Affordable Care Act set in stone 
guaranteed insurance benefits to protect everybody who shops on the 
open market, the private open market, regardless of their gender, no 
price gouging women just because they are women. Now, however, the 
Republican plan lets States hack away at those essential health 
benefits, and it always seems that maternity care is the first benefit 
that then gets cut.
  If TrumpCare goes through, what will happen in America is insurance 
companies will carve maternity care out of the plans they offer on the 
open market. It would, in effect, become an add-on--an add-on that 
would come with a higher price, as if a pregnant women's healthcare is 
a luxury item like a sunroof on a new car.
  Let's set aside the fact that every man in the country was born to a 
woman. My colleagues on the other side have spent 7 years telling 
Americans that they were laser-focused on bringing costs down for 
everybody. Apparently, that notion of ``everybody'' that we are hearing 
from Republican Senators doesn't include mothers because their costs 
are going to be going up in a number of instances.
  Second, the public has heard time and time again that nobody would be 
hurt under TrumpCare and that repeal and replace is all about putting 
the patient at the center of care. Tell that to the hundreds of 
thousands of women who will lose their right to see the doctor of their 
choosing as a result of TrumpCare defunding Planned Parenthood. Just 
unpack that for a moment. I think one basic, almost sacred principle 
for women is that they ought to be able to make the choice of the 
physician they trust for their healthcare. Yet what we are talking 
about here--apparently tomorrow--is a real prospect that women will 
lose the right to see the doctor they trust.
  This ideological campaign against Planned Parenthood ignores the fact 
that there are already laws on the books that prevent tax dollars from 
funding abortions. It ignores the fact that Planned Parenthood doesn't 
get a dime of taxpayer funding above what is available to other 
comparable healthcare providers. It ignores the fact that women rely on 
Planned Parenthood to get routine medical care from the doctors they 
know and trust--basic checkups, cancer screenings, preventive care, HIV 
tests.
  It is long past time to end this crusade against Planned Parenthood, 
which is taking away from women in this country the ability to make 
their own judgments about whom they want to see and the doctors they 
trust.
  Finally, the TrumpCare plan would significantly slash Medicaid, and 
this is a special threat to women. Medicaid is at the heart of women's 
healthcare in the country. Women live longer than men on average, and 
Medicaid helps pay for two out of three seniors living in nursing 
homes. Women are more likely than men to have a disability, and 
Medicaid is the key to helping millions of Americans with disabilities 
live successful, independent lives in their communities. The Republican 
healthcare plan would slash Medicaid so deeply year after year that 
States would be forced to cut benefits and access to care. Women would 
be hit the hardest by those cuts.
  The public needs to know that right now, it is go time in America on 
healthcare. This vote is right around the corner. And because my 
colleagues on the other side have in effect locked into this ``our way 
or the highway'' approach--the Washington word for it is 
``reconciliation,'' and my guess is that in a lot of coffee shops in 
North Carolina and Oregon and points in between, people aren't that up 
on Washington lingo like reconciliation, but they really want Democrats 
and Republicans to work together. That has been the cornerstone of my 
work with respect to healthcare. That is what Chairman Hatch and I have 
done with respect to the transformation of Medicare, to update the 
Medicare guarantee. I have worked with my colleagues in a bipartisan 
way in terms of independence at home, more care for older people at 
home, and on a host of issues, particularly with respect to holding 
down pharmaceutical costs in a bipartisan way. The reality is, that is 
the only way you come up with approaches that are sustainable--build on 
principles that both sides feel strongly about and lock it into a 
bipartisan agreement.
  What we are looking at, again, not in 6 weeks but tomorrow, is the 
Senate Republicans saying: We are going to use this reconciliation--not 
the bipartisan approaches that I think yield the real dividends but a 
partisan approach. It is called reconciliation. It means ``It is our 
way or the highway.'' And then what you are going to do is you are 
going to have one of the most consequential debates about domestic 
policy in decades. It is going to fly through the Senate with hardly 
any public input and debate.
  A big part of what I wanted to do tonight is come to the floor of the 
Senate to say to Americans that this is the time to get loud, to get 
very loud and to tell your friends and your neighbors and your 
relatives to get out there and be loud with you. This isn't some 
mundane debate where the two sides couldn't square their differences, 
the kind most people choose to ignore; this is an out-and-out attack on 
the healthcare of millions of Americans and especially women.
  I think that when the facts get out to women in this country, they 
are going to say this is wrong, and they are going to say this is 
personal. The people in Washington, DC, talk about lots of things and 
throw around lots of Washington lingo like ``reconciliation,'' but I 
think they are going to see through exactly what these proposals mean 
for them. It is a significant rollback of their rights on matters like 
being able to choose the doctor they trust.
  I will close with this, and I have felt this way since the days when 
I was co-director of the senior citizens at home in Oregon. Political 
change hardly ever is top-down--top being it comes from government 
buildings and then trickles down to people--it is almost always 
bottoms-up, where the voices of Americans are heard and they tell their 
elected officials when they are off base, when they are doing something 
that will hurt them rather than help them.
  I close by way of saying that I hope this has provided at least some 
useful information so Americans--particularly women--can get engaged, 
get loud, and do it now.
  Mr. President, I yield the floor.
  I note my colleague is prepared to speak.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I am proud and honored to follow my 
colleague from Oregon who has been such a steadfast leader when it 
comes to our Nation's healthcare and insurance and particularly when it 
comes to women's healthcare. I have been really proud to stand side by 
side with him, Senator Murray, and other colleagues who have been here 
today.
  I must say, sometimes on the floor of the Senate, at this hour of the 
day or

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night, we can feel alone, as though no one is listening, but I know 
millions of Americans are listening because of the voices like my 
colleague Senator Wyden. I would join him in urging our fellow 
Americans to make their voices heard, to be loud, and we are going to 
be loud in Connecticut this Friday, at 1:30 in the afternoon, when I 
continue the emergency field hearing we began on Monday, giving the 
people of Connecticut an opportunity to make their voices and their 
faces known, seen, and heard because, unfortunately, that opportunity 
has been denied by a process that has been secretive and hasty. Secrecy 
and speed are a toxic recipe for any democracy. They can disguise 
deception and mistakes.
  I am here to call attention to one of the profoundly mistaken courses 
that this new bill is expected to take. There is no doubt in my mind 
that the Republican bill will contain language to defund one of the 
most respected and accessible and significant of our healthcare 
providers in the United States; namely, Planned Parenthood.
  I have been an advocate of women's healthcare and reproductive rights 
and choice since my days as a law clerk for Justice Blackmun in the 
1970s. Our Nation has made progress--halting and sometimes it steps 
back--but Planned Parenthood has helped to improve, enduringly and 
profoundly, women's healthcare.
  In my home State of Connecticut, Planned Parenthood has 17 sites and 
services for more than 60,000 women and men, and they have been covered 
by the Medicaid Program. That coverage will be decimated under the 
measure we expect to see. Defunding these clinics could do irreparable 
damage to the communities that Planned Parenthood clinics serve.
  As a nurse practitioner at Planned Parenthood in Southern Connecticut 
told me, patients trust the services they receive at Planned Parenthood 
because they rely on them, and they know Planned Parenthood clinics 
have one interest and only one interest in mind, which is the well-
being of their patients and clients. Planned Parenthood has, therefore, 
expanded into primary care. Not only does Amina provide family planning 
services and STI and cancer screenings, she now screens for and treats 
patients for chronic medical conditions that disproportionately impact 
low-income patients, such as depression, diabetes, asthma, and 
hypertension.
  In her clinic, my friend who is a nurse practitioner there, Amina, 
has seen her primary care practice grow from 8 patients initially to 
112 a few months later. Her clinic offers these services, in addition 
to the contraceptive services that are so important to many patients. 
Patients who will simply go unseen and uncared for have this care at 
Planned Parenthood, but they will not have it if Planned Parenthood is 
defunded.
  In Connecticut, other kinds of healthcare providers, like health 
centers and hospitals, would need to increase their capacity to provide 
contraceptive care, and they would have to increase it by 228 percent 
to overcome the care deficit left by defunding Planned Parenthood. With 
these craven attempts to immediately and completely defund Planned 
Parenthood as a part of TrumpCare--really TrumpCare 2.0--it will be 
even more challenging for so many women to get the healthcare they need 
and deserve.
  Defunding of Planned Parenthood also jeopardizes gains our Nation 
made for women of color and patients who are served in areas where 
there are few, if any, other options.
  Planned Parenthood centers and clinics are nothing short of a 
lifeline for quality healthcare in the underserved communities. The 
fact is, the Affordable Care Act has worked for women and particularly 
women of color. Planned Parenthood and other women's healthcare 
providers are an integral part of that success story, but it isn't only 
women of color, it isn't only women in underserved communities, and it 
isn't only women. It is families who have benefited--men, women, and 
children--because the quality of healthcare and preventive healthcare, 
particularly, has been raised immeasurably.
  To decimate that network of care would be profoundly destructive to 
our Nation. I hope my colleagues will think again before they side with 
the forces of degrading and demeaning women who seek those protections. 
We need a national effort and appreciation to make sure our conscience 
prevails because the repeal of these provisions would mean they are 
gone, and all women--including healthy women--will see insurance costs 
rise. It is absolutely clear to me that the Affordable Care Act repeal 
would be cruel. It would be mean and most particularly to the women who 
depend on Planned Parenthood for so many of the services that help them 
and their families.
  I hope my Republican colleagues will cease to ignore and deny these 
benefits. We stand ready to work with them to improve the Affordable 
Care Act, not to repeal it, not to decimate or destroy it, to improve 
it, to mend its defects, to preserve Planned Parenthood, to make sure 
the women of America and their families have the healthcare they need 
and deserve.
  Thank you. I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I am joining my colleagues on the floor 
this afternoon because I share their concerns about what will happen to 
women's healthcare. I am concerned about what will happen to everyone's 
healthcare, but particularly this afternoon we are talking about our 
concerns with respect to healthcare for women.
  If the Senate passes legislation like the House passed recently--the 
American Health Care Act--that legislation has been widely described as 
cruel and poorly crafted. Just last week, President Trump described it 
simply as mean. Republican leaders in the Senate are now writing a 
companion bill that reportedly makes mostly cosmetic changes to the 
House bill. By some accounts, it would make the House bill even more 
extreme.
  Obviously, any legislation that, by design, takes health insurance 
away from tens of millions of Americans, I believe, is deeply 
misguided. I am particularly concerned about the harmful effects this 
legislation would have on women's health. Indeed, I received countless 
emails and letters from women who are offended that, once again, 
powerful men are meeting behind closed doors to make critical decisions 
regarding women's health, and we have been excluded from the room.
  This Republican bill would take us back to the days before the 
Affordable Care Act, when insurers could charge women more just for 
being women, with no other reason needed. It would take away the 
Federal protections against discrimination based on preexisting 
conditions. Bear in mind, some of these conditions apply mostly or 
exclusively to women.
  In the days before the Affordable Care Act, insurance companies 
treated pregnancies, sexual assault, domestic violence, and cesarean 
sections as preexisting conditions. Insurers routinely charged higher 
premiums to women with these ``preexisting conditions'' or they denied 
coverage all together. For example, more than 30 percent of mothers 
have a cesarean section. Once again, if this House-passed bill passes, 
and if we see something out of the Senate that does the same, women 
would face discrimination, mothers would face discrimination from 
insurance companies.
  The American Health Care Act would also harm women by allowing 
insurers to opt out of the 10 essential health benefits that all 
insurance plans must cover under the Affordable Care Act. These 
benefits are called essential because that is exactly what they are. 
They are essential, not only to good health but, in some cases, to 
actually staying alive. A number of these essential health benefits 
apply exclusively to women, including contraception, maternity and 
newborn care, mammograms, and cervical cancer screenings.
  Several months ago on Facebook, I asked people across New Hampshire 
to tell me their stories--stories about how the Affordable Care Act has 
made lifesaving difference or otherwise improved their lives. I heard 
from many women across New Hampshire who

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have written about how the Affordable Care Act has ended discrimination 
against them by the health insurance industry because of their gender. 
In particular, they are grateful that the Affordable Care Act includes 
maternity care and contraception.
  This is a picture of Maura Fay, of Exeter, NH. She writes:

       My husband and I are self-employed. Before the ACA we were 
     paying rates that were simply unsustainable for a middle-
     class family like ours. When I was pregnant in 2013, we were 
     forced to pay a maternity rider of an additional $822 a 
     month.

  That is in addition to her premium. She says:

       I'm worried about the rollbacks in regulations around 
     Essential Health Benefits, especially since so many of them 
     impact women. Maternity coverage shouldn't come with an 
     additional $800 a month price tag.

  Well, I appreciate that letter from Maura, but I am worried she may 
actually be underestimating the cost of maternity care coverage if the 
Affordable Care Act is repealed. According to one analysis, women who 
seek maternity care under the American Health Care Act--the legislation 
passed by the House--could pay up to $17,000 in surcharges to their 
insurance company.
  The American Health Care Act that the House passed also makes 
draconian cuts to Medicaid, and this will disproportionately harm 
women--nearly 40 million women--who make up the majority of Medicaid 
beneficiaries. Medicaid provides healthcare for nearly half of all 
pregnant women in the United States, supporting them through their 
pregnancies and ensuring that their babies get a healthy start in life. 
This coverage is directly threatened by the Republican legislation.
  The American Health Care Act the House passed, if we combine that 
with the administration's budget proposal, it would cut Medicaid by a 
staggering $1.4 trillion by the year 2027--so, in 10 years, a $1.4 
trillion cut. This would reduce Medicaid funding by nearly half and 
mean that tens of millions of people would lose coverage, including 
many women of reproductive age.
  Let me also point out that both the American Health Care Act passed 
by the House and the President's budget terminate all Federal funding 
for Planned Parenthood, and we just heard Senator Blumenthal speak 
eloquently about the importance of Planned Parenthood. This would leave 
millions of women and families with fewer healthcare options. In New 
Hampshire, it would mean that between 12,000 and 13,000 women and men 
would lose access to basic primary and preventive health services, 
including lifesaving cancer screenings and HIV testing.
  According to poll after poll, the American people all across the 
political spectrum strongly support Planned Parenthood and oppose 
efforts to defund it. Despite efforts by Republican leaders in the 
House and Senate to misrepresent the facts, Planned Parenthood does not 
use taxpayer dollars to fund abortions. Indeed, Federal law expressly 
forbids the use of Federal funds to pay for abortions except under 
extremely narrow circumstances that have been agreed to by Congress, so 
the real issue here is not abortion. This is about ensuring that 
American women have access to the basic healthcare they need where they 
want to receive it. Remember that Planned Parenthood plays an 
especially important role in delivering essential health services to 
low-income, uninsured, and vulnerable individuals, including in rural 
areas.
  Earlier this year I received a letter from Samantha Fox of Bow, NH, 
and she writes:

       In 2007, I was a 19-year-old just barely starting out when 
     I was denied health insurance due to a preexisting condition. 
     Had I been able to access affordable coverage, my preexisting 
     condition, a reproductive system disorder, would have been 
     easily manageable. . . . [A]t that time, I was able to access 
     care through Planned Parenthood which likely preserved my 
     ability to conceive in the future. Flash forward 10 years: I 
     am expecting my first child and I have coverage which, thanks 
     to the Affordable Care Act, includes prenatal care.

  Now, here in Washington, some people think that repealing the 
Affordable Care Act is all about politics and notching a win on their 
scoreboard. But for ordinary people in New Hampshire and across the 
country, including millions of women, repealing the Affordable Care Act 
isn't about politics, it is about life and death. We need to listen to 
the women and men in each of our States whose lives and finances would 
be turned upside down if the Affordable Care Act is repealed.
  Furthermore, it is just wrong to exclude women, to exclude their 
colleagues, to exclude Democrats, to exclude the public and to pursue a 
strictly partisan approach to healthcare--the same approach that 
produced a terrible bill in the House. And it is deeply misguided to 
bring legislation to the floor that we all know would hurt tens of 
millions of Americans and do particular harm to women.
  There is a better way forward in the Senate. Let's put ideology and 
partisanship aside. Let's work together. Let's strengthen the elements 
of the Affordable Care Act that are working in the real world, 
including Medicaid expansion, and let's fix what is not working. It 
doesn't matter what we call this. It doesn't have to be called 
ObamaCare. We can call it whatever we want. The important thing is to 
have legislation that would provide access to healthcare for Americans, 
healthcare they can afford, that is quality, that is there when people 
need it. This is what the great majority of the American people want us 
to do. It is time now to respect their wishes. Let's strengthen the 
Affordable Care Act so that it works even better for all Americans.
  I yield the floor.

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