We are engaged in nothing short of a rescue mission to finally bring relief to americans struggling under this law and to give everyone access to the care they need. Will break away from this paul ryan event and piggyback life to the floor of the u. S. Senate a senator mr. President . The presiding officer the senator from south dakota. Mr. Thune mr. President , its hard to argue that obamacare is not a failing law. Seven years after it became law, its laundry list of problems continues to grow. Higher premiums, higher deductibles, customers losing health plans, patients losing doctors, fewer choices, failed coops, unraveling exchanges. Unfortunate, without action that list will only become longer and the consequences will only become more severe. Republicans know that. Democrats know that. Unfortunately, Many Americans know it firsthand. The American People deserve better, and they rightly expect us to act. And thats why choosing to watch from the sidelines as obamacare fails is not an option. To say that obamacare has created significant problems for the American People is an understatement. And thats why Senate Republicans are working to fix the mess created by obamacare and to provide Real Solutions to this failed law. We want to save the millions of hardworking families who are trapped by obamacares taxes and mandates. Average annual individual market premiums have increased by 2,928, an increase of 105 . Since 2013 in the 39 states that use health care healt healthcare. Gov and 62 of states using healthcare. Gov including my home state of south dakota saw premiums double between 2013 and 2017. We will help stabilize these collapsing Insurance Markets that have left millions of americans with little or no options. Today one in three counties has only one insurer on its obamacare exchange. According to c. M. S. , 47 counties nationwide are projected, i should say, to have no insurers which means americans in these counties could be without coverage on the exchanges for 2018. As many as 1,200 counties, nearly 40 of counties nationwide, could have only one issuer in 2018. Hard to argue, mr. President , that you have a market, that you have competition when you have one option. Thats 40 of the counties in america in 2018. We will improve the affordability of health care by eliminating the obamacare taxes and mandates that are causing premiums to increase the most. These taxes and mandates have cost the American Economy a trillion dollars, a cost that was ultimately incurred by patients in the form of higher costs and larger tax bills. Reversing these taxes will provide millions of American Families and businesses with much needed tax relief. Mr. President , we will also preserve access to care for individuals with preexisting conditions. Theres been a lot of debate and misinformation, i might add, about this issue over the past few months. In the senate well ensure that individuals with preexisting conditions continue to have access to the care that they depend on. Well also safeguard medicaid biff giving states by giving states more flexibility while ensuring those who rely on this program wont have the rug pulled out from under them. States should have the flexibility to design and operate Medicaid Programs in a fiscally responsible way and not be stymied by the federal government. Making these Critical Reforms to medicaid will empower states with the tools that they need to implement Health Care Programs that best meet their residents needs. Mr. President , we must also ensure those americans who all rely on this program will not be left in the lurch. Republicans recognize our responsibility to make sure that medicaid continues to provide quality care for these vulnerable citizens. We will balance the needs of the individuals who have medicaid coverage while ensuring sustainability of the Medicaid Program. And finally, mr. President , we will free the American People from the onerous obamacare mandates that in some cases forced them to purchase insurance that they dont want or cant afford. These mandates have resulted in burdensome taxes that have been levied against most Small Businesses and the American People. Republican Health Care Plan will revoke these burdensome mandates and put the American People, not washington, back in charge of their health care. This would be a huge leap in the right direction for hardworking families and Small Businesses. Reforming Americas Health care system isnt easy, but that doesnt mean that we shouldnt try. We spent years, literally years debating this issue, and weve had lots of ideas along the way. Now its time to take action. The Core Principles of the republican Health Care Plan are as follows. Helping to stabilize collapsing Insurance Markets, improving the affordability of Health Insurance, preserving access to care for those with preexisting conditions, safeguardin safeguad cead medicaid for those who need it the most and freeing the American People from onerous obamacare mandates. Mr. President , without meaningful action, obamacares problems arent going anywhere. Without action the individual market will continue to collapse and more and more americans will be without insurance options. Without action, americans will continue to experience Rising Health care costs because of the laws costly taxes and mandates. Without action states will continue to be hamstrung by medicaids bureaucracy and we will not be able to put this Critical Program on a more sustainable path for the folks who need it the most. Without action the washington knows best approach to health care will live on. Mr. President , we cannot let that happen, which is why we plan to deliver patientcentered Health Care Reforms that lower costs and increase access to care for the American People. Mr. President , i yield the floor, and i suggest the absence of a quorum. The presiding officer the clerk will call the roll. Quorum call a senator mr. President . The presiding officer the senator from montana. A senator i would ask that the quorum call be advice rated. The presiding officer advice rated. The presiding officer erisch vitiated. The presiding officer without objection. A senator were about to embark on something that is Pretty Amazing to me. Next week i am told were going to take up the Senate Health care bill that is going to be the first cousin of the house bill, and theres a lot of things being referred to putting lipstick on a pig but this is truly putting lipstick on a pig where were going to take Health Care Away from millions of americans, we might make it a little better, extend some medicare or medicaid moneys but in the end, that will go away. Mr. Tester potentially set up highrisk pools for people with preexisting conditions and i will tell you from my time in the state legislature when we dealt with highrisk pools, that gives access to the health care for rich folks. In essence what were going to do next week, because some folks in this body forgot to read the Affordable Care act when it came up. Were going to repeal it and were going to replace it with a piece of garbage. And so today, mr. President , i rise on behalf of the 48 rural and frontier hospitals in montana. 48 rural and frontier hospitals that are the backbone of our state. The 77,000 hardworking montanans who now have health care because of Medicaid Expansion, i rise for them. And the 41,000 jobs of our state of one Million People, 41,000 jobs that are sustained by our Health Care Industry today. And i rise on behalf of every montanan who deserves to know whats going on in washington, d. C. , whats going on back there. Are you guys really talking about jerking my Health Care Away from me . Are you guys actually talking about taking something up thats really not going to do much for the 30 million americans that are getting pounded by high premiums and high deductibles . And are you doing this to give the top. 1 of the americans in this country a tax break . Ive got to tell you, right now the Senate Majority in this body, the Senate Majority is playing russian roulette with peoples lives. A handful of washington politicians are crafting a secret health bill Health Care Bill in a smokefilled room probably a little whiskey is involved, a few steaks and theyre crafting a bill that will impact every man, woman, and child in this country. You know, i heard earlier today that they said these meetings were open. It would be nice to know where theyre at. Id love to go in and give the two b by b by the the two biw Rural America feels. This is a problem thats not going to go away unless we address it in a commonsense way. Theyre crafting this bill in secret. We dont know whats in it. But we have indication that its going to be very, very similar, a first cousin to the American Health care act that was passed in the house. So we should be deeply concerned. This is irresponsible legislation that would jeopardize health care for over 250,000 montanans. Deny coverage to over 152,000 montanans who have a preexisting condition, like cancer, heart disease, even high blood pressure. And quite frankly, it would put many of our rural hospitals at risk, at risk of closure, at the very best changing the very methods by which they deliver health care to these Rural Communities, that, about the by the way that, by the way, are hanging on by their finger nails. This is creating caution across our nation. I do not believe it will be for the better. My office has received over 3,600 pieces of correspondence related to the American Health care act. Many montanans are terrified by the implications of this horrible bill. And as elected officials, we are obligated to answer the tough questions, defend our positions, and advocate for our constituents. Thats not whats happening he here. And, as a result, the senate, through their secret meetings and through a rushedthrough potential rushedthrough Health Care Bill next week and i see no reason why it wont be were not doing right by our constituents. The process in this bill are to service to are a disservice to folks like Julie Williams from shepherd, montana. Julie was diagnosed with multiple sclerosis, m. S. , in 2011, five months before the Supreme Court was set to make the decision on the Affordable Care act. She spent those five months terrified that she was in for a constant fight with Insurance Companies over coverage, but the Supreme Court upheld the a. C. A. Julie has insurance and doesnt have to worry about being denied coverage if she moves, changes jobs, or, god forbid, becomes unemployed because she now has a preexisting condition. Julie also doesnt have worry about Insurance Companies cutting off their treatments because she happens to hit a lifetime cap, ways very real concern which is a very real concern for a healthy young woman with a disease like m. S. She doesnt have to worry. She didnt have to worry until now. If a bill like the American Health care act passes, julie could be charged more because of her disease. Shes unable to afford that coverage. The plan may not pay for the Health Services that she needs. This legislation is has disservice to a lady, same last name, no relation, jennifer williams, east glacier, montana, one of the most beautiful places in the world. Jennifer and her husband have been able to catch a few conditions early and avoid Bigger Health problems in the future. Thats going away. Unfortunately, their premiums are rising. Congress needs to address that problem headon. I couldnt agree more. But this bill that passed from the house doesnt do that. It will send folks like julie and 250,000 montanans on medicaid into the cold, no access to Affordable Care, jack up the cost of health care for folks with no Health Insurance, jack up the cost to folks in their 50s and 60s. We can and should be working together to lower those costs for folks like jennifer and julie and other montana families. Instead, were here scoring political points or trying to, upending all the things much the congress, republicans and democrats, should be working together, not in some back room but right here on the floor, to lower copays, deductibles, while increasing access to care. The Affordable Care act isnt perfect. But its got a lot of good things. Lets fix the things thats wrong with it and keep the progress weve made. But instead we here in washington, particularly the republican majority, is creating chaos in the marketplace, driving costs up. This chaos is putting our rural hospitals and Community Health centers at risk, and that is not just a statement, that is a statement of fact. Every day folks in Rural Communities rely on their local hospitals, their clinics, everything from a basic checkup to emergency treatments. Thanks to Medicaid Expansion in montana, these hospitals and Community Health centers have seen a reduction in charity care and have been able to keep their doors open. If the yet the ahca puts those at risk. These medical professionals are sworn by oath to provide health care for folks. If Medicaid Expansion goes away, the hospital will be forced to absorb those costs. Over the last ten months, youve held over a dozen listening sessions eyeballtoeyeball reasoning sessions with montanans. Were going to be holding some more, and they have been over health care. Ive heard one thing loud and clear from the people if Medicaid Expansion goes away, these rural frontier hospitals will have to fundamentally change how they deliver health care or they may be forced to shut down altogether. These hospitals operate on razorthin margins and cannot afford to see these funds disappear. Take my hometown, big sandy, montana. Back in 1910, my grandfather came out, took a look around, saw grass as tall as the belly hon a horse on a horse and said, this is where were going to homestead, went back and got my grandmother, and the farm that charlotte and i farm today was started, patented back in 1915, they worked together with their neighbors, the homesteaders of that area, they built barns, they built businesses, but it took them 50 years to build a hospital. In the mid1960s, the hospital was finally built in big sandy, montana. 50 years of people working together to get that hospital built. Im going to tell you, if we dont do smart things in this body, if we take steps backwards and not very many and this bill that ive seen from the house was horrible, and i dont think the bill in the senate is going to be much better, because it a low bar hospitals like the hospital in big sandy will go away. And im going to tell you something. When that hospital goes away, big sandy goes away. Rural america goes away because big sandy is just an example of hundreds of small towns in montana and throughout this country that depend upon rural hospitals for health care. Without hospitals in montana, frontier communities will be forced to drive 100 miles to deliver a baby or take an expensive ride after an accident. People are not going to be able to afford or theyre not going to choose to live there because of a lack of health care. Theyre not going to take that risk. Theyre going to move out of those small towns. Theyre going to move to places where they have health care. In some cases, families who have lived in that house and on that property for generations will be forced to move. These hospitals just dont keep patients alive. They keep communities alive. The house bill would kill those rural hospitals. It would be the death of Rural America. But thats not the only uncertainty facing Rural America. In montana, Insurance Companies file their proposed rate rates h the insurance commissioner of montana. But these insurers are left out or left without Vital Information for their proposals. They dont know if this administration will continue the costsavings reduction payments that help make health care more affordable. Insurers have said if these payments go away, consumers will face doubledigit rate increases. Montanans deserve to know from their elected officials what kind of impact this action has on premiums, and yet the Insurance Commissioners leaving the montanans in the dark. Transparency builds a more effective government. Hiding Important Information from the public is unacceptable at any level of elected official. We live in a country where citizens can hold their government accountable, and the American People make good decisions when they have good information. But right now a select few in this body are shielding the American Public from whats really going on. We hear about a bill thats going to impact onesixth of the economy. We hear about a piece of legislation that will rip Health Care Away from 23 million americans. We hear about a bill that will take us back to the days when montanans couldnt afford to get sick. But we havent seen anything. Families across montana are setting at the Kitchen Table wondering if their Health Coverage is going to go away. Folks are walking out of the doctors offices with newfound witness and wondering, will i be able to with newfound conditions and wondering, will i be able to get treatment if something similar is patsed by the senate . Parents are left fearing that their son or daughter will never be able to afford insurance. These families deserve more from congress. At a bare minimum, they deserve hearings. They deserve a panel of experts discuss being how we can lower premiums, reduce Health Care Costs and put transparency into prescription drugs. They deserve smart action, not political action. They deserve a congress that will Work Together to improve the lives of all americans not one that works behind closed doors to closed doors to draft secret legislation that will send shock waves through homes across this country. Our founders expected more from this body. Quite frankly, i expected floor this body before i got here. I expected more from this body before i got here. Montanans expect their u. S. Senate to work for them. Im going to leave you with one story. I was in butte, montana, one of my listening sessions. A gentleman was sitting at the table and he said, you know, hes probably 45 years old he said, you know, ive got two kids. I cant work. Ive had diabetes since i was a teenager. He says, ive had some issues with Mental Health for a good portion of my adult life. He says, i havent been able to work, havent been able to support my family, and then the Affordable Care act came along and the state of montana was wise enough to pass Medicaid Expansion. I was able to go to a doc. I was able to get my diabetes handled because of Medicaid Expansion. I was able to see a psychologist and get my Mental Health issues under control and i was able to go back to work. I was able to support my family. He said, and now you guys back in washington, d. C. , want to take all of that away from me. Well, i will tell you. I will fight like hell to make sure that never happens. And if the majority leader wants to try to ram this down the peoples throats, i will spend the rest of my life telling them why and who did what to them. Mr. President , i yield the floor. Mr. Menendez mr. President. The presiding officer the senator from new jersey. Mr. Menendez i ask that the quorum call be waived. The presiding officer the senate is not in a quorum call. The senator is recognized. Mr. Menendez thank you, mr. President. Mr. President , i come to the floor like many of my colleagues, shocked at the republican majoritys brazen, secretive effort to pass a bill that would hurt millions of americans. Now, i have served in Public Office for more than four decades, and never once in my 45 years as a mayor, a state legislator, a congressman, or a senator has it been so hard to understand the motivations of an opposing party. What kind of problems are republicans trying to solve with legislation that raises premiums, reduces coverage, decimates medicaid, and increases costs for everyone . Certainly not any of the concerns ive heard back at home in new jersey. never has someone come up to me at the local diner to say that their premiums are too low or that medicaid covers too many children or that Cancer Patients dont pay enough outofpocket. Theres only one place in america where these bad ideas have any traction, and thats behind closed doors here in washington where 13 republican men are working on a secret bill to take Health Care Away from millions of people and raise costs on millions and millions more. They want no transparency, no bipartisan input, no hearings. These are the same republicans who, back in 2009 and 2010, accused democrats of ramming Health Care Reform through congress too quickly. In fact, it was the majority leader who said at the time, and i quote, this massive piece of legislation that seeks to restructure onesixth of our economy is being written behind closed doors without any input from anyone. Even the Vice President , a congressman at the time, said, quote, its wrong for legislation that will affect 100 of the American People to be negotiated behind closed doors. Now, mind you, all of these complaints came during what was a far more open transparent process. I sit on the Senate Finance committee. I remember the process quite well. I remember our chairman at the time, senator baucus, bending over backwards to get republican input. We held 53 meetings, hearings, and roundtables, and briefings and negotiations on Health Care Reform, and afterwards we held the longest finance Committee Markup in over 20 years a markup that led to the adoption of nearly a dozen republican amendments on top of the two dozen amendments we accepted before the markup began. Democrats also made huge bipartisan overtures on the health, education, labor and pension committee. They too held a transparent process and adopted over 160 republican amendments 160 republican amendments. Then, and only then, did we bring the bill to the floor of the United States senate. And when we did, we spent 25 consecutive days in session debating the bill on the senate floor in front of the American People. In short, democrats spent months making compromise after compromise in the hopes of getting republicans on board only to learn that they never had any intention of working with us at all. They never cared about expanding access to care or reducing drug costs for seniors or making insurance affordable. It didnt work with us then and it is certainly not working with us now. Behind closed doors 13 republican men are debating just how many millions of americans will lose their coverage under this bill. Is it 23 million . Is it 20 million . 16 million . Behind closed doors they are discussing just how high the age tax should be on middleaged workers. Is it 8,000 a year, 12,000 a year . Behind closed doors they are picking and choosing which Consumer Protection its to gut . Should they bring back lifetime limits on coverage, which is a real problem if you have a serious disease . Before there were lifetime limits to you had a coverage and then all of a sudden you hit that ceiling and then if you had a problem with cancer and then expended all of your coverage and still had an illness to be treated now, you were one illness away from bankruptcy. Would you let patients with preexisting conditions sink or swim in highrisk pools, allowing insurers to once again charge women more than men simply because they are a woman this . Same age, same bracket, same geography. Its easy to see why republicans want to keep it out of the eye. If its anything like the house version passed earlier this year, it is going to be a terrible, meanspirited bill a bill that the Congressional Budget Office said would take insurance away from 23 Million People. It would raise premiums by 20 a year and price middleaged consumers out of the market. A bill, according to reports, even President Trump said is too mean. Well, i have to tell you something if a bill is too mean for President Trump, its certainly too mean for new jersey. And today i understand that a comment was attributed to the president he was meeting with a group of business leaders, and he said he wants a health bill with heart with heart. Well, i can tell you its not this bill. Because the house bill and what im hearing behind closed doors of the potential senate bill, thats a heartless bill. Its not a bill with heart. Im not the only one with that view. I was glad that most of my new jersey colleagues in the house of representatives rejected this bill in a bipartisan way. Indeed, every House Democrat and nearly every House Republican in our delegation understood why this bill would devastate new jersey. This bill will price thousands of new jerseyians out of the private Health Insurance market, especially those nearing retirement age. According to the Kaiser Family foundation, premiums for a 60yearold worker who earns 20,000 a year in mommouth county will see their premiums increase by 900 . Thats an increase of nearly 9,000. Every day new jerseyians are reaching out to tell me whats at stake in this debate and what this secretive effort will mean for their health and their p financial security. Take dr. Howard fredericks, a 51yearold from park ridge he emailed to say, quote, without subsidies provided under the a. C. A. , my 51yearold wife and i would have no insurance. We would not afford premiums in excess of 1,100 a month. Without these subsidies millions will go uninsured, and many of these people, including myself, will die. Of course, my republican colleagues like to say they are giving americans more choice. But if all of the choices are unaffordable, what good are they . What good is it to have, quote, unquote, more choices if you cant afford any of the choices . And if they provide significantly less coverage, what good is it to say i have insurance when that moment that i get sick i dont have the coverage for it so ive been paying for a policy that doesnt really help me at the moment i need it. They also say their plan will give states more choice on how to run medicaid. But when you cut medicaid by 800 billion, you leave states no choice but to scale back the Health Services they provide. Thats not a choice. Thats not a choice. Leaving nursing home patients out in the cold, ending respite care for children with disabilities, denying lowincome children a shot at the American Dream thats not a choice. New jersey alone will face 30 billion in cuts to medicaid over the next decade, cuts that will not only leave thousands of families uninsured, but according to the milken institute, cost new jerseyians more than 41,000 jobs. Its no wonder why republicans are tired of having top defend this bill. Its a terrible, mean bill. They dont have the guts to tell the American People whats in it even though they want to pass it next week. If only they had the courage that so many new jerseyans have shown me in recent weeks as i have toured our state. Hardworking americans who have been willing to share their personal health care stories. Not easy to share a serious illness that you have with everybody in the world, but so compelled are they and so courageous, i would add, that they do. People like a constituent i recently met in jersey city. She told me about her battle with uterine cancer nearly a decade ago. She was fortunate to survive, but without the Affordable Care act, she would be blacklisted by health Insurance Companies for the rest of her life, simply because she is a survivor, a survivor of that cancer. Today irma has recovered and is receiving worldclass care. I also met with samantha williams, a young mother in burlington city. She told me about her sons brush with a lifethreatening asthma attack. They were uninsured, so they avoided going to the emergency room, as so many people do. This gets worse and worse, more consequential to your life, more consequential to the cost. But eventually his breathing got so bad, she had no choice. The doctor said if they had waited any longer, her son might have never made it. She credits medicaid with saving his life. I also want to know how my republican colleague can reconcile their concern with the Opioid Epidemic with their plan to end the Medicaid Expansion that saved so many lives. Just yesterday, i received an email from irene in oak hours, new jersey. She in oakhurst, new jersey. She wrote my daughter is a recovering addict on the Medicare Program which pays for Mental Health Care Services. She is part of the Opioid Epidemic that has taken so many young lives like her. She has been drug free for almost a year. Taking money from this program would be disastrous not only for her but for so many people who cannot afford any other health care. So i listened to those stories compelling their they are courageous to tell their stories to the whole world, very personal stories. If there isnt the courage here to come forth with the bill, lets dont ceebt it debate it in public. This bill leaves americans with no options at all. And for what . To give Health Insurance health executives, real estate moguls and Hedge Fund Managers a massive tax cut that they dont need. If there was ever such a thing as class warfare, this is it. This is it. In my home state of new jersey, 250 millionaires, 250 millionaires are slated to get a collective tax cut of 14 million. Yup, you heard it right. 250 millionaires get a tax cut while over half a million new jerseyans lose their Health Coverage. Its pretty a pretty awesome thought, incredible thought. Totally meanspirited. Certainly without heart. Many of them are people who work in some of the toughest jobs, but they dont get Health Benefits at the jobs they work at. From dishwashers and cashiers and home health aides, just to mention a few. These were my neighbors growing up in a ten meant in union city in a ten he meant in union city, people who worked tirelessly to give their family a better life. Many of us thought the cruel legislation republicans passed in the house would be dead on arrival in the senate. Instead, an incredibly unpopular bill has a new lease on life. Why . Because padding the pockets of the Health Insurance industry, capping medicaid spending and cutting taxes for millionaires have been at the top of republican wish lists for years. The notion that the g. O. P. Can pass this secret bill with no debate is insulting to our democracy. And the idea that they can dismantle this historic law without hurting millions of people is just not true. Its just not true, because make no mistake, when you take 800 billion out of medicaid, everyone feels the pain. When you add 23 Million People to the ranks of the uninsured, everyone feels the pain. When you send more people back to the emergency room as their way of getting health care, saddle consumers with higher outofpocket costs and then protections against Insurance Company abuses for patients, everyone feels the pain. What really boggles my mind, why i just cant understand, is that there is no shortage of problems in our Health Care System. Real problems that need Real Solutions. Ask anyone, and i mean anyone, about our Health Care System, and i will guarantee you will get an earful about whats wrong with it. You will hear from parents about deductibles that are too high, from workers about how hard it is to find innetwork doctors, from seniors about generic drugs that suddenly cost thousands of dollars. Police officers about the Opioid Crisis tearing apart our communities and hospital staff concerned about the nursing shortage, Business Owners like the group i met from cumberland county, new jersey, yesterday who Want Congress to work in a bipartisan way to lower employees Health Care Costs. Imagine just for a moment, imagine how thrilled americans would be if republicans actually had a bill that solved some of their problems instead of bringing back old ones. Imagine how excited would my republican colleagues be to show off a bill that improved instead of endangered peoples lives. But my republican friends are not excited to show off this bill, because when youre excited to show off a bill, when you have a great product, you want the whole world to know about it. When you have a terrible problem, you dont want anybody to know about it. And they dont want it defended because they know its indefensible. Now, for seven years, my republican colleagues put politics over policy. For seven years, they demonized obamacare with no substance behind their rhetoric. Now their polltested platitudes have caught up to them, and they know it. They know it. Thats why they have let 13 senators who represent less than a quarter of the country, 13 senators who represent less than a quarter of the country meet behind closed doors, and thats why their hope is to keep this bill a secret until the very last minute. So today i have come to the floor with a message for my republican colleagues. If you want to have a debate about how to improve our Health Care System and about how to help more families get covered and about how to lower costs more and create a healthier, more productive nation, these issues are issues that democrats have been ready, have been ready to have that debate. I have said it in the Senate Finance committee. We did remarkable things under the Affordable Care act, but there is still room for improvement. Were ready to have that debate, because democrats know that while the Affordable Care act was a historic law, a law that stopped Insurance Companies from dropping your coverage if you got sick, that covered 90 of americans for the first time in our history, that required health plans to cover essential Health Benefits like visits with specialists, prenatal care, Mental Health and addiction treatment, hospital stays and more. Despite all of the positive steps forward, despite all the good that the Affordable Care act did, democrats have never stopped believing that we could even make it better. But before we can make our Health System better, we must stop republicans from making it worse. We cannot go back to a time when health care was a privilege granted only to those who could afford it, when it must always, i think, be a right afforded to all americans. The only way we can go forward is by working together with bipartisan input, with open debate, with full transparency on an issue that affects virtually every american, in full view of the American People we were elected to serve. They deserve no less, but they are getting a lot less by the majority as it relates to this bill behind closed doors, in secret, that even the president of the United States says is mean. The one thing i can agree with President Trump, we need a we need a bill with heart, and from what i have seen and heard so far, this is pretty heartless. Mr. President , with that, i yield the floor. Mr. Durbin mr. President. The presiding officer the assistant democratic leader. Mr. Durbin let me thank my colleague from new jersey for his excellent remarks on this Affordable Care act and its future and really spotlight the point that you made. You and i have been around legislatures for a long time, both in the local level, state level, and here in washington. If you have something youre really proud of, a bill, you cant wait to roll it out. We have got a place for a press conference about every 15 feet in the corridors around here, and we have a press corps that fills this gallery when they all show up and they are anxious to hear our stories. If you have something you are proud of and each of us have had that kind of legislation, you will put out the press release and the social media and the whole number. But on the other hand, if you are forced into the position of bringing a bill to the floor that youre not very proud of, you dont know how you can explain it back home, you keep it secret. You do it behind closed doors. And what you have said is exactly the truth as we know it and our colleagues on the other side know it. They have for the past several weeks, since the house passed their bill, been meeting behind closed doors, 13 male senators, why they couldnt invite the women republicans of the senate, it is their decision, i understand, and they have not produced one thing for public consumption, nothing. And yet, senator mcconnell, the republican leader, tells us, well, you have got ten days. Were going to pass the new Health Care System for the United States of america in ten days, and pretty soon were going to show you what were going to propose. Well, it tells you the whole story. There is something in there that is painful, that hurts them politically, and that they cant really explain. After all these years of repeal obamacare, repeal obamacare, they cant come up with an alternative that they can sell to the American People. So thank you for pointing out your experience and the experience youre finding in new jersey. Im finding the same thing back in illinois, and i thank my colleague from new jersey for his statement. Mr. President , this last saturday, i was invited to debate a Republican House member from my hometown of springfield, illinois, on his vote in favor of trumpcare, if you want to call it that, the republican Health Care Plan in the house. We were invited by the Ministerial Alliance of the city of springfield, the African American ministers. I accepted the invitation on a saturday afternoon, and he did as well, but he put conditions. Number one, no media coverage. This is not open to the public. Really . Were going to debate a Health Care System change for america thats going to affect millions of people, and we wont talk about it in public, but that was his ground rule. And then in the midst of it, he thought someone was taping him while it was going on and he stopped in full sentence and said i dont want this taped. Well, here is a bill that he voted for to change the Health Care System for the people it represents, including the folks in that room, and he didnt want to be on the road of public about that discussion. That tells me a lot as well. It isnt just a secret bill that we havent seen. Its a lot of Republican House members who voted for it, and they were all republicans that passed by, i believe, two or three votes, and now they dont want to talk about it. Well, there is a message there. Hears here is what i have concluded after looking at this in a lot of different ways. Where you stand on health care in america depends on where you start. Question do you believe that every american has a right to Affordable Quality Health care . If the answer is no, thats for people who are lucky or rich or have the right job, then you can reach the same conclusion they did in the house when they passed the republican measure, because you see their bill removed Health Insurance coverage from 23 million americans instead of expanding the percentage of americans with Health Insurance coverage, which we set out to do with the Affordable Care act, the republicans have reversed field, they are taking away Health Insurance for more from more people than the Affordable Care act gave. Now, is that press release from the Democratic National committee that i just quoted . No. It was the Congressional Budget Office, a bipartisan, Bipartisan Group here, an agency in washington that analyzes our legislation and gives us their analysis. They looked at the republican bill and said it will cost 23 Million People in america their Health Insurance. Well, if you started with the position that health care is a right, you would stop at that point and say, well, this bill clearly doesnt work because it takes away Health Coverage instead of creating Health Coverage. The second questioner, where you start is where you stand. The second question is if you believe the highest priority of this effort is to cut taxes on wealthy people, then of course you would vote for what they passed in the house, 700 billion in tax cuts. Now, that tax cut came right out of the Health Care System of america. That is the tax revenue that is used to expand medicaid Insurance Coverage to those who are lower income workers. That is the money that is used to help subsidize the Premium Payments of middle income workers who cant afford the monthly premium. What they believe, the republicans who voted in the house, there is a higher priority than helping those people to Health Insurance, and that is cutting the tax burden of the wealthiest people in america. So if you start with that premise youve got to cut taxes by 700 billion regardless of what happens this is what you end up with. The measure that came over from the house of representatives. I dont know what the Senate Republicans will come up with in response to that, but clearly it must be a parallel or close to what the house of representatives did. Lets take a close look at this measure and take a look at the history that brought us to this moment. As i mentioned, we still dont have the text of the republican secret bill to repeal the Affordable Care act. Six years and counting, they cant produce a replacement. It looks like were going to vote on this in a few days. By congressional standards, this is a high crime and misdemeanor. To think that we are going to consider a bill within ten days affecting every american, affecting onesixth of the American Economy, a bill that will say to some people you are going to lose your Health Insurance, and to others, were going to offer you a Health Insurance policy that really isnt worth the paper its written on. And we havent seen the bill . Whats the history of this . Is this the way the republicans always operate . Not really. In december of 2009, republican senator mcconnell their leader said, when we were debating the Affordable Care act, this massive piece of legislation that seeks to restructure onesixth of our economy is being written behind closed doors without input from anyone in an effort to jam it past not only the senate, but the American People. End of quote. That was senator mcconnell about the Affordable Care act when it was being proposed by president obama. Well, whats the fact . During the passage of the Affordable Care act, the senate held over 50 bipartisan hearings on the bill. How many bipartisan hearings have we held on the new Republican Health care proposal . None. Not one. At that time six years ago we had a weeklong markup in the finance committee and a monthlong markup in the health committee. The senate spent and i remember this well 25 consecutive days in session on the floor of the United States Senate Debating this bill. Its the second longest consecutive period of time ever spent on a bill in the United States senate. We considered on the floor of the Senate Hundreds of amendments. You know, we ended up adopting 150 republican amendments to the Affordable Care act. Not a single one of them would vote for it, but we took their proposals to make it better seriously and adopted 150 changes. How much of a chance will we have to amend the Senate Republican bill that may come before us as soon as this week . It remains to be seen. It could be what we call a votearama around here, which is a corruption of what this grand, this grand institution really established as a standard of operation for generations and centuries. The votearama lets you vote on an amendment offered to the bill with two minutes debate. Changing the Health Care System of america, and you have one minute on each side to debate your amendment, is that a serious undertaking with something that is that consequential for so Many Americans . No one has seen this secret bill, not democrats, not Many Republican senators. And when i asked the secretary of health and human services, tom price, last week at a hearing, have you seen the bill . Youre the one who is going to have to implement it. No, he said, i havent seen it either. This weekend the presiding officer, senator rubio, a republican from florida, said, and i quote, the senate is not a place where you can just cook up something behind closed doors and rush it for a vote on the floor. Mr. President , i couldnt agree more. Senator ron johnson, republican from wisconsin, said, and i quote, i want to make sure the American People i want to make sure the members of congress have enough time to evaluate it. I want to have enough time to really take a look at what were voting on. Republican senator ron johnson of wisconsin. Senator bob corker, republican senator from tennessee, said ive said from day one, ill say it again, the process is better if you do it in public. Obviously thats not the route that is being taken. I didnt pull these quotes from months and years ago. Theyre from the weekend. The comments made over the weekend by republican members about their very own leadership and the process theyre following in preparing to change Americas Health care system. Lets talk about some numbers. Lets start with zero. How many hearings have we had on the senate bill to repeal the Affordable Care act . Zero. How many markups have we had . Zero. How much time has the secretary of health and human services, the man responsible for implementing this bill spent on it to review it . Zero. How much democratic input has been allowed in the secret negotiation . Zero. How many women senators have been involved in crafting the bill . Zero. How many medical organizations or patients groups support the secret senate bill . Zero. And most concerning of all, how much time has the public had to even read this bill . Zero. Take a look at another number. 23 million. The Congressional Budget Office estimates 23 million americans will lose their Health Insurance under the housepassed repeal bill. One million in illinois. Ive said it before and ill say it again, this is a driving factor in terms of my views on the subject. If you have ever in your life been the parent of a seriously ill child and didnt have Health Insurance, youll never forget it as long as you live. I know. Ive been there. I was a law student, newly married, brandnew baby girl with a real Serious Health issue, and i had no Health Insurance. My wife and i sat in the Charity Section of Childrens Hospital waiting for them to call our names so we could take our little girl in to the latest resident with 100 questions who wanted to go through them all over again. And i thought to myself, durbin, how did you ever reach this point where you dont have Health Insurance . I fixated on Health Insurance from that point forward, from the time i got out of law school for years afterwards, while my daughter was growing up, i not only had Health Insurance, i sometimes had two Health Insurance policies. I was so worried about having coverage if i ever really needed it. So we want to take Health Insurance away from 23 million americans . You want it to be your family . Your son . Your daughter . I sure wouldnt. Another number 750. Lowerincome, Older Americans would see their premiums increase 750 under the housepassed repeal bill. From 1,700 under a. C. A. To 14,000 under the republican plan. How can that happen . How can you see the premiums go up that fast . Because we built into the Affordable Care bill a guaranteed protection for disparity in Premium Payments of no more than than three to one. The lowest cost Health Insurance policy cannot be i should say the most expensive one cannot be more than three times the lowestcost policy. The republicans changed that to five to one. Who does that affect . If you live between 50 and 64 years of age, youre in a category of people not yet eligible for medicare. If youre now facing chronic illnesses that could make Health Insurance more expensive, you will pay the higher premiums. The higher premiums, when calculated, are dramatically higher for this group. Thats why the American Association of retired persons has come out foursquare against the republican trumpcare, the republican repeal bill. Its just unfair to those between the ages of 50 and 64. 130 million, thats how many people nationwide is preexisting conditions. Almost half of the people in illinois have a preexisting condition. Several weeks ago i had a procedure for an atrial flutter. It worked out just fine. Now i have a preexisting condition. Im in the category. What does that mean . If you went to buy Health Insurance with a preexisting condition, youre charged more, if you can buy insurance at all. So when the republican bill that passed the house does not guarantee, as the Affordable Care act, that you cannot be discriminated against because of a preexisting condition, it makes millions of americans 130 million more vulnerable. Is that what they wanted to achieve . Where you stand depends on where you start. If you think everyone is entitled to Health Insurance, then you cant be standing for something that allows for preexisting conditions to be used against you. A lot of people im talking about have employer insurance but what be those who shop on the individual market or purchase individual insurance in the future . Under the house repeal bill, insurers would once again be allowed to charge people with preexisting conditions more money for insurance. The next number is 33,000. Senator menendez referred to it. Thats how many people are dying every year because of the opioid or heroin overdose. 33,000. 1,800 a year in illinois. Now listen to this. The republican bill dramatically cuts the Medicaid Program, the nations largest provider of Substance Abuse Treatment Services and allows insurers to once again refuse coverage for those needed services. Ive been here a few years, and i can remember that desk because thats where Paul Wellstone of minnesota sat. And i remember that desk because thats where Pete Domenici of new mexico new mexico sat. You ask for two polar opposites politically. Paul wellstone, a garrulous, proud liberal and progressive. Pete domenici, a proud conservative. One from minnesota, one from new mexico, and they came together on an issue. You know what the issue was . Each of them had someone they loved in their family who suffered from a Mental Illness. And they said why in the world will health Insurance Companies refuse to write coverage for people with Mental Illness . They fought for years against the Insurance Companies, and they finally won. And we included in the Affordable Care act the requirement that your Health Insurance policy cover not only physical illness but Mental Illness. It was a breakthrough. For the first time we stopped treating Mental Illness like a curse and treated it like an illness that could be treated. They added a section at the end that most of us didnt even notice. Mental illness and Substance Abuse treatment. I didnt know it was there until the Opioid Crisis, and i started going to these rehab facilities and saying to these people there, how are you paying for this care . Some of them were under medicaid. But those under private Health Insurance said my policy covers it. It covers it because wellstone and domenici insisted on you pug it in. After that historic victory you would think the republicans would include Mental Illness and Substance Abuse treatment as one of the basic essential services for Health Insurance but they dont. When they say were going to write a bill that gives americans more choice, more choice in your Health Insurance, oh that sounds appealing. The choice is whether you want Mental Illness and Substance Abuse treatment or you dont. From where im sitting, thats the kind of Insurance Coverage that should be basic to everyone. You never know whether that little girl that youre raising, that beautiful little girl, six years from now is going to be struggling with an addiction. And at that point you better hope that your Health Insurance policy has some coverage so that you can save her life and bring her back from that addiction. 280,000 is the next number. Thats how many children in illinois depend on medicaid for schoolbased health and medical services. From feeding tubes and handicap buses to special education teachers. I made a point this last week when i was home to visit the schools in chicago and bloomington and hear firsthand what cuts in medicaid meant to local School Districts. Many senators dont realize this, but the kids that youre dealing with who have learning disabilities and other disabilities, many of them are supported at your local schools by medicaid dollars. The medicaid dollars pay for the counselors, pay for the special buses, pay for the feeding tubes for these kids to survive. So when you make a dramatic cut in medicaid, as the republican bill that came out of the house does, you endanger the very services, the very benefits that these special ed kids need. The School District is mandated by law to help these kids. But if the money is cut off from medicaid, what are they going to do . The republican repeal bill that every republican congressman in my state voted for slashes 40 billion in medicaid funding to illinois, including money to School Districts. Three, this is the most important single number in the next ten days in the United States senate. Three. Thats the number of republican senators needed to stop this. Surely there are three republican senators who are concerned enough about this secret behind closed doors process that were witnessing when it comes to rewriting health care in america. At least three republican senators who want to take time to properly review this legislation that affects onesixth of our economy. Just the senators who have publicly stated their personal concerns about this process, if the three of them would come together, we could stop this and do it the right way. I said to a republican senator last week after the tragedy where a republican congressman was shot at a baseball practice, i said to him privately, isnt this the moment when we ought to get together quietly, democrats and republicans, when we ought to sit down and write a bill we can both be proud of . Im hoping he was listening. And im hoping three republican senators, if they stand up for it, will help us achieve that goal. Surely there are three republican senators who are worried about the kids in their state like im worried about the kids in mine who dont want to make the Opioid Epidemic any worse, who want to make certaind certain that theyre protecting the people they represent from discrimination because of preexisting conditions. At least three republican senators who dont want to throw millions of americans off of Health Insurance coverage. Maybe some of the senators who represent states that have been ravaged by the Opioid Epidemic will step forward. There are a lot of them. It only takes three to change this. To republican senators, i say dont 20 this. Dont do this secret process. Democrats are willing to work with you to improve our Health Care System. Ive said before the only perfect law that i know of was carried down a mountain on clay tablets by senator moses. All the other efforts can use some work. In this case were willing to work with you. Take repeal off the table and well pull a chair up to the table. Over the past week, ive received thousands of emails and letters from illinoisans who are worried about what is happening in the senate today. Helen from river forest, illinois, 47 years old, shes the primary caregiver for her parents. Her mom has alzheimers and is in a nursing home. Heres what helen writes. Just before thanksgiving, my dads health deteriorated. Hes now in a hospice in the same nursing home. I spent all their savings. My mom and dads savings on health care. My mom is finally eligible for medicaid. Without medicaid i would need to bring my parents to my home and quit my job to personally nurse them myself because i dont have the money myself to keep them in the nursing home and pay for private care. Please protect obamacare and medicaid. Thats what helen of river forest has river. Heres madeleine from chicago. She writes, my younger sister is disabled. Before the Affordable Care act went into effect, she was just about to hit the maximum lifetime limit on her private insurance policy. That used to be the case. Youd sign up for insurance and theyd say oh, great coverage. No copays. No extra charges. And then you find in the fine print theres a limit to the coverage of 100,000. My friends, i can tell you we are one diagnosis, each and every one of us one diagnosis or one accident away from more than 100,000 in medical bills. It happens pretty quickly. That used to be built into insurance policies. We outlawed it under the Affordable Care act. Now in the name of choice, the republicans want to bring that back. Madeleine says before the a. C. A. Went into effect and my daughter was about to hit the maximum lifetime limit on her private insurance policy, she was going to have to apply to be part of a highrisk pool, but that was going to involve a long wait without any Insurance Plus high premiums if and when she was accepted in the pool. The Affordable Care act came just in time for my sister and for our family. So when the republicans of the house say dont worry about people with preexisting conditions, weve set aside 8 billion, 8 billion to take care of them in private risk pools. Its sad and in a way tragic that they would say that. That isnt nearly enough money and no guarantee that private risk pools that never worked under before the obamacare would before the Affordable Care act would work again in the future. Its a way to give an answer to the obvious question of why theyre dropping so many people with preexisting conditions from guaranteed coverage. Last notice from erin from chicago. She writes, i employ you to force a public hearing on the a. C. A. Repeal that the republicans are trying to sneak through. If this bill passes, many of my friends and family will lose coverage either do to preexisting conditions or because the deductibles are too high. Additionally, my parents are selfemployed and getting older. Under the proposed act, their Health Insurance premiums will likely increase to 14,000 a year. They cannot afford it. They just cant. They will not have coverage, get sick and be unable to afford care. If the republicans have a better idea than the Affordable Care act for goodness sakes, stop hiding it from the American People. Stop talking about it behind closed doors. If its such a good idea, bring it out for the world to take a look at it. Oh, there will be critics. There are certainly critics to the Affordable Care act. I remember that very well. But thats what this body is all about. The United States senate is supposed to be a place where we deliberate on the important issues of our time. Is there anything, anything more important than your health, the health of the people that you love, and your opportunity to get basic health care so that you can protect them . I implore the republicans and those who know that this is the wrong way to go to stand up and say something. It only takes three republican senators to do this a much different way, to bring credit to this institution, and create a bill, create a change which makes health care more affordable, more accessible, and fairer to more americans. Mr. President , i yield the floor. A senator mr. President . The presiding officer the senator from mississippi. A senator mr. President , before beginning my remarks today about the requirement for a larger navy, i do want to extend my deepest condolences to the loved ones of those who lost their lives aboard the u. S. S. Fitzgerald recently. During saturday mornings early hours, the u. S. S. Fitzgerald, a guided missile destroyer, collided with a filipino merchant ship off the coast of hunchu, japan. The fitzgerald sustained significant damage, including the rapid flooding of three compartment areas. Mr. Wicker seven sailors lost their lives. These Young Americans were on board because they chose to serve their country. They are heroes whose names are added to the list of those who will be forever honored by our country questions remain about the collision and i hope they will be answered soon. Administrative, safety investigations into this tragedy are already under way but we couldnt change cannot change the horrific turn of events that occurred at 2 00 a. M. Off the coast of japan. Our hearts go out to the loved ones dealing with the grief this accident has caused. We wish a quick recovery to those who were injured and our gratitude goes to the many sailors who acted swiftly and resolutely to save lives and prevent further damage aboard. Now, lets talk about the size of our navys fleet. The Current Fleet has 276 ships, but the navys requirement is now for 355 ships, a figure supported by congressionally mandated future fleet architecture studies. Last week i spoke on the floor about the national imperative to build a larger navy. I outlined the Critical Missions our navy performs every day to help secure the countrys vital interests. I also described an intense naval competition with our real and potential adversaries. This is a competition that america cannot afford to lose, mr. President. America needs a bigger navy. How do we get there . Related to that question is when we get to a 355fleet ship. According to the chief of naval operation, admiral john richardson, we should reach our 355ship objective in the mid2020s. To do that we should have started yesterday, building and sustaining technologically advanced ships as a longterm National Project. It cannot happen overnight. It takes years. As chairman of the seapower subcommittee, i intend to lay a Firm Foundation this year to help support a buildup. Based on my subcommittees work, im convinced congress has a Critical Role to play in determining how we get to 355. All options should be on the table. Here are four ideas to consider. First, ramp up hot production lines. The navys accelerated fleet plan states that over the next seven years, the Shipbuilding Industrial base can support building more ships than currently planned. The navy plans to build 59, but the Ship Builders can actually complete 88. We should do this. Many hot production lines have excess capacity. Congress should authorize the navy to buy in bulk using multiyear and block contracts. These contracts would help solidify the skilled work force, stimulate suppliers, and drive down costs. We can also authorize advanced procurement funding to buy long lead time pieces and parts. Number two, extend the surface life of ships in the fleet. A quarter century ago, the navy had 450 ships and deployments that averaged 167 days. Now the average deployment exceeds 200 days. In other words, the navy is smaller but the tempo of its operations has accelerated. An extra month of deployment puts additional wear and tear on ships, and this can force early retirement and ultimately squander taxpair dollars taxpay taxpayer dollars. Better maintenance can extend service lives, early retirement and reach the 3455ship goal 355ship goal. I applaud the budget request. We must build new ships and maintain the Current Fleet better. Does the distinguished majority leader wish me to yield for some business . Mr. Mcconnell mr. Mcconnell if i may just do a wrapup here. Mr. Wicker i would be delighted to yield. Mr. Mcconnell i thank my friend. The presiding officer the majority leader. Mr. Mcconnell i ask unanimous consent that when the senate completes its Business Today it adjourn till 12 00 noon wednesday, june 21. Further, that following the prayer and pledge, the morning hour be deemed expired, the journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed. Further, following leader remarks the senate proceed to executive session and resume consideration of the mandelker nomination postcloture. Finally all time during morning business recess, adjournment and leader remarks count postcloture on the mandelker nomination. The presiding officer is there objection . Without objection. Mr. Mcconnell if theres no further business to come before the senate, i ask it stand adjourned under the previous order following the remarks of senator wicker and senator hassan. The presiding officer without objection. The senator from mississippi. Mr. Wicker in a recent speech to the Naval War College, the c. N. O. Admiral richardson noted that extending the lives of class destroyers could help the navy reach the 355ship objective 10 to 15 years earlier. The commander of Navy Sea Systems command, vice admiral thomas moore agreed with the c. N. O. At a recent speech where he stated that proper maintenance would extend the service lives and help grow the fleet more rapidly. Number three, we can reactivate ships in the Ready Reserve fleet. During the reagan buildup, the navy brought ships out of mothballs, including battleships with massive guns to help grow the fleet size. The navy should look at the reserve fleet ship by ship to determine if any can be restored to operational status. In his Naval War College speech, the c. N. O. Revealed he is considering bringing some retired Oliver Hazard Perry class frigates out of mothballs. Vice admiral moore also suggested examining the merits of returning some logistic ships to the force. Reactivating retired ships does not simply mean bringing back less capable ships. Jerry hendricks and robert c. Obrien wrote in politico in april that reactivated ships could be outfitted with modern Missile Systems and potentially cutting edge electromagnetic rail guns and directed energy weapons. In other words, reactivated ships could perform completely different and Relevant Missions at a fraction of the new of the cost of new construction. And fourth, we could develop and deploy unmanned maritime systems. The fleet of the future will include new types of ships. Again according to the c. N. O. Theres no question that Unmanned Systems must also be an integral part of the future fleet. Unmanned under sea and surface ships can offer significant advantages, such as the ability to conduct persistent operations. We have seen drones, revolutionized combat if the skies. The same is possible on the seas. I believe the navy needs a dedicated range to test Unmanned Systems with other manned and unmanned platforms while also training new operators and maintainers. I applaud the navy for including substantially r d funding for unmanned underwater vehicles in his list. Im hopeful congress will provide the resources necessary to rapidly develop and deploy new Unmanned Systems. To conclude, we should be considering all options for building up our naval capacity. I do not dismiss the fact that these options cost money and some are controversial, but they deserve to be explored. It would be irresponsible for congress not to do the work now to ensure that the navy of the future has what it needs to respond to challenges and fulfill its missions. This means 355 ships, i look forward to working with my colleagues to set this imperative National Project into motion. Thank you, mr. President. I yield the floor. The presiding officer the senator from New Hampshire. Hasnms. Hassan thank you, mr. President. I thank my colleague for his remarks about the brave men and women of the navy and their need for support i rise today to join my democratic colleagues in spoke being out against the dangerous trumpcare bill, which is currently being drafted behind closed doors by our republican colleagues. The secrecy around this bill shows that Senate Republicans know that they cannot defend it to their constituents. Thats why Senate Republicans are even refusing to hold a single hearing on the bill. In my state of New Hampshire, you cant pass a bill if its not had a hearing. And the senate here in washington should work the same way. I continue to urge my colleagues to hold public hearings on this bill so that we can examine the bill for ourselves and get feedback from our constituents and stakeholders. We do know that this legislation will be very similar to the house trumpcare bill, which President Trump himself called mean. And calling it mean is even putting it lightly. Trumpcare threatens to have devastating impacts on millions of americans. Today im going to address three specific ways that trumpcare is mean to people in New Hampshire and across the nation. First it undermines the Medicaid Program. Second, it hurts our seniors. And, third, it continues this administrations efforts to roll back womens access to health care. Mr. President , as governor, i worked to pass and then reauthorize New Hampshires bipartisan Medicaid Expansion plan. That provides coverage now to over 50,000 hardworking granite staters. And trumpcare, by proposing to repeal Medicaid Expansion, hurts many of the hardworking people served now by that Expansion Program whose care depends on the Expansion Program being continued. This includes people like joe from portsmith. I met joe at a round table earlier this year. Joe has a painful precancerous disease that eats at her abdominal organs. Shes had it for most of her life. And require and prior to the greagreat recession, she a job t had Health Coverage. But in 2009 jo was laid offer from her job. Then unable to find reliable fulltime work, so she worked several parttime jobs, but they didnt offer Health Insurance. In 2012, she desperately needed surgery. She didnt have Health Insurance. She couldnt get the surgery. Her health declined. The recession continued. And her ability to support herself also declined. In 2014, after New Hampshire came together and passed its bipartisan Medicaid Expansion program, she was able to get health care coverage. The Medicaid Expansion Program Helps her get eight to 12 prescriptions, necessary medical tests, physical therapy, treatments, and specialists. This is also this has also meant that jo is healthy enough to work again. Trumpcare would end Medicaid Expansion, putting people like jo at risk. Trumpcare also changes medicaid into a per capita cap system. Thats a fancy label for massive cuts to the Medicaid Program that would force states to choose between slashing benefits, reducing the number of people who can get care, or both. Under trumpcare, states will be faced with Cutting Services that children, people with disabilities, and seniors depend on. Which brings me to the second point id like to highlight today about this mean bill and who it impacts. Mr. President , it is clear that trumpcare would hurt seniors across the granite state. The majority of nursing home residents in New Hampshire are served by medicaid. Trumpcare would jeopardize the ability of seniors to stay in nursing homes. It would also threaten services for seniors who receive athome care. And these cuts to medicaid are just one of the ways seniors would be hurt under this mean proposal, because trumpcare would also create an age tax, letting insurance plans charge older adults five times more than younger people. If you are between the ages of 50 and 64, you will be especially hard hit. According to the nonpartisan Congressional Budget Office, under trumpcare, you could face 20 higher premiums in 2018 with especially high premium hikes for Older Americans. And the aarp opposes trumpcare because it would and this is a quote make Health Care Less secure and less affordable. Finally, my third point, mr. President , is that it is clear that trumpcare would continue this administrations efforts to roll back womens access to Critical Health Care Services. To compete economically on a level playing field, women must be able to make their own decisions about if and when to start a family. They should not have to pay more than men do for health care, and they should be able to visit providers of their own choice who understand their health care needs. And to fully participate not only in our economy but also in our democracy, women must be recognized for their capacity to make their own health care decisions, just as men are. Under trumpcare, if you are a mother giving birth could now be considered a preexisting condition. Trumpcare would also undermine the requirement that Insurance Companies have to cover essential Health Benefits, including maternity care. And trumpcares medicaid cuts would have drastic impacts for women across the country. According to the Congressional Budget Office, medicaid pays for nearly half of all births in the United States, and it provides Health Coverage for one in three children across our country. Trumpcare also defunds planned parenthood, which provides critical primary and Preventive Health Care Services to thousands of New Hampshire women, including preventive care, birth control, and cancer screenings. Mr. President , my democratic colleagues and i are ready to work with anyone who is serious about working to build on the Affordable Care act and lower Health Care Costs for hardworking people. But what we do not need is legislation that even the president himself admits is mean. Ill continue working with my colleagues to speak out against and defeat trumpcare, and i urge the people of New Hampshire and people all across america to keep making their voices heard and make clear that this mean bill is simply unacceptable. Thank you, mr. President. I yield the floor. The presiding officer the Senate Stands adjourned until noon tomorrow
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