[Congressional Record (Bound Edition), Volume 163 (2017), Part 7]
[Senate]
[Pages 9936-9938]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTHCARE LEGISLATION

  Mr. MARKEY. Mr. President, we have now reached a point where the 
Senate majority, the Republicans, and President Trump, have been unable 
to put together the package that allows them to take Medicaid and try 
to successfully turn it into a shadow of what it once was in our 
country, to turn it into a debt-soaked relic of what it is today by 
taking out $770 billion that otherwise would have gone to the families 
of those in our country who need healthcare services, who need help in 
providing for those who need it the most within our country.
  The same thing was true in the House of Representatives when they 
were moving through their bill over there. People said: Trump doesn't 
have the votes. The Republicans don't have the votes. They are not 
going to be able to be successful. However, this TrumpCare Hail Mary 
that they threw in the House, notwithstanding the remarkable defense 
put up by the American people--the millions of phone calls, protests, 
and rallies--they still were able to find the votes to ultimately pass 
this incredible attack upon the healthcare of tens of millions of 
Americans.
  What they did in the House is what they are doing in the Senate. The 
GOP retreats; they wait for the defense to disperse, but then they plow 
through to get this bill over the finish line, hoping that a 2-week 
hiatus will be sufficient for the energy level of the defense against 
these cuts to so wane that then they can come back and finish off the 
job on their second try in the same way they did in the House of 
Representatives. Right now it is only halftime.
  It is halftime. They are coming back. The ball is in their court. 
They will attempt again to destroy the healthcare system of our country 
as we know it today. We have not defeated this bill yet.
  Now is the time for those who oppose this bill to redouble their 
energy, to play even tougher defense against this Republican attempt to 
undermine Medicaid, to undermine access to care to everyone in our 
country. Their bill is now down, so let's keep it down for the count. 
Let's make sure this bill cannot get up and come back and haunt us in 
the middle of July.
  The Senate proposal right now has $188 billion, which is now going to 
be within the hands of the Trump administration, in the hands of the 
Republican leadership as a slush fund to be used to get the votes they 
need in order to pass their bill. That $188 billion is right now being 
divided up in a way that will help them to get the votes.
  What is the ultimate goal of the GOP? The ultimate goal is to take a 
machete to Medicaid because they harbor an ancient animosity toward 
Medicaid, and I will throw in Medicare and ObamaCare--all of it. They 
see this as the best opportunity they have had in two generations to be 
able to leave these programs as debt-soaked relics of what they are 
today. When they say: Well, we are going to cap the funding and send it 
back to the States with more flexibility--when they say ``cap'' the 
funding, they are talking about decapitating the funding, to cut it in 
half, send it back to the States, and then say to the States: You 
figure it out. You try to help those people who are poorest in your 
State whom you were never able to figure out how to help in the first 
place, which is why we put the Federal programs on the books in order 
to help those who are most in need in all of those States.
  What is their real goal? It is pretty simple: Slash these programs 
and then turn them into one huge tax break for the richest people in 
America. That is what this program will do. One little example of that 
$770 billion--let's take $33 billion of it. That $33 billion gets 
divvied up by the 400 wealthiest families in America; 400 billionaires 
walk up and say: Can I please have my $7 million that I get as part of 
taking away coverage for cancer, coverage for Alzheimer's, coverage for 
opioid treatment? Can I now get my payoff for the success in your 
wealth-income transfer program? Because that is what you have. You 
don't have a healthcare program; you have a wealth care program. The 
wealth of the wealthiest--please make them even wealthier; that is what 
their entire plan is about.
  By the way, that $33 billion would be enough to take care of the 
healthcare of 700,000 people in our country, but the Republican 
priority is to give all that money back to the wealthiest people in our 
country. That is immoral. That is inhumane. It is just plain wrong. The 
American public has to rise up and fight against the greatest 
legislative injustice that has been perpetrated or attempted to be 
perpetrated on the American people in more than a generation.
  This bill is ``the bill'' of my entire career in the U.S. Congress, 
which is now 41 years. This is the worst bill. It is the greatest 
attack upon the well-being of our Nation. This program is of the rich, 
for the rich, by the rich, and where are they going to take the money 
from? From the poor, from the sick, from the elderly, from the 
disabled. It is selfishness on stilts.
  To think that there is a plan to take healthcare away from the 
poorest and sickest and most disabled people in our country in order to 
give a tax break to the wealthiest is the most indecent action that may 
have ever been perpetrated on the floor of the U.S. Congress.
  There are billions in tax breaks for those who don't need them or 
deserve them, paid for by people who cannot afford it. It is healthcare 
heartlessness; that is what it is. If you kicked these people in the 
heart, you would break your toe. There is no heart. There is no sense 
of decency toward those families who are going to see their loved ones' 
diseases get even worse or to see them ultimately die because of lack 
of coverage.
  The Republicans say that their plan--at least they purport it as 
their plan--is to decrease the deficit by passing this bill, but what 
do they do with the money that they save? Ah, a tax break for the 
wealthy.
  I thought that you were shedding tears about your concerns of 
subsequent generations having such huge deficits, but we know those are 
crocodile tears about future generations because you want to pay off 
this generation of billionaires and this generation of millionaires who 
need no additional wealth for their families today.
  So there is no real concern about the deficit. This is, once again, 
just an attack on the programs that the Republicans have always 
opposed, and if they combine it as a tax break at the same time, all 
the better.
  From my perspective, people are just going to wind up paying more for 
healthcare, and they are going to be getting less. They are going to be 
paying for a Cadillac but only getting a tricycle as the people go 
forward. For too many families, they will not be able to afford 
anything, and there will be no subsidy to help them get healthcare for 
their families. The anxiety of suffering from an illness will only be 
exacerbated by their families' understanding that they cannot even 
afford the care for their loved ones because of the financial 
insecurity in their own families.
  This is going to be a historic 2 weeks in which we must raise our 
voices as they have never been raised before--in which we stand on the 
ramparts and let those Republicans know that they are

[[Page 9937]]

in for the fight of their lives. Cassandra-like, we must warn of the 
dangers of complacency, of the misunderstanding of what is happening 
right now.
  The Republicans have removed the healthcare bill from the Senate 
floor for consideration. They are not defeated. They are just at 
halftime. They are now trying to construct a plan that will bring it 
back as soon as we return and with the votes now secured, from their 
perspective, in order to pass this bill and send it over to the House 
of Representatives and then down to President Trump for his signature.
  These next 2 weeks will be the most important 2 weeks for the 
healthcare of our Nation in two generations. This battle is the battle 
to ensure that they are not successful. From my perspective, this is a 
fight that each and every American has to be a part of because it is 
your families who are going to be harmed.
  If we just take opioid addiction coverage in Massachusetts, 2,000 
people died from opioid overdoses last year. We are only 2 percent of 
America's population. If that number were to multiply across the whole 
country, that would be 100,000 people overdosing and dying. That would 
be two Vietnam wars of deaths in one year from one disease--a disease 
that we could begin to reverse if there were the treatment for families 
and if the prevention were put in place. Yet, if there is no treatment, 
if there is no prevention, if there is no access, then people, who 
otherwise would have been able to live normal lives with treatment, 
will now die.
  If you have Alzheimer's, if you are in a nursing home, there is a 
very high probability--since two-thirds of all grandmas and grandpas in 
nursing homes are on Medicaid, if you slash Medicaid, the care that 
loved one is now receiving in a nursing home is going to be slashed. 
Grandma and Grandpa in that nursing home are going to see the services 
that they otherwise would have been provided not being available to 
them. That is what this Republican plan is going to do.
  It says to a kid--a family member--with opioid addiction problems, it 
says to Grandma and Grandpa in a nursing home, it says to a woman who 
has cancer, it says to a man who has diabetes: I am sorry. We no longer 
can afford in America to help you get the healthcare you need.
  We are better than that. We are a better country than that, and we 
are definitely a better country than our saying that we are going to 
take away that healthcare from all of those people and then give it as 
a tax break to billionaires. We are better than that. That is just 
wrong. So this is the battle, the most important battle.
  In 1967, Martin Luther King said that the most important civil right 
was access to healthcare because health is the first wealth. Without 
health, you have nothing. That is what we are fighting for right now. 
We are fighting for that fundamental civil right for everyone.
  This slashes coverage for those who are disabled in our country. We 
have made progress over the last generation in reconfiguring how we 
view the disabled in our country. We have given them access to the help 
they need so that they can be fuller citizens in our society. This bill 
slashes the funding to help 20 million disabled in our country live 
fuller, more functioning lives in order to give a tax break to a 
billionaire.
  It is wrong. It must be stopped. We must put up the defense against 
this bill's ever becoming law. For the next 2 weeks, while they sit and 
plot to try to find a way of camouflaging what they are doing, the 
American people must rise up and say: No, America is better than that. 
We will not allow this to happen. God help us in 2017 in the United 
States of America.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Rounds). The Senator from Hawaii.
  Mr. SCHATZ. Mr. President, this is the beginning, not the end. Today, 
we claim an important victory because of thousands of people across the 
country. There are not enough Senators who support this Republican 
healthcare plan, so there will not be a vote this week. Because of all 
of the people who spoke up, the realities of this bill are delayed--the 
tens of millions of people without insurance, a decimated Medicaid 
Program, the closure of health clinics and hospitals. Yet that is the 
key word here--that this bill is delayed. This bill is not dead.
  Everyone who spoke up about this bill should take a victory lap. Pat 
yourselves on the back tonight. It is an extraordinary moment in terms 
of what grassroots democracy can accomplish. You did what you had to do 
with what you could, and you succeeded but only for tonight. Tomorrow 
morning, we have to get ready because the minute that the Senate comes 
back from the July 4 recess, they will have 3 weeks to ram through a 
bill. They are not done.
  I heard the Vice President say today that they are going to keep 
working until they get it done. They are not giving up, so we cannot 
rest either.
  Most importantly, we cannot let them forget that we are watching, 
that we are waiting, and we will still be here when they try to come 
back and jam this bill through.
  I really hope that the Republicans take another course. In setting 
aside the policy disagreements that we are having, there is really a 
better way. There is a way for the Senate to be a Senate, which is to 
empower two of the best Republican Senators whom we have seen in 
generations. They are Lamar Alexander and Orrin Hatch--two people whose 
conservative credentials nobody doubts. They are the chairmen of two of 
the biggest committees in the U.S. Senate--the Health, Education, 
Labor, and Pensions Committee and the Finance Committee. They have done 
bipartisan work--Orrin Hatch for decades and Lamar Alexander for 
decades. Both of them, relatively recently, have done bipartisan work 
on tax extenders and on repealing No Child Left Behind. These are not 
easy issues. For these two chairmen, because they understand the 
committee hearing process and because they earned those gavels, I can 
only imagine their frustration.
  Look, I am a Progressive, and I support the Affordable Care Act, but 
if I were sitting there as a Republican member of the HELP Committee or 
the Finance Committee and if these bills were going through and taking 
the country in a direction to which I objected and if I were the 
ranking member or were, maybe, a couple off from being the ranking 
member, I would be thinking to myself that I cannot wait until I get 
that gavel back.
  I can tell you that I can have my own hearings, and I can listen to 
expert testimony, and I can craft a bill. That is what I want to do. 
The point of being a legislator is to actually work together on a 
bipartisan basis. Everybody knows that the chairman or the chairwoman 
has the lion's share of the authority, but it is still a collaborative 
process. It is politics. You try to accommodate people on both sides of 
the aisle, and you have quite an ideological spectrum, both on the D 
side and the R side, but that is the fun of it. That is the way the 
Senate is supposed to work.
  You have a hearing, and the thing that we should remember about a 
hearing is that, generally speaking, if you have four testifiers--I do 
not know if it is a rule or just kind of an operating assumption--the 
majority party gets to pick three out of the four testifiers. So you 
are going to get three Republican witnesses and one Democratic witness 
if you have a normal hearing in HELP or Finance about the Affordable 
Care Act or what ought to happen with the American Health Care Act or 
whatever it may be. So it is not as if you cannot control the message, 
and it is not as if you cannot, in the end, do whatever bill you want 
to do. Isn't that the fun of being in the Senate?
  Forget the Democrats for the moment. I mean, the Democrats were 
totally in the dark, and the public was totally in the dark. Even for 
the Republican Members, I mean, this has to irritate them that 13 
people were sort of kept in the loop--some more than others, some less 
than others--but it was like these consecutive conversations: What will 
it take to get you to yes? OK. We will consider that. We will let you 
know what we are able to do.

[[Page 9938]]

  Why not just have a public hearing?
  That is, literally, what we do for everything--for the Defense 
authorization, for appropriations bills. Of the 12 subcommittees, we 
have several hearings. Whether it is telecommunications or railroads or 
education or even other healthcare issues, we have public hearings, and 
we do so on a bipartisan basis.
  As tough as we are on each other in the election context and as tough 
as we are sometimes with each other on the floor, the committee hearing 
process is rarely as partisan. The committee hearing process allows you 
to kind of get to the work of legislating.
  All I am suggesting is that I understand what Leader McConnell is 
going to try to do. He is going to try to peel off votes. Senator 
Markey is exactly right in that he is going to try to peel off votes. 
Yet there is another way to go here, and that is to legislate. Let me 
just make the political argument for this on behalf of Republicans.
  The problem with being the majority party and trashing the healthcare 
system by not properly funding the exchanges right now and by creating 
all of this uncertainty is that prices go up, and everybody understands 
this. Barack Obama is not the President. He was river rafting when all 
of this was happening, and he deserves it. I am happy for him. He is 
not the President. So the idea is that you are going to sort of say: 
Well, we are going to cut Medicaid, cut opioid funding, and we are 
going to turn this into a big tax cut for people who are already doing 
well financially because that last bill was called ObamaCare. It had 
the word ``Obama'' in it.
  Listen, Republicans and Democrats across the country may not be 
politically sophisticated like we pretend to be, but they are smart. 
They are thinking to themselves, I am a Republican, I am a 
conservative, but I don't care about Barack Obama anymore. He is gone. 
He is not the President. So if you sit there and tell me we need to 
slash funding for mental health services or slash funding for my 
community health center in a rural neighborhood, I don't care--your 
argument cannot be: Because ObamaCare, right? You can't be: Because 
ObamaCare.
  Now you have a majority in the House, a majority in the Senate, you 
have the Presidency. So now Republicans own the healthcare system. So 
here we are trying to figure out a way where we can both own the 
healthcare system. We are acting like this is impossible to discover. 
We are acting like: Gosh, what way would we work where we can each sort 
of shoulder some of the political and policy responsibility, the 
personal responsibility for the American healthcare system?
  There is a very simple answer to that. We just do this through the 
regular order. If you do this through the regular order--what that 
means is--it is interesting to me that the difference between now and, 
say, 6 months ago is people actually know what reconciliation is. They 
know there is a threshold for regular legislation of 60 votes to 
overcome a filibuster, but it is a really important point. The moment 
the Republicans decided to do this via reconciliation, that was 
tactical, and that was kind of technical, but what that meant was, they 
said: We have 52. We only need 51. We don't need to talk to you.
  I understand that kind of rationale. You have 52 votes. You can give 
up actually two and have Vice President Pence break the tie. That may 
be a judgment they made; I am not sure if they regret it or not.
  So here we are. The way to take this off the table as a political 
liability for the Republicans is to get a bill that could get 60 votes 
because once it becomes a bipartisan enterprise, it cannot be a cudgel. 
We cannot beat each other up over it.
  When the Affordable Care Act passed originally, one of the challenges 
we had as a political matter is that we had not a single, solitary 
Republican vote. I will take everybody at their word that they just 
couldn't vote for it because it was against their political ideology 
and their principles, but it also had the side benefit of, the moment a 
bill doesn't have the patina of bipartisanship--the moment only one 
party participates in a process--boy, do you own it.
  So the question I have is, Do you really want to own the American 
healthcare system, whatever happens, good or bad? You become like the 
utility company. Nobody likes their utility company. The best thing 
that can happen, if you are a utility company, is the lights stay on 
and the rate of increase slightly slows. You are never going to have 
cheaper rates, right? And when you flip your light switch on and your 
lights go on, you don't say: Gosh, I am so pleased with my utility 
company. You ignore it.
  The best thing that can happen is, you come up with a brilliant bill, 
without any Democratic support, and then everybody shrugs their 
shoulders and moves on. More likely you are going to own all the 
problems you are creating, and you are creating myriad problems. I just 
want to say, there are a lot of Democrats who are on the level about 
wanting to legislate here, and we will do it the moment repeal is taken 
off the table, the moment there is a commitment to public hearings, the 
moment there is a commitment to doing things through the regular order.
  Now, those were not my prepared remarks, but that really matters to 
me. I really believe in the Senate. For all of our flaws, we are still 
the place that has to solve the problems. We are still the world's 
greatest deliberative body because we must be, because these are 
Federal problems and we are the Federal legislature so we have to fix 
this ourselves. There are only two paths; one is the partisan path, 
which is great peril for people across the country and great political 
peril, and then there is the path of statesmanship and 
stateswomanship--the path of us working together and being a Senate 
again. We can do that, but we have to decide that is what we want to 
do.
  I am hoping we go home, we participate in our parades, we hang out 
with our families, we cook some burgers, we cook some hot dogs, and we 
think: You know what, I want to legislate again. That was the battle, 
that was tough, I am angry, I am disappointed, I am relieved--it 
depends on who you are--but I would like to start legislating again, 
and I would like to do so in the regular order.
  I am hoping that is what happens over the next week. If it doesn't, 
then we will be ready to fight again, and I know there are literally 
millions of Americans who are not going to let up until this bill is 
dead.
  I yield the floor.

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