Thank you, mr. President. I yield the floor. Mr. Prince president , the majority leader says he will move forward this week with about on a straight repeal of the Affordable Care act in its entirety. I dont believe that a majority of senators are willing to support a reckless leap in the dark but that both would mean. Its a vote that would end protections for people with preexisting conditions and would take Health Coverage away from tens of millions of americans, tens of thousands in New Hampshire. It would terminate the Medicaid Expansion that has been critical to siding the Opioid Epidemic in my state in so many states across the country. According to the nonpartisan Congressional Budget Office, a straight repeal of the Affordable Care act would result in more than 32 Million People losing their Insurance Coverage by 2026. Premiums would roughly double in the individual marketplaces. I urge my republican friends not to go forward with this misguided approach. The idea that they can repeall the healthcare bill now and give us a new bill in two years or whatever period of time is in the bill just doesnt pass the smell test. If we have to havent seen an attorney to the Affordable Care act in the last seven years there is no reason to believe that our republican colleagues will be able to produce a bill in two years when there is chaos in the marketplaces. There is a better way forward for the senate in our country. During the fourth of july recess, majority leader mcconnell said that if he cant secure the vote to repeal the Affordable Care act, hes prepared to work in a bipartisan way with democrats on legislation to repair and strengthen the law. I believe that bipartisanship is the best way to get somethingnd done. Thats what i try to do when i was governor of New Hampshire and i worked closely with our republican legislator and we got things done. W it should not be a last resort for what we are doing. It should be the first resort. It should be what we do to build the foundation for policy in this country. I am hopeful that following the Floor Consideration of whatever the majority leader decides to do on healthcare and hopefully it will get defeated that we will move forward with the majority leaders fallback plan which i believe should be the starting position. We need to start fresh with regular order to craft Bipartisan Legislation that builds on the strength of the Affordable Care act, that builds on what is working and fixes what is not working. We have been hearing at town halls and countless messages from our constituents this isep exactly what the American People want us to do. There is remarkable consensus in this country that the Republican Leaders bill is the wrong approach and abc Washington Post poll on sunday found that moreic than twoone margins american for the Affordable Care act to the Republican Leaders bill. Their bill is strongly opposed by hospital associations, by Healthcare Providers and by thei nearly every page and Advocacy Group and there is no reason to think that just repealing the Affordable Care act will make it any better. On saturday the New Hampshire hospital association, to New Hampshire medical society, our physicians and the New Hampshire aarp joined together in opposition to the bill. They noted that more than 118,000 nearly one in ten people in New Hampshire would lose nume Health Coverage under the republican bill and that number is greater if we just repeal the Affordable Care act. Their joint statement urging summers to start over, to create a new version of legislation that protects coverage for those who have it and provide coverage who need it. We ask unanimous consent for a joint statement by these groups included in the record. Without objection protecting you. I strongly agree with these New Hampshire groups. After spending six months trying to pass a deeply unpopular deeply flawed bill, shouldnt we welcome a bipartisan effort to improve the lot. I believe the answer is yes and that the place to begin is by taking urgent action on a matter where most of us agree and that is providing the certainty to Health Insurance markets in order to hold down premium increases. In their 2018 filings, insurers the say that large increases are necessary because of the uncertainties surrounding the repeal of the Affordable Care act. Because the Trump Administration refuses to commit to making costsharing reduction payments. Those payments say no to Insurance Company so they can help their consumers with the cost of Health Insurance and make sure that more people can get Health Insurance. We now have the opportunity to end the certainty by putting a repeal effort behind us and passing a simple bill to authorize regular appropriations for the costsharing reduction payments. The current instability in the ach marketplace is a manufactured crisis and congress can to stop to it very quickly. Thats why ive introduce the marketplace certainty act which is a bill to permanently appropriate funds to expand the costsharing reduction payments so it does two things, guarantees that these payments are coming and it will cover more people to get help. Im pleased to be joined by 26 senators already cosponsoredte this bill. We can end this artificial crisis and we can immediately restore certainty and stability to the Health Insurance market. In turn, we can get the time we need in order to come together in a bipartisan way to improve this law, to build on what is working, to fix what is not. We have a number of these commonsense measures and this is one that has been embraced not just by democrats but by key Republican Leaders. Chairman lamar alexander, kevin brady, they have urged that these payments be continued. As chairman brady put it, the payments are needed quote unquote quote to stabilize the m Health Insurance markets and help lower premiums for americans. He added and i quote insurers have made clear the lack of certainty is causing 2018 proposed premiums to rise weve significantly. Now, we heard from our constituents at home we heard from factors, nurses, hospitals, particularly rural hospitals and Nursing Homes, patient advocates, insurers and those constituents who are in the letter that i asked just like the statement i asked to be included in the record. They are pleading with us to set aside our partisan differences and Work Together to prepare these Affordable Care act. Ot again, we know what we can do. It is not just the market place bills that have been introduced that can fix the uncertainty in the market and allow us to address other issues with the la law. Bipartisanship should be the senates first resort, not the last resort, an excellent place to start is by coming together right now to permanently appropriate funds for the costsharing reduction payments that keep Health Coverage be affordable and to look at some of the other measures that willl be talked about by my colleagues, like senator who will be coming to the floor. She has legislation that helps us deal with the high cost of Prescription Drugs which is one of the things that is driving the increase of healthcare. M we need to pass these commonsense measures and we need to do it now. Thank you, mr. President. I yielded four. Mr. President , i want to thank senator shaheen for her leadership and im proud to be one of the cosponsors of her bill and her commonsense approach which i believe is the one that will Work Together to change for the Affordable Care act for the American People. I joined my colleagues on the floor in sharing the concerns that ive heard from so many people in my state and acrosst the country about the bill that is been introduced by her colleagues and the other issue that ive heard from them is their desire to Work Together to bring down the cost of healthcare and to make fixes to the board is correct. Healthcare leaders in my state has come out strongly released last week and it would be devastating to those in our rural areas especially for people and so many of our seniors who arrive on medicaid funding for Nursing Homes and assisted living. Last night we heard that we will not be proceeding to that bill and the majority leader will bring up a repeal parts of theus Affordable Care act without a replacement. I want to remind my colleagues that the Congressional Budget Office has looked at that it is just as bad. Instead of 22 Million People losing interest by 26, the cbo estimated that 32 million would lose under the repeal approach and premiums for double. Di this repeal effort doesnt help the minnesotans who according to the association would be harmed by what they call it draconian medicaid cuts. It doesnt help our childrens hospitals. I met with several last week and they were very concerned that medicaid cuts would hurt their ability to provide healthcare to our kids, something that i heard repeatedly on the fourth of july in the praise when people would come up, out of the blue, out of the sides of the streets mixed in with the hot dog and american flags, you would see families predominately kids with disabilities and they would bring children over to me to meet and would say how important this medicaid funding is for their entire family. The i remember once when he mom brought over a child with down syndrome, all the people on the parade route in that block cheered for that family and thats because we know we are all in this together and we know that what happens to one family could next year happen to another family. You can have a child with disabilities and you can suddenly have a disease that could be debilitating to your familys finances and that basically we never know what will happen to the health of ourselves and thats why we have Health Insurance and we have Health Insurance that is affordable. In addition to that, our Health Care System has stood up and said that these approaches would lead to major job losses in our state and as i said for seniors aarp it is said that nearly half of all adults in my state receive tax credits under the Affordable Care act of 5060 yearolds and the subsidies would be eliminated under the repeal bill. This could make health care unaffordable especially for the more 350,000 in my state aged 50 to 64 have a preexisting condition. It doesnt have to be this way, as senator shaheen has so le articulately pointed out. I know several of my republican colleagues said they cant support legislation that would take away insurance for tens ofi millions of americans and i agree. Instead of making these kinds of recording cuts and moving backwards, i think we have to move forwards to actually help make health care in america better and more affordable. We can and we should make changes to the Affordable Careeg act. Inning year is not an end but the beginning. You can have legislation like that and go for years without any significant changes. Thats not how it works with major legislation in the past. Every time we have tried to make changes we have heard back that we have to repeal it. Maybe the result of all of this chaos in the last month has been the people have finally come together to realize what the American People want as senator shaheen is pointed out as well as what is the best policy and that is to make changes. I support the marketplace certainty act because it would stabilize the individual markets in contact and expand out of Health Care Costs for consumers. I also support senator mccain with your with us today, senato kane in virginia and the individual Health Insurance bill improvement act to reestablishns federal insurance program. By the way, this idea is something the republican legislator in minnesota just passed on a state basis and are supportive of. I see this as not just a pie in the sky idea but i see these ideas of things we can work ony across the aisle. I want to end by talking about some of my ideas, many of which have bipartisan support, again, i throw them in a package ofne things we could be working on, a bill that would harness and negotiating power of 41 million seniors on medicare to bring drug prices down. Right now, by law, medicare is advanced from negotiating prices with all of the seniors. Think of the Better Bargain that the seniors could get if their a Marketing Power was unleashed. Senator mccain, the colleague of the presiding officer and i have a bill to allow americans to bring in less expensive drugs from canada which is, by the way, similar to the American Market as i have often noted we can see canada from our porch in minnesota so we would be right across the border and that kind of prices that they are able to get and we think we should, senator mccain and i and several republican voted, for similar measures should be allowed to bring in kind of less expensive drugs in other countries too. If there is no competition, prices have ballooned for these top ten drugs in this country. Senator lee and i have a bill that would allow importation of safe drugs from other countries when there is an healthy competition. Senator grassley and i have a bill to stop something called pay for delay where Big Pharmaceutical Companies are paying generics to keep the products off the mark to market. 3000 in savings for the Us Government by passing that. I would challenge my colleagues to vote against something asio simple as that. Last, senator grassley, feinstein, lee and i have this back we make sure that we get the samples of generics on the market and create more competition and bring prices down. I will end with this. This debate is about the patience of a Nurse Practitioner who provides Psychiatric Care in my state. She wrote to me to say please, please, do all you can to prevent these people from losing the health Insurance Coverage for medical and Mental Health care that is so vital to their lives. In minnesota, 32 of the funding for our Mental Health comes from medicaid and across the country Medicaid Expansion has helped 1. 3 Million People receive treatment for Mental Health and Substance Abuse issues. This debate is about the mom and minnesota private insurance has colon cancer. She is working fulltime, raising two schoolaged boys and going through chemo every single week. She said she fears she will be able to afford the care she needs to stay alive. This debate is about the world i constituentworld constituents wp to me during the fourth of july nearly every other block telling me their stories and how they are concerned about their house with disabilities in the rural hospitals. We have things we can do to make this better and now is the time where we must get them done. Lets come up and we have bipartisan support for the Affordable Care act just like lets Work Together on them across the aisle and lets remember that this is about one team, one country and we can get this done. Thank you, mr. President. I you before. Mr. President , thank you. I also take the floor to talk about healthcare and i see my colleagues were here to earnestly plead with all of our colleagues to be about a procesr where democrats and begins and the Committee Process that we have in the senate does the work we are supposed to by listening to the american public. Let me tell you about my first meeting of the day. It was an amazing one. I had a mom and a five yearold daughter, charlie, in my office and they had asked for the opportunity to meet with you and talk about healthcare. Bout charlie is just about five and she starts kindergarten in september and she was born at 26 weeks. About 14 weeks early. She was 1 pound 11 ounces at birth. She went to the nicu and the great care. Le when she was released to go home the doctors thought she would be fine but within a couple of months it was pre clear that she had significant challenges. She had cerebral palsy, 80 of her food through a feeding to and his family has many unique needs. From a cognitive standpoint she is very sharp, excited about starting school but she has significant needs. The mother, rebecca, said she is the case study for why a repeal of the aca would be a disaster. Charlie has a preexisting condition because of the cp and her challenges. She has already had all of the lifetime caps that wouldve rendered her unable to get insurance pre aca. Charlie, in the hospital, because of her dramatic birth weight was the recipient of medicaid funds that would be cua under the current bill. Charlie is currently the recipient of a medicaid waiver to help her afford supplies for her feeding tube and if she starts kindergarten in the charlottesville Public Schools would be given an individualized Education Plan under the individuals with disability education act of some of those expenses are being compensated by medicaid. Caps, medicaid cuts, they all affect this dynamic young five yearold who is entitled as any of us to try to be all she can be. E. If we persist on the path we are on now, the bill that is being proposed, we would hurt families like these and we dont need to do that. Instead, we can help them. U before the passage of the Affordable Care act, we knew preexisting conditions like charlie based on their barriers to Health Care Coverage since 2010 and there are challenges we need to fix the lets celebrate a few things. The rate of uninsured americans had declined to historic low in more than 20 Million People with access and have Health Care Coverage, many for the first time in their lives. Another statistic that is interesting, the number of bankruptcies in our nation has been cut in half because medical costs drove bankruptcies pre aca and it has brought the bankruptcy rate down. We have to move forward to makef healthcare stronger, not destroyed. The republican bill that is being discussed right now because of its reductions of coverage, slashing medicaid, increases two premiums for seniors would make the weather worse. The approach amendment by the senator from texas and utah has led Insurance Companies to come out and say this will create a twotier system that will punish those with preexisting conditions and the latest plan discussed this morning by the majority leader would be a straight repeal of the Affordable Care act with the promise that we would fix it in a couple years, thats been scored by the cbo and the cbo said that would cost a 32 million americans to lose their coverage dramatically increased premiums. N we do need to find improvements. We should be working on it together. There have been actions taken by the demonstration that compounded challenges. In general, the president signed attractive order not to enforce the elements of the Affordable Care act and they terminated components of outreach and spending and the administration has offended and threatened in these actions and additional interactions have created such uncertainty in the individual market place that rates have been unstable and in some areas companies are not writing individual policies. The amendment that i discussed earlier in the senators from texas and utah would make these problems even worse. There is a better way. There is a better way forward and im here to brieflyrt, reference a bill that senator carper and i have put on the table. We think it will do a good job and have strong bipartisan support. The individual Health Marketplace women act. One of the ways to address uncertainty in the individual market is to establish a Permanent Program that will stabilize premiums that will get Insurance Companies some stability so they can stay in markets will also enable those companies to write premiums atat an average level of not having to take in account the high cost. We think it would decrease premiums dramatically. Ro this should be controversial. We use it in other programs, crop insurance, medicaid part b, a key part of medicare that was achieved under the bush three administration, the affordableei care act had a reinsurance in its first three years of expired that reinsurance helps maintain stable premiums. This is not a duck the senators on the finance committee and im on the Health Committee and we are just waiting for the opportunity to present it and get a hearing for it. N we ought to be able to Work Together on reinsurance, on cautionary guarantees that present untrained senator shaheen is proposed. Senator cassidy and collins have a bill that uses auto enrollment which is an interesting concept we should be looking at. As i conclude, mr. President , let me tell you how naive i am. Im just going to conclude and tell you how naive i am. S i was the mayor and governor before i got to the senate and when you are a mayor and governor what you know is education and healthcare. You know education and weve got four governors, four governors sitting on the floor. What you know is education which is her biggest line item in your secondbiggest line item is medicare and healthcare. I tried to get on the committee when i got to the senate and i was not put on the committee am very disappointed but for four years and try to get on the health care committee. I got on january 3rd and i was so excited, finally, working on something i know about. I got a group of 13 democrats and within on genera that i wrote a letter to my Committee Chair senator alexander and the majority leader and said if you want to fix healthcare we are here to sit down with you right now and fix it. I was naive enough to think that because i was on the Health Committee i might be included in a discussion about healthcare. Weve had hearings in our committee, many hearings, anemones on pensions and higher ed and the fca but theres been one taboo topic topic on the health since i got on it on january were not allowed to have a hearing about healthcare. S we havent had a hearing about do t we havent had a hearing about Senate Proposals. We are being told that we wont have a hearing and were just going to rush whatever we do to the floor either on a house t proposal or Senate Proposal or senate repeal. It will completely skip the committee. R mr. President , you know about this community and we have a doctor on the committee. Senator cassidy from louisiana. Our chair of the committee is senator alexander who was a governor. He had a medicaid program. Was president of the university of tennessee and the hospital, medical school, physician practice groups and there are people on the Health Committee who know something about healthcare. There are people on the finance committee that covers medicare and medicaid to know something about healthcare that we have not been allowed to have a hearing about this. When you have a hearing you bring people up to the witness table, patients like charlie who was in my office this morning, doctors, hospitals, who asked him what works and what doesnt and what can be fixed. To hear from folks. Why wouldnt we do exactly what senator mccain said yesterday. Senator mccain said weve gone about this the wrong way. We should be the United States senate. We should take advantage of the Senate Procedures and the expertise on the senate committee. T if we let the committees do the work that they are supposed to do, we will find improvements that can get bipartisan support and will help virginians and help americans. That doesnt seem too much to sc. I hope my colleagues will consider that and i hope we will be engaged in those discussions soon. With that, mr. President , i with that, mr. President , i i hope my colleagues will consider that i hope will being engaged in those discussions in. I yield the floor. Mr. President. Senator from delaware. I like to preface my remarks test that you can been to your wingman, senator john mccain, our best wishes and i hope he is on the way to a speedy recovery and will be back here, because we need him and we need his leadership. I want to thank the leadership that he and senator shaheen have shown and to help us stabilize the marketplaces. A i believe with senator hatch of the week weve talked about what we do now, i think this is an opportunity. Ea this is an opportunity and i realize there is a fair amount of confusion as to which path to take them which way to go. And i just hope we would do not waste this opportunity. I sent a message to the chairman of the National Governors association and the vice chairman from nevada new chair, the senator from nevada, previously the vice chair and from montana was republican the other a democrat. I sent a message is morning say it would be good to hear from the governors. There been working on a bipartisan plan for a while. This is really the time that might make a positive impact. We have three people, four of ul lined up that are part of the governors association. Vernors ma here i suggested that the governors they want to consider their message. Number one, his hit the pause button. Lets just stop in place for a moment. Ike pivot soon, like not in september, not in august, but now. Like this week. Se number three, we turn to regular orders. Senator mccain has already mentioned this when i talked with senator mccain last week a couple briefly. You have good ideas lets introduce them. Witnesses including governors come before the jurisdiction couple committees in the housend and senate lets hear from the experts in the governors whoo have to run these medicare programs have a lot of expertise in this program to offer us. Then, after the august recess, if we can actually do something real, and stabilizing the exchanges, what a confidence builder that would be among us. And i think among the country. It would be a great confidence builder. The other thing i will mention is will come back after the august recess, dont just look around and wonder what were going to do. We should pull together in a bipartisan way, something that things often do to really do a couple of things. Lets figure out what we need to fix in the Affordable Care act, republicans believe in democrats feel is perfect, and nothing should be changed, i dont feel it my guess is most of the democrats dont. Every bill ive ever worked to was not perfect. S. They can always get better, the same is true with big programs like medicare and social security, budget programs, they call be done better in this is the case is well. Lets fix the parts of the aca that need to be fixed, lets preserve the parts that are to be preserved. Ing against reiterate, speaking on behalf of recovering governors they need to be heavily involved in this. I suspect each of the former governors were part of the nga, we were not here actually, i was on this floor because governors had access to the floor, we had many opportunities to testify before senate committees, house committees, on a wide range of issues. I think we brought value and we need to hear from them today. I want to talk about how we go about stabilizing exchanges. The first thing that would help is for the administration to stop destabilizing them. Senator kane is right on little legislation i want to drill down just a little bit that provide the insurance, in much that we do in the metacarpal Medicare Part d program. O use of insurance is a common tool. Say youre standing before meme with healthcare and it was expensive and her healthcare needs, the Insurance Plan regarding 2018, 2019, first 50000 that she used in year one, 2018, the federal government and the Insurance Companies would be on the hook for the first 50000 of care that she would get. Eral between 50,500,000, under our proposal the federal government would pay for 80 of the cost. Between 50 and 500,000 would be on the federal government. Anything above 500,000 would be on the Insurance Company. Thats all do for three years starting 2021 Going Forward will be first 100,000 on the Insurance Company, of the cost of an individual, between 10500000. 80 would be on the federal government and after that is back to the insurance is company. Thing that is our proposal. We have a bunch of cosponsors on it and we need some republican cosponsors as well. O its not a democratic idea or a republican ideas just a good idea and it deserves bipartisan support. Second thing we have to do to stabilizing exchanges was a center shaking has proposed. That is these costsharing reductions and i think of them as subsidies tub subsidize are people whose income is under certain level, people in the exchanges bidding other coverage, their income is under 250 of poverty, they currently receive some subsidy to help by down the cost of their copays and the deductibles. And its not really clear whether that is authorized orrs. Being funded, but its been being done for a number of years. The Current Administration is fl saying we dont awful continue to do that. Theres folks who want to go to court and say you cant do thatg we need to pass along say were going to have these cost sharing reductions. The subsidies will continue to be offered. The last thing that we need to do is make clear that the at individual mandate or somethingg as good as or as effective as is going to be around. The administration will say i dont know if youll enforce ang individual mandate. Encourages Young Healthy people to not get coverage. We have to make it clear they could be a proxy for. Or maybe several things that Work Together that could be as effective as the individual mandate. If they dont work maybe we can have the individual mandate again. We need to appearance on this kind of thing and discussing here from all kinds of folks. The other thing i want to mention is, i go around my sta state, ive never heard people so interested in and encouragine us, lois senator koons and lisa rogers, were regarded as bipartisan people. We like to work with republicans too. I think thats part of being a governor. But the people in my state on the subject come on healthcare reform Going Forward, they dont want a democratic victory. They dont want republican victory. Frankly, they dont want to trump victory. They want a victory for our country. Thats what they want. A victory forco country. , said why. And so must democrats in this chamber and must republicans. Les so lets hit the pause button and stop in place right now. Ut lets pivot and figure out how to stabilize the exchanges. Lets return to regular order. Hold hearings, bipartisane hearings. Expert witnesses including folks all walks of life and a lot about healthcare coverage and healthcare. After the august recess we come back, lets watch a realngs bipartisan effort to fix things in the aca that need to be fixed and preserve those aspects that should be retained. When he governors at the table, not just recovering governors, and private folks as well as a lot to contribute. If we do those things we will,ma in the words of martine hes to say, one in doubt, tell thend truth, youll confound your enemies and to let your friends. In this case, i would just say, what in doubt, do whats right. One in doubt, do its right. Well compounder enemies and delight our friends. With that, youll the floor. Mr. President. The senate from New Hampshire. Thank you mr. President. Nk sn mr. President , i am honored to join my colleagues here today. I think senator carper for his excellent suggestions and leadership in terms of reachingt out to both current and former governors as we proceed on this issue. A very grateful for my colleague, senator kane on his g leadership of the Health Committee and what he brings as a former mayor and governor. I rise today to join my calling from New Hampshire and supporting her efforts to help lower premiums for middleclass americans and to stabilize the insurance marketplace. The Trump Administration has been working to sabotage the wih individual market by playing games of costsharing reductions. Those costsharing reductions help lower outofpocket expenses such as deductibles and copays for individuals with Health Insurance plans in the t marketplace. Being this legislation from senator shaheen is a common sense measure which would work to prevent instability and chaos being pushed by the administration. T i also join my colleagues inss making clear that we are ready and willing to work across the island priorities that will improve and build on the Affordable Care act and bring down costs for people in New Hampshire and across the country. Mr. President , over the course of the last several months, we have seen that the person process Republican Leadership has pushed with trump care is simply will not work. It is going to take o bipartisan approach in order to make progress. Not a senseless repeal bill that would pull the rug out from millions of americans. Ive seen firsthand that it is possible for democrats and republicans to come together in order to improve the Health Care System. As governor of New HampshireWork Across Party Lines to pass a bipartisan Medicaid Expansion plan that deliver quality affordable insurance to over 50000 hardworking. And expansion has truly made a difference for communities across my state, particularly for people impacted by the heroine vatanen and opiate crisis. Just last week, i visited a Community Health and summer source. I heard from a woman named elizabeth. Life, as a result of Substance Abuse disorder, elizabeth was homeless. She lost the custody of for some. But, elizabeth is now in recovery and she works at the sos Recovery Community organization in rochester. Helping mothers get this worth any. She said she owes her recovery to the insurance she has inched received through Medicaid Expansion and the Affordable Care act. Elizabeth story is a great example of the power of what is possible will come together and Bipartisan Solutions to help improve the health of our hpl people. Ition this is the same approach we need to take in the senate. I believe there are areas for bipartisan cooperation that we should be working on in order to improve the Affordable Care act. In addition to senator shaheens legislation to stabilize the market. In addition to the legislation discussed by senator kane carper, there are other things we can do. I believe its critical that we take a big pharma and bring down the cost of Prescription Drug prices, including allowing affordable safe and Affordable Drugs and allowing medicare to negotiate drug prices. S i believe we should eliminate the existing income cliff in the Affordable Care act that blocks many middleclass individuals mr assistance. People mr. President , these are commonsense measures we should be taking a. People across the nation have made clear they do not Want Congress to do a whole repeal of the affordabl affordable of char because of have devastating effects. I urge my colleagues to put the partisan gamesmanship aside. I joined senator kane as a member of Health Committee and asking for hearing at the very committee that is supposed to set healthcare policy in this body. So that we can listen to the voices of constituents, to providers, to other stakeholders. We need to come to the table ready to work on Bipartisan Solutions in order to improve our Health Care System. All of our people deserve to have access to quality, Affordable Care so they can be healthy. That makes our country healthy, productive, and strong too. Thank you mr. President. Mr. President . The senate from hampshire. Im really pleased to have been joined by my colleagues to talk about the importance of addressing health care for all americans, especially my colleague from New Hampshire, sheena have been touring the state for months now talking with people in hospitals, people with physicians, with providers for people with Substance Use disorders, who are providing treatment for people with Substance Use disorders, but people all over New Hampshire tr but what we can do to make sure that people can get healthcare when they need it. That should be the goal of this body. It should not be throwing peopla off of their healthcare which a repeal of the Affordable Care act would do. It with a 32 Million People off their healthcare. No, we can address the instability in the marketplaces. We can do that pretty quickly. Senators kane and carper talked about reinsurance, something that has worked very well for the first three years of the Affordable Care act. The reason it doesnt work knows because they have stopped. Thats why were seeing some of these rate increases. We can address the uncertainty by being clear that we are not going to repeal the Affordable Care act. By addressing those costsharing reduction payments. In fact, the aca already the stipulates that those payments which reduce the cost of copays and deductibles are to be made pursuant to 31 usc 1324. My bill provides for payments to be made jointly from a permanent appropriation, rather than subject to yeartoyear whims of the annual preparations process. Marketplace and dx removes all basis for any further questions about what is already clear from a fair reading of the Affordable Care act as a whole. That both csr payments and the advance premium tax credit subsidies are to be funded from the same permanent a appropriation. Now, see my colic from texas on the floor. Im sure he is going to object from the unanimous consent request that im going to be proposing a couple of minutes. He he objected last thursday when i asked for unanimous consent to pass the marketplace certain dx. And justified that objection by asserting that the car sharing reduction payments i think he called it a bailout of the Insurance Companies. That is an inflammatory term and i think we have to be careful with how we use it, the truth is, costsharing reduction payments are no way, shape, or form a bailout. Their orderly payments built into the low to go directly to keep premiums, copays, and deductibles affordable for lower income americans. The in fact, the same payments were included in the bill that senator mcconnell said he is not going to go forward with, the republican bill. It included those very same costsharing reduction payments. I think they were included because there is a recognition that these are important to help address the cost of health care for all americans. As i said earlier, we have had statements the chairman of the Health Committee talking about these payments to be continued. We have heard from house ways and means chairman, kevin brady who said that to continue these payments to help stabilize the t insurance market. It is the uncertainty that is causing the current problem. We can address that today, this week if people were willing to Work Together. As democrats we have come to the floor to say, we want to Work Together. We think we can address the w challenges that we face with the Affordable Care act. We can do it in a bipartisan way. I know we can because senator scott and i have done it. We passed a bill several years ago by unanimous consent that basically gave the ability to control and companies a marketplace. Ne i know it can be done and i know we could do today if there is a willingness on the part of all of our colleagues to Work Together. Thats what the American People want. They dont want 32 Million People thrown off their Health Insurance. We dont hospitals to close in New Hampshire. We dont want Nursing Homes to close. We dont want people to be thrown out of the Nursing Homes. I was up in northern New Hampshire at a nursing home over the weekend where i talk to a group of women in their 80s and older. One woman said to me, i worked my whole life, i paid my taxes, i did everything i was supposed to do. I sold my house so i could get into this nursing home, so i could qualify under medicaid, got rid of all of my assets, another telling me that im going to get thrown out . What would i do . I have no place to go. I have no family to help me. Look, people dont want that. But they want is for us to Work Together, to help fix healthcare so that people can get what they need when they need it. So, mr. President i ask unanimous consent that the committee on Health Education labor intentions be discharged from further consideration of s1462, that the center proceed towards immediate consideration, that the bill be considered read a third time in the past, and the motion to reconsider be considered made and laid upon the table, with no intervening action or debate. Is her objection . Mr. President. The senator from texas. Mr. President , the centerec from has acknowledged that she is made this previous request last week. Ons in the Kaiser Family foundation, among other publications has clearly stated the costsharing reductions that she is asking ci for i paid directly by the federal government to Insurance Companies. Thats when i called this an Insurance Company bailout, i believe that is literally true. The Congressional Budget Office estimates the cost of these payments at 7 billion in 2017, 10 billion in 2018, and 16 billion by 2027. So my friend and senator is proposing here is an Insurance Company bailout in the tens of billions of dollars, with no bro reform. The throwing more money at a broken Affordable Care act which has been in existence for seven years. Yea i know they would like to blame this on President Trump was been in office just a short time, but half year. This is built in to the structure of the Affordable Care act and is not working. I personally will not be part of any bailout of insurancery companies without reform. That is why were trying to structure something under the better care act, which unfortunately we have not been successful with so far but we will keep trying. This is not the answer. I object. Enolleag mr. President . Im disappointed but not surprised that my colic has objected. I dont believe he objected because of the efforts to help pay the subsidies which are pastors to Insurance Companies. I think reforming how we do those, and certainly happy to sit down and talk about that. The fact is, that is not the issue right now. Hat th the issue is that this is a way that we could address the current uncertainty in the marketplaces in a way that will be good for maintaining stability of healthcare for all americans. Im disappointed that there is not a willingness to Work Together to do that. I hope as this debate continues will finally see people come together to get something done to address not Just Healthcare for americans, but to address the 16 of the economy that depends on the healthcare industry. Thank you mr. President , yield the floor to make the process and republicans will try to move forward with their plants replay or a bomb care next week, even as they appear short of the needed votes to pass their proposals. Here senator mcconnell is he o close the senate session. Mr. President , for the informational senators at the request of the president and the Vice President , and after consulting with their members,l will have the vote on the motion to proceed to the obama care pe