[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[Senate]
[Pages 9699-9701]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTHCARE LEGISLATION

  Mr. WYDEN. Mr. President, it has been a rough day at the office for 
the

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Senate Republican healthcare plan, and my take is that it is going to 
be even tougher over the next few days. There will be a lot of Senate 
Democrats home, meeting with folks in open meetings. We will see if any 
Senate Republicans have the courage to do that as well.
  Earlier this morning, the whole Senate had its first opportunity to 
look at this bill in the light of day. The debate that unfolded on the 
floor made it clear that our colleagues are committed to a partisan 
scheme to jam this bill through at any cost. There isn't going to be a 
full debate. There isn't going to be any bipartisan input.
  If you read through the fine print in this destructive proposal, as 
the American people have had the chance to do over the last several 
hours, it becomes clear why my colleagues on the other side have kept 
this bill hidden and want to jam it through as quickly as possible.
  This proposal is stunning in its sameness to the cruel House bill 
that the American people have rejected outright--in fact, rejected, 
according to polls, by really eye-popping numbers. So I want to begin 
by warning against anybody's buying into the sales job that is 
inevitably going to unfold in the days ahead. This bill may change, but 
Senate Republicans will only be putting lipstick on a devastating blow 
to the healthcare of the American people.
  This is a plan to raise costs, slash Medicaid, and cut millions of 
people off of their healthcare to pay for tax breaks for the fortunate 
few.
  My colleagues on the other side have spent the last month telling 
every reporter and constituent who would listen that they were throwing 
out the House bill and they would be starting anew with a fresher and 
kinder bill. That has turned out to be fiction. Republicans are going 
to keep telling Americans that they are fixing their healthcare right 
up until the second it gets taken away.
  This bill doubles down on the meanness that even the President 
described in the bill from the other body. The Senate Republican plan 
doesn't fix the problems with people's healthcare. It creates a bunch 
of new ones.
  After a day of pouring over this bill--and the Finance Committee 
Democratic staff has been looking at this in detail--I would like to 
lay out, as we close up this afternoon, some of the most devastating 
effects this bill will have.
  First, Senate Republicans are so committed to slashing Medicaid that 
their bill cuts it even deeper than the House. Today, Medicaid comes 
with a guarantee to the most vulnerable Americans and their families 
who walk an economic tightrope every day. Today, if you get sick or 
suffer an injury, you will get the care you need. The Senate Republican 
plan ends that guarantee for good. It ends the Medicaid program as our 
country knows it for good.
  People shouldn't be distracted by date changes or sweeteners for 
people already enrolled. This is a radical plan plucked from the wish 
list of the far right, and it is cloaked in the complicated language of 
inflation rates and dollar figures. When you talk about slashing 
Medicaid by hundreds of billions of dollars, you are not simply talking 
about the lingo of healthcare policymakers, like bending the cost 
curve. You are talking about people's lives.
  Medicaid helps to pick up the bill for two out of three seniors in 
America's nursing homes. These are the people who have done everything 
right. They are our older parents, our grandmothers, our grandfathers. 
They scrimped, they saved, and they worked hard. But it is pretty 
clear: It is really expensive to grow old in America. So Medicaid is 
there to support them and cover the cost of nursing home care when 
savings run out.
  The Senate Republican plan slashes Medicaid so deeply that States are 
going to be forced to cut benefits, and the guarantee of nursing home 
care will be in danger. This is one of the greatest threats seniors 
have ever faced, and it is being imposed on them by an act of Congress.
  I don't make that statement lightly. My background is working with 
the older people of Oregon and our country. I was director of the 
Oregon Gray Panthers for 7 years and ran the legal aid office for the 
elderly before I was elected to Congress. I will say point-blank, 
having worked in this field now for more than three decades, that this 
is an extraordinary threat to the well-being of the Nation's older 
people, who shouldn't have to worry about winding up living in squalor 
or on the street.
  Families shouldn't have to worry about where they will find the money 
to cover the cost of a nursing home. That is $90,000 a year--$90,000 a 
year, on average, for nursing home care. Independence, safety, and a 
reasonably comfortable old age should not become a privilege reserved 
just for the wealthy in our country.
  Second, the age tax in the Senate Republican bill is going to hit 
older Americans between 55 and 64 like a wrecking ball. They are going 
to be forced to pay several times as much as a younger person for 
health insurance. You are going to see older people desperately hoping 
and praying that they can hold on to their health until they make it to 
65 and enroll in Medicare. I would like to hear somebody try to explain 
what healthcare problem that is fixing or why it is a good approach to 
healthcare policy.
  Third, Senate Republicans have now cooked up a scheme to decimate the 
value of middle-class tax cuts for healthcare and send deductibles into 
the stratosphere. Here is how that is going to work. A whole lot of 
families in the middle class are going to lose their tax benefits 
outright.
  As the ranking member on the Senate Finance Committee that has 
jurisdiction over tax policy, I have seen that. Then, as if that is not 
enough harm, this plan cheapens the value of the tax benefits that were 
created under the Affordable Care Act. It is a scheme to force people 
into bargain basement insurance plans with sky-high deductibles. It 
also risks kicking off a death spiral in States where the private 
insurance markets are stable and competitive today.
  Fourth, Republicans have twisted a part of the Affordable Care Act I 
wrote to promote State innovation, and they are using it to give 
insurance companies the power to run roughshod over individual 
Americans. What we are talking about here is what are called section 
1332 waivers. What was done in 2009, in the Senate Finance Committee--
it came out of my original bipartisan bill, the Healthy Americans Act--
we told States that the Affordable Care Act was going to set a new bar 
for insurance in terms of coverage and affordability. We said to the 
States--the laboratories of democracy--if you believe you can do even 
better, you can get a waiver so you can go test an innovative, new 
approach. We did build in protections, basic protections, so people 
would get decent coverage, and their lives would be protected.
  The Republican plan wipes those protections out, wipes out the 
consumer protections. It tells States: OK. If you want to do worse, go 
right ahead. In fact, the Senate Republican plan offers States a bribe 
to end basic health protections and lower the bar for insurance. You 
will see insurance companies given a green light to cut essential 
benefits out of the plans they sell on the open market.
  For example, take maternity care. The Affordable Care Act banned the 
practice of price-gouging women just because of their gender, but the 
Republican plan takes the side of the big insurance companies in this 
debate.
  On a fundamental level, this plan says that health insurance in 
America ought to be based on what men need and what women need ought to 
cost extra. Services like maternity care would be an add-on item, and 
that means women are going to face higher costs just because they are 
women.
  Fifth, this proposal attacks Planned Parenthood and deprives hundreds 
of thousands of women of the right to see the doctor of their choosing.
  I want to come back to what that really means. Women in America ought 
to be able to see the doctor of their choice, the doctor they trust, 
the doctor, in their own judgment, is the best

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doctor for them. This provision keeps them from doing that. Never mind 
that there is already an air-tight ban on taxpayer dollars funding 
abortions. Never mind that Planned Parenthood doesn't get a single dime 
of Federal funding above what is available to other Medicaid providers. 
Never mind that Planned Parenthood is where millions of women get 
routine medical care from doctors they know and trust--services such as 
basic checkups, cancer screenings, preventive care, HIV tests. The 
Senate Republican bill continues this ideological crusade against 
Planned Parenthood, and it is going to cost women across this country 
the right that I see as so fundamental--the right of women to be able 
to choose to go to the doctor they trust.
  Sixth, at a time when the opioid epidemic is ripping apart 
communities from one corner of this Nation to another, this bill would 
be a devastating setback in the fight against opioid abuse. No 
community has been spared from this crisis, and I would wager that 
virtually every Senator has come to the floor at some point and spoken 
about the impact it has had on their State.
  By the way, it would be hard to forget the parade of Presidential 
candidates in 2015 and 2016 that went through State after State 
claiming they had the very best plan to end the opioid crisis, but now 
the Senate Republican healthcare bill makes the crisis worse.
  Medicaid is the only lifeline that thousands and thousands of people 
across America have in their struggle to try to put their lives back 
together after falling victim to opioids. For thousands and thousands 
of people, over the last few years, the treatment they have gotten 
through Medicaid has been their escape, their path out of a downward 
spiral that too often leads to heroin abuse and overdose deaths. The 
Republican plan takes this lifeline away.
  Some on the other side have proposed creating a separate pool of 
money, a separate slush fund to replace the loss of treatment through 
Medicaid. In my view, this is a very serious mistake because it is 
based on a complete misunderstanding of the opioid crisis, and it is 
not going to work.
  The opioid epidemic is a public health crisis, and fighting it means 
making sure people can get the healthcare they need. That means 
treating substance abuse disorders the same way you treat other 
diseases. Our country doesn't pay for heart surgery through grant 
programs. We don't pay for chemotherapy through congressional 
appropriations. If you are sick and you have healthcare coverage, you 
get the care you need. Anything less when it comes to opioid addiction 
treatment is going to fail.
  Finally, when you listen to that parade of horribles--all the harm 
this bill is going to do to generations of Americans across the 
country--you have to wonder why my colleagues on the other side would 
push this bill forward.
  People have been asking me this all day. There is a simple answer for 
it. This bill takes healthcare away from millions of Americans and 
raises costs for millions more for one reason--to give tax breaks to 
the fortunate few in America. This isn't a debate about two competing 
visions of healthcare--one liberal and one conservative. One side in 
this debate wants to protect Americans' healthcare coverage, make sure 
they can go to the doctors they trust and afford the medical care they 
need. The other side in this debate has a plan to take away healthcare 
coverage and raise the cost of care for the vulnerable, the middle 
class, families struggling to get by--all to pay for tax breaks for the 
wealthiest few. This is an out-and-out attack on millions of Americans' 
health and well-being.
  In the debate that played out on the Senate floor this morning, it 
was suggested several times that Democrats turned down a chance to 
participate in the process. This is completely, entirely 100 percent 
false.
  I am the ranking member of the committee that is responsible for 
healthcare. I have not once been asked by a single Republican to work 
on this bill or discuss fixes to the Affordable Care Act. I was stunned 
this morning when I heard the Democrats had been given an offer to work 
on these fixes; that Democrats aren't interested in being bipartisan.
  I have made the center of my time in public service working in a 
bipartisan way on healthcare. I have written healthcare legislation 
that has been signed into law that has been bipartisan. It was based on 
principles that both sides of the aisle could agree on. Certainly, if 
there had been any interest in a process that would actually give both 
sides the opportunity to do the kind of give-and-take that you do with 
a bill--not through this partisan ``my way or the highway'' 
reconciliation--I would have been very interested in it, and I know 
Senate Finance Democrats would have been very interested in it. That 
wasn't on offer. The claim the Democrats have refused to work in a 
bipartisan way is fiction, a gross fiction.
  It is clear now that the only way to bring this partisan process to a 
halt is for Americans to stand up and speak out. I am going to close 
with two points. Ever since those Gray Panther days, I have always 
thought healthcare was the most important issue because if Americans 
and their loved ones don't have their health, then pretty much 
everything goes by the board. You can't go to the game. You can't spend 
time with family. It is hard to do much of anything.
  It is very clear that healthcare, as a result of this proposal for 
millions of Americans and for our country, is going to be at risk. What 
is at risk is the prospect that the Senate will turn back the clock to 
the days when healthcare was basically for the healthy and wealthy. We 
shouldn't go there.
  In the past, Democrats and Republicans have agreed we shouldn't go 
there. With the bill I wrote--seven Democratic Senators, seven 
Republican Senators--that was the centerpiece of it. By the way, 
several Senate Republicans who are here in this body were cosponsors of 
that legislation. We shouldn't go back to those days when healthcare 
was basically for the healthy and wealthy.
  For all those who are paying attention to these proceedings, my view 
is, the only way you are going to end a partisan process and make 
policy the way it ought to be made is not through something Washington 
lingo calls reconciliation--it is just partisan--but through the give-
and-take of Democrats and Republicans finding good ideas that the other 
side can agree on. The only way we are going to do that is for 
Americans to stand up and speak out.
  Political change does not start in government buildings and then 
trickle down to the people. It is not trickle-down. It is almost always 
bottom-up, starting from communities where we are going to hear people 
speaking out over the next few days.
  I am going to close by way of saying that over the next few days, 
this is one of the most important times for Americans to make their 
voices heard. As we wrap up the first day of actually seeing what the 
draft Republican proposal is all about, I hope Americans will weigh in, 
that we will see that grassroots juggernaut develop, and we will defeat 
a partisan plan and set about the task of doing healthcare policy again 
in a bipartisan way--where you find common ground that is sustainable 
rather than just a partisan approach, which continues the gridlock and 
the polarization on an issue that is the most important issue of our 
time.
  I yield the floor. I believe there are no other speakers.

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