[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[Senate]
[Pages 9928-9929]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTHCARE LEGISLATION

  Mr. COONS. Mr. President, I have come to the floor tonight to join my 
colleagues in opposing the Senate healthcare reform bill, what I will 
call the Senate TrumpCare bill. I am also here to thank the thousands 
of my constituents, the thousands of Delawareans who called and emailed 
my office to express their opposition to this bill that is about 
neither health nor care. It is because of your efforts, because of the 
efforts of thousands of Americans across the country who have made 
their voices heard, that today the Senate doesn't have enough votes to 
pass this TrumpCare bill.
  I urge everyone watching and listening to remember that this fight is 
not over. The Senate will be back next month, and Republicans will be 
doing everything they can to make tweaks or shaves or changes or 
amendments to the bill to get it past this body. We need the 
engagement, the persistence, even the resistance of Delawareans and 
Americans to make sure the Senate TrumpCare bill never becomes law.
  This is as urgent now as ever because of how fundamentally heartless 
this bill is. As many nonpartisan organizations, including the 
Congressional Budget Office, have pointed out, this bill is essentially 
a massive tax break for the wealthy paid for on the backs of some of 
America's most vulnerable citizens.
  Many of my colleagues have already discussed the devastating impact 
this bill would have over time on millions of Americans. This Senate 
bill would make hundreds of billions of dollars in cuts to Medicaid, it 
would slash tax credits that help Americans buy health insurance, and 
it would force 22 million Americans off their health insurance and 
drive up costs for many millions more.
  If that is not bad enough, the Senate TrumpCare bill does all of this 
slashing and cutting in large part to give another tax break to our 
wealthiest citizens. If this bill becomes law, the very richest 
Americans would get an extra $700 billion in tax breaks over the next 
decade.
  If it only affected the millions of Americans who depend on Medicaid 
or who purchase insurance on the individual market, it would be 
unconscionable, but it is even worse. Let me explain.
  Many of our constituents don't realize that even Americans who get 
their health insurance through their employer--the 150 million 
Americans who get their health insurance through their employer--have 
benefited from the Affordable Care Act. In fact, I think that in some 
ways, the consumer protections put in place by the ACA are the most 
important accomplishment of that bill.
  A core requirement of the ACA was that all health insurance plans 
cover what are known as essential health benefits. These are basic 
services, such as emergency care, prescription drugs, pediatric 
services, maternity and newborn care, hospitalization, healthcare for 
the mentally ill, and substance abuse treatment for the addicted. To 
put it more succinctly, these are all the reasons many people want 
health insurance in the first place. Thanks to the ACA, almost every 
insurance plan in the country today has to carry these core services, 
and that includes the more than 150 million Americans and the half a 
million Delawareans who get their health insurance through their jobs.
  The Senate TrumpCare bill would allow States, through waivers over 
time, to gut these essential health benefit requirements, gradually 
making many Americans' health insurance less and less valuable and less 
and less protective of their and their families' health.
  That provision of the Senate TrumpCare bill would also allow States 
to waive the ban on insurers imposing annual and lifetime limits on 
essential healthcare coverage. Even if you get good insurance through 
your employer, if you have an unexpected development--let's say the 
premature birth of a child, who develops serious medical challenges, or 
a terrible diagnosis that requires expensive and repeated surgery--you 
either have to come up with that money on your own or you are forced 
into bankruptcy once you hit the lifetime cap.
  Let me demonstrate with an all-too-real example. About 1 in 10 
newborns has to spend time in the neonatal intensive care unit, or 
NICU, after they are born. According to the American Medical 
Association, in the NICU, ``it is not unusual for costs to top $1 
million for an extended stay.'' That means even a baby born to parents 
with great insurance coverage through their employer hit their lifetime 
insurance cap before they even leave the hospital for the first time.
  As Americans are scrambling to find ways to pay for their 
astronomical out-of-pocket costs under the so-called Senate TrumpCare 
bill, wealthier Americans and corporations will be given big tax 
breaks.
  Moreover, while Senate Republicans may claim their bill still covers 
preexisting conditions, insurance under this bill would be rendered 
meaningless if it doesn't cover what you need to treat your preexisting 
condition through these essential health benefits.
  Let's briefly recap this Senate TrumpCare bill. Millions of Americans 
lose health insurance. Those who managed to keep it end up paying more 
but get less coverage. The wealthiest Americans get another big tax 
break. That is a painful, even cynical, political calculation.
  Since I came to the Senate 7 years ago, I have said more times than I 
can count that I want to work with Republicans to fix the parts of the 
Affordable Care Act that need fixing. Let's simplify the reporting 
requirements that burden small businesses and increase the tax credits 
that help small business employers offer insurance to their employees. 
Let's find ways together to increase competition and expand the tax 
credits to bring down premiums and deductibles on the individual 
market. Let's explore new mechanisms that control healthcare costs by 
incentivizing reforms and producing healthier outcomes, rather than 
more tests and services. Sadly, this Senate TrumpCare bill does none of 
these things.
  It is my hope that after today's developments, that after the next 
few weeks, that after hearing from their constituents and returning in 
the next month, that my colleagues will recognize that if we work 
together, we can address the broken parts of the ACA and sustain the 
best of what it has done to expand insurance and healthcare for 
millions of Americans.
  Let me close with a story I shared earlier today on the steps of the 
Capitol. This is Kerry Orr. Kerry is from my hometown of Wilmington, 
DE. Kerry is a massage therapist and self-employed yoga instructor. 
Like many Americans, she considers the Affordable Care Act ``nothing 
short of miraculous.''
  Kerry signed up for health insurance in 2014, thanks to a subsidy 
that made it available to her through the ACA. She had some nagging 
abdominal and lower back pain for years but didn't think much of it, 
considering she had no family history of disease and had never even had 
stitches before. But that next year, in January of 2015, a routine 
procedure covered by her new insurance--which she told me she wouldn't 
have even gone for if it hadn't been covered by this new health 
insurance--revealed that Kerry, in fact, had stage III colon cancer. 
She had surgery a week later. She had 6 months of chemotherapy, and she 
ultimately faced no out-of-pocket expenses and is fully in remission. 
Kerry's cancer has now been in remission since September 2015.
  She wrote to me earlier this year:

       The ACA came along at the last possible moment to save my 
     life. I am certain that without it, I would have continued to 
     live with the discomfort and try to self-treat until the 
     cancer was too advanced to be successfully treated.

  I am opposing the Senate TrumpCare bill for Kerry and for the 
thousands of Delawareans and millions of Americans just like her. I 
have heard stories from Delawareans about things that need to be fixed 
in the Affordable Care Act, and I hope I get a chance to work across 
the aisle to do that, but I have also heard from hundreds of 
Delawareans whose lives have been improved or, in

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cases just like Kerry's, saved by the Affordable Care Act. I will not 
yield on defending the best parts of the ACA that have saved the lives 
of Americans across this country.
  In the days and the weeks to come, I hope all Americans will stay 
active, stay engaged, and stay the course so that we can push aside 
this cruel, cynical bill and find an opportunity to work together on a 
bill with real heart. That fight is not yet over, and I will not yet 
yield.
  Thank you, Mr. President.
  I yield the floor.

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