Transcripts For CSPAN2 Blumenthal Van Hollen Et Al. 20170627

Our responsibility as elected representatives is at the very least to listen. And ive been listening over thb last week, but really over the last year, the constituents of mine in the state of connecticut, over the week, to Emergency Fuel tank that i conducted because no hearing were held by United States s senate. And no markups and no votes in committee. What we saw here was complete secrecy, a deal produced behint closed doors, and seeing the light of the day for the first time last thursday. Our republican colleagues have gone from total secrecy that total chaos. The reason for the chaos is the fact, 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 Health Care Coverage. And 49 million americans eventually would be without Health Care Coverage by 2026. Next year alone, 15 million more people will be uninsured under the republican plan, trumpcare two. Low income americans would be able to afford, 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 received less as a result. A 64yearold making almost 57,000 will go from paying x thousand 800 under the Affordable Care act, the 20,500 under the proposal before this p body. This jump in causes absentlyci staggering and it will destroy the Financial Wellbeing of middleclass america. Who also, when they need nursing home care, after they have exhausted their savings, will be thrown to the walls. And i visited one such facility just last friday, where twothirds of its 60 beds will be unaffordable when those middleclass families find their savings no longer covered. 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. And the Administration 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. Pl and the American People get it. None of us can look ourr constituents in the eye, looks ourselves in the mirror, look inside ourselves and our heartsy and justify a vote for this bill. The American People are angry, many of them, because we are even considering it. And its not an anger that is kind of a shrug of the shoulders. Its a deep vocal vehement vitriolic anger, and ive seen it and heard it at those hearings where ive listened to people coming forward and talking about this bill, this recognizing it for what it is. Not a health care bill, a massive tax cut for the wealthy. Just friday afternoon, one of the folks who attended the hearing said dont call it a health care bill. Its a wealth care bill or cant in fact, she is absolutely right. This bill cuts millions, 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 health care bill. It is a wealth care bill. And for most americans, it is ad 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. Colle despite the best efforts of our republican colleagues to keepar americans in the dark about what this proposal would do, i had seen growing awareness. Again, not only at these hearings but as i walked to the airport, as i march in parades twice over this weekend, as i attend public gatherings, whether it is boy state sponsored by the American Legion for 16 and 17yearolds, or nursing facilities for elderly citizens, 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 him lives to live. But they have come to these hearings on very short notice, in hartford and new haven literally filling rooms so that there was standing room only. And i challenge my colleagues to hold the same kind of hearings to delay this vote so they can go home at the end of this week and hold hearings in their t state, listen to their the constituents about what they have to say and what the consequences will be. Nearly one in ten veterans have medicaid coverage, meaning that a staggering 1. 75 million veterans, including 18,000 cuts be impacted by these reckless cuts. Let me repeat that number for all of us who rejoice in the recent accountability and whistleblowers act. And 1 1. 75 million veterans, and 18,000 of them in connecticut, would be harmed by this reckless and needless insult and injury. For simply come this bill would make it harder for veterans with Mental Health disorders, like posttraumatic stress, to get care. Nearly a quarter of all veterans receive care for the Mental Health disorders outside the va system, meaning they rely onua protections that guarantee their access to Affordable Care. Under this proposal those protections would be severelyned 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 medicaid. If my colleagues listen to their constituents, they would hear from many of the people who have come to my town halls, like christine, christina has two beautiful fouryearold twins n named mckenzie and camera. Gene genetic disorder that her mom described as quote, including low muscle tone, seizures, temperature instability, sleep apnea, infertility, ocd, intellectual disability and developmental delay. End quote. In the first few weeks of her life, mckenzie was in the hospital for 57 days, accountinn for 2 billion in costs. The fan was spending 30,000 a year to help their daughter thrive. Hat so when christine learned that her daughter had received a waiver to become a medicaid beneficiary, she was overjoyed. Christine told me quote, when we received her diagnosis, we were told that she wouldnt do a lot of things, and that only four years old she is already defying the odds. M i have no doubt in my mind that if wer were able to continue dn 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 the picture is worth a thousand words, and many more than a thousand statistics. And no one, no one should be confined to be a statistic. This family is one of the many faces and pictures and stories t of medicaid. O they deserve to be heard. 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, medicaidor has been the path for them to success. And that rug will be polled from that family, beneath mckenzie. At the hearing on friday in new haven i heard from ken obrien, who told me about the eight Prescription Medications he takes, four for psychiatricns reasons and four for medical ones. M now, 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 help Patrick Kennedy to help advocate for the bill as a sender. Th i advocated the regulations that were necessary for its enforcement and we finally got it done. I want to quote what he said directly. He told me quote, 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, end quote. He went on, let me quote him, now for the republicans who are seeing in this washington, can you please listen to me carefully . I am speaking to an empty chamber, but nobody making a mistake that republicans are hanging on his 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 e the record, and i will place his testimony in the record, along with all of the testimony that we heard last friday, as i did the testimony from mondays Emergency Health care hearing. If there is no objection. Without objection. Thank you, mr. President. L so please listen to me carefully. The if i lose that medication, i will end up in the hospital and is 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. E if there were ever a message that washington should hear, it is from canada obrien, can obrien, who closed by simply saying quote, dont hurt the American People, end quote. Now, if you met him, you would f wonder how he was capable of that eloquent. Hes an ordinary american, someone who looks like all the rest of us, like he has said to this body what it needs to hear. Dont hurt the American People. And he couldnt be more right. This proposal will cost our nation so much, not just financially, ken had it right, but morally. It will lead to a weakening of what makes our country strong and great in the first place. Ao to care about our neighbor to fight what is right and to listen to the people we represent here in the United States senate. First, do no harm. Thats what the esop of the medical profession is, and it ought to be our mantra as well, and it ought to be what my colleagues, if nothing else, hed come as we reach this decision, to listen to people who sent you here, and hear their stories. Listen to the anxieties and fears and values of america. They will tell you all you need to know about this bill. Ken told me, as he said, the cost will be staggering. Terms not just in financial terms, but human terms. This bill, written behind closed doors, away from the light of day, away from the realities of medical care and the United States, away from the voices and faces that i have brought to the floor today, and i will continue to bring him to the floor, ignore the most important thing we can do this week. As ken said, dont hurt the American People. As the doctors tell us, first do no harm. Thank you, mr. President. I yield the floor. Offic mr. President . The senator from maryland. Thank you, mr. President. I want to start by thanking my colleague from the state of connecticut for bringing those powerful testimonies to the floor of the United States senate, and its really important that all of us, all 100 of us spend time back home in other states listening to people who are telling us those kinds of stories. I have gotten over 2500 phone calls in my office just since thursday. All of them strongly opposed to this health care proposal,he socalled health care proposal. You know, mr. President , some things improve with time. Some things improve with age, like red wine. Some things get stinky here in e smelly air the longer they set out there. Er like rotten things, and that is the case with this series of republican socalled Health Care Bills trumpcare one, trumpcare 2. 0, now trumpcare 3. 0. R they are all rotten to the core, and the more they set out there, the stinky here they get any American People know it. If you had any doubts, take a look at the most recent Congressional Budget Office report that weve got today. And theres a pretty clear pattern between all these Congressional Budget Office reports. On the first to resolve, on the second bill and now on this latest version. And heres the pattern, mr. President , tens of millions of americans will lose access to Affordable Health care in thee United States of america, in order to provide tax breaks for powerful special interests and richer americans. Thats the pattern. In this most recent report, we are told by the nonpartisan professionals of thess Congressional Budget Office that 22 million of our fellow americans are going to lose access to Affordable Health care. And for what . To give powerful special interests a tax break and wealthy americans. You know, Insurance Companies can actually, currently not, are not allowed to deduct the bonuses they pay for their ceos. Now youre going to about Insurance Companies to deduct the bonuses they pay to their ceos. And while tens of millions of americans would lose access to Affordable Care millionaires will get an average annual tax break of 50,000 a year every year. So make no mistake, you can call this a health care bill, but it has nothing to do with health care and everything to do withlt wealth care and transferring wealth for more struggling vulnerable americans to the very wealthy. Tragic if this was about health care, if this was about health care why is it weve all gotten it in our offices long lists from Patient Advocacy organizations that are dead set against this legislation . These are organizations that of a dedicated to try to improve health care 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, national multiple l sclerosis society. And the list goes on and on from organizations that have dedicated themselves to p advancing patient health. And on the other side, i havent seen a single, not one, Patients Advocacy Group thats come out to support this socalled health care 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 that are dedicated to the cause against it and notc one for it . How about Health Care Providers . The folks who will 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, real part of our state, the rural hospital bl associations are opposed to this bill. They know that the people they serve are going to be badly hurt and by the way, its also going to hurt the economys in those parts of our state, especially the real part of the states because those hospitals depend heavily on many other people who expa act, whether through the exchanges or through expanded medicaid. And 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, lay people off, a double whammy. Bad for patients and bad for those who provide the care to our patients. Thats why aarp has been all out against this because they know that for americans between the ages of 5064, before you get a medicare, this is a total disaster as they said there is an age tax. If your older you will pay a whole lot more under this republican bill than you pay today. And 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 i 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 wasnt going to cut medicaid. 0 this catch it by over 750 billion. And make no mistake, on this issue, this senate bill is a lol meaner than the house bill. We all know that President Trump out in the rose garden, december the passage of house bill, and behind closed doors, what did he call it . Mean. This senate bill, as time goes on, will cut medicaid for more deeply than the house bill. As you look at thise Congressional Budget Office report, it talks about how you get to the end of your eight, nine, ten and go beyond that. Youre going to have very deep cuts. Much more painful, much meaner than in the senate bill. Isting and mr. President , weve heard a lot about preexisting conditions. The reality is the senate bill is very devious in this regard. Its a great sleigh sleightof. On one hand it creates the impression that if you have preexisting conditions you will be all right. But what it pretends to give with one hand, it takes away with the other. And makes those americansable cr vulnerable as they were before the passage of the Affordable Care act prick that are not talking about those who are directly benefiting like those on expanded medicaid are those in exchanges. Im talking about those who are benefiting from the patient protections in the Affordable Care act. I just got a note the other day di maryland saying my son was diagnosed with Crohns Disease in 2008 at age 18. He was repeatedly denied t insurance and was only able to cover part of the cost of care through the maryland highrisk pool. It was obamacare that made it possible for him to be insured, and care for his disease. It was obamacare that quote will literally save his life unquote. And we have many stories like that from others who were denied access to care because of preexisting conditions beforeff the Affordable Care act. Mr. President , is another major sleightofhand in the Senate Republican proposal. And that relates to premiums. Ni ive 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. Mr. President , we all know that what Americans Care about is h what theyre having to put out total for their health care premiums. How much is the deductible . Bl great, i got a lower premium that my deductible is now 10,000. Into copays, and heres 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 because this is in the budget chief of the Congressional Budget Office. What they say on page nine is, quote, 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 health care, even though benchmark premiums would decline on average in 2020 and years later. So translation, 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 because nongroup insurance, nor to the individual market would pay fora a smaller aperture of benefits under this legislation, most p people purchasing it would have higher outofpocket spending ow health care than under current law. And 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 Health Care Costs. Fi, and the Congressional Budget Office, the nonpartisan analysts, are telling you they are going up. So mr. President , this brings ma to my final point. I said at the beginning that w some things get better with time and some things get stinky air and smelly or. We know that the more the mor American People get a look at this latest Senate Republican proposal, trumpcare 3. 0, we know the more they get a look at it, 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, it is stinky with time. This will get worse and worse with time. And you know, mr. President , thats what its so important we not try to jam this thing to the United States senator i understand republican leader. He knows of this thing is run to the core and he knows the more it sits out there, the more people are going to see what its all about and the more they will hate it. So lets have a full debate and lets make sure all of us go back to our states over the fourth of july, to the parade and the barbecues and the picnics, and look our constituents in the eye and tell them that were going to take away health care for tens of millions of americans, that were going to open up the discrimination once again to preexisting conditions here we are going to increase the Overall Health care costs, even though we tell them will be reducing it. Al lets look them in the eye and tell them what this bill is all about. Rather than try and push it through in 24 or 48 hours or later this week. Our constituents deserve to know the facts, and we need to make sure we vote to protect the america, not just provide another round of tax breaks to powerful special interest and millionaires. And i thank you, mr. President. Mr. President . The senator from hawaii. Thank you, mr. President. You might think of the last seven years a major complaint t 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 health care plan. The they get a giant tax break. The rest of america on the other hand, is in trouble with trumpcare, health care will cost more, and 22 Million People people are going to lose their health care altogether. Some health care bill. To put this in perspective, imagine if everyone lost their health care in hawaii, maine, nevada, alaska, West Virginia, ohio, idaho, wyoming. Thats what trumpcare does. Thats 22 million americans. It also devastates one of the best Health Care Programs that this country has. Going with this bill medicaid is going to lose nearly 800 billion. So if youre only worry is your Investment Income gets taxed at 3. 8 every year, you can breathe a sigh of relief. And let me drill down on that. Because one of the most egregious tax breaks in this bill, and this is mostly a tax l cut bill and not a health care bill, is of the following. If you are making 200,000 as an individual or 250,000 as a 3. 8 couple, Capital Gains income is currently taxed at 3. 8 . If you are making either 200 as an individual or a quarter of an billion as a couple million as a couple, and jeff Capital Gains, not regular income, in fact, 3. 8 . This bill zeros that tax out. This bill zeros that tax out, and on top of that itsabout retroactive. Think about the absurdity here. Here we are, and look at the senator from pennsylvania and how much hes advocated for children and especially children with disabilities. Im looking at the senator on connecticut and the work that is done with people with chronic diseases and Mental Health n challenges and the resources that we need for that. And in the middle of a supposedly oriented towards health care piece of legislation, we are giving a retroactive Capital Gains tax cut to people who make over a quarter of a Million Dollars a year in combined income. It is just absurd. Its not a health care bill. But if you have a loved one in a nursing home, if youre pregnant or thinking of having a baby, if your kid has a disability that requires costly care company to work two jobs but your employer doesnt provide Health Insurance, and this bill does not take care of you. Instead of less taxes you just get less care. And youre going to pay more for it. This is what happens when legislators dont have Committee Hearings or they refuse to meet with patients, doctors, nurses, advocates, their own constituents. There have been so few town halls about health care. There been so few real Senate Debates about health care. Ive seen every sale democratic member of the senate come downae here and talk about this piece of legislation. Ive seen every singleican mem 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 were not even debating health care policy. Its not a question of whats the best way to get people to sign up for insurance or how can we lower premiums and deductibles, how can we improve the delivery system. M its a question of how many people are going to lose their health care so that Insurance Company ceos can continue to make millions of dollars a year. That is literally within this actually reforming the Health Care System or getting peoplefo more coverage for less more fort all the Nursing Homes dont exist. Because of an 800 billion cuts to medicaid. This is not a theoretical conversation, this isnt even a partisan conversation. Everybodys got nursing home beds in all of your homes and everybody at least ought to know some middleclass people who rely on medicaid for Nursing Homes. And cbo gave us the answer today too many people are going to be locked out of the Health Care System if this bill goes forward and all four giant tax cuts. Our Healthcare System is not perfect, changes need to be made that this bill is just not it. It has no clear guiding principle other than slashing medicaid and to pay for tax cuts so weve got to start over here. Im looking at a presiding officer whos a speaker of the house in North Carolina who understand how to do a bill on a bipartisan basis. Im 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 50 vote threshold and we come up with a bill together, we own the american Healthcare System together. We dont get to play this blame game about whats happening with premiums or whats happening with coverage numbers. We actually on the level collaborate. You think about a bill or an issue that use to be as partisan as public education, and the last congress you had jimmy and half and Barbara Boxer do a bill together. It is possible for us to do a bipartisan piece of legislation but 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 cant defend. So 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 our Healthcare System is not perfect. It is in need of improvement but this bill doesnt get it done. I yield the floor. The senator from connecticuts thank you mister president. I want to pick up where my colleague from hawaii left off. Theres this wonderful analogy that president obama used after the 2016 election, if you can imagine mister president , 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 pennies, republicans and democrats but in the end we all belong to the same team. We are all americans and elections and legislative fights are just temporary skirmishes before we recognize and realize our greater identity which is that we have this commonality. Clearly thats what the American People see. They think that our primary identity is our partisan identity and theres a lot of days in which we give them fodder for that belief. But it really is amazing when it comes down to it that when you think about the Health Care System, we do have the same goals in mind. There are lots of other issues where we dont have the same goals. Republicans want to go left and we want to go right, republicans want to go right, we want to go left. On healthcare, we want to get to the same place which is more people have access to Health Insurance, that the cost of that insurance is less than what it is today and that the quality of the care that people get is better. And its funny because underneath that its really just mechanics. And its not actually ideology, its just the decision as to which u press and which you dont. So i get a lot of my republican colleagues dont 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 its sincere. We dont want to blow up medicaid. We are not with you on that. We dont want to pass along big tax breaks only going to be very wealthy but we get that you want more flexibility. We get that you want maybe an additional plan offered on the exchanges that doesnt 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 forward. I think its a really important conversation to be had here. And our hope is that with this tv owes for, maybe it will be the straw that breaks the camel back that will cause our republican colleagues to give up this nonsensical approach to health carereform and work with us. So im going to repeat some of the ground thats already been covered here in the next minutes but i do want to go over some of the highlights of this cbo report. Senator shots previewed this but its 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 but that held it under their approach, 23 Million People would lose insurance but we now have 22 Million People that lose insurance under the senate approach. Thats the entire combined population of alaska, delaware, maine, montana, nebraska, new hampshire, north dakota, West Virginia and south dakota. All that happened between the house bill and senate bill is the people of rhode island got saved so i asked out rhode island. 1 Million People more will have insurance under the senate bill as a humanitarian catastrophe. Thats a big deal. On that many people losing insurance and i know thats not what you set out to do. I know the republicans didnt set out to do this. In part because i listen to senator cornyn complain on the senate floor relentlessly that the Affordable Care act still left a lot of people without insurance. He sent out to today, highlighting the cbo does confirm that if current law continues there will still be a lot of people without insurance. He left out the fact the cbo says under the republican bill, 22 more Million People lose insurance but thats a whole lot of people and by the way, in the first year cbo says 15 Million People lose insurance. 15 Million People, the entire population of 13 states and that happens next year. The Emergency Rooms in this country cannot in 12 months or 15 Million People losing insurance. And for all the folks that say that the aca is in a death spiral, the cbo says youre wrong. Very flatly. The cbo says if the existing law remains even without any improvement, the number of people without insurance remains static. At the end if you make no improvements you will go from 26 Million People not having insurance to 28 Million People having insurance. But 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 pass the bill that senate is going to consider this week. The death spiral happens if we pass the republican healthcare proposal. Thats not a death spiral, thats stability. Its not an optimal result, 28 Million People having insurance but it is preferable to 49 Million People having insurance and i understand republicans will quibble with cbo saying they are exactly right but even if they were 50 percent wrong, thats still over 10 Million People losing insurance. For good measure, cbo was right in their estimates of the percentage of americans who would have insurance under the Affordable Care act. Inside their estimates, the details worked out differently but they said that by 2016 89 percent of americans would have Health Insurance but from 83 percent prior to the passage of the Affordable Care act, how many people have Health Insurance today . 80 to 90 percent of americans. We agree that premiums should go down, that if were going to pass something the results should be premiums go down and heres what cbo said, premiums go up not by a little bit. They go up by 20 percent in the first year. After that, admittedly cbo, i admit im painting a partial picture here, after that cbo says that for certain populations in this country, premiums will go down. But its largely for the young, the healthy and the wealthy. Cbo says you will have massive premium increases for older americans, or lower income americans that are in that 50 to 64 age bracket. Your premium increases will go up by at least two times. Of four times. And cbo says that if your lower income, youre not going to buy insurance because you cant afford it so it doesnt even matter what your premiums are because its going to be so high you cant afford it. Premiums go up for everybody. Off the bat for lots and lots of Vulnerable People after that. Quicks so who gets hurt, everybody. Except for the folks that are getting tax cuts. If your Insurance Company, a drug company or your superrich, maybe thats an unfair term for people making 200,000 or more a year get tax cuts but most of those tax cuts go to the superrich, people making over 1 million, you do fine. Your Insurance Company, drug company or you are wealthy, you get a great deal out of this piece of legislation but everybody else gets very, very badly hurt. Today, one of our republican colleagues said this, to a reporter and i will give you a name. One of our Republican Senate colleagues said when he was asked about republican healthcare proposal he said quote, im not sure what it does. I just know its better than obamacare. Im not sure what it does, i just know its better than obamacare. Thats about as perfect in cancellation of the republican positioning on this bill is i can imagine. Because if you didnt know what it did, if my republican colleagues did get deep into the cbo report, it doesnt solve a single problem in the american Healthcare System. There are big problems, 26 Million People still dont have insurance. This bill makes it worse. People are paying too muchfor insurance. Especially those folks who are making middle incomes were just outside of qualifying for the aca subsidies. This bill makes it worse. Almost every problem is made worse by this piece of legislation. And i guess thats sort of what a lot of americans wonder. If our republican colleagues do know whats in this bill. Im not sure what it does, i just know that its better than obamacare. This solves one problem for republicans. Its a political problem. Republicans said for the last eight years that you were going to repeal the Affordable Care act. Our republican friends promised it in every corner of this country at every opportunity they had. This does all that political problem, if you pass this bill you can successfully claim that you have revealed the Affordable Care act. Thats the only problem thats all. It takes almost every other problem in this system worse. The number of people with insurance go up, premiums especially for the poor and vulnerable go up, theres nothing in this bill that addresses the cost of healthcare. Of drugs, devices , of procedures. Theres nothing in this bill that talks about the quality of healthcare. Every problem virtually every problem in the Healthcare System gets worse. And so i will just end by reiterating the offer that senator shots made, i think you have a lot of people of very good will that want to work with republicans. Our sincere about it. Ill be part of whatever group gets put together if this bill for falls apart this week because i held an emergency hearing in avon connecticut on monday just to try to explain to people what was in the Republican Senate proposal and to get peoples feedback and it was hard to sit through. It was 2 and a half hours of some really, really scared folks and ill 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 on medicaid and they were 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 their drugs are still too expensive. The fact that many of them still to pay too much for healthcare. They wanted us to work with republicans on it. Senator shot was right, if we get this together we would own it together, it would stop being a political football. And while that would be a secondary benefit to the actual that would come from a bipartisan piece of legislation that addresses the issues in the underlying Health Care System that would be a pretty remarkable good. It is possible. Because we had the same goals in mind. We both want the same things and it is just in the end of putting aside this bill that makes all those problems worse and instead of sitting down together and deciding which letters we want to push to make things better. I yield the floor. Mister president , the senator from pennsylvania. Eye rises well to talk about the addition of healthcare, i want to thank my colleagues from connecticut for maybe down the road when we can Work Together on this issue. We are in conflict this week and thats not place any of us want to be. Mister president i want to ask consent for two things this evening, one is with regard to my staff, i asked unanimous consent at christopher freeze, a congressional fellow on my staff be granted floor privileges for the duration of the debate on the better care reconciliation. Without reconciliation. Ill have one in a few moments, and additional request. But we are in conflict because of the elements of this bill. And ill make two basic points in my remarks. One about medicaid and one point about another provision in the bill which i think is particularly insulting. A lot of our discussions start with policy and data and thats important. Thats obviously part of the debate about the bill and what impact it will have on programs and people over a long period of time but a lot of this debate is about the people it represents. I know the presiding officer understands this and im heartened that hes paying attention to our arguments because sometimes ive done it myself where sometimes youre doing Something Else so were grateful for his attention but i talked on this floor a couple times over the last couple weeks, even months and i wont repeat the stories because theyve been told a number of times but Roland Simpson is a young man that i recently met his mom and he sent me a letter. He is on the autism spectrum and his mom is very worried about his future. Because of the potential impact on medicaid. And the benefits hes getting today from medicaid. Just refer the other day i guess it was thursday on the floor to a letter from a dad about his son anthony who what has a number of challenges, one of them being one of several i guess, maybe one of four that hes on the autism spectrum. Just have to have another letter as well which i will put for tonight but its a name on in northeastern pennsylvania writing to me about two of her children, principally her son who has type i diabetes and a loss of medicaid coverage and what that will mean forthat child. In this case, just four years old. So everyone in this chamber in both parties has stories like this to tell. Stories about people who are totally dependent because of a disability, totally dependent on medicaid. That is not unique to one state and of course is not unique to one party. But one of the more egregious and objectionable parts of this hundred and 40 page bill is the impact it will have on medicaid both Medicaid Expansion which many people know now represents probably on the order of 11 Million People that got healthcare coverage since 2010. Got that coverage because medicaid would ask was expanded but the bill speaks to Medicaid Program itself by the socalled, capping the dollars the federal government with would provide in the future with regard to the federal state partnership on medicaid. So these are big states when it comes to a program that is has been with us for 50 years , as everyone knows medicaid is principally about individuals with disabilities and thats obviously those children i mentioned. Its about folks who need some help getting into a nursing home, Senior Citizens and of course its about kids from low income families who have no other healthcare apps in medicaid, in our state it happens to be 1. 1 million kids on medicaid from low income families and the disability number both children and adults is my one estimate more than 722,000 people so these are big states, even if its just involving one of those individuals or hundreds or thousands. But as i referred 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 not just inform us but inspire us to keep working, keep fighting. And ill be fighting against this bill as long as it takes but its likely we will have about this week. Im assuming we will likely only half hours in 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 weve had people not just writing those stories but telling us their story but also telling us and giving us ideas about how to conduct the debate, how to fight and how to oppose it. I got in my hand and ill describe it first before i offer a consent request but i have in my hand several pages that list almost 600 names from people in pennsylvania that have written to me over the past number of weeks and months, actually and what they are urging me to do is to pursue a legislative strategy to protect their health care. Why are they doing that . Its not because they have nothing else to do. Theyre worried. These people are really worried. Worried about those kids like and anthony and i mentioned. And a fouryearold with type i diabetes or a whole long list of other disabilities that a lot of kids have. Theyre worried about their parents who may not be able to get the longterm care they need if medicaid is and cut and decimated. Theyre worried about their friends and family , they are worried as anyone has ever been about the health care of those they love and healthcare of those that they care about. Thats why they are writing and going to meetings and making phone calls and engaging in such a robust way all these weeks and months. Mister president , with regard to this particular list i would ask consent that this list of almost 600 names from pennsylvanians be made part of the record. Without objection. Thank you mr. President. I will make two final points about medicaid and then suppose medicaid with another part of the bill. If you look at the bill, its about 140, 42 pages. More than 60 pages deal with medicaid. So this is principally a bill about medicaid. Theres some other issues obviously addressed on the exchanges and the fundamentals of healthcare but its mostly about medicaid. And tax cuts, unfortunately and thats particularly objectionable to me that youve got a small group of very wealthy people that are going to make out in ways we cant even imagine, like a big bonanza for the superrich. Let me just talk about the medicaid part of it first and then i will refer to a chart. Im holding in my hand the cbo report from today which came out which of course is a document produced by the Congressional Budget Office as well as the joint committee on taxation. So its a joint effort and on the cbo socalled Congressional Budget Office report from recent recently, a couple weeks ago, 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. That number was 14 million americans would lose medicaid over the decade, up until 2026. Well unfortunately, as of four or something this afternoon, i guess about 4 00 or 430 , weve got the Congressional Budget Office assessment of the senate bill. So the senate bill that was unveiled last week, not on page 17 in this report but on page 16 years what the Congressional Budget Office and the joint committee on taxation says about enrollment in medicaid and im quoting at the bottom of page 16. Enrollment in medicaid would be lower throughout the coming decade with 15 million fewer medicaid enrollees by 2026 then projected under current law in cbos march 2016 baseline. And they refer to a figure in the report. So house bill cbo assessment says 14 million will you lose medicaid coverage, analyzed by cbo which is supposed to be a more moderate bill, a better bill in the eyes of some republican members at the house and senate. That was supposed to be better but heres what we know now. 15 Million People will lose medicaid. That alone, 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. Lets say someone says you know what . I can put that into context and i think actually that wont 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. Lets 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 and when they go home or when they have to talk about this legislation over time. But heres where it gets worse. This is a chart rather simple even though its got a lot of data on it. Rather simple, heres what it says at the top. This is inmy chart, center on budget and policy priorities , you can go to see vpp. Org to see it. This is based on the house bill. But i just told you the Medicaid Enrollment number is 1 million higher or the number of losing medicaid is 1 million higher under the senate bill and the tax cuts that are in the senate bill are almost identical. Just go down and count them to the house and senate bill are virtually identical on tax cuts but heres what the headline is. Tax cuts for top 400 roughly equal the federal spending cuts from ending Medicaid Expansion. Remember, i said before that Medicaid Expansion is one problem that i see. Per capita is another so this chart just deals with one of the medicaid problems. Medicaid expansion. Ending Medicaid Expansion in nevada, West Virginia, arkansas andalaska. Just four states. So alaska, they project it will lose 2 billion worth in medicaid over the decade. Arkansas would lose seven. West virginia would lose 12 and nevada would lose 12. That adds up to 33 billion federal medicaid cuts ending Medicaid Expansion. 33 billion just for states. By the way, not really high population states. Theres no california, new york or texas or big states like that so 3 billion lost in medicaid. 33 billion lost in medicaid in just those four states. What does this orange bar graph show . The same number, 33 billion in tax cuts for the highest income households in the country. The same number. So 400 households get a taxcut 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 taxcut in whats called a health care bill. And at the same time its equivalent to the total medicaid loss 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, its about the same as all the tax cuts together. Here we just talk about four states and 400 families. I hope im not offending anyone if theyre in those top 400 households who are making either billions for my one estimatethe average might be 300 million. I know its been difficult to make ends meet. They been struggling and trying to pay the mortgage and the light bill and youre one of the top 400 richest households in the country. But this chart, when you juxtapose this chart and especially the orange part, the tax cuts for 400 families the giveaway to families that dont need it and frankly they dont even want to taxcut. I havent found one person came up to me in the last couple years and said you know what, i wish my taxes didnt go up. I wish those taxes didnt go up while you were trying to help people in medicaid. Not a Single Person said that. Most people that will get this taxcut would rather that we make sure that we take care of those children i mentioned with the disabilities or those families who need the protections of medicaid. When you put this chart next to the policy and those 50 pages of the decimation of medicaid, there are a lot of rewards we could use that we are not allowed to use on this floor but one of the words we should use is obscene. Thats an obscenity. When you match these cuts for 400 families next to the cuts to medicaid. That is obscene. And obnoxious and bad policy. If there was ever a reason to take this hundred 42 page bill and throw it in the trash, throw it in the garbage pail as fast as we can, it would be discharged. Because thats not what the American People are asking for. They think that some people in the senate are working on a health care bill. Thats what they believe. A lot of people dont know about this yet but theyre going to know. Theyre going to know by the end of the week is not sooner. This is a 400 richest households in the country are getting that money. 1 billion. Maybe the senate bill its only 32 billion or 31 billion. So we will stand corrected if it goes down. But is really an abomination. Thats an insult to the American People. People should be ashamed that this is part of that bill. I get it, we can have a debate about medicaid. I get that. But when youre taking medicaid dollars and transferring to wealthy people, no one should support that kind of policy. But thats what we have. Thats what we are up against area and if there was ever a reason to fight to the end of the earth against a piece of legislation, it is this. Going to continue to fight this, point out this asic in equity, this insult for the rest of this week. We hope that folks on both sides of the aisle will be listening but we hope that our republican senators will take another look at this bill and understand how objectionable this is to so Many American families. All of that worry that i talked about before is made worse, is aggravated by this kind of result when it comes to tax cuts. So we can do all that as a great nation. We can make sure that wealthy folks who need a break once in a while, theyve got a lot of them in line for 25 years, that they can get a fair tax code. You can also make sure that kids with disabilities, seniors and kids in rural areas and big cities and small towns can get the health care they need from medicaid. Were a great country, we can do that. We can have a growing economy and still support an Important Program like medicaid and mister president , with that i would yield the floor mister president s the center from massachusetts thank you mr. President. Mister president , we got the latest numbers on the reckless plan to take away Health Insurance from millions of american families, take away from sick little kids and seniors and Nursing Homes and 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 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 dont have a lot of time left and i know its easy to tune out these debates, to assume this is all a bunch of partisan games. If you dont want to take my word for it, dont and dont take the republicans work either. Take a look at what the experts are saying about the republican bill. Cause sense 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 Childrens Hospital Association Says it is quote, a major step backwards for children and their health. And the National Council for Behavioral Health says instead of repeal and replace, it is rec and wreak havoc. Lynn nicholas, the hand 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 health care in the us better for patients or Healthcare Professionals who care for them. Think about that. She says you have a test, one thing. Thats a low bar. One thing. And yet the republicans cant pass that test. They cant name one thing in this bill that will improve health care in america. Thats because this bill is not supposed to improve health care in america. It is not a health care bill. It is a tax cut for the rich. Paid for by betting health care for millions of working americans. Doctors, patients, parents, families, experts are terrified by this bill. Terrified because they read it and they concluded that nearly every line in this bill would make life works for young people and for old people and for families across this country. So i want to focus on just one major part tonight. The part that rips away the Medicaid Program and lets do some basic medicaid facts. Who uses medicaid . 30 million kids, thats about four out of every 10 kids in this country count on medicaid to help pay the medical bills. About six out of 10 children with complex medical needs, children who need breathing tubes and special therapies and multiple surgeries. Six out of 10 of those children count on medicaid to help pay their medical bills. Nearly 2 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 counseling medicaid to help pay for treatment. Who uses medicaid . America uses medicaid. Children, the elderly, hardworkingfamilies, people with disabilities, 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. So what are these people supposed to do when the Medicaid Expansion goes away . When this bills additional minutes massive medicaid cuts go into effect . What are they supposed to do . What are their families to post to do . It depends on one issue on this, dated on opioid abuse. This is aproblem growing around the country. Last year we lost 2000 people in massachusetts alone. I hear from parents who have lost children, from brothers and sisters who watched a loved one disappear. I hear from people who are desperate because their child or sister or brother cant get into a treatment facility. I hear from dedicated doctors and nurses and counselors who need more resources so they can expand treatment programs. And 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. Quick i do not understand, i cannot understand how the republicans could turn their backs on literally millions of people. Who need help area 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 quote, most people, most people would quote, have higher outofpocket 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 draw expensive benefits that the Companies Just dont want to cover, including, are you ready . Opioid treatment. If this bill passes it will devastate our ability to fight opioid overdoses. This is hypothetical, this isnt speculation, before the Affordable Care act became law, a third of individual Market Health plans didnt cover Substance Use disorder services. About one in five plans didnt cover Mental Health services. The Insurance Companies dont want to cover these services. Mathe aca made coverage mandatory. And that meant that no one in this country had to wonder when they showed up in a clinic whether or not there insurance would help them out. Thats a 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. This is cruel. Our country is already struggling with a treatment gap and far too many patients facing addiction cant get the care they need. The last thing, the last thing we should be doing is picking millions of these patients off the coverage they already have. Now lets face it, the republicans realize they have a plan on this issue. They know that what they are doing is indefensible. So they had 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. Every dollar the republicans propose to put into opioidtreatment , they are taking out more than 100 from medicaid. The rock on which our ability to provide opioid Addiction Treatment built. And why is mark why treat our brothers and sisters, our children, our elderly parents so shamefully . Why is it the republicans can produce a giant tax cut for a handful of millionaires and billionaires . Thats it. Our friends, our families, our kids can struggle on their own, they can die on their own so the 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 jump this bill and start over. And i hope the Senate Republicans have the courage to do exactly that. Mister president , i yield. Senator from colorado. Thanks to my colleague from massachusetts and my colleague from pennsylvania. Before that i noticed my colleagues on the other side of the aisle are here tonight to defend this piece of legislation. It doesnt surprise me given whats in the legislation, given what weve heard over the last week. The senator from massachusetts explaining what it was we were trying to do when we passed the Affordable Care act years ago and part of what we were trying to do is extend coverage to a lot of americans that didnt have in colorado. My state, that meant over 600,000 coloradans who now have Health Insurance that didnt have it before the Affordable Care act is sad. Another thing we were trying to do was say to Insurance Companies that its not okay to have this business practice, chasing months after months of premiums from people and then when they call you on the phone and say my kid was sick, my kid got struck by lightning, my kid had an accident, and then hold them on the phone as long as possible, this is a way of denying their claim. Because most people in america are too busy trying to move theirfamily ahead , trying to get by to stay on the phone all day with an Insurance Company. And while there at that we said its not fair to deny People Insurance in the richest country in the world because they have preexisting conditions. Its not fair that its a Business Plan in america to have lifetime people in the richest country in the world who might get those lifelong caps because they get cancer. Its not fair in america, the richest country in the world that some seniors have to cut their medicines in half every month just to get through the month and to pay their bill. And these are some of the issues that we are trying to address when we passed the Affordable Care act area and mister president , i grew up in the state like you, i was out all thosemonths in colorado , having town hall after townhall, 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 medicinal coverage, less costly coverage but also to try to do something to bring down Health Care Costs in this country. We succeeded at some of those things, we didnt 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 dont 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. Both only in this country the seniors have to make choices about cutting those pills in half. Only in this country if people have to make choices about paying their rent and taking care of their kids, it doesnt happen in the rest of the industrialized world and before i hear it from the other side tonight, let me say our results are getting worse, not better. Populations across this country, longevity is shorter, not longer. This is a difficult complex but urgent question. Country. And thats what we are trying to do with the Affordable Care act. So ill talk more about that in a minute. For years for eight years, republicans ran for election after election after election on obamacare. Obamacare is socialism. Obamacare is a plot to take over the United States. Obamacare is destroying god at a time when we are coming out of the worst recession since the great depression. And an uneven job growth but undeniable job growth over the entire period of time they were saying obamacare was destroying the country. Destroying our economy. The recession was at the end of the last administration, this administration saw the largest Previous Obama Administration saw the largest job increase that weve seen in this country since world war ii, i know its inconvenient to believe that were to say that and i know that in corners of the internet where false news really does dominate, people dont believe it but its true. Im the first to say there are not enough good job and im the first to say there are not enough highpaying jobs but tocompare to the record thatwas inherited , it was a success. All the 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 that didnt have adequate coverage before we passed the Affordable Care. Its been called every name in the book, just like president obama was called every name in the book and they let those two things, healthcare reform the Affordable Care and obamacare, that became its name. And every single attack under the sun was letting on that, why . , because people leave it was destroying the Healthcare System . Maybe some people did. Cause it was destroying american businesses . Maybe some people day. I suspect it was a more simple reason and that was to try to win elections. Either way, while were on the subject, no matter whether you support the Affordable Care act and i support him think about it, there are other parts that have been disappointing to me, whether you support the Affordable Care act or whether you dont, i think its fundamentally important for people to understand that the Affordable Care act is not our care system. Its part of our Healthcare System. The regulations placed on insurance providers so that people with preexisting conditions couldnt 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 is Something Like 18 or 19 percent of ways of billions of dollars in this country area down to two or three percent, thats healthcare. But theres a lot of healthcare that ends up being with obamacare. Or some of you would do it if it wasnt the creation of obamacare. As medicaid, theres medicare. Theres doctors,theres nurses. Theres patients, their strong companies. That our Healthcare System. And our Healthcare System is a mess. It is a mess. And we tried to take some things and improve it when we passed the Affordable Care act. Some of it works, some of it didnt work. Some people would argue we went too far, some people have said we didnt go enough but i can tell you this, ive been doing those town halls in colorado and what i know is that people feel defeated. Not my obamacare but by the american Healthcare System. But by our Healthcare System. Which is less predictable, less affordable than many countries around the world. Now, President Trump new this. Hes a smart politician. I never thought he was going to win, never thought he was going to win. But i on a campaign that on so many dimensions was out of step with conventional american political thought. And i was wrong, he won. I dont think he represents a traditional republican view and that may be one reason you want. In no sense do i think of donald trump as a conservative. In 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 probably good reasons were losing patience with. But you cant deny that the guy somehow in the far reaches of trump tower somehow had his finger on the pulse of what was going on in this country. In some parts of this country. I dont know if its because he was a reality tv star or what was but one of those things was healthcare and he understood the American People dissatisfaction with our Healthcare System just as these seven years and eight years of republican campaigns have understood it and they said majority leader mcconnell made it clear when we were passing the bill, you own it. You own it. A you said in a book later that was very important to him that they were able to demonstrate between the democrats responsibility for the Healthcare System as it was as the republicans willingness to take no responsibility for it. Even though we had hundreds of hours of hearings lasting more than a year and we had, there are not countless but more than 100, well over 100 republican amendments that were made in committee and on the floor and incorporated in the legislation. In the end, not a single republican voted for the bill. And maybe that was a principal reason. Thats not a political reason. Because maybe there are some people who have a few in the Republican Party that the federal government shouldnt have any increase involvement in their Healthcare System, ive heard some people say the federal government should play no role in the Healthcare System. But whatever the reason, not a single republican voted for obama care and then the rest of history writes itself. Itches that every rhenium increase in america whether it was related to obamacare or not becomes part of obamacare, every place against increased in price becomes obamacare. Everybody who loses their insurance, thats obamacare. When whats really happening is something far more complex than that. There are very legitimate critiques of obamacare, but it is not the same thing as our entire Health Care System and i think its important to make that point because whether we are considering the republicans proposed bill tonight for someone elses proposed bill tonight, we have to understand that it wasnt going to fix the whole problem all at once. And people in my state are deeply dissatisfied with our Healthcare System. I say that as somebody who voted for the Affordable Care act. Ive said before, people have tried to make a political issue out of it, they write ads about the Healthcare System is not perfect, ill go farther than that. It is a crying shame that people in this country have to spend their lives wrestling with Insurance Companies. The layout that weight wondering if their kid is 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 that 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 quote, such great healthcare at a tiny fraction of the cost, those knuckleheads in washington dont know what theyre doing. Im going to deliver you such a great healthcare at a tiny fraction of the cost. That was his promise. To the American People. Thats what he said that he was going to deliver. He just lectured himself from other republicans running by saying ill never medicare, i never cut medicaid, those other republicans say they will, im not going to do that. But i am going to supply better healthcare than youre getting now at a tiny fraction of the cost. He said quote, everybody is going to be taken care of better than their taken care of now. Everybody is going to be taken care of much better than they are taken care of now. No cuts to medicare, no cuts to medicaid. And so we had our election. 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 i think on largely a complete fiction about whats actually going on in our country or for that matter in the world with respect to our economy. So he won and he didnt just win, the senate is republican and the house of representatives is republican. And now after running elections for years to get rid of that on america, stain on america, legislation that destroyed our economy and destroyed ourHealthcare System , they wrote a bill. Took them a long time really to get through the house of representatives which was shocking because they had eight years to figure out what was wrong with the Current System and how to address the Current System. And they tried it once and they couldnt even bring it to a vote in the house. Could not even bring it to a vote. And then, understandably, the people that said those republicans in the house said what are you talking about . You said you were going to repeal obamacare. You told us all these terrible things obamacare had done. Your first order of business was to repeal obamacare. How dare you not have a vote . Im glad they said that because people should keep their promises. I believe for a long time that people want consistency out of their politicians. That dont put up with inconsistency if you say the facts are different than i thought they were. And thats why i changed my view. But in these times of fake news, of the media having to challenge the challenge that there are and the rest of the things that they are either our system, consistency is not something that a lot of politicians Pay Attention to and i think thats because voters dont Pay Attention. But in this case, they did. They said you said you would repeal obamacare, you didnt say once, you said it year after year after year. And then finally, they passed the bill in the house. Not a single democrat voted for it. And we learned from that process which took place before the Congressional Budget Office had even scored the bill. Imagine that. All these people that criticize the Affordable Care act, proponents for rushing the bill through, the bill that had as i said between one and i think it was closer to 200 on the propaganda and minutes adopted, a bill that had almost countless Committee Hearings in the Senate Finance committee and the Senate Health committee. A bill that consumed mister president 25 days of the legislative process on this floor , of modern record in terms of time. In fact, we had all that process and heres what senator mcconnell, what senatormcconnell said about that after all that process. He said on this floor i think that americans were quote, tired of giant bills negotiated in secret. That bill was negotiated completely in public, painfully in public. I used to come home and people in my town halls literally had copies of the bill. You remember the chance, read the bill . Thats because everybody had the bill. Negotiated insecret , then jammed through on a partyline vote in the middle of the night. On the house side, its important for people to understand they pass the bill without even getting a score from whats called the Congressional Budget Office. Congressional budget office, the head of that is appointed by republicans when the republicans are in the majority, not the democrats. Didnt even get a score. We had a score on the Affordable Care act before we passed thebill. 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 roles. They didnt even have the decency to do that in the house and they should have because guess what happened . When the score came out said 24 Million People would lose their Health Insurance. 24 Million People would lose their Health Insurance after a candidate for president said youre going to have such great healthcare and a tiny fraction of the price everybody is going to be taken care of , thats better than their taken care of now. Unless youre one of the 24 million. And i would argue that many of the rest as well have come to that. So mister president , 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 ive been in the senate. Its still not as low as the Approval Rating of this place which used to be nine percent. The president found out what was in the Congressional Budget Office score and he had some republican senators over in the white house and he said i hope you will pass a bill like that. Thats a mean bill. Thats not my description. Thats President Trumps description of the house bill. That is a mean bill. A mean bill. Say i want a bill with a little more love in it than that bill which is what he said, out of the senate. Well, he ought to be disappointed tonight because the Congressional Budget Office floor came back and said that under the Senate Version ofthe 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 that literally half the country is going to pay thousands more in outofpocket expenses because of what has been known as trump care. There are three principal parts to the bill that has passed the senate and house. There are differences but i would say they are differences without distinction, they are immaterial differences. There are three major components to the socalled healthcare bills. The first is a massive tax cut for the wealthiest people in america. If you are making 200,000 or less in colorado or any state in thecountry , you will get a penny from this tax cut. Not a penny. But as my colleague from pennsylvania said, if you are one of the top 400 taxpayers in america, 400 taxpayers in america, together youre going to get 33 billion in tax cuts that an average tax cut for each of those 400 million americans of 82 . 5 million. , 82. 5 million. There is not a person in colorado at any one of my town hall who is said to me michael, the key to doing a better job with our healthcare, the key to fixing obamacare, im talking about the credits of obamacare, theres not one who has said repeal those taxes. On the top one percent of taxpayers in america. At a time when our income inequality hasnt been greater in 1928. At times when we are collecting in revenue only 18 percent of our Gross Domestic Product and we are spending 21 percent, not a Single Person is still up in the town hall meeting and said the key to success here is putting those taxes. I should mention that 82. 5 million is over a 10 year period, just to be clear. Theres 8. 25 million a year. And as senator casey from pennsylvania noticed, that 33 billion adds up to be the equivalent of what it would cost to pay for the medicaid of 772,000 people that live in just four states. The entire medicaid population of four states. But what they would presume his healthcare, to try to support themselves and their family is not and a half Million Dollars year, its not 85 million over 10 years, on average 4500 a year. On healthcare. Thats the first part of this bill. A massive tax cut thats 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 cant is massive. Its about a quarter of the program. Its 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. That house bill was mean. Ill get you that he would say the senate bill is cruel because it perpetuates those cuts and i have heard the rhetoric from politicians in washington about why its so important to cut that medicare. They need to cut back medicaid so they can pay for the tax cuts for people that are so wealthy, most of them probably dont even need to mess around with insurance. To pay for their healthcare or their doctors. Now theyre going to have another 8 and a half billion dollars a year, now another 85 million over 10 years if they want to spend it, not on insurance but what ever else they want to spend. And 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 thereare. And how did they justify that . They justified by taking a picture that says that there 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 all know they have to get a job in order to buy Health Insurance. And they wont be on the federal Medicaid Program. So they say go to work. And thats why we can cut this program. Keep people out of that hammock that 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. Mister president , are they supposed to go to work or should they go to school. And while were at it, maybe we should think about giving them better schools so they could compete in this economy. But are we really going to take away their healthcare. Then there are a whole bunch of people who had set down their life savings for the privilege of being in a nursing home pay for by medicaid. , theres not, all that i had where there are tons of sons and daughters and grandsons and daughters 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. But the family has to come near bankruptcy before we say we will give you a helping hand, but its what they have. And they cant work, theyre in a nursing home. s there in longterm care. Then there are a whole bunch of people who might say that other states, 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, are working and theyre getting paid and are not getting paid enough to be off the medicaid rolls. They are working and they still are on public assistance. And were coming a quarter of the Medicaid Program because people need to go to work . Im not making this stuff up. I asked secretary price, hes the secretary of hhs, thats health and human services. Hes in charge of the healthcare administration, i said mister secretary, let me take you through the faces of the people in my state that are on medicaid and not only did he confirm that is on medicaid in my state, he said thats the way it looks all over the country. What an insult to justify a massive tax cut for the richest americans by taking away for peoples healthcare by saying they are not working for it. When they are children, when they are in Nursing Homes, when theyre working. One and sometimes two jobs. In the richest country in the world. So thats the second part, mister president of this health care plan. Tax cuts for wealthy people, cutting medicaid for poor people and in the middle of that, is the only thing that could barely be described as a healthcare plan, its just a terrible plan. Senator paul from kentucky, one of the more principled people in this chamber has said it very well and he called it not politely, obamacare light. Hes absolutely right. , if you hate obamacare, youre really going to hate obamacare light. Its the same structure which amazes me because all the people who said we should repeal obamacare now are preserving the very structure of how the program works, thats the problem with it is they cut the subsidies. They turn them into tax credits and cut the value of the subsidies, you think insurance is expensive now, in the individual market, wait till you meet obamacare light area in the words of rand paul. So those are the three components of the bill and its not surprising to me that for those reasons, senator mcconnell has written is still in secret. Its not surprising to me that he hasnt wanted to have a committee here. Its not surprising to me that he wants a hearing on the floor last thursday, then accuse 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 4 and say to the American People, we did it. 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 hes hoping the American People wont notice, let me tell you something. The American People are noticing. Theres a reason why the house bill as the worst Approval Rating of any piece of legislation in modern american history. The American People are not stupid. I was in frisco colorado mister president. Not that long ago. This is a place that everybody should visit. From all over the country, its a tremendous skiing and hiking, wonderful people. And before i have a town hall meeting, i went and visited a Healthcare Center there, 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 the people in frisco and the surrounding areas healthcare. This is not a Poor Community by american standards. And i asked if they resort community but there are people who lived there all year round, mister president , i asked the people at london clinic, who are the payers for healthcare in your country. Who are they, whats the pay for healthcare here . And she said well, michael, medicaid is 33 percent which shocked me because if you are in rural colorado, the medicaid number is a lot higher than that because people dont have access to a lot of resources and we all know they dont have access to a robust insurance market. 33 percent medicaid. 53 percent with uncompensated care and the rest with private Insurance Companies. To pay for the insurance. And that shocked me and i said 53 percent is on care, people with no insurance, how can that be . And she said these are people in our community who make too much money to be eligible for medicaid. But they cant afford private insurance. , there are working people, thats not the problem. , theyre not even as i described before in a place where somebody is paying them too little so there eligible for medicaid. Their problem is theyre being paid too much and are not eligible for medicaid as a result but they cant afford private insurance. I think mister president is an indictment of the Affordable Care act. And i accept this 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. And i had people in rural colorado say to me mike, look. Why would require me to buy something where theres not enough competition so the premium is high , then the deductible is ridiculous so its of no use to my family and youre requiring me to buy something that useless to me. And we should havemore competition and drive down the price and i say no what . You are 100 percent correct. And if we had a person in 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, socalled health care bill, theres none of that. Theres none of that. To the extent that you dont like obamacare because if you dont like your premiums to go up, youre not getting enough for it as opposed to the millions of people that have gotten insurance as a result of it, some of whom for the first time. To the extent youre worried about that, this house bill makes it worse. The senate bill makes it worse. 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. Its not because donald trump as he said to the country has provided such great healthcare and a tiny fraction of the cost. Thats not the reason. Its because they provided terrible healthcare at a fraction of the cost thats not a benefit to anybody. The Insurance Company can put you on lifetime caps. Of course theyre going to charge you less. 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. To make sure that people in america will have to continue to make the choices that people all over the world dont have to make. About having to stay in the job you hate because you have to keep the insurance or being able to quit a job and do Something Else because you 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 thats still a problem in america. I think fundamentally the problem we have here tonight is that the proponents of this legislation didnt set out to fix our Healthcare System, they set out to repeal obama care. Or the cartoon of obamacare they been running on for the last eight years, thats what they set out to do. And 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 taxes access to healthcare by poor children. I know there are people who are hearing this wont believe it, that what im saying is true. It is true. But i hope you will familiarize yourself with the tax. I hope in particular people that feel that the last bill that we considered on this floor didnt get the process that it was deserved. People who quite rightly wanted to make sure that members of the senate and 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 for months and months, 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 effect of the terrible Opioid Crisis words really even a gleam in our eye when we passed the Affordable Care act. And i especially say to People Living in rural america, how sorry i am. That people arent paying attention to your needs. That your hospitals may be cut because of an ill considered piece of legislation that has nothing to do with delivering healthcare in rural colorado were rural america. We can do so much better than this but to get to a place unfortunately where democrats or republicans have the opportunity to Work Together, the first order of business has to be to defeat the bill thats on the floor and i hope people know this is the week when its critical to call and let your voices be heard, let people know you expect Something Better than what we are getting. An american, i dont have a Healthcare System that affordable , thats predictable and that actually creates stability instead of instability for their families. Mister president , i yield the floor. The senate takes up the healthcare law replacement bill this week, the Congressional Budget Office scored the bill an estimate that an additional 22 million americans will be uninsured while the federal deficit will be reduced by about 321 billion over the next decade. We posted the bill at cspan. Org and you can follow such coverage when members return at 2 pm eastern on cspan2, online at cspan. Org and on the free cspan radio. Later today are hearing on terrorist threats to europe. House floor subcommittee holds a hearing on the subject and you can watch live coverage starting at 2 pm eastern on cspan3. Also follow live at cspan. Org or stream using our free cspan radio. Recently on cspan, College Student zachary wood had a judiciary midi hearing on free speech on college campuses. The president of Williams College universally canceled a speaker. Days later the president enacted a new speaker policy that made bringing speakers campuses and especially arduous process. In my student group. What i find impermissible, undemocratic and antithetical to the intellectual carrier of the college i attend is the president s decision to disembark the speaker solely on the basis of his inflammatory remarks about race. Fibrous woman dyad on the Opioid Crisis in the us. I was sitting next to the Denver Public library and and i said, what are the issues you are facing here at the Denver Public library and i thought she would say Something Like Cyber Security or access to books. She said you know, weve had people overdosing in the Library Every day. We need to get our librarians so they can get people who have over. At the Denver Public library. Do not do that again, mr. Shanahan. Holding a press conference this morning to talk about the Senate Health care lock replacement bill and its effects on people in their state. Its expected to start from the National Press club here on cspan2. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] good morning. This is in the white house press. Come on, you can smile. Come on, john. I want to tell you i met john