Legislative uncertainty created instability and chaos in the Insurance Market resulting in the Cost Increases for consume consumers. The president and ceo of care h source adventure that offers plans through the Insurance Marketplace. The rate would increase by about 2 in 2018 compared to 2017. Now the company says thent Administration Stopped the m costsharing payments and refused to commit to make the payment rate would increase by a minimum. This is real healthcare and real life and death decisions. , he said, and i quote, in addition we believe that seizing the payments may adversely impact the risk pools leading to further increases in future years. The chairman and ceo said in part in a letter, and i quote without the certainty of the funding, and some will have no choice but to reevaluate the approach to failing 2018 raids. Such could include reducing surface area participation requesting additional rate increases, eliminating certain Product Offerings and exiting certain compliance markets the altogether. Let me be clear that these limits on the Product Offeringst and market exits are not the result of the current law were even the Healthcare System. This is a deliberate choice. They are the result of a deliberate choice by the president to undermine the rea healthcare law at the expense of real people, moms, dads, m sisters, brothers, dads and daughters. If your house needs repairs you dont set the house on fire. I the. We can do with working together. In my home state in indiana ih was proud to work with the then indiana governor. They expanded to over 2,000 helps reduce the rate in indiana by 30 . Its a National Level t law to e Affordable Healthcare to the most vulnerable citizens and treatment to those studyingnd opioid abuse which is a scourge on the country. We can improve the system by working together. Its to do no harm comes to doing damage to the current care system and the people that rely on it. They will immediately stop these efforts to damage the Healthcare System and work with all of us on the shared goal to make Quality Health care more affordable. Its for all of the people in the beloved country. Madam president , i yield back. Speed hearing that the senate will vote on the new version by the end of the month. The American People are still in the dark about this bill. There is no text, there is no legislative analysis of the bi bill. Much of the senate is in the dark about how much costs are going to rise and preexisting insura used against them by insurance companies. If thats all youve got right p now is a vote on the massive proposal affecting the lives of virtually all people is the casa of a. They do their part and make sure the voices are heard on an issud that is so vital to our people and families. If and when the bill hits the floor it is going to go veryew quickly. This afternoon i want to be perfect with a few key points for those across the country to remember. The Healthcare Plan is going to raise the cost for the typical american. If you are an older person nearing retirement, this divided 58, 61 you are going to get hammered within h. Tax and be forced to pay several times as much as a younger person of insurance. 64yearold seniors of moderatey means. I would like to hear somebody try to explain to a lifelong trucker or someone that spends decades to put food on their families table why that is an improvement in American Health care. Theyve been told at the last several years that repealing and replacing the Affordable Care act is going to lower the cost and then we face the reality that says they will somehow have to spend a couple of their income on Health Insurance and in some cases nearly all of it and its not just older people that face this tax that will see the cost rise. It will cut middleclass tax benefits for health care that were put in place under the Affordable Care act particularly in rural areas that means premiums were going to be a much bigger burden on typical middleclass families. The Republican Health care planh and the guarantee that protects americans from being discriminated against for preexisting conditions. Ho working adults, 30, 40, 50yearsold. Or with employersponsored insurance under this bill. There is the end of a lifetime of benefits and the new report says 27 million americans could get hit by annual limits and 20 million could face lifetime s limits. If you are a 35yearold, for example who develops cancer you could bust the cap in a hurry if you have to go through surgerie, and chemotherapy that could mean that you face decades digging out medical debt. You will get the care you need. You cant be denied benefits or slashing the program by hundreds of billions of dollars in stock air and he because the states. The best way is to look at seniors who need nursing home care. The nursing home benefits picked up the tab for two out of three nursing home beds in america because of growing old is expensive. You can do everything writing of vacation for big purchases to be financially prudent. But still, a lot of people go through their savings. Thats when medicaid steps in to help cover the cost in Nursing Homes and other longterm care. One year in a nursing home now costs more than 90,000 on average. R that is two or three times as much as a year of education. It is so deeply that seniors are at risk of losing their benefits. How are families who are finding it hard to pick their own bills going to be in positio the posiu take care of older loved ones . Medicaid does more than cover the nursing home care. V 37 million kids are enrolled in medicaid. A vital source of support for kids and adults withus disabilities. Medicaid is the only lifeline of thousands and thousands of americans fighting opioid addiction have two be able to put their lives back together. No community anywhere in theded country since the kid was expanded under the affordablet care act leading the fight against the Opioid Epidemic by improving access for millions of people for treatment, Mental Health and Substance Abuse orders. But with the republican plan, enormous cuts, thousands ofir people could lose their shops to recover from addiction and lead a healthy life. Finally, what is especially unfortunate about this legislation is the process for writing this bill. Its being written behind closed doors. No input from across the aisle and particularly the American People. S madam president i serve as the Ranking Member on the senateomme finance committee and i can tell you our committee has authority over hundreds of billions of dollars in payments for medicare and medicaid. We have not seen a bill. Its not the traditional process of a Committee Markup where you consider the legislation. Its also the committee that ona a staff level always has tried to work back and forth between democrats and republicans to try to find the Common Ground with the majority leader keeping thee process locked behind closed doors, the sheer man and died along with all of the democrats and most of them republicans ons the committee have simply been p cut out. In the runup to the Affordable Care act, one that president obama was involved in in 2009 in the finance committee be held td more than 50 hearings and we roundtables, and we thought through carefully the Health Reform bill. When the legislation was introduced it sat online for six days before it was voted on in the committee. 564 amendments were posted online and more than 130 amendments were considered during the markup and more than two dozen republican amendments were adopted in the bill passed on a bipartisan basis. Again, madam president , let me highlight more than two dozen republican amendments were adopted in the finance committee and as of now there wont be a single democratic amendment adopted in the finance committee. When the legislation went to the floor, the senate dispensed 25 consecutive legislative days when of the longest consecutive sessions in history. The total opposite of process ought to look. The committees do the hard work in the open and gather input for the American People and have a chance. Democrats and republicans to h work together. That is not what is happening. B this is a bill in secrecy and the public is kept in the dark. There are not going to be anyn hearings on the impact on the millions of people that rely on medicaid for Health Insurance, no hearing on what it means if you have all these loopholes to the guarantee of protection. Agt now americans have against discrimination for preexisting conditions. No hearings asking how a 64yearold of limited means is supposed to deal with an aged hacks that swallowed up most ofe their income when the Republican Health bill hits the floor, there will be a very short debate before the time expires in the final vote. If im going to close by saying now is the time for americans to be heard on health care this is the time for americans to speak out for those who have a story about how trump care will affect their family you can share it on my website or you can use thehe hash tag america speak out. I intend to be here on the floor with my colleagues as many of us will be here often in the hours and the days ahead. But i want to close by way of saying political change doesnt start at the top and then is trickledown. Political change is bottoms up as americans across the country speak out and speak loudly now is the time to do that becausese this debate is coming fast. With that i yield the floor. A senator madam president . The presiding officer the senator from california. Mrs. Feinstein madam president , i rise to speak on health care, but id like to ask unanimous consent that i be able to conclude my remarks prior to going into scif session. Into executive session. The presiding officer is there objection . Without objection. Mrs. Feinstein thank you very much. Madam president , i rise today to speak against the republican effort and what it appears to be thus far to repeal the Affordable Care act and the process theyre using to do it. Ive just in my 24 years in the senate. Former Senate Historian said you have to look back before world war i to find another example of such a secret partisan process to pass a major bill. The Senate Health care bill in fact, is written behind closed doors with a draft American Heart Association, the march of dimes, and the American Lung association, tried to get a meeting with senator mcconnell or his staff and were told no. Thats unbelievable. Think of it. Think of the American Heart Association, the marc march of , the American Lung association asking to meet with either the leader or his staff and somebody says no . Do my republican colleagues really believe that groups like the American Heart Association dont deserve an opportunity to weigh in on a Health Care Bill . When our Health Care System affects every Single Person in this country . Health care is the last subject that should be addressed behind closed doors, hidden from public view. Yet, apparently, republicans intend to bring the bill to the floor without a single hearing. Senator mcconnell wants to vote on a bill by next thursday, im told. Thats ten days from now. Well, if theres not going to be a hearing, we shouldntvestment i think no hearing, no vote. Its important to point out the contrast between whats happening now and our consideration of the Affordable Health care act thats whats known as obamacare. There were 100 hearings, meetings, round tables, and walkthroughs of the bill between 160 hours of debate on the senate floor. Help there were 300 Committee Amendments including more than 160 republican amendments. And was our process in 2009 and 2010 perfect . No, it was not better but evidently better than what is happening now. This process is such an affront to the democratic system of government the senator harris and i represent california, we hear the sixth largest economy in the world and represent more than 40 Million People. More than 22 other states combined. 14 million californians are covered by the medicaid p program that the house bill says we will stop the funding for. E 14 million californians more than the entire populations from the secret health care negotiations. 4 million. T negot and of those 10 states represented in despite thoseny significant defects and negative effect they haveo ben shutout. I know there are challenges we need to address in their want to be part of the process but there is no opportunity to do so. If the bill as anything like the house bill the effects are devastating if it is like the house bill this is what it would do to take Health Care Coverage away from 23 million working andut middleclass families for the richest 5 of americans this is indefensible. There is no justification for giving millionaires the 50,000 tax break by taking Health Care Away from our most honorable citizens. Tical it is a blighted political agenda to take the elderly and the sec to justify the taxpayer or the tax break that would end medicaid with 8,304,000,000,000. Enies to define and planned parenthood so one must it changes to cover reproductive care including Abortion Services for about was a black male provision. Medi so i will talk about the changes to medicaid node at known as metical. The changes that they have proposed that we think that they are proposing for the senate bill go much further than the expansion of the program of the Affordable Care act. Med that they are looking at changes to medicaid that is similar to the house bill. And with those of they will be devastating. Re to . Who does medicaid provide health care to . Not the wealthy but elderly in nursing home and pregnant women and children and people with disabilities. And those that only get Health Insurance through their jobs. Medicaid covers one of three californians that isne 14 Million People want out of two children and nursing home residents face a three beds would be lost in each home with people of disabilities. The American People need toy understand about medicaid the maturity of medicaid dollars are spent on elderly people or people with disabilities. They are the most in need and have the most serious wom health issues. C a woman by the name of christian from sacramento wrote to us about her daughter riley who was autistic. Covered by a medical providing Critical Services that allows her to lead a more normal traffic childhood. We quickly learned she had difficulty with the basic task of sleeping and eating. After turning three and to be diagnosed with optimism now 08 years old and she is thriving thanks to the medicated for the support programs like physical therapy and Speech Therapy she is no verbal, learning to write and reading above grade level. She would not be doing as well if not for medicaid. I am counting on you to protect to medicaid. Those depending onie medicaid i will give you a few examples. Those ago to los angeles to raise money 40 of Valley County is covered by medicaid. Do you know how many . It is that half a million or 1. N. 5 million or 3 million but it is 4 Million People. Those that could lose medicaid funding for pro 28 of seeing diego is covered by medical that is more than 900,000 and 37 percent of Sacramento County is covered by medical, a 56,000 people. Illion and half of fresno county, half a Million People. I was in fresno a week ago there is a wonderful Childrens Hospital the director was practically in tears we treat 300,000 children at the bell thisca day and relives the medicaid we can cannot provide that treatment if it takes place. Fresno has those assisted living facilities for the sick and elderly and they would lose three out of five beds. But my whole county recovered via medical 230,000 people. E but as republicans we learn k to end the Medicaid Program and under current law the federal government pays a certain percentage of the Health Care Cost so we will likely see the phaseout of the current structure of the program to about at 8,304,000,000,000 cuts overth 10 years there would be in every state of the republican side of the aisle ste at her know how a Civilized Society could do that to people. The effects of the change could devastate access of the state budgets nationwide is they tried to replace those funds. But the bottomline, in my state by 2027 california would need to find 24 billion for those who depend on medicaid for their health care today. And levy well though obamacare covers preexisting conditions so if you had Breast Cancer you could get coverage you could be charged 28,000 more per year per girl and it goes on and on like this. Nd you if you take away coverage for preexisting conditions including 6 million of california who had preexisting conditions today that would be a big huge problem. Fro i have another case. Cro another who has paddled battled consistencies his said going without insurance bef 10 years because of the preexisting condition before obamacare. During this time it caused Severe Damage to the small intestine he was finally able to get insurance through cover california had received treatment for girl that is after obamacare passed in he had surgery to remove the various blockages and scar tissue that probably saved his life. I am so scared his coverage may be taken away. How can we do that . Sherry from sierra madre california. Ex both sons have preexisting conditions says, as a single mother of two young men each with preexisting conditions under the g. O. P. Plan one has lyme disease and requires infusions every three weeks this is a huge expense currently manageable under my Health Care Plan and has been a lifesaver under truck care trump care this will probably not be covered and that is david devastating eyelet get mys phone calls and we get a lot of calls i know it is serious if we get more than 100,000. These were largely people between the age of 50 and 64 per girl as part of the individual market to find your own insurance company. Was so under obamacare there was a subsidy for the premiumsbout with 400 percent of poverty is about 47,000 per year so if you earn under 47,000 it was much easier to get health care