From the Congressional Record Online through GPO
Mr. BLUMENTHAL. Mr. President, I am proud to be on the floor today,
proud to stand with my colleagues, and I hope that at the end of this
week, I will be proud of all of my colleagues when we vote to defeat
this measure, or at least to delay it, because we owe the American
people the right to be heard.
Our responsibility as elected representatives is at the very least to
listen. I have been listening over the last week but really over the
last year to constituents of mine in the State of Connecticut and over
the last week at two emergency field hearings that I conducted because
no hearings were held by the Senate and no markups and no votes in
committee. What we saw here in Washington was complete secrecy, a bill
produced behind closed doors, only seeing the light of day for the
first time last Thursday.
Our Republican colleagues have gone from total secrecy to total
chaos. The reason for the chaos is the facts that were most
dramatically revealed today--just hours ago--when the Congressional
Budget Office told us, not surprisingly, that 22 million Americans
would be thrown to the wolves as a result of this measure--thrown to
the wolves of no healthcare coverage--and eventually 49 million
Americans would be without healthcare insurance by 2026.
Next year alone, 15 million more people will be uninsured under the
Republican plan, TrumpCare 2.0. Low-income Americans would be unable to
afford any plan at all, and anybody who does would be paying higher
costs for fewer services of lesser quality. Americans will pay a higher
share of their income and receive less as a result. A 64-year-old
making almost $57,000 will go from paying $6,800 under the Affordable
Care Act to $20,500 under the proposal before this body. This jump in
cost is absolutely staggering.
It will destroy the financial well-being of middle-class Americans
who also, when they need nursing home care, after they have exhausted
their savings, will be thrown to the wolves. I visited one such
facility just last Friday, where two-thirds of its 60 beds will be
unaffordable when those middle-class families find their savings will
no longer cover it.
These facts are the reason for the Republican chaos. One of our
former colleagues, my mentor, Senator Daniel Patrick Moynihan, famously
said: “Everybody is entitled to his own opinion, but not to his own
facts.” The administration's statement that the CBO is not to be
blindly trusted--nobody has to trust the CBO blindly. Those facts are
driven by reality. Their report speaks truth to power and to the
American people, and the American people get it.
None of us can look our constituents in the eye, look ourselves in
the mirror, look inside ourselves, in our hearts, and justify a vote
for this bill. The American people are angry, many of them because we
are even considering it. It is not an anger that is kind of a shrug of
the shoulders; it is a deep, vocal, vehement, vitriolic anger. I have
seen it and heard it at those hearings, where I listened to people
coming forward and talking about this bill, recognizing it for what it
is. It is not a healthcare bill; it is a massive tax cut for the
Just Friday afternoon, one of the folks who attended the hearing came
to the microphone and said: Don't call it a healthcare bill; it is a
wealth care bill. In fact, she is absolutely right. This bill cuts
hundreds of millions of dollars in taxes for the richest so that they
will do better, but it also cuts $800 billion in Medicaid spending and
investment to provide for that kind of tax cut. It is not a healthcare
bill; it is a wealth care bill. And for most Americans, it is a
catastrophic, cruel, and costly insult to their intelligence, their
health, and our American values. It is a sham and a charade, making
possible those cuts for the rich--tax cuts for them--at the expense of
our most vulnerable citizens. And it has been the result of a
profoundly undemocratic process--secrecy and speed.
Despite the best efforts of our Republican colleagues to keep
Americans in the dark about what this proposal would do, I have seen
growing awareness, again, not only at these hearings but as I walk
through the airport, as I march in parades--twice over this weekend--as
I attend public gatherings. Whether it is Boys State, sponsored by the
American Legion for 16- and 17-year-olds, or nursing facilities for
elderly citizens, there is a growing awareness that this bill is bad--
profoundly bad--for the American people.
The people I have heard from have prescriptions to fill, appointments
to make, lives to live, but they have come to these hearings on very
short notice in Hartford and in New Haven, literally filling rooms so
that there was standing room only.
I challenge my colleagues to hold the same kinds of hearings, to
delay this vote so that they can go home at the end of this week and
hold hearings in their State and listen to their constituents about
what they have to say and what the consequences will be.
Nearly 1 in 10 veterans has Medicaid coverage, meaning that a
staggering 1.75 million veterans, including 18,000 veterans in
Connecticut, would be impacted by these reckless cuts. Let me repeat
that number for all of us who rejoiced in the recent Accountability and
Whistleblowers Act. Some 1.75 million veterans--18,000 of them in
Connecticut--will be harmed by this reckless and needless insult and
Put simply, this bill would make it hard for veterans with mental
health disorders like post-traumatic stress disorder to get care.
Nearly a quarter of all veterans receive care for mental health
disorders outside the VA system, meaning they rely on protections that
guarantee their access to affordable care. Under this proposal, those
protections would be severely threatened, and the veterans who need
that care would see that care at risk.
Here we are talking about a choice program that enables veterans to
seek care outside the VA system, privately, and we are endangering care
for millions of Americans--veterans--who need and seek it by using
If my colleagues listen to their constituents, they will hear from
many of the people who have come to my townhalls, like Christine
Girassi. Christine has two beautiful 4-year-old twins named McKenzie
and Cameron. McKenzie was born with Prader-Willi syndrome, a rare
genetic disorder that her mom described as “including low muscle tone,
seizures, temperature instability, sleep apnea, infertility, OCD,
intellectual disabilities, and developmental delay.”
In the first few weeks of her life, McKenzie was in the hospital for
57 days, accounting for $2 million in costs. Their family was spending
$30,000 a year to help their daughter thrive. So when Christine learned
that her daughter had received a waiver to become a Medicaid
beneficiary, she was overjoyed.
Christine told me:
When we received McKenzie's diagnosis, we were told that
she wouldn't do a lot of things, and at only 4 years old
she's already defying the odds. I have no doubt in my mind
that if we are able to continue down our current path of the
proper therapies and doctors, McKenzie will be able to have
her fruitful life. I am terrified if the rug comes out
beneath her that she will become just another statistic.
Another statistic? There are enough statistics in that CBO report. We
will hear a plethora of statistics on the
floor, but a picture is worth a thousand words and many more than a
thousand statistics, and no one--no one should be consigned to being a
This family is one of the many faces and pictures and stories of
Medicaid. They deserve to be heard. If we gut this program, if we strip
away the important services it provides, we know all too well what will
happen to McKenzie and her family as statistics. Like her mother said,
Medicaid has been the path to success for them, and that rug will be
pulled from that family, from beneath McKenzie.
At the hearing on Friday in New Haven, I heard from Kent O'Brien, who
told me about the eight prescription medications he takes--four for
psychiatric reasons and four for medical reasons.
Of course, mental health parity has been one of the crusades of my
life. When I was State attorney general, I worked with Senator Ted
Kennedy and Congressman Patrick Kennedy to help advocate for that bill.
As a Senator, I advocated for the regulations that were necessary for
its enforcement, and we finally got it done.
I want to quote what Kent said directly. He told me:
Hi, everybody, how are you today? I'm going to keep this
brief, because I know the senators are on a very strict time
constraint and I respect that. So I'm just going to talk very
quickly about my prescription medications; there are eight of
them. Four of them are for psychiatric reasons and four are
medical. And if I lose my Medicare and Medicaid, I will be
unable to pay for them obviously, which in turn I will end up
in the hospital.
Kent went on:
Now, for the Republicans who are seeing this in Washington,
can you please listen to me carefully?
I am speaking to an empty Chamber. Let nobody make any mistake that
Republicans are hanging on Kent's words as I speak now, but every one
of them should go to the Record. Every one of them should be listening
in their offices. Every one of them should go to the Record.
Kent goes on:
If I lose that medication, I will end up in the hospital,
and it's going to cost the state and the federal government
much more money than it would be to simply let me go to the
pharmacy and pick up my medication.
If there were ever a message that Washington should hear, it is from
Kent O'Brien, who closed by simply saying:
So I'm just going to close up with that, and don't hurt the
American people. Help them!
If you met Kent, you would wonder how he was capable of that
eloquence. He is an ordinary American, someone who looks like all the
rest of us. He has said to this body what it means to hear: “Don't
hurt the American people.” He couldn't be more right. This proposal
would cost our Nation so much, not just financially--Kent had it
right--but morally. It will lead to a weakening of what makes our
country strong and great in the first place: our ability to care about
our neighbor, to fight for what is right, and to listen to the people
who represent here in the Senate.
First, do no harm. That is what the ethos of the medical profession
is. It ought to be our mantra as well. It ought to be what my
colleagues, if nothing else, heed as we reach this decision to listen
to people who sent us here and hear their stories. Listen to the
anxieties and fears and value of America. They will tell you all you
need to know about this bill. Kent told me. As he said, the cost will
be staggering--not just in financial terms but in human terms.
This bill--written behind closed doors, away from the light of day,
away from the realities of medical care in the United States of
America, away from the voices and faces I have brought to the floor
today, and which I will continue to bring to the floor--ignores the
most important thing we can do this week. As Kent said, don't hurt the
American people. As the doctors tell us: First, do no harm.
I yield the floor.
The PRESIDING OFFICER (Mr. Tillis). The Senator from Maryland.
Mr. VAN HOLLEN. Mr. President, I wish to start by thanking my
colleague from the State of Connecticut for bringing those powerful
testimonies to the floor of the Senate. It is really important that all
of us--all 100 of us--spend time back home in our States listening to
people who are telling us those kinds of stories.
I have received over 2,500 calls in my office just since Thursday,
all of them strongly opposed to this so-called healthcare proposal.
Some things improve with time. Some things improve with age, like red
wine. Some things get stinkier and smellier the longer they sit out
there, like rotten things. That is the case with the series of
Republican so-called healthcare bills, TrumpCare 1, TrumpCare 2.0, and
now, TrumpCare 3.0. They are all rotten to the core, and the more they
sit out there, the stinkier they get, and the American people know it.
If you had any doubts, take a look at the most recent Congressional
Budget Office report we got today. There is a pretty clear pattern
between all of these Congressional Budget Office reports and the first
bill we saw and the second bill and now on this latest version.
Here is the pattern. Tens of millions of Americans will lose access
to affordable healthcare in the United States of America in order to
provide tax breaks for powerful special interests and richer Americans.
That is the pattern. In this most recent report, we are told by the
nonpartisan professionals at the Congressional Budget Office that 22
million of our fellow Americans are going to lose access to affordable
healthcare. For what? To give powerful special interests and wealthy
Americans a tax break.
Insurance companies currently are not allowed to deduct the bonuses
they pay to their CEOs. Now you are going to allow insurance companies
to deduct the bonuses they pay to CEOs, and while tens of millions of
Americans will lose access to affordable care, millionaires in America
will get an average annual tax break of $50,000 a year, every year.
So make no mistake. You can call this a healthcare bill, but it has
nothing to do with healthcare and everything to do with wealth care and
transferring wealth from more struggling vulnerable Americans to the
If this were about healthcare, why is it that we have all received in
our offices long lists from patient advocacy organizations that are
dead-set against this legislation? These are organizations that have
been dedicated to trying to improve healthcare for people and patients
in our country: the American Cancer Society, the American Diabetes
Association, the American Heart Association, the American Lung
Association, National Alliance on Mental Illness, National Breast
Cancer Coalition, and National Multiple Sclerosis Society. The list
goes on and on from organizations that have dedicated themselves to
advancing patient health.
On the other side, I haven't seen a single--not one--patient advocacy
group that has come out to support this so-called healthcare bill. How
can that be? If this is good for the health of our fellow citizens, why
is it we have a long list of organizations dedicated to that cause
against it and not one for it?
How about healthcare providers, the folks who help provide the care
to our constituents? They are all dead-set against it: the nurses, the
doctors, the hospitals, the people who have that network of care.
I was just out on the Eastern Shore of Maryland, a rural part of our
State. The National Rural Health Association is opposed to this bill.
They know the people they serve are going to be badly hurt, and, by the
way, it is also going to hurt the economies in those parts of our
State, especially the rural parts of the States, because those
hospitals depend heavily on many of the people who get help through the
Affordable Care Act, whether through the exchanges or through expanded
Medicaid. As those patients come in the door and no longer can pay for
their care, those hospitals said they may have to close down operations
and lay people off. It is a double whammy--bad for patients and bad for
those who provide the care to our patients.
That is why AARP has been all out against this, because they know
that for Americans between the ages of 50 and 64, before you get on
Medicare, this is a total disaster. As they have said, there is an age
tax. If you are older, you are going to pay a whole lot more under this
Republican bill than you pay today.
Many people are just realizing now as they follow this debate that
two out of three Americans who are in nursing homes today are supported
by Medicaid payments. So millions of our fellow Americans who now get
their care in nursing homes, where Medicaid is providing support for
two out of three, are going to be put at risk and made vulnerable
because of this legislation.
Remember, Donald Trump said he wasn't going to cut Medicaid. This
cuts it by over $750 billion. Make no mistake, on this issue, this
Senate bill is a lot meaner than the House bill. We all know that
President Trump out in the Rose Garden celebrated the passage of the
House bill. But behind closed doors, what did he call it? Mean. This
Senate bill, as time goes on, will cut Medicaid far more deeply than
the House bill. As we look at this Congressional Budget Office report,
it talks about how you get to the end of year 8 and 9 and 10, and you
go beyond that. You are going to have very deep cuts, much more
painful, much meaner than in the Senate bill.
We have heard a lot about preexisting conditions. The reality is that
the Senate bill is very devious in this regard. It is a great sleight
of hand. On the one hand, it creates the impression that if you have
preexisting conditions, you are going to be all right. But what it
pretends to give with one hand, it takes away with the other. It makes
those Americans as vulnerable as they were before the passage of the
Affordable Care Act.
I am not talking about those who are directly benefiting, like those
on expanded Medicaid or those in the exchanges. I am talking about
those who are benefiting from the patient protections in the Affordable
I just got a note the other day from Mark in my State of Maryland
My son was diagnosed with Crohn's disease in 2008, at age
18. He was repeatedly denied insurance and was only able to
cover part of the cost of care through the Maryland high-risk
pool. Obamacare made it possible for him to be insured and
care for this lifelong disease.
It was ObamaCare that “will literally save his life.” We have many
stories like this one from others who were denied access to care
because of preexisting conditions before the Affordable Care Act.
There is another major sleight of hand in this Senate Republican
proposal, and that relates to premiums. I have been listening. We have
been hearing a lot from our Republican Senate colleagues about how this
is going to bring down the price of premiums. We all know that what
Americans care about is what they are having to put out in total for
their healthcare. There are premiums. How much is the deductible?
Great, I got a lower premium, but my deductible is now $10,000. There
Here is the dirty little secret if you dig into the Congressional
Budget Office report, after listening to many of our Republican
colleagues talk about premiums. Now, you have to translate a little bit
here because this is in the budgetese of the Congressional Budget
Office. What they say on page 9 is this: Some people enrolled in
nongroup insurance--in other words, in the individual market, the
people who are currently in the Affordable Care Act exchanges--would
experience substantial increases in what they would spend on healthcare
even though benchmark premiums would decline on average in 2020 and
So the translation is that in some cases the premium--that sticker
price--may go down, but you are going to end up paying a whole lot more
when it comes to your deductible and your copays.
It goes on to say that because nongroup insurance--in other words,
the individual market--would pay for a smaller average share of
benefits under this legislation, most people purchasing it would have
higher out-of-pocket spending on healthcare than under current law. It
goes on and on.
In other words, keep your eye on the ball, America, because when
someone tells you your premiums are going to go down, watch what
happens to all your other healthcare costs. The Congressional Budget
Office, the nonpartisan analysts, are telling you they are going up.
This brings me to my final point. I said at the beginning that some
things get better with time and some things get stinkier and smellier.
We know that the more the American people get a look at this latest
Senate Republican proposal--TrumpCare 3.0--the less they are going to
like it. The more they see it, the more they will hate it. Just like
something that is rotten gets stinkier with time, this will get worse
and worse with time. That is why it is so important that we not try to
jam this through the Senate.
I understand the Republican leader. He knows this is rotten to its
core, and he knows the more it sits out there, the more people are
going to see what it is all about and the more they are going to hate
Let's have a full debate, and let's make sure all of us go back to
our States over the Fourth of July--to the parades, the barbecues, and
the picnics--and look our constituents in the eye and tell them that we
are going to take healthcare away from tens of millions of Americans,
that we are going to open up the discrimination once again to
preexisting conditions. We are going to increase their overall
healthcare costs, even though we tell them we are going to be reducing
them. Let's look them in the eye and tell them what this bill is all
about rather than trying to push it through in 24 or 48 hours or later
Our constituents deserve to know the facts, and we need to make sure
we vote to protect the interests of the United States of America, not
just provide another round of tax breaks to powerful special interests
The PRESIDING OFFICER. The Senator from Hawaii.
Mr. SCHATZ. Mr. President, you might think that for the last 7 years,
the major complaint people had about the Affordable Care Act was that
it hurt rich people, because they seem to be the only people who stand
to gain with this Republican Senate healthcare plan. They get a giant
tax break. The rest of America, on the other hand, is in trouble.
With TrumpCare, healthcare will cost more, and 22 million people are
going to lose their healthcare altogether. Some healthcare bill. To put
this in perspective, imagine if everyone lost their healthcare in
Hawaii, Maine, Nevada, Alaska, West Virginia, Ohio, Idaho, and Wyoming.
That is what TrumpCare does. That is 22 million Americans. It also
devastates one of the best healthcare programs this country has.
With this bill, Medicaid is going to lose nearly $800 billion. If
your only worry is that your investment income gets taxed at 3.8
percent every year, you can breathe a sigh of relief. Let me drill down
on that because one of the most egregious tax breaks in this bill--and
this is mostly a tax cut bill and not a healthcare bill--is the
following: If you are making $200,000 as an individual or $250,000 as a
couple, capital gains income is currently taxed at 3.8 percent. If you
are making $200,000 as an individual or $250,000 as a couple and you
have capital gains, not regular income, it is taxed at 3.8 percent.
This bill zeros that tax out. This bill zeros that tax out. On top of
that, it is retroactive. Think about the absurdity.
Here we are. I am looking at the Senator from Pennsylvania and how
much he has advocated for children and especially for children with
disabilities. I am looking at the Senator from Connecticut and the work
he has done for people with chronic diseases and mental health
challenges and the resources we need for that. And in the middle of a
supposedly oriented toward healthcare piece of legislation, we are
giving a retroactive capital gains tax cut to people who make over
$250,000 a year in combined income. It is absurd. It is not a
If you have a loved one in a nursing home, if you are pregnant or
thinking of having a baby, if your kid has a disability that requires
costly care, if you work two jobs but your employer doesn't provide
health insurance, then this bill does not take care of you. Instead of
less taxes, you get less care, and you are going to pay more for it.
This is what happens when legislators don't have committee hearings
or they refuse to meet with patients, doctors, nurses, advocates, their
own constituents. There have been so few townhalls about healthcare.
There have been so few real Senate debates about healthcare.
I have seen every single Democratic Member of the Senate come here
talk about this piece of legislation. I have seen every single
Republican Member of the Senate talk about legislation that they are
proud of. I have seen very few people on the Republican side of the
aisle come down and talk about this bill because they know it is not a
good piece of legislation.
At this point, we are not even debating healthcare policy. It is not
a question of what is the best way to get people to sign up for
insurance or how we can lower premiums and deductibles or how we can
improve the delivery system; it is a question of how many people are
going to lose their healthcare so that insurance company CEOs can
continue to make millions of dollars a year. That is literally what is
in this bill. Those are the conversations we are having--nothing
related to reforming the healthcare system or getting people more
coverage for less but, rather, tax cuts for people who are involved in
the healthcare industry.
How many grandparents are going to get kicked out of nursing homes?
It is not a rhetorical question. My wife's grandmother was in a nursing
home 2 months ago. It was a beautiful facility. They took great care of
her. They had three beds, three nursing home beds. I think the normal
reimbursement is about $9,000 a month. They took wonderful care of my
wife's grandmother. They won't exist. That nursing home and all the
nursing homes like it won't exist if there is an $800 billion cut to
Medicaid. This is not a theoretical conversation. This isn't even a
partisan conversation. Everybody has nursing home beds in all of their
home States. Everybody at least ought to know some middle-class people
who rely on Medicaid for nursing homes.
CBO gave us the answer today. Too many people are going to be locked
out of the healthcare system if this bill goes forward, and all for
giant tax cuts.
Look, our healthcare system is not perfect. Changes need to be made,
but this bill is just not it. It has no clear guiding principle other
than slashing Medicaid to pay for tax cuts. We have to start over.
I am looking at the Presiding Officer, who was a speaker of the house
in North Carolina and understands how to do a bill on a bipartisan
basis. I am thinking of the numerous Republicans who are capable of
working on a bipartisan bill that can get 60 votes.
By the way, the politics would change because if we worked on a bill
that could get 60 votes, we would be in a wonderful position--the
Senate is set up to encourage us to work together--because if we abide
by that 60-vote threshold and we come up with a bill together, we would
own the American healthcare system together. We don't get to play this
blame game about what is happening with premiums or what is happening
with coverage numbers. We actually, on the level, collaborate.
When you think about a bill or an issue that used to be as partisan
as public education, we had Lamar Alexander and Patty Murray come
together. Heck, in the last Congress, we had Jim Inhofe and Barbara
Boxer do a bill together. It is possible for us to do a bipartisan
piece of legislation.
The decision was made to go with reconciliation, and that is
backfiring because the problem with not involving Democrats is that
there are Democrats across the country. The problem with not involving
experts is that you end up with a product you can't defend.
What we really need to do is take a breath, take the Fourth of July
weekend, and reconvene as a Congress--not as Democrats and Republicans
but as Americans who understand that our healthcare system is not
perfect, that it is in need of improvement, but this bill doesn't get
I yield the floor.
The PRESIDING OFFICER. The Senator from Connecticut.
Mr. MURPHY. Mr. President, I want to pick up where my colleague from
Hawaii left off. There is a wonderful analogy that President Obama used
after the 2016 election. As you could imagine, Democrats were pretty
dejected the day after, and President Obama put it pretty simply. He
said: Listen, just remember, these elections are intramural scrimmages.
We put on temporary pinnies, Republicans and Democrats, but in the end,
we all belong to the same team. We are all Americans.
Elections and legislative fights are temporary skirmishes before we
recognize and realize our greater identity, which is that we have this
commonality. Clearly, that is not what the American people see here.
They think our primary identity is our partisan identity, and there is
a lot of days in which we give them fodder for that belief.
It really is amazing, when it comes down to it, that when you think
about the healthcare system, we do have the same goals in mind. There
are actually lots of other issues on which we don't have the same goal.
Republicans want to go left, and we want to go right. Republicans want
to go right, and we want to go left. On healthcare, we actually all
want to get to the same place: More people have access to health
insurance, the cost of that insurance is less than it is today, and the
quality of the care people get is better. It is funny because
underneath that, it is just mechanics. It is not actually ideology. It
is a decision as to which lever you press and which you don't.
I get that a lot of my Republican colleagues don't think we are
sincere when we say: If you put this monstrosity of a bill aside, we
will work with you to do something better. But it is sincere. We don't
want to blow up Medicaid. We are not with you on that. We don't want to
pass along big tax breaks, only going to the very wealthy. But we get
that you want some more flexibility for States. We get that you want
maybe an additional plan offered on the exchanges that doesn't have all
the bells and whistles the existing plans do. But you get that we want
stability in the exchanges. We want some certainty in the markets going
There is an important conversation to be had here. Our hope is that,
with this CBO score, maybe it will be the straw that breaks the camel's
back, that will cause our Republican colleagues to give up this
nonsensical approach to healthcare reform and work with us.
I am going to repeat some of the ground that has already been covered
here in the next few minutes, but I want to go over some of the
highlights of this CBO report.
Senator Schatz previewed this, but it is hard to get your head
wrapped around what it means for 22 million people to lose insurance.
This is an old chart from the CBO score on the House bill that held
that under their approach, 23 million people would lose insurance. I
X'd that out. We now have 22 million people who would lose insurance
under the Senate approach. That is the entire combined population of
Alaska, Delaware, Hawaii, Idaho, Kansas, Maine, Montana, Nebraska,
Nevada, New Hampshire, New Mexico, North Dakota, West Virginia, and
South Dakota. All that happened between the House Bill and the Senate
bill is that the people of Rhode Island got saved. I X'd out Rhode
Island because Rhode Island has about 1 million people. About 1 million
more people will have insurance under the Senate bill, but that is
humanitarian catastrophe. That is a big deal, to have that many people
I know that is not what you set out to do. I know the Republicans
didn't set out to do this, in part because I listened to Senator Cornyn
come down and complain on the Senate floor relentlessly that the
Affordable Care Act still left a whole bunch of people without
insurance. In fact, he sent out a tweet today highlighting that the CBO
does confirm that if current law continues, there will still be a lot
of people without insurance. He left out the fact that the CBO says
that under the Republican bill, 22 million more people will lose
insurance, but that is a whole lot of people.
By the way, in the first year, CBO says 15 million people will lose
insurance. Fifteen million people is the entire population of 13
States. That happens next year. Emergency rooms in this country cannot
in 12 months absorb 15 million people losing insurance.
For all the folks who say that the ACA is in a death spiral, CBO says
you are wrong. Very flatly, CBO says that if existing law remains, even
without any improvements, the number of people without insurance
effectively remains static. Yes, at the end, if you make no
improvements, you will go from 26 million people not having insurance
to 28 million people not having insurance.
CBO says--I had to change this because it used to be 51 million under
the House bill. CBO now says 49 million people will lose insurance if
you actually pass the bill the Senate is going to consider this week.
The death spiral happens if we pass the Republican healthcare proposal.
That is not a death spiral; that is stability. It is not an optimal
result, 28 million people not having insurance, but it is far
preferable to 49 million people not having insurance. I understand that
Republicans will quibble with CBO and say that maybe they didn't get it
exactly right. Even if they were 50 percent wrong, that is still over
10 million people losing insurance. By the way, just for good measure,
CBO was right in their estimates of the percentage of Americans who
would have insurance under the Affordable Care Act. Inside of their
estimate--the details worked out differently--but they said that by
2016, 89 percent of Americans would have health insurance, up from 83
percent prior to the passage of the Affordable Care Act. Guess how many
people have health insurance today: 89 percent of Americans, 89 to 90
percent of Americans.
We all agree that premiums should go down. If we are going to pass
something, the result should be that premiums go down. Here is what CBO
says: Premiums go up and not by a little bit. They go up by 20 percent
in the first year. Admittedly, I am painting a partial picture here.
That is 2018. After that, CBO says for certain populations in this
country, premiums will go down, but it is largely for the young, the
healthy, and the wealthy.
CBO says that you will have massive premium increases for older
Americans. For lower income Americans who are in that age bracket of 50
to 64, premium increases will go up by at least two times, up to four
CBO also says that if you are lower income, you are not going to buy
insurance because you can't afford it. It doesn't even matter what your
premiums are because they will be so high, you can't afford them.
Premiums go up for everybody off the bat--and for lots of vulnerable
people after that.
So who gets hurt? Everybody, except for the folks who are getting tax
cuts. If you are an insurance company, a drug company, or you are super
rich--maybe that is an unfair term--people making $200,000 or more a
year get tax cuts, but most of the tax cuts go to the super rich.
People making over $1 million a year will do fine. If you are an
insurance company, a drug company, or you are very wealthy, you get a
great deal out of this piece of legislation, but pretty much everybody
else gets very badly hurt.
Today, one of our Republican colleagues said this to a reporter--I
won't give you a name. One of our Republican Senate colleagues, when he
was asked about the Republican healthcare proposal, said: “I am not
sure what it does. I just know it's better than ObamaCare.” That is
about as perfect an encapsulation of the Republican positioning on this
bill as I can imagine, because if you did know what it did--if my
Republican colleagues did get deep into the CBO report, it doesn't
solve a single problem in the American healthcare system. There are big
problems, such as 26 million people still don't have insurance. This
bill makes it worse.
People are paying too much for insurance, especially those folks who
are making middle incomes who are just outside of qualifying for the
Medicaid subsidies. This bill makes it worse. Almost every problem is
made worse by this piece of legislation. I guess that is sort of what a
lot of Americans wonder--if our Republican colleagues do know what is
in this bill. “I am not sure what it does. I just know that it's
better than ObamaCare.”
This solves one problem for Republicans. It is a political problem.
Republicans have said for the last 8 years that they are going to
repeal the Affordable Care Act. My Republican friends promised it in
every corner of this country, at every opportunity they had, and this
does solve that political problem. If you pass this bill, you can
successfully claim that you have repealed the Affordable Care Act, but
that is the only problem it solves. It makes almost every other problem
in this system worse.
The number of people without insurance goes up. Premiums, especially
for the poor, the vulnerable, go up. There is nothing in this bill that
addresses the cost of healthcare, of drugs, of devices, of procedures.
There is nothing in this bill that talks about the quality of
healthcare. Every problem--virtually every problem in the healthcare
system gets worse.
I will just end by reiterating the offer that Senator Schatz made. I
think you have a lot of people of very good will who want to work with
Republicans and are sincere about it. I will be part of whatever group
gets put together if this bill falls apart this week.
I held an emergency hearing in New Haven, CT, on Monday, just to try
to explain to people what was in the Republican Senate proposal and to
get people's feedback. It was hard to sit through. It was 2\1/2\ hours
of some really scared folks.
I will be honest with the Presiding Officer. Most of the people who
came had disabled kids. Most of the people who came had disabled kids
who were on or relied on Medicaid, and they were just scared to death
about what was going to happen to their children. But they also talked
about the problems that still exist in the healthcare system--the fact
that drugs are too expensive. Many of them pay too much for healthcare.
They wanted those problems solved, and they wanted us to work with
Republicans on it.
Senator Schatz was right. If we did it together, we would own it
together. It would stop being a political football. While that would be
a secondary benefit to the actual good that would come from a
bipartisan piece of legislation that actually addresses the issues in
the underlying healthcare system, it would be a pretty remarkable good
that is possible because we have the same goals in mind. We both want
the same things. It is just, in the end, putting aside this bill that
makes all of those problems worse and, instead, sitting down together
and deciding which levers we want to push to make things better.
I yield the floor.
The PRESIDING OFFICER. The Senator from Pennsylvania.
Mr. CASEY. Mr. President, I rise, as well, to talk tonight about the
issue of healthcare. I thank my colleague from Connecticut for looking
down the road to when, maybe, we can actually work together on this
issue. We are in conflict this week, and that is not a place any of us
want to be.
We are in conflict because of the elements of this bill. I will make
two basic points in my remarks tonight, one about Medicaid and then one
point about another provision in the bill that I think is particularly
A lot of our discussions start with policy and data, and that is
important. That is obviously part of the debate about the bill and what
is in it and what impact it will have on programs and people over a
long period of time, but part of this debate, of course, is about the
people we represent. I know the Presiding Officer understands this, and
I am heartened that he is paying attention to our arguments because
sometimes--I have done it myself--when you preside, sometimes you are
doing something else. So we are grateful for his attention.
I have talked on this floor a couple of times over the last couple of
weeks--even months--and I will not repeat the stories because they have
been told a number of times, but Rowan Simpson is a young man whom I
recently just met. His mom had sent me a letter. Rowan is on the autism
spectrum, and his mom is very worried about his future because of the
potential impact on Medicaid and the benefits he is getting today from
I just referred the other day--I guess it was Thursday on the floor--
to a letter from a dad about his son Anthony, who has a number of
challenges, one of them being that he is on the autism spectrum. I have
another letter, as well, which I will not go through tonight, but it is
from a mom in Northeastern Pennsylvania, who wrote to me about two of
her children--principally, her son who has Type 1 diabetes and what the
loss of Medicaid coverage will mean for that child, who, in this case,
is just 4 years old.
Everyone in this Chamber in both parties has stories like this to
tell--stories about people who are, because of a disability, totally
dependent upon Medicaid. That is not unique to one State, and, of
course, it is not unique to one party.
One of the more egregious and objectionable parts of this 140-plus
page bill is the impact it will have on Medicaid--the Medicaid
expansion, which many people now know represents probably on the order
of 11 million people who got healthcare coverage since 2010 and got
that coverage because Medicaid was expanded. But the bill also speaks
to the Medicaid Program itself by the so-called per capita cap, capping
the dollars the Federal Government would provide in the future with
regard to the Federal-State partnership on Medicaid. These are big
stakes when it comes to a program that has been with us for 50 years.
As everyone knows, Medicaid is principally about individuals with
disabilities, and that is obviously those children I mentioned. It is
about folks who need some help getting into a nursing home, senior
citizens. Of course, it is about kids from low-income families who have
no other healthcare, absent Medicaid. In our State, there happen to be
1.1 million kids on Medicaid who are from low-income families. The
disability number in both children and adults is, by one estimate, more
than 722,000 people. These are big stakes, even if it is just involving
one of those individuals or hundreds or thousands. But as I will refer
to later, some of the numbers are, of course, a lot higher than that.
So those stories and those pleas for help from those families obviously
do not just inform us, but they inspire us to keep working, to keep
fighting. I will be fighting against this bill as long as it takes.
It is likely that we will have a vote this week. I am assuming we
will, so we have only hours and a few days to fight and point out what
we believe to be the defects. One of the things that is significant
about this debate is that we have had people not just writing those
stories and telling us their story but also telling us and giving us
ideas about how to conduct the debate and how to fight and how to
I have in my hand--I will describe it first before I offer a consent
request. I have in my hand several pages that list almost 600 names
from people in Pennsylvania who have written to me over the last number
of weeks and months, actually. What they are urging me to do is to
pursue a legislative strategy to protect their healthcare. Why are they
doing that? It is not because they have nothing else to do. They are
worried. These people are really worried. They are worried about those
kids like Rowan and Anthony, whom I just mentioned, and a 4-year-old
with Type 1 diabetes or a whole long list of other disabilities a lot
of kids have. They are worried about their parents, who may not be able
to get the long-term care they need if Medicaid is capped and cut and
decimated. They are worried about their friends and their families.
They are, in a word, as worried as anyone has ever been about the
healthcare of those they love and the healthcare of those they care
about. That is why they have been writing and going to meetings and
making phone calls and engaging in such a robust way, all these weeks
Mr. President, I ask unanimous consent that this list of almost 600
names from Pennsylvanians be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Ashley De Padua, Carol Ribner, Lisa Brown, Adam Huard,
Julie Strauss, Amy Reynolds, Dianne Spatafore, Pamela Nolan,
Karin Fox, Claire Witzleben, Wendy Albertson, Laura Rose,
John Mack Jr., Elizabeth Failor, Lisa Bargielski, Peg Welch,
Jason Carnahan, Robert Perry, Morgan Vinokurovi, Melissa
Patricia DeWald, Kristin Kondrlik, Michael Crane, Diane
Smith-Hoban, Diane Sayre, Benjamin Andrew, Janice Diehl,
Robert Bahn, John Bair, Angela McClain, David Cassiday, Dara
Bortman, Judi Reiss, Nicholas Marritz, Amber Blaylock, Tina
Nightlinger, Lisa Bradshaw, Kimber Schladweiler, Michael
Dwyer, Vashti Bandy.
Christine Russell, Mary Farrington, Ralph Mcdermott, Anna
Cunningham, Linette Schreiber, Barbara Powell, Shelley
Francies, Joyce Fentross, Shannon Bearman, Jocie Dye, Ina
Martin, Mary-jo Tucker, Bracken Babula, David Mosenkis,
Martha Franklin, Nathaniel Missildine, Kristin Nielsen, Maria
Duca, Erica Bartlett, Irina Pogrebivsky.
Stephanie Romano, David Hincher, Diane Holland, Tracy
Krider, Michelle Nutini, Anne Martin, Tracey Miles, Alexis
Lieberman, Dorothy Posh, Thomas Hennessey, Cynthia Mould,
Jennifer Kunkle, Ann Calamia, Jennifer Zoga, Barbara Turk,
Raymond Hopkins, Carol Proud, Alex Hesten, Kimberly Jones,
Robert Huff, Klvdiya Vasylenko, Mike Kass, Bernadette
Flinchbaugh, Jo Johnson, Carolyn L. Johnson, Abby
Godfrey, Mark Herr, Jeri Sebastian, Lisa Hartjen, Anne
Smith, Melissa Nurczynski, Christine Crooke, Ellen
Garbuny, Harry Richards, Ruth Hetrick, Carolyn Rahe,
Stephanie Moats, Sally McAfee, Abigail Gertner.
Stacey Smith, Davinica Nemtzow, TC DeAngelis, Shelley
Schwartz, Lisa Keppeler, Katie B, Joseph Willard, Maryam
Deloffre, Kathie Brown, Ellen Catanese, Cynthia Donahue,
Porter Hedge, Gretchen Bond, Mary Dallas, Fae Ehsan, Kathy
Goldberg, Jennifer Jarret, Dan Potter, David Dutkowski, Rich
Patricia Kay, Sharon Doros, Stephanie Doyle, Lynn Loomis,
Elizabeth Adams, Kathryn Petz, Agatha Andrews, Alex Lombardi,
Erin Gautsche, Marie Turnbull, Carol Sinclair, Robert
Turnbull, Elisa Bermudez, Marie Vincent, Florian Schwarz,
Daniel Pencoske, Ina Shea, Beth Collins, Meenakshi Bewtra,
Mari Greipp, Michael DiEva, Andrea Epstein, Fredrica
Friedman, Starla Crandall, Stanley G., Cindy Fogarty, Ron
Ashworth, Trudy Watt,Kristen King, Kathleen Sheehan, Ryan
Brown, Kevin Collins, Kelly Collister, Ambry Ward, Joseph
Melchiorre, Catherine Abrams, Michael Bourg, Ed Gragert, Hien
Jo Johnson, Cody McFarland, Maggie Deptola, Sandra Blair,
Zoe Soslow, Yoko Takahashi, Anna Drallios, William
Dingfelder, Shawna Knipper, Cheryl Brandt, Larissa Mogano,
Linda Bishop, Lital Levy, Laurie Pollack, Judith
Navratil, Natalie Duvall, Richard Owens, Elaine Giarusso,
David Thomas, Leslie Collier.
Nicole Seefeldt, Jonathan Lipman, Ellen Gallagher, MaryAnn
Black, David Hughes, Michael Niemeyer, Pegene Watts, Kelly
Sack, Glynnis Arnold, Ruth Lawson, Michelle LeMenager, Iris
Valanti, Danielle Callahan, Frederick Ward, Martha Haines,
Audrey Marsh, Lynn Campbell, Kristen Cochran, Judith Brennan,
Joshua Miner, Jaime Bassman, Rachel Murphy, Elena Knickman,
Nelson Vecchione, Daniel Laurison, Karen Osilka, Roger
Knisely, Theresa Baraldi, Holly Best, Thomas Baraldi,
Patricia Walsh, Michelle Herr, Karen Heenan, James Paul
Johnson, Alexander Kimball, Sigal Ben, Leah Durand, Ingrid
Gustafsson, Mary Jo Maggio.
Ken Hardis, Lisa DeAngelis, Mary Jo Harris, Alice Ung,
Lance Flowers, Deborsh Hoelper, Joel Cardis, Georgine
Dongillig, Renee Donahey, Anna Payne, Hallie Kushner, Linda
Cortese, Mark Vecchione, Natalie Garner, Rachel Marx, Janet
Cavallo, Adrianne Gunter, Heather Turnage, Kenneth Reisman,
Tricia Connell, Nicole Conley, GiGi Malinchak, Ellen
Toplin, Eileen Brumbaugh, Theodore Fallon, Elizabeth Dooley,
Stacy Klein, Deena Thornton, Barbara Stephan, Cheryl Dungee,
Louisa Alexander, Brett Krasnov, Mary Gallant, Kathy Gardian,
Irene Lin, Colleen Dunn, Liane Norman, Susan Yerk, Ann
Leslie Elder, Sheri Utain, Christine Hooper, Teri Vanore,
Paula Baxter, Mordecai-Marl Mac Low, Nicolette Byer, Donna
Vito, Michele Forbes, Rebecca Kane, Katherine Fein, Sue
Meyers, Deb Yohman, Sherri Suppa, Jim Greipp, Jeffrey
Bussmann, Rachel Smith, Eileen Reed, Louise Beer, Mary
Tesia Barone, Nicole Gilchrist, Richard Greenstein, Amy
Levengood, Judith Max, James Walton, Mary Widing, En B, Mary
Jo Harris, E. E. Zachai, Tammy Harkness, Timothy McCormick, J
Pensiero, Betty Fisher, Cindy Shannon, Elisabeth Whyte,
Carmela Daniels, Amy Felton, Judith Gold, Jack Guida.
Sarah Gaffen, Linda Bullock, Pamela Woldow, Katherine
Kurtz, Lisa Harrison, Esther Wyss-Flamm, Catherine Roundy,
Jim Barlow, James Schreiber, Dave Carlton, Andrew
Famiglietti, Maria Catrambone Rosen, Breanna Jay, Bethany
Altieri, Alicia Olivant Fisher, Chris Braak, Jessica
Atchison, Elizabeth Dennis, Elizabeth Cates, Elizabeth
James Berry, Marita Scheibe, Sheila Thomas, Randy Sarner,
Alyson D'Alessandro, Suann Snavelt, Chantal McKelton, Theresa
Glennon, Josie Byzek, Marlene Katz, Deborah Grill, John
Moffa, Anne Coles, Liane Norman, Chanda Lawrence, Norma
Kline, Colleen Kessler, Maria Catrambone Rosen, Laurence
Coles, Kate Wallis.
Carol Harris-Shapiro, Briana Latta, Melanie B, Charlotte
Ridge, Nathan Krisanda, Meredith Sonnen, Margaret Walter,
Hallam Carrie, Leslie Richards, Jenny Anne Horst-Martz, Karen
Roberson, Richard Vanore, Susan Devenny, Rhana Cassidy, Maria
Golden, Kathy O'Brien, Vanessa Baker, Robert Brucicman,
Sarah Smith, Yuliya Benina.
John Ascenzi, Melanie Cichy, Paul Gottlieb, Shannon Browne,
Jen Britton, Erin Dunke, Debi Seltzer, Anna Edling, Brianna
Wronko, Francis Palombaro, Katie Morrison, Jennifer Hombach,
Jessica Lennick, Ellen Toplin, Charlene Kurland, Joanne
Mahoney, Sherry Greenawalt, Abigail Hyde, Sara Sierschula,
Emmy S, Renee Broxk, Kimberly Winnick, Melissa Reed, Lisa
Jaremka, Karen Shelly-Genther, Melissa Welshko-Williams,
Naomi Pliskow, Joan Susski, Rachael Pinsley, Lindsay
Friedman, Shari Johnson, Melanie B, Keith Adams, Lynn Martin,
Anastasia Frandsen, Brooke Petry, Tamara Davis, Martha
Posnet, Phoebe Wood.
Lindee Fitting, Isabelle Mahoney, Tamar Granor, Nancy
Berman, Karen Jensen, Katie Haurer, Beth Collins, Catherine
Budd, Miriam Phillips, Christine Bradley, Michelle Gorski,
Chris Gorski, Sophie Taylor, Catherine Borges, Mary Alice
Clevenger, Nick Ingram, Brenda Scholtz, Melissa Miller,
Jeanne Burd, Nad Rosenbe.
Joanna Kempner, Maria Boyd, David Shen, Sara Sobel, Jessica
White, Jennifer Pennington, Margot Keith, Catherine Sunnen,
Naida Reed, Ashley Morgan, Beth Brindle, Amy Friedlander,
Millicent Wilson, Richard Baron, Max Ray-Riek, Ruth Cary,
Sandy Heisey, Sharon Furlong, Laura Tilger, Donkey Dover.
Lynn Jones, Kaytee Ray-Riek, Janice Test, Mary Terp, Faith
Cotter, Sarah Campbell-Szymanski, Frank Wallace, Judie
Howrylak, Minna Ltumey, Erin Hetrick, Melinda Kohn, Jenny
Stephens, Susan Gambler, Olivia Landis, Terry Hirst-Hermans,
Jill Hall, Roseanne Mulherin, Susan Miller, Julie Platt, Lori
Hiro McNulty, Greg Carey, Amanda Fogarty, Sissy Gault, Mona
Callahan, Meryl Mintzer Puller, John Hoetzel, Stacey Kallem,
Thomas Paquette, Karen Clark, Paige Wolf, Patricia Scanlon,
Ellen Reese, Rosalind Bloom, Gary Stein, Eric Berue, Jenn
Hrehocik, Tamara Myers, Mara Kaplan, Amanda Cranney.
Deborah Miller, Debra Nathans, Paul Stockhausen, Johanna
Hollway, Leah Holstein, Susan Robbins, Roger Latham, Alison
Yazer, Melissa Marshall, Mary Lynn Colabrese, Harry
Mclaughlin, Samantha Payne, Elizabeth Hawkins, Julie Krug,
Lisa Heinz, Shoshana Kaplan, Corrine Richter, Lee Baer, Eve
Glazier, JoEllen Bitzer.
Judith Cardamone, Hilary Schenker, Faye Clawson, Caren
Leonard, Carol Feldhaus, Judith Moyer, Sharyn Feldman,
Jessica Martucci, Mike Kutik, Marylou Streznewski, Ann Baker,
Abby Martucci, Dennis Cusin, Marie Norman, Debra Brokenshire,
Martha Cornell, Maria Swarts, Sherell Chambers, Suzan Hirsch,
Patricia Carbone, Marcella Glass, Benjamin Mills, Peg
Welch, Rita Shah, Marcia Gever, Karen Phoenix, Tabitha
Felton, Carolyn Stillwell, Katherine Parys, Roxanne
O'Toole, Harold Love, Nicole Jaffe, Steven Weitzman,
Meredith Brown, Lauren Lewis, Sarah Wheeler, Maria Lauro,
Jason Magidson Lorette Lefebvre.
Denise Marcolina, Eric Krewson, Joseph Bosh, Joan Stein,
Kami Schaal, Melissa Nerino, Dorothy McFadden, Heather
muntean, Donna Devonish, Gloria Rohlfs, Terry McIntyre,
Kaitlin Marks-Dubbs, Frederick Page, Douglas Graham, Sarah
McKay, Zack Greenstein, Janice Nathan, Michel Wilcox, L
Roulston, Laura Wukovitz.
Andrew Wilson, Amy Moulton, Christina VanSant, Donna
Bullard, Nancy Entwisle, Tessa Lamont-Siegel, Ben Cocchiaro,
Yasmeen Ali Khan, Rachel Amdur, Amalia Shaltiel, Sara
Stetler, Bruce McDowell, Pat Hanahoe-Dosch, Mara Rockliff,
Tristan English, Ryan Bross, Lynn Rubenson, Elizabeth Cheney,
Regina Vicoli, Vicki Hewitt.
Kelli Servello, Charles Ang, Kierstyn Piotrowski Zolfo,
Leah Bailis, Tom Petersen, Pamela Magidson, Kathleen
Morrison, Genevieve Coutroubis, Susan Rubinstein, Ruth Ann
Davidson, Frances Winsor, Janis Rainer, Margaret Grubbs, Anna
Kuhnreich, Melissa Melan, Wendy Forman, Kristina Witter, Joan
Mr. CASEY. Mr. President, I will make two final points about Medicaid
and then juxtapose Medicaid with another part of the bill. If you look
at the bill--it is about 140, I guess, 142 pages--more than 60 pages
deal with Medicaid. So this is principally a bill about Medicaid. There
are some other issues, obviously, addressed on the exchanges and the
fundamentals of healthcare. But it is mostly about Medicaid and tax
cuts, unfortunately; and that is particularly objectionable to me that
you have a small group of very wealthy people who are going to make out
in ways we can't even imagine, like a big bonanza for the superrich.
Now, let me just talk about the Medicaid part of it first, and then I
will refer to a chart. I am holding in my hand the Congressional Budget
Office report from today, which came out. It, of course, is a document
produced by the Congressional Budget Office as well as the Joint
Committee on Taxation so it is a joint effort.
On the CBO--so-called CBO Congressional Budget Office report,
recently--a couple weeks ago now--on page 17 of that document, there
was an assessment made of the number of people who would lose Medicaid
as a result of the House bill, and that number was 14 million Americans
would lose Medicaid over the decade up until 2026.
Well, unfortunately, as of 4 p.m. or something this afternoon--I
guess about 4 p.m., 4:30--we got the Congressional Budget Office
assessment of the Senate bill, the Senate bill that was unveiled last
week. Not on page 17 of this report but actually on page 16, here is
what the Congressional Budget Office and the Joint Committee on
Taxation says about enrollment in Medicaid. I am quoting from the
bottom of page 16:
Enrollment in Medicaid would be lower throughout the coming
decade, with 15 million fewer Medicaid enrollees by 2026 than
projected under current law in CBO's March 2016 baseline.
Then, they refer to a figure in the report.
So the House bill CBO assessment says 14 million will lose Medicaid
coverage. The Senate bill, analyzed by CBO, which is supposed to be a
more moderate bill, a better bill in the eyes of some Republican
Members of the House and the Senate, that was supposed to be better,
but here is what we know now: 15 million people will lose Medicaid.
That alone should cause any Senator to be very concerned about the
impact of this legislation. That alone should, I hope, require some
people to use an old expression: Examine your conscience about what
will happen if you vote for this legislation.
Let's say someone says: Do you know what? I can put that into
context, and I think actually that will not happen or I have another
explanation or whatever justification or rationale you use for voting
for a bill that will result in 15 million people losing Medicaid
coverage. People are very vulnerable. Let's just say you can analyze
that a different way and come to a different conclusion. We will see
how people deal with that number this week when they go home and when
they have to talk about this legislation over time.
Here is where it gets a lot worse. This is a chart that is rather
simple. Even though it has a lot of data on it, it is rather simple.
Here is what it says at the top. First of all, this isn't my chart; it
is the Center on Budget and Policy Priorities' chart. You can go to
cbpp.org to see it.
This is based upon the House bill, but I just told you that the
Medicaid enrollment number is 1 million higher--or that the number
losing Medicaid is 1 million higher under the Senate bill, and the tax
cuts that are in the Senate bill are almost identical. You can just go
down and count them. The House and Senate bill are virtually identical
on tax cuts.
Here is what the headline is: Tax cuts for the top 400 roughly equal
to Federal spending cuts from ending Medicaid expansion.
Now, remember, I said before that Medicaid expansion is one problem I
see. The per capita cap is another. This chart just deals with one of
the Medicaid problems--Medicaid expansion--so ending Medicaid expansion
in Nevada, West Virginia, Arkansas, and Alaska, just four States,
right? Alaska, they project, will lose $2 billion worth of Medicaid
over the decade, Arkansas would lose $7 billion, West Virginia would
lose $12 billion, and Nevada would lose $12 billion. That adds up to
$33 billion Federal Medicaid cuts from ending Medicaid expansion. So
$33 billion dollars just for States. By the way, these are not really
high-population States. There is no California, New York, Texas or big
States like that. So $33 billion lost in Medicaid in just those four
What does this orange bar graph show? The same number, $33 billion
tax cut for the 400 highest income households in the country. It is the
same number. So 400 households get a tax cut of $33 billion, not in
some other bill down the road, not in some other year, not in a budget
bill or a tax bill. They get this massive tax cut in what is called a
healthcare bill. At the same time, it is equivalent to the total
Medicaid lost in just four States.
It gets worse if you add more States. Guess what. If you add up about
30 States in a different chart, it is about the same as all the tax
cuts together, but here we are just talking about four States and 400
I hope I am not offending anyone if they are in those top 400
households who are making either billions or, by one estimate, the
average might be $300 million. I know it has been difficult to make
ends meet. You have been struggling and trying to pay the mortgage and
the light bill when you are one of the top 400 richest households in
But this chart, when you juxtapose this chart--and especially the
orange part, the tax cut for 400 families, the giveaway to families who
don't need it. Frankly, they don't even want this tax cut. I haven't
found one person who came up to me in the last couple of years and
said: You know what, I wish my taxes didn't go up. I wish those
taxes didn't go up while you were trying to help people on Medicaid.
Not a single person said that.
Most people who will get this tax cut would rather that we make sure
we take care of those children I mentioned with the disability or those
families who need the protection of Medicaid.
When you put this chart next to the policy and those 60-plus pages of
the decimation of Medicaid, there are a lot of words we could use that
we are not allowed to use on this floor, but one of the words we should
use is “obscene.” That is an obscenity. When you match these cuts for
400 families next to the cuts to Medicaid, that is obscene, obnoxious,
and bad policy.
If there was ever a reason to take this 142-page bill and throw it in
the trash, throw it in a garbage pail as fast as we can, it would be
this chart because that is not what the American people are asking for.
They actually think some people in the Senate are actually working on a
healthcare bill. That is what they believe. A lot of people don't know
about this yet, but they are going to know. They are going to know by
the end of the week, at least, if not sooner, that the 400 richest
households in the country are getting that much money--$33 billion.
Maybe in the Senate bill it is only $32 billion or $31 billion, so we
will stand corrected if it goes down, but that is really an
abomination. That is an insult to the American people. People should be
ashamed this is part of that bill.
I get it. We can have a debate about Medicaid. I get that, but when
you are taking Medicaid dollars and transferring to wealthy people, no
one should support that kind of a policy, but that is what we have.
That is what we are up against.
If there was ever a reason to fight to the ends of the Earth against
a piece of legislation, it is this. We are going to continue to fight
this. We are going to continue to point out this basic inequity, this
insult for the rest of this week.
We hope folks on both sides of the aisle will not only be listening,
but we hope our Republican friends will take another look at this bill
and understand how objectionable this is to so many American families.
All of that worry I talked about before is made worse, is aggravated by
this kind of result when it comes to tax cuts.
We can do all that as a great nation. We can make sure wealthy folks
who need a break once in a while--they have gotten a lot of them in the
last 25 years--that they can get a fair tax code. We could also make
sure kids with disabilities, seniors, and kids in rural areas and big
cities and small towns can get the healthcare they need from Medicaid.
We are a great country. We can do that. We can have a growing economy
and still support a critically important program like Medicaid.
I yield the floor.
The PRESIDING OFFICER. The Senator from Massachusetts.
Ms. WARREN. Mr. President, we have just gotten the latest numbers on
the Senate Republicans' reckless plan to take away health insurance
from millions of American families, take it away from sick, little
kids, take it away from seniors in nursing homes. These numbers are
worse than anyone expected.
After weeks of secret work behind closed doors, the Republicans came
up with a plan that will take away health insurance from 22 million
people and slash the Medicaid Program by nearly $800 billion, all in
exchange for shoveling hundreds of billions of dollars of tax cuts to
the richest families in this country.
You know, with results like these, Senate Republicans should not
still be trying to figure out the best way to ram this bill through the
Senate. They should just throw it in the trash.
We don't have a lot of time left, and I know it is easy to tune out
these debates and to assume these are all just a bunch of partisan
games. So if you aren't inclined to take my word for it, don't, and
don't take the Republicans' word for it either. Take a look at what the
experts are saying about the Republican bill because since this brutal
bill was finally revealed on Thursday, it has been denounced by
nonpartisan doctors groups, health policy experts, and patient
organizations. The American Medical Association says the bill violates
the fundamental principle of medicine: “First, do no harm.” The
Children's Hospital Association says it is “a major step backward for
children and their health.” The National Council for Behavioral Health
says, “Instead of `repeal and replace,' it is `wreck and wreak
Lynn Nicholas, the head of the Massachusetts Health and Hospital
Association, has actually come up with a pretty simple test for the
Republican plan: “I challenge any Republican Senator to name one thing
in this bill that will make healthcare in the U.S. better for patients
or healthcare professionals who care for them.”
Think about that. She says use that as the test, one thing. That is a
pretty low bar--one thing. Yet the Republicans can't pass that test.
They can't name one thing in this bill that will improve healthcare in
America. That is because this bill is not supposed to improve
healthcare in America. It is not a healthcare bill. It is a tax cut for
the rich, paid for by gutting healthcare for millions of working
Doctors, patients, parents, families, experts, they are terrified by
this bill because they have read it, and they have concluded that
nearly every line in this bill would make life worse for young people
and for old people and for families across this country.
I want to focus on just one major part tonight, the part that rips
away the Medicaid Program. Let's do some basic Medicaid facts. Who uses
Medicaid? Thirty million kids. That is about 4 out of every 10 kids in
this country count on Medicaid to help pay the medical bills. About 6
out of 10 children with complex medical needs--children who need
breathing tubes, special therapies, and multiple surgeries, 6 out of 10
of those children count on Medicaid to help pay their medical bills.
Nearly two out of three seniors in nursing homes count on Medicaid to
help pay their bills, and one out of every three people dealing with
addiction counts on Medicaid to help pay for treatment.
Who uses Medicaid? America uses Medicaid--children, the elderly,
hard-working families, people with disabilities, and people struggling
with addiction. At any given moment in this country, one in every five
Americans is counting on Medicaid to help pay the bills. What are these
people supposed to do when the Medicaid expansion goes away, when this
bill's additional massive Medicaid cuts go into effect? What are they
supposed to do? What are their families supposed to do?
Dig in on one issue around this. Dig in on opioid abuse. This is a
problem that is growing around the country. Last year we lost 2,000
people in Massachusetts alone. I hear from parents who have lost
children, from brothers and sisters who have watched a loved one
disappear. I hear from people who are desperate because their child or
sister or brother can't get into a treatment facility. I hear from
dedicated doctors, nurses, and counselors who need more resources so
they can expand treatment programs. Now the Republicans propose a bill
that is like throwing gasoline on a bonfire. One in three people
struggling with an addiction are counting on Medicaid, and the
Republicans plan to cut nearly $1 trillion from the program. I do not
understand. I cannot understand how the Republicans could turn their
backs on literally millions of people who need help.
The cuts to Medicaid are terrible, but there is more. The Republican
bill also slashes the tax credits that people use to help pay for
insurance. The budget nerds at the Congressional Budget Office say that
“most people” would “have higher out of pocket spending on
healthcare than under current law.”
Think about that. Under the Republican plan, healthcare costs will go
up for most people, and even if someone can manage, somehow, to afford
coverage under the Republican bill, the Republicans are willing to let
insurance companies drop expensive benefits that the companies just
don't want to cover, including--are you ready?--opioid treatment. If
this bill passes, it will devastate our ability to fight opioid
overdoses. This isn't a hypothetical. This isn't speculation. Before
the Affordable Care Act became law, one-third of individual market
health plans didn't cover substance use disorder services, and about
one in five plans didn't cover mental health services. The insurance
companies don't want to cover these services, but the ACA made coverage
meant that no one in this country had to wonder when they showed up at
a clinic whether or not their insurance would help them out, but the
Republican bill opens the door to dropping those requirements. Millions
more people could be left out in the cold at a time when they most need
help. This is cruel. Our country is already struggling with a treatment
gap, and far too many patients facing addiction can't get the care they
need. The last thing we should be doing is kicking millions of these
patients off of the coverage they already have.
Now, let's face it. The Republicans realized this, and they have a
plan on this issue. They know that what they are doing is indefensible.
So they have a plan. They propose to throw $2 billion into a special
fund for opioid treatment and say: Problem solved. This is political
spin at its worst.
For every dollar the Republicans propose to put into opioid
treatment, they are taking out more than $100 from Medicaid, the rock
on which our ability to provide opioid addiction treatment is built.
Why? Why treat our brothers and sisters, our children, our elderly
parents so shamefully? Why? So that Republicans can produce a giant tax
cut for a handful of millionaires and billionaires. That is it. Our
friends, our families, and our kids can struggle on their own. They can
die on their own so that Republicans can cut taxes for the richest
people in this country.
What the Republicans propose is morally wrong. It is not too late to
do the right thing. It is not too late to reverse course. It is not too
late to junk this bill and start over. I hope the Senate Republicans
have the courage to do exactly that.
I yield the floor.
The PRESIDING OFFICER (Mr. Rounds). The Senator from Colorado.
Mr. BENNET. Thank you, Mr. President.
I appreciate very much the comments from my colleague from
Massachusetts and my colleague from Pennsylvania.
I notice my colleagues from the other side of the aisle are not here
tonight to defend this piece of legislation. It doesn't surprise me,
given what is in this legislation and given what we have heard over the
The Senator from Massachusetts was explaining what it was we were
trying to do when we passed the Affordable Care Act, now years ago.
Part of what we were trying to do was to extend coverage to a lot of
Americans that didn't have it. In my State of Colorado that meant over
600,000 Coloradans who didn't have it before the Affordable Care Act
was passed. Another thing we were trying to do was to say to insurance
companies that it is not OK to have as your business practice that you
take month after month after month of premiums from people and then
when they call on the phone and say: My kid was sick; my kid got struck
by lightning; my kid had an accident, to then hold them on the phone as
long as possible just as a way of denying their claim. Most people in
America are too busy trying to move their family ahead, trying to get
by, to stay on the phone all day with an insurance company. While we
were at that, we said: It is not fair to deny people insurance in the
richest country in the world because they have preexisting conditions.
It is not fair that it is a business plan in America to have lifetime
caps on people in the richest country in the world who might hit those
lifetime caps because they get cancer. It is not fair that in America,
the richest country in the world, some seniors have to cut their
medicines in half every month just to get through the month and to pay
their bills. These were some of the issues that we were trying to
address when we passed the Affordable Care Act.
Mr. President, I am from a Western State, like you. I was out all
those months in Colorado, having town hall after town hall, not just in
Democratic parts of the State but in Republican parts of the State,
trying to explain what it was we were trying to do--both to give people
better coverage, more predictable coverage, and less costly coverage
and also to try to do something to bring down healthcare costs in this
country. We succeeded at some of those things. We didn't succeed at
others of those things. It was a legitimate attempt at trying to
deliver something for the American people that people all over the
industrialized world don't have to live with.
Only in this country do people have to make choices about feeding
their family and taking care of their kids at the doctor. Only in this
country do seniors have to make choices about cutting those pills in
half. Only in this country do people have to make choices about paying
their rent and taking care of their kids. It doesn't happen in the rest
of the industrialized world. Before I hear it from the other side
tonight, let me say: Our results are getting worse, not better. For
populations across this country, longevity is actually getting shorter,
not longer. This is a difficult, complex, but urgent question for our
That is what we were trying to do with the Affordable Care Act. Some
of it succeeded and some of it didn't. I will talk more about that in a
For 8 years Republicans ran for election after election after
election on ObamaCare: ObamaCare is socialism; ObamaCare is a Bolshevik
plot to take over the United States; ObamaCare is destroying jobs--just
at a time when we were coming out of the worst recession since the
Great Depression. We saw uneven job growth in this country but
undeniable job growth over the entire period of time they were saying
ObamaCare was destroying the country and destroying our economy.
The recession was at the end of the last administration. The Obama
administration saw the largest job increases we have seen in this
country since World War II. I know it is inconvenient to believe that
or to say that. I know that in corners of the internet where false news
really does dominate, people don't believe it, but it is true. I am the
first to say there are not enough good jobs, and I am the first to say
there are not enough high-paying jobs, but compared to the record we
inherited, it was a success, all while we had the Affordable Care Act
being implemented, all while we were extending coverage to millions of
people in America--many of them children who didn't have adequate
coverage before we passed the Affordable Care Act.
It has been called every name in the book, just like President Obama
was called every name in the book, and they linked those two things--
healthcare reform, the Affordable Care Act, and ObamaCare. That became
Every single attack under the sun was levied on that. Why? Because
people really believed it was destroying the healthcare system? Maybe
some people did. Because they believed that it was destroying
businesses? Maybe some people did. I suspect there was a much more
simple reason, and that was to try to win elections.
By the way, while we are on the subject, no matter whether you
support the Affordable Care Act--and I support some things about it;
there are other parts of it that have been disappointing to me--I think
it is fundamentally important for people to understand that the
Affordable Care Act is not our healthcare system. It is part of our
healthcare system. The regulations that it has placed on insurance
providers so that people with preexisting conditions couldn't be denied
insurance is part of our system. The fact that it tried to create
accountable care organizations so people got better primary care so we
would reduce the amount of hospital readmissions from something like 18
percent or 19 percent, which wasted billions of dollars in this
country, down to 2 percent or 3 percent, that is healthcare.
But there is a lot of healthcare that has nothing to do with
ObamaCare or that has something to do with it but it was not the
creation of ObamaCare. There is Medicare and Medicaid. There are
doctors. There are nurses. There are patients. There are drug
companies. That is our healthcare system, and our healthcare system is
a mess. It is a mess. It is a mess. We tried to take this thing and
improve it when we passed the Affordable Care Act. Some of it worked;
some of it didn't work. Some people would argue we went too far. Some
people would say we didn't go enough.
But I can state this. I have been doing those town halls again in
Colorado, and what I know is that people feel defeated not by ObamaCare
but by the American healthcare system--by our healthcare system, which
is less predictable and less affordable than in many countries around
Now President Trump knew this. He is a smart politician. I never
thought he was going to win. I never thought he was going to win on a
campaign that on so many dimensions was out of step with conventional
American political thought, and I was wrong. He won. I don't think he
represents a traditional Republican view, and that may be one reason he
won. In no sense do I think of Donald Trump as a conservative. I think
of him as quite radical in his proposals. I think of him as a
reactionary force on a political system that the American people, for
whatever reason--some of them are probably good reasons--were losing
their patience with.
You cannot deny that the guy, somehow, in the far reaches of Trump
Tower, had his finger on the pulse of what was going on in some parts
of this country. I don't know if it was because he was a reality TV
star or what it was, but one of those things was healthcare. He
understood the American people's dissatisfaction with our healthcare
system, just as these 7 years and 8 years of Republican campaigns have
understood it. Majority Leader McConnell made it clear when we were
passing the bill: You own it. You own it. He said in a book later that
it was very important to him that the American people were able to
demarcate between the Democrats' responsibility for the healthcare
system as it was and the Republicans' willingness to take no
responsibility for it.
Even though we had hundreds of hours of hearings that lasted more
than a year and even though we had--they are not countless--well over
100 Republican amendments that were made in committee and on the floor
that were incorporated in the legislation, in the end, not a single
Republican voted for the bill.
Maybe that was a principled reason, not just a political reason,
because maybe there are some people who have the view in the Republican
Party that the Federal Government should not have any increased
involvement in their healthcare system. In fact, I have heard some
people say the Federal Government should play no role in the healthcare
system. Yet whatever the reason, not a single Republican voted for
The rest of the history writes itself, which is that every premium
increase in America, whether it was related to ObamaCare or not,
becomes part of ObamaCare. Every drug that gets increased in price
becomes ObamaCare, and for everybody who loses his insurance, that is
ObamaCare when what is happening is really far more complex than that.
There are very legitimate critiques of ObamaCare, but it is not the
same thing as our entire healthcare system. I think it is important to
make that point because, whether we are considering the Republicans'
proposed bill tonight or someone else's proposed bill tonight, we would
have to understand it was not going to fix the whole problem all at
People in my State are deeply dissatisfied with our healthcare
system. I say that as somebody who voted for the Affordable Care Act. I
have said it before. People have tried to make a political issue out of
it. They write ads about it: Look, Bennet said the healthcare system is
I will go further than that. It is a crying shame that people in this
country have to spend their lives wrestling with insurance companies,
lying awake, wondering whether their kids are going to be able to get
primary care or dental care or cancer care if they get sick. That keeps
families up every night in my State, not so much the people who are on
Medicare but a lot of other people.
So Candidate Trump saw this unease in the American people, this
concern that the American people had with our healthcare system, which
I share, and in his campaign--in his very populist campaign for
President--he promised to provide “such great healthcare at a tiny
fraction of the cost.” Those knuckleheads in Washington do not know
what they are doing. I am going to deliver you “such great healthcare
at a tiny fraction of the cost.” That was his promise to the American
people. That is what he said he was going to deliver.
He differentiated himself from other Republicans by saying: “I will
never cut Medicare.” “I will never cut Medicaid.” He said: Those
other Republicans say they will. I am not going to do that, but I am
going to supply better healthcare than you are getting now at a tiny
fraction of the cost. He said: “Everybody is going to be taken care of
much better than they're taken care of now” with no cuts to Medicare
and no cuts to Medicaid.
We had our election, and people voted for this nominee who made not
just these promises but many other promises about what he was going to
do for our economy based on, I think, largely, a complete fiction about
what is actually going on in our country--for that matter, in the
world--with respect to our economy. So he won. He did not just win--the
Senate is Republican, and the House of Representatives is Republican.
Now, after running elections for 8 years to get rid of that scourge
on America, that stain on America, that legislation that has destroyed
our economy and destroyed our healthcare system, they wrote a bill. It
took them a long time, really, to get it through the House of
Representatives, which was shocking, because they had 8 years to figure
out what was wrong with the current system and how to address the
current system. They tried it once, and they could not even bring it to
a vote in the House. They could not even bring it to a vote.
Then, understandably, the people who sent those Republicans to office
in the House said: What are you talking about? You said you were going
to repeal ObamaCare. You told us all of these terrible things that
ObamaCare had done. Your first order of business was to repeal
ObamaCare. How dare you not have a vote?
I am glad they said that because people should keep their promises.
I have believed for a long time that people want consistency out of
their politicians, that they will put up with inconsistency if you say
to them that the facts are different than I thought they were and that
is why I changed my view. Yet, in these times of fake news, of the
media having the challenges it has, and the rest of the things that ail
our system, consistency is not something that a lot of politicians pay
attention to. I think they think that is because voters do not pay
attention to it, but, in this case, they did. They said: You said you
would repeal ObamaCare. You did not just say it once. You said it year,
after year, after year, after year. Finally, they then passed a bill in
the House. Not a single Democrat voted for it.
We learned from that process, which took place before the
Congressional Budget Office had even scored the bill--imagine that.
There were all of these people who criticized the Affordable Care Act,
and proponents were rushing the bill through. As I said, I think there
were 200 Republican amendments adopted. It was a bill that held almost
countless committee hearings in the Senate Finance Committee and the
Senate HELP Committee. It was a bill that consumed 25 days of
legislative process on this floor, a modern record in terms of time. In
fact, we had all of that process, and I will come back to this.
Here is what Senator McConnell said about that. After all of that
process, he said on this floor, I think, that Americans were “tired of
giant bills negotiated in secret and then rammed through on a party-
line vote in the middle of the night.” Oh, that bill was negotiated
completely in public, painfully in public. I used to go home, and
people in my townhalls literally had copies of the bill. Do you
remember the chant: “Read the bill. Read the bill”? That is because
everybody had the bill.
On the House side, it is important for people to understand that they
passed the bill without even getting a score from what is called the
Congressional Budget Office. The head of the Congressional Budget
Office is appointed by Republicans when the Republicans are in the
majority, not by the Democrats. It did not even get a score. We had a
score on the Affordable Care Act before we passed the bill. We had a
score that every single American could see about what it would cost and
what money it would spend, what money it would save, how many people
would be added to the insurance rolls. We had that. They did not have
the decency to do that in the House.
They should have because--guess what happened--when the score came
out, it said that 24 million people would lose their health insurance
a candidate for President said that you are going to have “such great
healthcare at a tiny fraction of the cost.” “Everybody is going to be
taken care of much better than they're taken care of now,” unless you
are one of those 24 million and, I would argue, many of the rest as
well. I will come to that.
So they passed that bill, a terrible bill. I think that bill has the
lowest approval rating among the American people of any piece of
legislation that has existed in the time I have been in the Senate. It
is still not as low as the approval rating of this place, which used to
be 9 percent, but it is low because people know it does not really
address their healthcare problems. It is not a healthcare bill.
Then the President found out what was in the Congressional Budget
Office's score, and he had some Republican Senators over to the White
House and said: I hope you will not pass a bill like that. That is a
That is not my description. That is President Trump's description of
the House bill. That is a mean bill.
He said: I want a bill with a little more love in it than that bill
out of the Senate.
He has to be disappointed tonight because the Congressional Budget
Office's score came back and said that under the Senate's version of
the bill--the less mean bill--only 22 million people will lose their
health insurance and that far from having better insurance at a lower
price, half of the country--literally half the country--is going to pay
thousands more in out-of-pocket expenses because of what has become
known as TrumpCare.
There are three principal parts to the bill in the Senate and in the
bill that has passed the House. There are some differences, but I would
say they are differences without a distinction. They are immaterial
distinctions. There are three major components to these so-called
The first is a massive tax cut for the wealthiest people in America.
If you are making $200,000 or less in Colorado or in any State in the
country, you will not get a penny from this tax cut--not a penny. As my
colleague from Pennsylvania said, if you are one of the top 400
taxpayers in America, together, you are going to get $33 billion in tax
cuts. That is an average tax cut for each of those 400 Americans of
$82.5 million. There is not a person in Colorado at any one of my
townhalls who has said to me: Michael, the key to doing a better job
with our healthcare and the key to fixing ObamaCare--and I am talking
about the critics of ObamaCare. There is not a one who has said to
repeal those taxes on the top 1 percent of taxpayers in America at a
time when our income inequality has not been greater than in 1928 and
at a time when we are collecting in revenue only 18 percent of our
gross domestic product and spending 21 percent. Not a single person has
stood up in a townhall meeting and said the key to success here is in
cutting those taxes. Just to be clear, I should mention that $82.5
million is over a 10-year period. It is about $8.25 million a year.
As Senator Casey, from Pennsylvania, noted, that $33 billion adds up
to be the equivalent of what it would cost to pay for the Medicaid of
772,000 people who live in just four States--the entire Medicaid
population of four States.
But what they would consume in healthcare to try to support
themselves and their family is not $8.5 million a year; it is not $85
million over 10 years; it is, on average, $4,500 a year on healthcare.
That is the first part of this bill--a massive tax cut that is not
going to benefit anybody in my State who earns below $200,000.
The second element of this bill is a massive cut to Medicaid, which
is one of the fundamental safety net programs in this country. The cut,
whether you look at the House cut or the Senate cut, is massive. It is
about a quarter of the program. It is about $840 billion. And in the
Senate bill, the cuts are even deeper than they were in the House bill.
I wonder what the President would say about that. The House bill was
mean. I bet he would say the Senate bill is cruel because it
perpetuates those cuts.
I have heard the rhetoric from politicians in Washington about why it
is so important to cut Medicaid. They need to cut Medicaid so they can
pay for the tax cuts for people who are so wealthy, most of them
probably don't even need to mess around with insurance to pay for their
healthcare or their doctors. Now they are going to have another $8.5
billion a year. Now they are going to have another $85 million over 10
years if they want to spend it not on insurance but on whatever else
they want to spend it.
So on the one hand, they had to find the money to pay for this tax
cut. They found it from some of the poorest Americans there are. How do
they justify that? They justify it by painting a picture that says that
there are Medicaid recipients all over America who are receiving
Medicaid but not working, and therefore we should cut the program
because if we cut the program, they will know they have to get a job in
order to buy health insurance, and they won't be on the Federal
Medicaid Program. They say to go to work, and that is why we can cut
this program. Keep people out of that hammock they are lying in instead
of working for their healthcare.
What an insult to the almost 50 percent of Medicaid beneficiaries in
Colorado who are poor children. Are they supposed to go to work, or can
they go to school? And while we are at it, maybe we should think about
giving them better schools so they can actually compete in this
economy. But are we really going to take away their healthcare?
Then there are a whole bunch of people who have spent down their life
savings for the privilege of being in a nursing home paid for by
Medicaid. There is not a townhall I have where there aren't sons and
daughters or grandsons and granddaughters of people who are in nursing
homes paid for by Medicaid after they had to spend their whole life
savings down to be there. What a terrible system it is that a family
has to be near bankruptcy before we say: We will give you a helping
hand. It is a terrible system, but it is what they have. And they can't
work. They are in a nursing home. They are in long-term care.
Then there are a whole bunch of people in my State and in other
States--and this may be the greatest insult of all--who are working at
one job or sometimes at two jobs, and in the richest country in the
world, they are working and are getting paid and are not getting paid
enough to be off the Medicaid rolls. They are working, and they are
still on public assistance. And we are cutting a quarter of the
Medicaid Program because people need to go to work.
I am not making this stuff up. I asked Secretary Price, who is the
Secretary of HHS, Health and Human Services--he is in charge of the
healthcare for this administration--I said: Mr. Secretary, let me take
you through the faces of the people in my State who are on Medicaid.
And not only did they confirm that that is who is on Medicaid in my
State, he said that is the way it looks all over the country.
What an insult to justify a massive tax cut for the richest Americans
by taking away poor people's healthcare; by saying they are not working
for it, when they are children, when they are in nursing homes, when
they are working one and sometimes two jobs in the richest country on
So that is the second part of this healthcare plan--tax cuts for
wealthy people and cutting Medicaid for poor people. And in the middle
of that is the only thing that could fairly be described as a
healthcare plan; it is just a terrible plan.
Senator Paul from Kentucky--one of the more principled people in this
Chamber--said it very well when he called it, not politely, “ObamaCare
lite.” He is absolutely right. If you hate ObamaCare, you are really
going to hate ObamaCare lite. It is the same structure, which amazes me
because all of the people who said we should repeal ObamaCare are now
preserving the very basic structure of how the program worked, but the
problem with it is that they have cut the subsidies. They have turned
them into tax credits and cut the value of the subsidies. If you think
insurance is expensive now in the individual market, wait until you
meet ObamaCare lite, in the words of Rand Paul.
So those are the three components of the bill. And it is not
surprising to me that for those reasons, Senator McConnell has written
this bill in secret. It
is not surprising to me that he hasn't wanted to have a committee
hearing. It is not surprising to me that he brought the bill here on
the floor last Thursday, then accused people on the other side of not
having read the bill and still wants us to act on the bill this
Thursday so he can go home before July 4th and say to the American
people: We did it. We kept our promise. We repealed ObamaCare. We may
have written a terrible piece of legislation that has nothing to do
with improving your healthcare, but we repealed ObamaCare. And he is
hoping the American people won't notice.
Let me tell you something. The American people are noticing. There is
a reason why the House bill has the worst approval rating of any piece
of legislation in modern American history. The American people are not
I was in Frisco, CO, not that long ago, which is a place that
everybody should visit from all over the country. There is tremendous
skiing, and there is tremendous hiking, wonderful people. And before I
had the townhall meeting, I went and visited a healthcare center there
that they are justifiably proud of. It turns no one away. It gives
phenomenal primary care. It gives phenomenal dental care. They have to
figure out every week how to get through, but they always figure out
how to get through so that people in Frisco and in the surrounding area
This is not a poor community by American standards. It is a resort
community, but there are people who live there year-round. I asked the
people who run the clinic: Who are the payers for healthcare in your
clinic? Who are they? What pays for healthcare here? And she said:
Well, Michael, the Medicaid is 33 percent. That shocked me because if
you are in rural Colorado, the Medicaid number is usually a lot higher
than that because people don't have access to a lot of resources, and
we all know they don't have access to a robust insurance market.
Thirty-three percent was Medicaid, 53 percent was uncompensated care,
and the rest was private insurance companies that pay for the
insurance. That shocked me.
I said: Fifty-three percent is uncompensated care, people with no
insurance? How can that be?
She said: These are people in our community who make too much money
to be eligible for Medicaid, but they can't afford private insurance.
They are working full time; that is not the problem. They are not
even--as I described before in a case where somebody is paying them too
little, so they are eligible for Medicaid; their problem is that they
are being paid too much, and they are not eligible for Medicaid as a
result, but they can't afford private insurance. I think that is an
indictment of the Affordable Care Act that I accept as somebody who
voted for it. The idea that we would require people in America to buy
health insurance and then not have a market that gave them quality
health insurance at an affordable price is ridiculous.
I have had people in rural Colorado say to me: Michael, look, why are
you requiring me to buy something where there is not enough
competition, so the premium is high and the deductible is ridiculous.
So it is of no use to my family, and you are requiring me to buy
something that is useless to me. We should have more competition to
drive down price.
I say: You are 100 percent correct.
And if we had a functioning Congress that wanted to take a bipartisan
approach to fixing that problem, we could fix it, and there are
probably 15 or 20 other things along those lines. But the Republican
healthcare bill--so-called healthcare bill--does none of that. It does
none of that.
So to the extent that you don't like ObamaCare because you feel as
though your premiums are going up and you are not getting enough for
it, as opposed to the millions of people who have gotten insurance as a
result of it, some for the first time--to the extent you are worried
about that, the House bill makes it worse and the Senate bill makes it
There is a projection in the CBO report that says that at a certain
point in time, your premiums might come down under the Republican bill,
but the reason for that is because you will be buying lousy insurance.
It is not because Donald Trump, as he said to the country, has provided
such great healthcare at a tiny fraction of the cost. That is not the
reason. It is because they provided terrible healthcare at a fraction
of the cost. That is not a benefit to anybody. If an insurance company
can put you on lifetime caps, of course they are going to charge you
I am all for working together in a bipartisan way to address the
issues in our healthcare system that, frankly, go far beyond the
Affordable Care Act to make sure people in America don't have to
continue to make the choices people all over the world don't have to
make about having to stay in a job they hate because they have to keep
the insurance or being able to quit a job and do something else because
they know the insurance will be there. Nobody else has to make those
decisions. And nobody else in the world goes bankrupt because of
healthcare, but that is still a problem in America.
I think fundamentally the problem we have here tonight is proponents
of this legislation didn't set out to fix our healthcare system; they
set out to repeal ObamaCare or the cartoon of ObamaCare they have been
running on for the last 8 years. That is what they set out to do. Along
the way, they obscured it all so they could have the opportunity to cut
taxes on the wealthiest Americans--which, for some reason, is an
obsession with some people around here--and dramatically cut access to
healthcare by poor children.
I know there are people who are hearing this will not believe what I
am saying is true. It is true. I hope you will familiarize yourself
with the facts. I hope, in particular, people who feel the last bill we
considered on this floor didn't get the process it deserved--people who
quite rightly wanted to make sure Members of the Senate and the House
had actually read the bill, people who wanted to know what it was like
to live in a country where your health insurance is uncertain from
month to month, where you have to decide between paying the rent,
buying the food or being on health insurance; people who are dealing
with and whose families are dealing with the effects of this terrible
opioid crisis that wasn't even really a gleam in our eye when we passed
the Affordable Care Act.
I especially say to people living in rural America how sorry I am
that people aren't paying attention to your needs; that your hospitals
may be cut because of an ill-considered piece of legislation which has
nothing to do with delivering healthcare in rural Colorado or rural
We can do so much better than this, but to get to a place,
unfortunately, where Democrats and Republicans have the opportunity to
work together, the first order of business has to be to defeat the bill
on the floor. I hope people know this is the week when it is critical
to call and let your voices be heard, let people know you expect
something better than what we are getting, and that Americans ought to
have a healthcare system that is affordable, that is predictable, and
that actually creates stability instead of instability for their
Mr. President, I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. BENNET. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.