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Well, the committee will come to order. The purpose of this afternoons session is to discuss the details of the chairmans mark. Were not here to speculate about items that may or may not end up in the house bill. Were not here to debate items that are not currently part of the chairmans mark. Because as of now there is no official or final version of the modification. As i made clear this morning, we are still working to finalize the details of the modification. When that work is done, the details will be provided to the committee with ample time to go through them. After that, most likely tomorrow morning we will have another walk through that gives members an opportunity to discuss and ask questions about the modification. Long story short no one needs to be talking about the individual mandate at this point. Its not part of the mark. Arguments, questions, or statements about the individual mandate are a distraction from the meeting were having now and, frankly, a waste of this committees time. Members have told me that they have additional questions to ask about the mark and i want to be reasonable, accommodating so ill ask, do any members have any questions or comments about anything other than obamacare or the individual mandate . I do mr. Chairman. I do. Mr. Chairman, yes. Lots. Yes, thank you, mr. Chairman. First, the press is reporting that what will be offered tomorrow will contain a repeal of the individual mandate under the Affordable Care act. Are those press reports correct . They quote mitch mcconnell. My understanding it just changes everyday, mr. Chairman. My understanding is that were going to have a. s at some point, fairly soon, Senate Republicans are going to propose a repeal of the individual mandate under the Affordable Care act. That means that the tax bill is going to hit the American People with a health care double whammy. First, the Congressional Budget Office announced today that if the republican tax bill passes, it would trigger a sequester that would result in 25 billion in cuts to medicare. Now, on top of that blow, to vulnerable senior citizens, according to the Congressional Budget Office, your change that will be getting later today will cause millions to lose their health care and millions more to pay higher premiums. All to pay for yet more tax breaks for multinationals. Now, in addition to the serious harm to seniors, and the middle class, our view is that this is a violation of committee practice. There was no amendment filed that in any way addressed the individual mandate or the Affordable Care act at all. So now weve got a provision flying into the modified mark that wasnt filed as an amendment, and it certainly goes against the wellestablished finance committee precedent. This is yet another example, one more, about how the process being used for this tax bill is not regular order. So my request, mr. Chairman, is this. If the modified mark opens up the Health Care Debate by including a major change to the Affordable Care act, it is only fair that members be allowed to offer amendments to address other health care issues. And since there was no notice that Health Issues would be addressed during this markup, i believe members ought to be allowed to file additional amendments addressing Health Issues. So i close by asking unanimous consent that members have until 5 00 p. M. Tomorrow, wednesday, november 15th, to submit additional amendments, and that any amendment related to health care that is within the jurisdiction of the finance committee be considered germane. Well, the amendment time has already passed. You already have your amendments. You can modify the existing amendments, but were not going to allow any new amendments. Well, mr. Chairman, again, because we were never told that health care was going to be part of it, and this just flew in literally out of nowhere in the last 20 minutes, i think basic fairness, basic fairness, would mean that members would have additional time i think 5 00 p. M. Tomorrow is reasonable, to submit additional amendments. And certainly, if republicans are going to put this in and say its germane to the work of the finance committee on taxes, it ought to be that any amendment related to health care within the jurisdiction of the committee be considered germane. Well, ive already ruled, so lets move on to the walkthrough. Because, you know, i think you can modify your amendments that you have on board here. Well, mr. Chairman, i think our staffs are going to have to do some work in the hours intervening between when we wrapup i agree. Oh this afternoon and tomorrow to ensure basic fairness. Because to me to be able to add something brandnew on the republican side, particularly something that puts at risk Health Care Affordability the Congressional Budget Office says this is going to raise premiums. And the reason its going to raise premiums is because you wont have as many Healthy People in the risk pool. So this is a major change. And well have plenty to talk about to ensure fairness. There is nothing brandnew here. Mr. Chairman, i would also appeal the ruling of the chair on this. This is so serious. All right. Can we speak to that, mr. Chairman . Mr. Chairman, the people want to speak to it. Senator mccaskill. Yeah. I am not really sure what the majority is afraid of. Huh . Im going to wait for the chairman. Im not really sure what the majority is afraid of. Ive been reading on my little device here that senator toomey just told a reporter that its in. Mitch mcconnell just told a reporter that its in. Were all reading that the individual mandate is going to be in the mark. We had no idea health care, and all the torturous debate around the Affordable Care act, and all of the debate weve had and all the attempts at trying to dismantle it that have occurred, the idea that we wouldnt be allowed 24 hours to offer amendments on a subject matter so incredibly important, what would be the harm, mr. Chairman . What would be the harm in allowing us to offer amendments on that subject matter . I need to understand, what is it were afraid of . Mr. Chairman . Okay. Mr. Chairman . Senator toomey . Yeah. I would just respond. Its my understanding that existing amendments can be completely modified. My democratic colleagues have submitted i dont know how many amendments. Is it in the hundreds . Its a large number. Its in the hundreds. Every one of them can be modified to deal with this very issue. If if that is what members want to do, theyll be free to do it. I dont understand this argument that its not possible to are democrats to offer amendments on health care issues. I suspect theres going to be a lot of them. And youve got the vehicle with which to do it. Im confused. I dont understand it either. Im a new committee member. Explain it to me, mr. Chairman. Youre saying i can take an amendment that i have offered on a passthrough guardrail, and i can say, by the way, i want to include something on the Affordable Care act . Is that what i can do . I am just rewrite the body of the amendment to add an addendum that modifies health care . You can certainly modify it. Mr. Chairman and colleagues, were talking about a whole in you subject. A subject that as ive indicated can raise Health Insurance premiums on millions of people, and i think this is a modest request, why i called and they havent done this for an opportunity for mechanimbers to on having until 5 00 p. M. Tomorrow. And were going to be interested in whether your distributional analysis is going to be updated to include the individual mandate. So there are a host of questions, which is the point senator mccaskill has mentioned. And mr. Chairman, i know you want to move on and some colleagues want to, and if we can vote on my motion. Lets see if there are any other comments. Senator stabenow. I support the Ranking Members motion. This is a very unfortunate turn. Instead of having something to be in this tax bill that will raise premiums, health care premiums, what we should be doing is focusing on a bipartisan effort that senator alexander and senator murray have put together to stabilize the markets that would actually begin to lower premiums. And so this is a very unfortunate turn of events. And also makes me very skeptical about what is coming next when theres a 1. 5 trillion debt increase in in this bill. And the next thing we see is a budget resolution with about 1. 5 trillion in cuts to medicaid and medicare. So if were going down this road, you know, were theres a whole lot of concerns that i know people in michigan will have about their health care. Parliamentary inquiry, mr. Chairman, before we vote. Go ahead. Thank you. So senator toomey has said everything is going to be hunky dory here. The that were going to be able to talk about our concerns with this amendment. I would just like to have clarified by the majority that Health Amendments would not be ruled as nongermane. That all the Health Amendments within the jurisdiction of this committee be considered germane. I think that is a mr. Chairman i think thats a minimum commitment, given the importance of this very important issue, which, as i say, just flew in through the door in the last couple hours. Mr. Chairman . Senator. Mr. Chairman, my understanding is, and that the individual mandate is a tax. Collected by the irs. The individual mandate the Supreme Court ruled is a tax. So it seems to me its perfectly within the jurisdiction of this committee to move forward and address something that is imposing a mandatory tax on millions of americans who for simply choosing not to buy Health Insurance. Thats what were talking about here. This is a tax. That punishes people for doing something they wouldnt want to do. So it seemed to me, its perfectly within this committees jurisdiction to address this in the form of an amendment. And so i dont know what the the outrage is about this not being germane or pertinent to the subject before us. Mr. Chairman . Mr. Chairman . Mr. Chairman, just before i yield to my colleague. Lets understand, this redefines the scope of this markup we didnt know anything about this. And thats why it is so important that we get the time to address it. Because this, in all the particulars, redefines the scope of this markup. Mr. Chairman mr. Chairman, how is how is it outside the scope to tax . Its the irs. Internal revenue code. I dont know how its outside the scope. Mr. Chairman . Let me just make this comment. The democrats have offered around 600 no, 60 60 amendments with no text at all. Seems to me, theyre awfully easy to modify. Theres nothing nothing strange about this at all. And i dont get the i dont get the crime. Mr. Chairman, i think the question still is germaneness. And thats what is most relevant to the question that senator mccaskill asked. Make sure that she is actually going to be able to offer amendments within our jurisdiction. I still havent heard an answer to this. Josh, why dont you clear this up for us. What is doable . During the aca, members were able to completely modify their amendments in any way possible. So nothing to stop them from doing it here . There is not based upon that precedent, there is no no way they theres no theres members could easily offer and change their amendments as they wish. So i want to hear the words, Health Care Amendments are germane. Because thats whats going to be asked tomorrow, in my view, unless we clarify this. I cant speak to germaneness, senator wyden. That is up to the chairman. Mr. Chairman . Well, lets understand. To be germane, they have to be related. To the Internal Revenue code. And at least the individual mandate. Is the Internal Revenue code. So thats my understanding. I dont see any problem here. Mr. Chairman, we have redefined the scope of the bill to health care. We were not talking about health care in the Senate Finance committee until about an hour ago. So i think it is only fair to allow members to submit additional amendments related to health care in the jurisdiction of the committee. This is now on the basis of the announcement thats been made a Major Health Care bill. Mr. Chairman . Mr. Chairman . What . Yes, senator cassidy. I have a question for the Ranking Member. Go ahead, nor cassidy. This is for senator wyden or mccaskill. Senator thune points out the individual mandate is a tax. But im suggest im getting from you, when you want to open up health care, you like to bring up medicaid, 340 b, medicare, part d. I mean, thats the jurisdiction this committee has over health care. Are we really saying, because were going after because we were discussing something which has been declared a tax, which is a tax, that were now going to go and bring in medicaid and 340 b . That just seems like a stretch. And as loud as the volume can be, and as forceful as the delivery, ive got to admit, this is a tax, and its not 340 b, and its not medicaid. I dont quite get the connection between the whole scope of health care that this committee has and that which is specifically a tax. Mr. Chairman, if i can respond to my colleague, this is related to a host of other health care issues. This is partial repeal of the Affordable Care act. And thats why the Congressional Budget Office scored it with such ominous consequences. Millions of people losing coverage. Millions of people having their premiums go up. My colleague has been involved in health care. Well have far fewer Healthy People go into the risk pool. Which means that premiums are going to go up in this country. This is turning a tax bill into a health care bill, with our colleagues getting an hours worth of notice. But that is not that does not address my question. If you wish to address the consequences of the individual mandate repeal, thats one thing. But if you want to bring in everything this committee has to do with health care, 340 b, for example, that is a stretch, and that is far beyond the scope of what were discussing here. Were happy to make this lets ask for recognition okay . From here on in. Its jumping in and yelling and screaming. I dont want any more yelling and screaming. Lets just talk like gentlemen here and women and ladies. Women and ladies. And lets treat each other with respect. Now, i made my ruling. The Internal Revenue code related amendments would be in scope. Thats it. Now, lets just move on. Mr. Chairman . Senator wyden. Thank you. To respond lets run this like it needs to be run. To respond to my colleague from louisiana yes. Were interested in making sure that it is germane to offer amendments related to the Affordable Care act. Thats what the individual mandate is all about. And i dont think we have locked this issue down, and mr. Chairman, unless my colleagues want to keep speaking, for those who have just come in, what we have pending is ive asked unanimous consent that members have until 5 00 tomorrow to submit additional amendments related to this matter of health care and the Affordable Care act. We have been turned down. The chair ruled against us. And what is pending is an appeal of the ruling of the chair. The senator from pennsylvania. Mr. Chairman, i think i would like to respond to the Ranking Members concern by saying, look, everything in the tax code relates to something. We have provisions in tax reform bill that affect the Financial Services industry. It affects trade. It affects every industry in the economy, because every industry pays taxes. That doesnt mean the entire universe is open for amendment and germane. What is germane is anything that directly affects the Internal Revenue code, because this issue is a tax. Its very clear. Its a tax. So i dont i dont understand the concern. Our democratic colleagues can modify the amendments. They have submitted 60 blank amendments. They can fill those in. And to the extent that they are related to the code, presumably going to be ruled germane. As our amendment is germane. So i just dont see the issue here, mr. Chairman. I have Something Else to say. Senator mccaskill is wanting to speak and then i have one other point, mr. Chairman. Let me make the point, you have 60 blank amendments. You can use them. Theres nobody is stopping you from doing that. Senator mccaskill, well turn to you now. Thank you, mr. Chairman. So i assume that all the cadillac tax and medical device tax and all those taxes are will be considered germane. Anything having to do with the Affordable Care act that has to do with taxes is germane. And i guess the point we would make is that when you start dismantling the aca, piece by piece, it has an effect on the entire operation of the aca. Its going to raise premiums. Its going to, in fact, what i would ask of jct, will we have a distribution analysis, a new one . That will show the impact of this . Because the people this is going to hit, or the people that dont get insurance at work. Theyre the Small Business people out there that are buying on the exchanges that make a little too much money to qualify for the subsidies. Thats who this is going to hit. Thats where those premiums are going to go up. As you all well know. So the people this is going to hit are middle class people that ostensibly this whole bill was supposed to be about helping. So the way i get it is, were going to make their insurance more expensive, create 13 million uninsured people, all to make sure that passthroughs get a 5 or 6 cut in taxes, unless, of course, a small passthrough would happen to be doing certain kinds of work. I wont get into the complexities. But golf course owners, real estate developers, massage owners, get a break. On the other hand, we charge for insurance. Will we have a distribution table . Senator mccaskill, we dont i dont have an amendment to examine our order of work, as we would estimate the revenue consequences of any modification that the chairman might propose. And then we try to produce distribution table. So its unlikely that the distribution table would be available at the time that as soon as we complete the work on the revenue table. But we would work towards providing a distributional analysis. Senator scott wants to be recognized. Well recognize senator scott at this point. Senator scott. Distribution analysis. Thank you, mr. Chairman. The Supreme Court has already ruled. Senator thune has pointed this out. Senator toomey has reinforced it, that the individual mandate, without any question, is a tax. So the question is, who is paying that tax . The reality of it is, a very simple answer. Very simple answer. Households under 25,000 of household income, onethird are paying that tax. Out of the entire folks who are paying the tax, 80 of the folks who are paying the tax today live in a household under 50,000. If we are seriously concerned about hardworking americans, lets look no further than the current debate over the individual mandate and its impact on lowincome americans. 25,000 household is half less than half of the average income in South Carolina. And yet a third of the folks who are paying the penalty, who are essentially having a higher tax rate, live in households under 25,000. Why . Because theyre paying a tax. 50,000 threshold, 80 of the folks, that is slightly around the slightly less than the average income in South Carolina 80 of the folks who are paying this tax are folks who live in a household under 50,000. If were talking about doing the right thing for the middle class, were talking about doing the right thing for hardworking americans, heres a good place to start cutting their taxes. Mr. Chairman . Senator corden was next. Mr. Chairman, ill give my time back. Senator scott made my point better than i could. Mr. Chairman . Mr. Chairman . Are we ready to vote . I think senator brown. One brief comment, mr. Chairman. I would like to make a quick close, and senator carper. Senator brown . Okay, thank you, mr. Chairman. I will be brief. You know, i listen to all of this, and i dont think my colleagues are thinking much about individual people that how this is going to affect their lives. Im im puzzled my colleagues on the other side of the aisle just cant help themselves. This is at least the fourth time this is a bunch of people sitting around a table, all of us have government Health Insurance. Have good insurance paid for by taxpayers. And it seems my colleagues are just sitting around, just these unreletting efforts to find ways to take Health Insurance from people in our states. In my state, 200,000 people are getting opioid treatment right now, because they have insurance under the Affordable Care act. And we sit around here as privileged members of the senate with great titles and good pay and insurance paid for by taxpayers, scheming up ways this comes out of a republican lunch today, when they were talking about we cant give up on getting rid of the Affordable Care act. Lets try to find a new way. And theyre doing it through this bill. I just i am just puzzled by the brain power that my colleagues and theres a lot of brain power on the other side of the aisle my colleagues are willing to put into these unrelenting efforts to take peoples Health Insurance away. And this is their fourth try at least their fourth try this calendar year. And im just puzzled by it, mr. Chairman. Im prepared. Senator wyden. Mr. Chairman, senator carper would like to speak, and then id like to just restate the motion so Everybody Knows what were talking about. Okay, senator carper. Thanks. Mr. Chairman, you said about five or ten minutes ago, we had cautioned us to be respectful of one another. And i can appreciate that. I think most of us try to abide by the golden rule to treat other people the way we would want to be treated. And i would just ask you today to think how does this line up with the golden rule . I know thats something you believe in. I know its something senator grassley believes in, and there are others that are here. Im not so sure that its consistent. I want to go back in time. I want to go back in time, maybe two months. And i spent a fair amount of time in this room two months ago on a committee that im not even a part of. And it was the Health Education labor pensions committee. And under the leadership of Lamar Alexander and patty murray, they for two weeks held bipartisan hearings in this room in this room. And they brought in governors, bipartisan across the country. They brought in insurance commissioners, bipartisan from across the country. They brought in health economists. They brought in health insurers. They brought in providers for Health Insurance. And the theme that emerge and had what they were trying to focus on is how do we stabilize the exchanges . Which i think our president is intent on destabilizing. But their focus is how do we stabilize the exchanges to bring down the cost of coverage. And the exchanges. And there is general agreement that there are three things, if we would do them, that we would stabilize the exchanges. We would have more insurers offering insurance and it would bring down prices significantly. Sometimes some folks said by as much as 30 to 35 . They basically gathered there seemed to be a consensus three things we ought to do in order to stabilize the exchanges. Number one, make it clear that these csrs, cost savings reductions, which are really a way to bring down the cost of copays, deductibles for folks who are lowincome. Make sure thats not going away. Make it clear thats not going away. Number two, said we need some kind of reinsurance make it clear that as much as we have done in Medicare Part d that we have a backstop there for really expensive cases. It might be their Insurance Companies might be otherwise stuck with paying. Third thing they said we ought to do is continue to have the individual mandate. And not get rid of it. And several of our witnesses said we could reduce the cost of premiums in exchanges by as much as 35 if we would do those three things. If we would do those three things. Mr. Chairman . Yes. I just walked us back in time too much. I want to walk us back in time to 1993. In 1993, i was a governor. I was a brandnew governor of my state. And in 1993, a senator named john chafee introduced legislation that was reported to this committee, and the legislation that he introduced was actually ideas that were brought to him by the heritage commission, as i recall. And those ideas were turned into legislation that was co sponsored by 23 republican senators. It was an alternative to hillary care. An alternative to hillary care. And among those five ideas that were introduced in that legislation that two of the finest people on this committee, you, mr. Chairman, and senator grassley, co sponsored, was legislation that said every state should have an exchange. It should be a sliding scale tax credit to bring down the cost of coverage for lowincome people. There should be an individual mandate to make sure that the exchange has a healthy mix of people, young and old. Healthy and unhealthy. There should be an employer mandate and there should be a prohibition that says insurers cannot refuse to cover people with a preexisting condition. That was a republican alternative to hillary care. In the end, hillary care didnt go anywhere. And neither did the legislation that two of our Colleagues Co sponsored. You had a good idea. That bill was a good very good idea. And for the life of me, i dont understand why youve been running away from this administration and so many of our colleagues have been running away from it for years. I think this president says he attacks it because its obamacare. He thinks obama had something to do with it. He had nothing to do with it. He had nothing to do with it. It was an effort by this committee to find a bipartisan plan or proposal around which to rally to extend coverage to people who otherwise wouldnt have it. I would just say, mr. Chairman, if the shoe were on the other foot, and Something Like this were introduced which really is a major change in the bill, and we asked for or you asked for another 24 hours to think about it and offer amendments, i think we would probably say yes. Thats the way we would treat you. We would put ourselves in your shoes. And i would just urge you to do that today. Give us 24 hours, treat us the way we would hopefully treat you, and lets just move on. This is not the way to develop bipartisan consensus. In fact, if anything, this just diminishes the trust and confidence in one another and takes us in the wrong direction. I urge us not to go there. Senator wyden. Mr. Chairman, im going to be brief. Because tom carper, who is always trying to bring people together, always a gentleman, has said it very well. And let me just kind of make two quick points, and then ill offer my appeal of the ruling of the chair. First, we have learned in the last hour that this tax bill will now be a Major Health Care bill. We just learned that. The individual mandate is an integral part of the Affordable Care act. And rumors abound about whether its going to be completely repealed or partially repealed. But the bottom line is, as senator carper just said, senators ought to be able to respond and have the tools to do so. So i had originally asked unanimous consent that members have until 5 00 p. M. Tomorrow to submit additional amendments and that any amendments relating to the Affordable Care act thats within the jurisdiction of this committee be considered germane. The chair ruled that my unanimous consent request was denied, so i ask for a vote, mr. Chairman, on appealing the ruling of the chair, and would now ask for the yays and nays. Mr. Chairman, just a point of order, because i dont understand whats happening here. Can i just raise a point . Go ahead. Would it be possible that we will get an amended chairmans mark that includes a Major Health Care provision, and that your ruling would deny us an opportunity to amend that provision thats added, that wasnt in there before . Is that what the ruling is about . Yes. Well, the individual mandate is in the Internal Revenue code, as i understand it. So i think you can amend that. So we will be able to offer amendments that will not be subject to the chairman ruling them nongermane and out of order . As long as they apply and are in the Internal Revenue code. The chair would uphold them. Mr. Chairman, id like to i have the yeahs and nays on my appeal of the ruling of the chair, because as senator cardin pointed out, there are a lot of Unanswered Questions with respect to the Dramatic New Development that turns this tax bill into a health care bill. I asked for the yeahs and nays on my appeal of the ruling of the chair. Okay. Yeahs and nays. Yeah. For colleagues, im asking for a repeal of the ruling of the chair, which means that those colleagues who agree that this would be basic fairness, which i do, for a brandnew matter, would vote aye. I would ask for the clerk to call the roll. Mr. Grassley. No. Mr. Crapo. No. Mr. Roberts. No. Mr. Ency. No. Mr. Cornyn. No. Mr. Thune. No. Mr. Burr. No. Mr. Portman. No. Mr. Toomey. No. Mr. Heller. No. Mr. Scott. No. Mr. Cassidy. No. Mr. Wyden. Aye. Miss stab now. Aye. Ms. Cant well. Aye. Mr. Nelson. Aye. Mr. Carper. Aye. Mr. Carden. Aye. Mr. Brown. Aye. Mr. Bennett. Aye. Mr. Casey. Aye. Mr. Warner. Aye. Mrs. Mccaskill. Aye. Mr. Chairman. No. Chairman votes no. Senator isaacson just came in. No. Mr. Isaacson no. Announce the results. Mr. Chairman, the final tally is 11 ayes, 14 nays. Let me just restate what happened. There will be no extension of the amendment deadline. You all have your amendments filed. There are 60 blank ones. You can use them as long as they comply within the scope, which is the Internal Revenue code. And we can move on from there. But thats where we are. Mr. Chairman . To your right . Could i be recognized for a moment . Yes, you can. Senator cardin. I dont mean to be presumptivous on this, but ive chaired a committee and a bunch of subcommittees. And i would ask you to think of a mr. Chairman . Go ahead. I would ask you to think about something for just a minute. Im listening. Everybody on this committee, and most of the people in this room and that are watching this, know that in order for the exchanges to be successful, there have to be a good mix in the exchanges of healthy and younger people, as well as those who are older and maybe not so healthy. There is more than one way to do this. The individual exchange is one. Auto enrollment might be others. There are different ideas. And one of the great things that the Health Committee did two months ago, they had a great lineup of witnesses from across the country, from all different walks of life, smart people and foreign people, democrat and republican, to come in and say this is how we think the different ways to stabilize the exchange. I would love for us to have a hearing here, or back in our regular hearing room, 215 dirksen, that just brought in smart people from around the country and say, in addition to the individual mandates, what are some other good ideas that either by themselves or in combination with other ideas, could actually get the mix of young people that we need in the exchanges. That would make a lot of sense to me. As my father would say, just use some common sense. And i think thats common sense. Weve had no hearing. Mr. Chairman . Senator wyden. Mr. Chairman, when now will we see the revised bill, including sunsets and any other changes . Because we are constantly being informed of changes, told were going to have to have responses, all of which is so far removed from the way the finance committee traditionally does business. I think what we need to do, before we go on to anything else, is get from the majority when we are going to see the revised bill, including sunsets, and any other changes. Could you and the majority staff give us some time when we could expect that . I have been informed we can do that later today. So thats like midnight . 10 00 . Well youll have it later today. Whenever we can get it done. I mean, thats all i can say. Is there anybody else . Mr. Chairman, just yes, maam. Just a comment. We whats being talked about now would at the same time were being told that the tax bill will raise taxes on 14 Million People in a year would now take away 4 Million Peoples insurance, on top of that. 13 million over the next ten years. I want to just address one thing. You know, one of the things that brings us together as human beings is we all get sick. The kids get sick. Our parents get sick. When, as my friend from South Carolina was talking about who pays a penalty if they dont have insurance, let me just remind all of us that if someone cant take their children to the doctor, they go to the emergency room. Which is the most expensive way to provide health care that there is. Who pays when somebody without insurance goes to the emergency room . Everybody else with insurance. Which is why you end up with an 80 aspirin or some other kind of cost. So when we talk about health care, part of this is also personal responsibility, accountability. But its also about the fact that we have seen in the last few years the costs of people walking into the emergency room who dont have insurance, who cant take their children to the doctor in the middle of the night, with a sore throat or a high fever. They can now go to the doctor, 97 of the children in michigan can now go to the doctor. And because theyre not using the emergency room, the costs have gone down for our hospitals and uncompensated care. And we have begun to see in other markets, insurance markets, the costs flattening out in terms of the Group Markets and so on. Someone pays when kids get sick. Someone pays for that. So either they pay by having the capacity to take children to the doctor, because they have insurance, or everybody else who has insurance pays for that when th. When they use the most expensive kind of care, which is going to the emergency room. I just want to indicate that thats the reality of the economics around health care. Understand. Do members of the committee have questions on the underlying mr. Chairman . Mr. Chairman . Mr. Chairman . Yes. Mr. Chairman, thank you. Mr. Chairman, i know the Ranking Member is asking you about timing, because this is seemed to be, you know, just a sprint. Like its like i dont know if theres ever been a bill i dont even know if there has been an ambassador thats been moved out of the committee and on to the senate floor in this record speed time. That is that we left here on thursday night with some language that we were supposed to see, and i worked all weekend, just like many people here. We were in veterans day parades, but we pulled aside and called people up and say, when do we have to have our amendments in . And what does the language say and what is the intent of this section . And what is the impact . Is this in, is that out . Are property taxes in . Are mortgage deductions out . Whats the so the notion that we leave here on a holiday on thursday night with one draft and now were having a major change proposed here, and another proposal is going to come out tomorrow morning, and then thats what were going to start marking up . Look, i think people are here i worked in software. I know what software hours are. You basically work 18 hours a day. People here were willing to work even 18 hours a day. But i guarantee you, we cant even keep up with that speed, because youre changing it every minute. Why are you rushing, is the point. Why are you rushing . Now, i would have said, after the august recess, i hoped our committee was going to play a big role on health care. I wanted us to play a big discussion. We kind of ceded over to the help committee all of the discussion about the changes as it related to the market. I proposed something that we passed out of this committee that is working very successfully in new york. Its 500 for an annual premium for the low end of the market. Why . Because you bundled up people and you created a market. Its a market force. So i wanted to discuss that program of the basic health plan and why its working so successfully, and what we could do get more people to adopt it here. But for whatever reasons, our committee hasnt spent the time and energy on the larger discussion of health care reform. I suggested many times on the senate floor the Delivery System reforms that are costsaving measures should be part of this discussion in general. Because i do believe, unlike speaker ryan, who thinks, well, hell just get this tax bill done, and then people will see, oh, we cant afford medicaid and medicare, because of the shifts in population. Oh, were just going to whack them. I instead want to see changes to the Delivery System that are going to make those programs more Cost Effective and have better outcomes. So to me, the notion that we abdicated on the Health Care Debate in our committee and basically let our colleagues discuss one aspect of it, even though we had good costsaving ideas. Ideas that will save us money and deliver better care. And we didnt talk about them. And now all of a sudden were supposed to keep going at record breakneck speed here on policy. And were willing to work around the clock. I mean, the commerce committee, god love it, it never gets serious until about midnight and then people negotiate between midnight and 6 00 a. M. But usually its a smaller area of law, and they come back and they like, okay, heres what weve dealt with and heres what we cant deal with. Youre asking us to change those books in front of claire, in major significant ways. Not just thursday night to now today. Youre proposing something right now thats different. And then youre going to roll out something at 7 00 a. M. Tomorrow morning thats also different, and then youre going to say lets start amendments. So i dont even know if staying up all night is going to help, because i dont even know when youre going to roll this out. So it shouldnt be in the dark. It shouldnt be a secret. Look, i do believe in this committee. And i believe in that people here can work together. I do think that things have continued to shift. And i dont know what the hurry is. God hope, its not a december election, okay . Because this tax code is too important to just try to jam it down peoples throats. We need to have for the certainty and predictability that this is policy that we are going to live with. Thank you. Senator brown will be the last one to ask some questions. Thanks, chairman. I think we were all waiting, because we all had i know senator i had questions sorry, mr. Chairman. Go ahead, senator brown. Well finish with the Ranking Member. A lot of us had questions we wanted to ask staff. The problem is, its hard to ask questions about a bill that when you all go to lunch and then you have a strategy meeting at lunch and then you come up with a different bill after lunch. So its hard to kind of ask these questions on the fly, on a bill we dont really quite were not able to digest. So but one thing we do know and what i wanted to ask about, is this is pretty troubling when you look at what my colleagues want to do in Health Insurance but we know for sure what they want to do in medicare. Keith hall, the director of the Congressional Budget Office sent a letter talking about a 25 billion cut in medicare. We know what the republican budget looks like on medicaid and medicare. We know that what Martin Feldstein said, the president reagans trickledown economics guru, supply side economics guru said, we know tax cuts dont pay for themselves. Maybe only a quarter for themselves. So lets raise the eligibility age for Social Security so the barber and Garfield Heights and construction worker in warren and the woman that works at the diner in mansfield, they cant work until theyre 70 years old. Maybe we can, because of the jobs we hold. But to ask others to wait until 70 for Social Security, all so we can do a tax cut . So those questions i wanted to ask and understand better from this committee. I guess youre saying we can do that tomorrow. I hope youll live up to that commitment tomorrow so we can ask those questions. Senator wyden. Thank you, mr. Chairman. Colleagues, this major tax bill is now officially a moving target. And it is an enormous departure from the way the finance committee has traditionally worked. This now does not resemble regular order. It sets a precedent, i guess, for letting practically anything fly through the chute at any time. And say its relevant to a tax bill if it amounts to an ideological trophy. And on our side, mr. Chairman, we had it for the day, and expect us to be back tomorrow with a lot of questions. Because there are a lot of unanswered matters that we have not been able to work through today. Well, thats fair. And we will recess until 9 00 a. M. Tomorrow. Well have the modified mark later today. We will then walk through the modifications tomorrow. This is a this is a change, and i apologize to every member of the committee for it, but thats the way it is, and weve all been through this before in some ways. But in any event, well recess until tomorrow morning, and hopefully we can all get together then. [ banging gavel ] the Senate Finance committee wrapping up their review of the republicans tax bill for today. The second day of work. Theyre expected back tomorrow at 9 00 a. M. Eastern, and well have live coverage here on cspan3 when they get under way. A look now at some of the committees deliberations on the bill that took place earlier today. Thank you, mr. Chairman. For any of the panel members, ive got in front of me the current tax code. And this was billed as simplification. Ive tried to the best of my ability in a very short period of time. Im jealous of senator toomey. I think hes much more familiar with this product than i am. I understand why he didnt need to use all of his time. I need lots of time. There is incredible complexities in this proposal, particularly as it relates to the pas passthrough deductions and the change in the passthrough brackets. The international is very complex in terms of all of the different provision that is are there. Would you estimate how many of these books were going to take away with a change in the tax law that is being proposed in front of us . How many books are we going to remove . I think theres one, two, three, four, five, six, seven, eight of them . How many are going away . Any idea, mr. Barthold . Well, i wouldnt hazard a guess. Its in what you have before you, most of the books, are

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