Transcripts For CSPAN2 U.S. Senate Democrats Call For Hearings On Health Care Bill In Late Night... 20170619

Disability in context with both the senate bill emerging and the house bill. On behalf of roan and those who have a loved one with a disability, i ask unanimous consent that no motion to proceed to calendar no. 120, h. R. 1628, the American Health care act, be in order until the bill is jointly referred to the committee on finance and the committee on health, education, labor, and pensions. The presiding officer is there objection . Objection is heard. Ms. Klobuchar madam president. The presiding officer the senator from minnesota. Ms. Klobuchar madam president , one of the things that i would most like to work on at the cost is the cost of Prescription Drugs and i think we should make sensible changes to the Affordable Care act. But the bill that came over from the house doesnt really do that at all. And whether its bringing the costs down for seniors by having negotiations under Medicare Part d, whether its allowing for less expensive drugs to come in by generic drugs or from other countries, the bill just doesnt do that and now were supposedly a bill is being considered here but its being done in secret, so i cant have my say. For any bill in the senate, committees meet, debate, and vote on amendments offered by senators on both side of the aisle. We need to hear ideas on how to fix this bill from the help committee. I ask that we agree that the bill wont come to the floor until the help committee has had an open meeting and considered amendments from both parties. I ask unanimous consent that no motion to proceed to calendar no. 120, h. R. 1628, Affordable Care act, be in order until the bill has been the subject of executive session meetings in the health, education, labor and pension during which amendments from the majority and minority receive votes and the bill has been reported favorably from the committee. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. Ms. Harris this bill will affect over 500,000 californians. It is important to have this bill go to committee so the public can understand whats in it. Any bill that is going to by pass our norm bypass our normal floor proceed yours and voted on with only one party heard should at least go through committee and have an open hearing process. The democrats introduced a bill to change our process to say exactly that. Any bill that gets expedited and gets the expedited simple majority of passing the senate has to at least go through committee and have a hearing. So im going to ask my colleagues now to agree to immediately consider that bill so we can fix this process before this Health Care Bill comes to the floor. I ask unanimous consent that the committee on budget be discharged from further consideration of s. 1376 and that the senate proceed to its immediate consideration. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. The senator from massachusetts. A are senator two mr. Markey last year 2,000 people in massachusetts died from Opioid Epidemic. Thank god, because of the Affordable Care act, many of those people received treatment who otherwise would have passed away last year. The number would have been a much larger number across our state and across the country, but because of the Affordable Care act, the number was low, but that number was still much too high. And i want to be able to tell the people in massachusetts what the impact of the republican Health Care Bill will be on their families in terms of getting access to the opioid Addiction Treatment which theyll need so the number doesnt continue to go up, but goes down. I want to be able to tell them what those what that coverage will be before i vote upon it, but the majority just wont let that happen. They are keeping the bill hidden. They dont plan to make it public until the very last minute with less than a day to view it before we vote upon it. That will be catastrophic for those families that need opioid Addiction Treatment absolutely catastrophic. So i have a unanimous consent request, mr. President. I ask unanimous consent that no motion to proceed to calendar no. 120, h. R. 1628, the American Health care act, be in order until the bill has been the subject of executive session meetings in the committee on finance and the committee on health, education, labor and pensions during which amendments from the majority and minority receive votes and the bill has been reported favorably from the committees. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. The senator from new york. Mrs. Gillibrand i am worried about individual that have preexisting conditions. I watched two of my best friends survive cancer this year. They had intensive treatments, surgeries, chemotherapy, and they both have young daughters. I cant imagine how worried they are right now because they dont know whats in had become bill and they dont know whether they will be able to afford Health Insurance coverage. Im worried about millions of americans who may not have access to affordable insurance under this bill because we have not read it. Therefore, i ask unanimous consent that it not be in order to proceed to calendar no. 120, otherwise known as the American Health care act, until the full text of the bill be available to the public for review and comment for a minimum of 30 days. That is the same amount of time we give every Day Regulations coming out of our agencies. Because this bill could have such a negative effect on millions of americans. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. The senator from massachusetts. Ms. Warren mr. President , i dont think we ought to vote on a bill that will touch every single human being in this country when one party is locked out of the debate, not able to read the bill and not able to discuss and it help make suggestions and changes. I think that families all across this country should be able to see this bill and should be able to evaluate the impact on themselves and on their families. Im here today, in part, because of a little boy named nicholas who was born way too early who is 2 years old and received a diagnosis of autism. He is a recipient of medicaid. I talked to his mother today. She wants to know whether or not this bill will cut nicholas care and what this means for nicholas future. I think its wrong for republicans to push through a bill when nicholas mother cant know what the impact will be on her and her child. So i believe we should post online any bill thats going to affect families like that and for that reason, i ask unanimous consent that a substitute or perfecting substitute amendment offered to calendar no. 120, h. R. 1628, not be in order if the text of the amendment has not been filed at the desk and made available on a public website for at least 72 hours, along with an analysis by the Congressional Budget Office of the bills budgetary coverage and cost implications. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. Mr. Schatz mr. President. The presiding officer the senator from hawaii. Mr. Schatz we democrats are here on the floor to take a and it against a bill thats a disaster for our Nations Health care. Medicaid patients, families with loved ones in nursing homes, people who struggle with opioid addiction, women who rely on planned parenthood, people who work in the health care industry, and so we stand with them and for them tonight. But we also stand for the American Public who is being left in the dark about what trumpcare will mean for them. This is not the normal order of senate business. The republicans are going about this in a way that is so procedurally flawed that it is an embarrassment to democracy itself. They are hiding this bill. They are hiding this bill because people will be outraged when they find out what is in it. Thats why a republican aide said they are not releasing the bill because, quote, we arent stupid. Think about what that statement means. First, it means they have a bill. Second, they think its political suicide to make the bill public. So they are bypassing the normal and necessary process needed to make good legislation. The way you make legislation is you allow the sun to shine in and that starts with hearings. Every legislative body in the country, from a school board to a county council, has hearings. Because we figured out that for all of our flaws, we figured out that over the centuries that you need hearings, not just to placate the masses, but to figure out whether your legislation is any good or not. Republicans have not held a single hearing on trumpcare. No one knows no one who knows anything about health care is allowed to say anything about this bill because they arent even allowed to see it. But anyone who has tried to understand the American Health care system knows that its complicated. The president said so himself up need expert testimony, you need public input, and you need time to talk to your home state. Thats the way you get a good product, but republicans have totally bypassed the two committees that exist to consider legislation like this. Think about it. Under normal circumstances, this legislation would be in the finance and help committee jurisdiction. There would be hearings and there would be a markup. Thats not the process being used. Theres no markup, there are no committee hearings, theres just 13 dos. They are rushing to pass pa bill without women, without democrats, and without input from the American People. Heres the order of the people who get to see the Health Care Bill, 13 men in secret, republican lobbyists, politico, republicans, democrats, and then the American People. This is shameful. This is a violation of the way that democracy itself should work. When they are done, the product will be the fruit from a poisonous tree. It cant be good because the process that processed it hasnt been good. I will highlight three groups that will stand to loose. First you will have people who will loose their insurance or loose the ability to choose their provider. Families wont be able to afford nursing home care for their loved ones or pay the hospital bills for a parent after she has a heart attack. Americans with preexisting conditions will struggle to buy insurance because Insurance Companies will be able to charge more for conditions like diabetes or cancer or asthma. Women will be blocked from getting annual checkups or screenings from planned parenthood. All of these people stand to lose if the bill moves forward. Second, you have people whose jobs will be at risk. Health care makes up onesixth of the american economy. It doesnt exist in a vacuum. You can bet those jobs will be affected by this bill. There is one estimate that the Trumpcare Bill will take away one million jobs by 2026. We are supposed to make it better for health care workers. Finally, this bill hurts the working poor. These are the people who will struggle even more under trumpcare and i dont know why we would punish them. Why would we leave them with nowhere to turn . I know that millions of americans feel the same way that i do. They care deeply about the poor, the vulnerable, and the sick among us because theyve made newsstanding up for their neighbors. One woman named jesse went to town hall to make her voice heard about trumpcare. Quote, it is my understanding that the a. C. A. Requires everyone to have insurance because the Healthy People pull up the sick people, right. And as a christian we are to help to pull up the sick people. If we take those people and put them in a highrisk insurance pool, its costlier and less coverage for them. Thats the way it was in the past and thats the way it will be again. So we are effectively punishing our sickest people. And i end the quote. We may not agree on policy, but i hope we can agree on the process. What will it take . What will it take for to this process to be restored and for trumpcare to be considered the way it ought to be considered . The answer is very straightforward. We need three republicans. It only takes three republicans and you can be a person who hates the Affordable Care act or who has mixed feelings about the Affordable Care act or anywhere in between. It only takes three republicans in the United States senate to restore the United States senate itself, to restore the hearing process, to restore Public Confidence and restore bipartisanship. All we need are three republican senators to say i wont vote for anything if there hasnt been a public hearing. I wont vote for anything that has been jammed down americas throats. I wont vote for anything without being able to go back home and figure out how it will impact my states hospitals. This is not an unreasonable ask. Were just asking for three republicans to say lets be a senate again. Lets restore order and transparency and do things the right way, because thats the only way that this bill will not be a total disaster. I yield the floor. Mr. Booker mr. President. The presiding officer the senator from new jersey. Mr. Booker i am grateful for the recognition. I am grateful for my colleague from hawaii, really my colleagues from across the country who are going to be coming to the floor tonight. This is going to be a long evening because there are a lot of folks who are frustrated. Now, its not just frustration about the actual bill itself. A lot of this frustration right now is building because of the brokenness of this process. A process that is right now about secrecy, a process that has been conducted behind closed doors, in back rooms, a process thats not reflective of our hilt, our traditions or many of the calls from both sides of the aisle that in my short time in the Senate Hearing an echo, a chorus of my colleagues on both sides of the aisle who talked about regular order, regular order, regular order. Several of my colleagues and i earlier were asking for unanimous consent, trying to use the process of the senate to bring about a better process, a process that would bring this legislation out into the light of day and create an opportunity reflective of the American Health care act where we would have people able to put input into this process, a debate would happen, discussion would happen, and actually we would come about with a bill that the American Public would see go through the debates. In fact, through the process, the very Constitutional Convention of this country, perhaps some of the biggest issues of humanity were debated in an open forum. We have records of those discussions, records of the deliberations, everything from the representation that each state should have to issues as profound as slavery were right there out in the open. Tonight its remarkable to me, its almost tragic to me to see a process that is so broken, a process that is so secretive, a process happening in back rooms and everything that americans dislike about politics of old. People working in secret on a bill that theyre going to try to force through congress with no public input, no hearings, no meetings, no markups, no debate, no public accountability. And so there will be a lot of voices tonight. Sure, speaking about the realities of this legislation. Im one of those folks. I came from a Childrens Hospital this afternoon, with parents, with children that suffered accidents, Car Accidents and more telling me how they were relying on medicaid. I think its one of the most terrifying things thats about to happen, because people look at the house bill, a bill that our president even called mean, and theyre fearing for their own communities, fearing for families like theirs. I understand the substance of this bill should have many people afraid about what kind of country were going to be. When you just look at the house version of the bill, it violates our common values and ideals as a nation. To give massive tax breaks worth hundreds and hundreds of thousands of dollars to the wealthiest and at the same time cutting the social safety net at a degree that we havent seen in my lifetime. The substance of this is frightening but the process to me, it violates the values that i know so many of my colleagues hold, that any of us watching this happen in an objective way would criticize this process. So we know the starting place in the house. We know the details of that bill. 23 million americans losing Health Insurance, the cutting of medicaid by 800 billion, throwing onesixth of our economy into crisis, but its the process thats fundamentally at odds with the principles and the values, especially of this body, the senate. When i was running for this office, i had so many people to me and say this is the greatest deliberative body on the planet earth. The senate which slowed things down, the saucer that cooled the tea as our ancestors called this body. It has a history for grappling with issues. But this process is so at odds with everything that i believe about this body and how its supposed to operate. The senate is meant to be a place of careful consideration, of debate, of discussion. Now, the history of this body and its debates and discussions is really interesting. The longest consecutive session in Senate History was a debate during the First World War about whether to arm merchant ships. Thats the record. And by the way, issues of war and peace, i would hope that they would bring about substantive, deliberative debate, discussion, open air. This probably is probably in fact, the elder statesmen and women in this body that i have talked to on both sides of the aisle tell me sometimes the most difficult decisions they have made are involving war and peace. But what is interesting, if you look at the history of the body, the longest debate, consecutive session debate was about war and whether to arm merchant ships in the First World War, what was the second longest debate . The second longest consecutive session in Senate History, it was actually health care. Or more specifically, it was the Health Care Debate in 2010 about the Affordable Care act or socalled obamacare. In fact, here we are looking at a process that seems to be screaming something to the fore, no hearings, no markups, no committee sessions, screaming to the floor in the shadow of the second longest consecutive session of debate. That to me is a contrast that speaks volumes about the wrongness of this moment in history, that anyone objectively standing back would agree and concur that for something that is so deeply at the core of what our country is about, we literally founded this nation because of life, liberty, and the pursuit of happiness. Life. And what more fundamental aspect of life is there . A critical constituent part of that has to be how we preserve life, how we embolden life, what is the state of our health care. And for this great historic deliberative body, to be doing that without so much as a pause, with the Brilliant Minds on both sides of the aisle, with the thoughtful people on both sides of this aisle, people who have come through portals and processes where they expose themselves and their lives to public discussion, public debate, thats what a democracy is. Thats what this republic is founded upon. Not secrecy, not back rooms. This body reflects the best of what democratic principles are, and now were rushing something through that fundamentally affects life. And were pushing it to the floor with an insult to our history, an insult to our values. Its been said before, but i remind you that the Affordable Care act had a lengthy process before that nearrecordbreaking consecutive days of session. The Senates Health Committee Held 14 burton roundtables, 13 bipartisan hearings, 20 bipartisan walkthroughs and considered nearly 300 amendments. The Affordable Care act actually accepted over 160 amendments, 160 republican amendments to shape the bill. The finance Committee Held 17 roundtables. Summits and hearings, 13 member meetings and walkthroughs, 38 meetings and negotiations and then a sevenday markup on the bill, the longest markup in over 20 years. Thats our history. In the end, the Affordable Care act went through a lengthy process through which the policy experts, market experts, medical professionals, health nonprofits, insurers, hospitals, families all came to this senate and put forward their input and their ideas. This wasnt a republican bill or a democratic bill on the politicians themselves. America was invited to the table. Hours and hours of hearing records show that people whethel ended up reflecting their ideas or not, they had their say. Thats whats beautiful about this democracy. Its the dignity and the voice and the opinions of others that is brought into the process. I was mayor of newark during the time that this process was going on. And people in my community were rivetted by it and knew that issues that would affect their life were going on here in the United States senate. At a time that the numberone reason for personal bankruptcy in my state was people declaring bankruptcy because of their insurance bills, something that because of their Health Care Bills, something thats not happening now at those levels. People were caring and concerning about what was going on, and representatives from my Community Came down. I saw how that process shaped the bill. I saw how republican ideas shaped the bill. I saw how hospitals and insurers and advocates and doctors and nonprofits, the aarp and others let their voices be heard, shape the process, had input, had voice, their dignity and perspectives were respected. Mr. Merkley mr. President. Mr. Booker yes. Mr. Merkley would my colleague yield for a moment . The majority leader has returned to the floor to hear a unanimous consent request, actually two of them, which we will make very brief and yield back to you. Mr. Booker i fully yield to the majority leader. Mr. Merkley thank you, mr. President. This weekend, i was out doing town halls in rural oregon. I was in Klamath County and lake county and wheeler county, counties that on any map would be described as solidly red, and at my town halls, people were turning out with one huge anxiety, and that is the Health Care Bill that might be considered next week with no consideration in committee, no consideration for amendments, no opportunity for extras to weigh in, and most importantly no opportunity for the citizens of america to weigh in, and so two veterans came up to me at one of the town halls at the paisley saloon, and they said does d. C. Understand the despair, the anxiety in rural oregon ove and the answer, of course, at this point is no, but we hope the answer will be yes. And then i was visiting a nursing home, and two different individuals i spoke to noted that virtually everyone in longterm care was there through medicaid, and they said, you know, if we lose medicaid, wer, one woman said to me, you know, i will be out on the street, and i cant walk, so thats a problem. Well, yes, it is a problem for folks with longterm care to be dumped onto the street. And thats why at this moment im asking for our normal process for any bill, any modest bill, but certainly a major bill to get thorough democratic consideration in this beautiful we the People Democratic republic, and that Means Committee hearings and that means experts testifying and that means input from citizens. So thats why i ask unanimous consent that no motion to proceed to calendar number 120, h. R. 1628, the American Health care act, be in order until the bill has been the subject of executive session meetings in the committee on finance and the committee on health, education and labor and pensions. During which amendments the majority and the minority have the opportunity to be presented and considered and the American People have the chance to weigh in and the bill has been reported favorably from the committee. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer objection is heard. Mr. Markey mr. President. The presiding officer the senator from massachusetts. Mr. Markey mr. President , when i was home in massachusetts this weekend, i constantly had people coming up to me, asking me about the credit republican Health Care Bill. What was in it. How was it going to affect their families . Because to use Donald Trumps word, theyre afraid that its going to increase premiums, and that would be mean, that its going to make it impossible possible for insurers to deny coverage for preexisting conditions and that would be mean, that it would create an age tax for older americans. That would be mean. That it would cut medicaid coverage for grandma and grandpa to get a nursing home bed if they had alzheimers. That would be mean. So the question that kept coming to me all weekend, recurring, was is this secret bill really meant to cut all of the funding that goes for the poor, the sick, the elderly, the disabled so they can give tax breaks to the wealthiest people in america . Can we get that out so that people can see that . They also said to me they didnt want to be fooled because their fear is that trumpcare is as much a health came irbil as Trump University was a College Institution and there really isnt any health care in it and that its cruel, inhumane and its immoral. So were demanding that the republicans show us the bill, that the American Public can see the American People can see the bill, and they can understand whats in it because the consequences for their Families Health is so dramatic. So as a result i ask unanimous consent, mr. President , that the calendar 120, h. R. 1628, the American Health care act be referred jointly to the committee on finance and the committee on health, education, labor, and pensions with instructions to report the bill with changes to eliminate provisions that, one, increase Health Insurance costs, two, reduce coverage, three, make Health Care Less affordable for those with preexisting conditions, and four, reduce tax liabilities for corporations and individuals with incomes over 1 million. I ask unanimous consent, mr. President , that that motion be put in order. The presiding officer is there objection . Mr. Mcconnell i object. The presiding officer the objection is heard. The senator from new jersey. Mr. Booker thank you very much. Im recognizing that my more senior senator is here from delaware. I would like to suspend at this time in deference to an opportunity for the senior senator from delaware to have a few words. Mr. Carper i want to thank my friend the presiding officer the senator from delaware is recognized. Mr. Carper thanks so much. I thank my friend for yielding. I take the train back and forth from time to time to my home state. Im going to try to get on a train later tonight to go home. Thank you for letting me have a few minutes to say this. I came to the senate in 2000, was elected in 2000. I got here in 2001. Two days after i was elected i called tom daschle who was the democratic leader in the senate. I said to him, i said i understand that what i need to do is to explain my committee selection, what my choice, my preference is for committee. I have to present those to you. He said yes, you should give me a letter today that tells me what committees you would like to be on. Im not sure how they work it on the republican side. Thats the way they do it here and i presume still do. I said my first three choices to be on committees, my first choice would be the finance committee. My second choice would be the finance committee. My third choice would be the finance committee. He said you want to be on the finance committee, dont you . I said yes, i do. He said so does everybody else. You have to get in line. So i did. It took me eight years. Id been on great committees in the interim including the Banking Committee and commerce, Homeland Security and Governmental Affairs and others as well. Eventually i got on finance. I got on the finance committee in 2009. That was the year we had a new president , barack obama, and Vice President joe biden. And the idea was, at least the hope from our new leaders was that we do something that, gosh, since harry truman wanted to do and that was to provide Health Care Coverage for just about everybody in our country. And they werent sure quite how to go about it but we did our homework and found in 1993 when hillary care when hillary was first lady, hillary clinton, we worked on something called hillary care. And the republicans felt like they had to come up with an alternative. That was provided by the people of heritage, the republican think tank. What they came up with had really like five components to it. It was introduced by john chafee, Chuck Grassley and 20 other senators, republican senators. And the hillary care in the end didnt go anywhere. The chafee bill didnt go anywhere, but it lived on beyond 1993, that congress. And when mitt romney ran for was governor of massachusetts, going to run for president , he took that 1993 legislation which called for creating in every state exchanges, marketplaces, large purchasing pools where people who didnt have Health Care Coverage could buy their Health Care Coverage in their respective state. The 1993 legislation also had sliding tax credits so people buying their coverage on the exchanges could get a tax credit to help buy down the cost of coverage. The idea was that folks whose incomes were lower would get a bigger tax credit. Those whose incomes were larger and larger wouldnt qualify anything at all. Another provision in the 1993 legislation that mitt romney borrowed was the idea of having an individual mandate to everybody had to get coverage in massachusetts and the if they didnt, they had to pay a fine. The idea was we need for for folks to get coverage we need to make sure the exchanges that were going to have in states, that we didnt have people sign up for the coverage in the exchanges when they were sick and were going to run up the tab a lot for the Insurance Companies. The Insurance Companies say we cant make money doing that. In massachusetts they had an individual mandate and also a an employer mandate, a certain number of employees, you have to provide coverage for your people. You dont have to pay for it all but you have to offer coverage. The last thing they took mitt romney took from the governor romney took from the 1993 legislation by senator chafee and others was the idea that Insurance Companies could not deny coverage to folks with preexisting conditions. Those were mitt romney thought those were pretty good ideas and made them sort of the centerpiece of what they call romney care in massachusetts which became the law and ultimately originally they didnt do a good job on affordability and one of the reasons they didnt do a good job affordability in massachusetts, im told by folks in massachusetts the fine was associated with the individual mandate wasnt very big. Eventually it scaled up but it took a while to get to a point where young people say, you know, im paying this fine, i might as well get coverage and stop paying the fine and get something at least for my money. And romney care ended up being pretty successful. He ran for president and one of the linchpins he used in running look, weve already done what barack obama wants to do. We already provided Health Care Coverage for people in my state. And in any event, in 2009 i ended up on the finance committee. You know what . We spent a huge amount of time in 2009 trying to figure out what this Health Care Plan should look like, that our new president , new Vice President wanted us to do. It looked a lot like what was offered in 1993 and it looked a lot like what was actually adopted with relative success in massachusetts. We held a whole lot of hearings. The reason im going back to this i remember being on the finance committee and it seemed like week after week after week we had meetings, round tables. We had discussions on the floor, off the floor to talk about does this make sense or not. We went for an extended period of time we had three democrats and three republicans on committee who i met endlessly to try to figure out what the reasonable compromises were that would enable us to extend coverage to everybody in an affordable kind of way. We ended up having extensive markup, voting, debating the legislation in both the finance committee and over on the health, education, labor, pension committee. People had the opportunity to offer amendments. A number of amendments were offered, adopted by democrats and republicans alike. I dont remember exactly, mr. President , but i seem to recall the health, education, labor, pension committee, some like 300 amendments may have been offered, 160 by republicans that were adopted, that were adopted. And long story short final le we had a chance finally we had the chance to finish the debate and it became law. I know our republican friends didnt think they had a chance to be involved. My reaction having been there, there was a lot of involvement. There was a lot of involvement by both sides. I thought at times that the debate on this legislation would never end and finally did and we finally passed it by a very close margin. The reason i bring this up, that was my first year on the finance committee. I loved it. I loved it. And i was on there with senator stabenow and a number of others. We were actually legislating. It was fun. It was challenging and we were trying to develop consensus. I want us to do that again. I want us to do that again. As good as we think that the Affordable Care act i know its not perfect. I think everybody in this comaim better know this chamber knows its not perfect. The idea of preserving what needs to be preserved, fix what needs to be fixed, thats what we ought to be about. As smart as our republican friends are, you cant do this by yourself. As smart as we like to think we are, neither can we. In this case we would be a lot better off by doing this together. I know our leader chuck schumer, senator schumer has has asked the republican leader to for us to actually meet later this week, maybe thursday i think in the Old Senate Chamber and just talk it over. Just talk it over. I dont know john kennedy used to say, we shouldnt be afraid to negotiate. We shouldnt a great quote. A great quote about not being afraid. He said we should never be afraid to negotiate or talk. I think that probably pertains to us today. So i want to thank the senator from new jersey for yielding his time to me to give me a chance to say something. Again, to my republican colleagues, over in africa a couple of years ago, tanzania, for a seminar, democrats, republicans, house, senate, learned a lot about africa. One thing i learned was a great african proverb. It goes Something Like n. You want to go fast, go alone. If you want to go far, go together. You want to go fast, go alone. You want to go far, go together. Something this important we need to go together. And were glad we did. I yield back. Thanks so much. A senator mr. President . The presiding officer the senator from california. Ms. Harris you talked about tanzania. It reminds me of a greeting that ive often heard from people who live in various african countries. You probably heard it. But when you meet someone for the first time, instead of what we would normally say please to meet you, the greeting back is, i see you. I see you. And i think that really is part of our concern here. Do we see the people who will be impacted and the way they are actually living their lives and do we understand if we see them, that this bill will not be in their best interest . And right now, for example, we know, 13 senators, all republicans are crafting a bill and this bill would restructure our nations entire Health Care System which when you add up what americans can spend on hospitals, doctors, Prescription Drugs, and all the rest, we understand that it makes up onesixth of our economy. It would affect the lives of everyone, our parents, grandparents, those in need of care giving, our children struggling with asthma or opioid abuse. Our spouses who may be battling cancer. And what is equally distressing is that this bill is being written in secret. The chairman of the finance Committee Says he has not seen the bill. The secretary of health and Human Services says he has not seen the bill. The American People, the people we all represent, have certainly not seen the bill. I think the American People deserve better. This bill is being written entirely along partisan lines without any attempt to bring democrats on board. And the American People deserve better. This bill is being written and rushed through the senate with hardly any time to debate the cost or the details of this proposal. And the American People deserve better. Now, i remember when our colleagues across the aisle said the Affordable Care act was being rammed down the American Peoples throats in the middle of the night. Well, the a. C. A. Went, in fact, through 106 public hearings. It incorporated more than 170 republican amendments. The whole process took an entire year. But this Health Care Plan involves no hearings, no bill text, and no transparency at all. As unctio as United States ss we were sent here to represent the American People, represent the American People. We answer to the American People. So why are my colleagues from across the aisle trying to put one over on the American People . Ive met folks all across california and this country, and they see whats happening. They know that if this bill were as wonderful as its proponents would like us to believe, it would be out in the open. The American People deserve greater transparency. But even though the authors of this bill have tried to conceal their plan this bill would be nothing short of a disaster. Weve been told its about 80 the same as the bill passed by the house, a bill so catastrophic that even the president , who hailed its passage, now called it, quote, mean. We know that it would throw 23 million americans off their Health Insurance within a decade, including putting 4 million to 5 million californians at risk of losing coverage. We know it would raise costs for middleclass families and seniors. In every county of california, average monthly premium costs would go up while Financial Support to pay premiums would fall. We know it would put americans with preexisting conditions at risk and leave people who need Maternity Care or opioid treatment without coverage or force them to pay huge outofpocket costs. We know it would cut about 834 billion from medicaid, which means less money for families to pay for nursing homes, to support children with special needs, or to treat Substance Abuse. Bless you. And that is another reason why we need the Affordable Care act to be in place in a way to fix whats wrong and we mend whats broken and not repeal it altogether. I recently visited, mr. President , a really remarkable treatment clinic in los angeles called the Martin Luther king jr. Outtreatment center. Everyone can tell you that when 46,000 4,600 californians are dying every year from Substance Abuse and opioid overdoses, it is wrong and irration nationalal in to cut irrational to cut medicaid. So it really makes you wonder, why would anyone support this bill . How does this bill help real people with real challenges . At a Health Care Rally in los angeles back in january, i met a woman named tanya. Before the a. C. A. , shed sign up for insurance just long enough to see a doctor. She then would have a few tests done and fill a transcription. Then a prescription. Then she would realize she couldnt afford to pay for the insurance beyond that and she said its, quote, the worst feeling in the world to have to tell your doctor, who is trying to make you well, that you cannot afford the treatment prescribed. Tanya told me, quote, before the Affordable Care act, living without Health Coverage was a nightmare in this country. But she went on to say that has all changed, and thanks to the a. C. A. , i can now see a doctor when i need to, monitor my condition, and stay healthy so i can keep working and contribute to our nations economy. If my colleagues in congress and she referred to them, if the republicans in Congress Repeal the law, i don i dont know whi will do. So i ask, how does the Republican Health care plan help tanya . Another woman, christa, told me, quote, i am married with four children, none of whom and one of whom is a 10yearold type 1 diabetic. He requires daily active insulin management to stay alive, 24 hours a day, seven days a week. She went on to say, health care is not optional for us. Even with Health Insurance, diabetes management is the type of thing that can bankrupt you. Without Health Insurance, i cant imagine what i would do. She went on to say, the a. C. A. Is a huge relief for my family. So i ask, how does this bill help christa and her family . Then theres rhett in march are incounty. More than seven years ago, he was diagnosed with leukemia. He is nine years old. He says, cancer cells are the bad guys. This is what he wrote me. For three and a half years i took chemo to get the bad guys out. I had more than 1,000 doses of chemotherapy. My parents had to tell my sister that i might die of cancer. And then he went on to write, thanks to my doctors and nurses, my family and friends, my church and my community and the Affordable Care act, now im and then he writes gone with the cancer. I have a preexisting condition. Thanks to the Affordable Care act, my parents dont have to worry about losing coverage. A 9yearold rhett is showing us the way. But how does this bill help rhet now, i dont know the Party Affiliation of any of these folks. I dont know if theyre democrats or republicans or independents, i dont know if theyre members of the green party. Aim note asking them im not asking them those questions. Im asking them, how are you doing . Whats helping you . What do you need . And how will this impact you . And i know that im just one of two senators that they have, and when it comes to their sneads and their to their needs and their need to be represented in the United States congress and their need to be heard and their need to be seen, party f. Fillation Party Affiliation should not matter. What should matter are the needs of the American People. And regardless that of who they vote for in a partisan election, i am certain of this this Health Care Plan that is being proposed by my colleagues from across the aisle will not solve their problems. And it will only create, in fact, more problems and potentially devastate peoples lives. So to my colleagues, i say this shouldnt be a matter of supporting this bill automatically if youre a republican or objecting just because youre a democrat. This is about whats right and whats wrong. If you know this bill is bad, stand up and stop it; speak that truth. Now is not the time to keep quiet and hope nobody notices. Forget the politics. Forget partisan pressure and talk radio and primary ads. Instead, just listen to the voices of the American People. Not just in california but in nevada, in arizona, in ohio, in alaska, in maine, in pennsylvania, in a west virgin virginia. Because they have made themselves overwhelmingly clear. Only 20 of americans support this bill. A majority opposes it in every state in this country. It is the least popular piece of legislation in modern history. Im asking you to think about the American People. Im asking to you think about tanya, think about christa, think about rhett living wither leukemia since he was just two and a half years old, undergoing infusions every night with such incredible bravery. Let the determination of americans like rhett bring us together, a 9yearold boy who tells us in his words, dont repeal the Affordable Care act; improve it. Because we all agree, the a. C. A. Can be improved. It must be improved. It isnt perfect. And i am ready to work with anyone who really wants to make it better. Instead of playing politics, instead of playing politics with Public Health and peoples lives, we can actually Work Together to strengthen our Health Care System. In fact, im proud to have recently cosponsored a bill with senator Dianne Feinstein and a number of my democratic colleagues. Our bill would make it safer and easier for middleclass americans to buy insurance if they currently dont qualify for any help paying their premiums. These are the kind of Solutions Democrats can get behind. These are the kinds of solutions that would help and not hurt the people we represent. We took an oath to represent all the people, so i am asking every member of this chamber to think long and hard about the consequences of this bill. Think about the responsibility weve been entrusted with. We owe it to the American People to tell the truth, not to hide it. We owe it to the American People to solve real problems, not to manufacture new ones. We owe it to the American People to do the job we were sent here to do. I urge my colleagues, vote down this bill and stand up for the people we represent and serve. I yield back. A senator mr. President . The presiding officer the senator from nevada. Ms. Cortez masto thank you, mr. President. I rise to speak out on the legislation that republicans are trying to jam through the Senate Without any public view or consideration. This is an insult to the American People. It is a shameful abdication of the role as a u. S. Senator to represent the concerns and priorities of the people of a state and country. We were elected to be a voice for the people of our individual states, and what aim hearing is and what im hearing loud and clear from my state, keep the Affordable Care act, do not repeal it. Keep it and Work Together to improve it. Like my colleagues, mr. President , i would like to share the story of one of the many nevadans who have contacted me to share their story about the a. C. A. And why they so desperately want to avoid its repeal. Jessica and her husband own a brewery in reno, nevada. I was lucky enough to get and speak with her in person when i was home last month touring the Community Health alliance center. After meeting with her, i had the opportunity to sit and talk with so many incredible people doctors, nurses, people who care about the very faces of women, men, and children we are talking about tonight. But this is jessicas letter to me, and this is what id like to share with you, what she wrote to me. Dear senator cortezmass stow i am a resident of nevada. A Small Business owner and a mother. I am writing to express my views about the Affordable Care act. The Affordable Care act has had a tremendously positive effect on my life, and i would like to share my story with you. The Affordable Care act saved my Small Business. When the Patient Protection and Affordable Care act was signed into law in 2010 and when it was upheld by the Supreme Court in 2012, my husband and i were in the planning stages of our Small Business. At the time, my family was provided Health Insurance through my corporate job. Knowing the a. C. A. Would take effect gave me the peace of mind to leave my job and become a fulltime Small Business owner. Today our business, under the rose brewing company, is celebrating our fourth year in existence, and we are in the beginning stages of a large expansion, which will create many new jobs in reno. This business would not have survived without my fulltime dedication, and i would not have been able to leave my corporate job without the ability to procure Affordable Health care for my family. The Affordable Care act allowed me to start my family in a healthy way. As my husband and i prepared to sign up for our first year of health care with the a. C. A. , we found out that i was pregnant. Prior to the a. C. A. , Health Insurance Health Insurers were allowed to consider pregnancy a preexisting condition. Instead of being denied coverage or charged higher premiums, i was able to receive appropriate and Affordable Care during my pregnancy through the a. C. A. The Affordable Care act saved my life and my life because 30 weeks into my pregnancy, at a regular checkup, with our midwife, my husband and i were advised to see a doctor. Since i didnt look sick or feel sick, we hesitated, but our midwife was positive it would be for the best. Our insurance through the a. C. A. Allowed us to see the recommended obgyn. Halfway through our appointment, my doctor became very concerned and rushed me into the hospital. My son was born by emergency csection a few hours later. Several doctors agreed that near the the baby nor myself would have survived a further 24 hours of pregnancy. Having Health Insurance through the a. C. A. Allowed my husband and i to seek treatment and care without having to worry about the affordability of following doctors orders. This is the first time i could say that the a. C. A. Saved my life and the life of my beautiful baby boy. The Affordable Care act saved my babys health it saved my babys health and provided us with Health Insurance. My son was born nine weeks early and was admitted into the nicu. He stayed in nicu for 32 days and was under constant doctor care. By the time he left the hospital, we had incurred well over 1 million in total costs. The a. C. A. Allowed him to start his life without a cap on his total lifetime Health Care Coverage. Prior to the a. C. A. , many nicu babies reached their lifetime limits before even feeling the sun shine on their faces. Im eternally grateful for this provision of the a. C. A. One week after bringing our beautiful little baby home from the hospital, i find myself in need of Emergency Care for a second time. I suffered a postpartum stroke. I was taken to the emergency room and admitted to the hospital for the second time in two months. Again, the a. C. A. Allowed me to seek treatment and care without worrying about coverage. The Affordable Care act will save my sons health care. My son now has a medical issue with his growth. Should the a. C. A. Be repealed, amended or replaced with something less inclusive, this issue will be considered a preexisting condition. The thought of my 18monthold son being denied coverage or potentially not being able to afford the health care offered to him makes me sick to my stomach. Why would our lawmakers vote to take this away from him . I implore you to consider the Great Lengths the Affordable Care act has gone to not only improve and save lives in my family, but families across the great state of nevada. I further implore you to consider the children currently could have had and benefiting from the a. C. A. As you contemplate your vote on this significant matter. I strongly urge you to defend this crucial legislation. Too many of your nevadan constituents rely on this lifesaving, healthsaving and financialsaving legislation. Thank you for reading my story and considering my views. I am happy to speak directly with you. Sincerely, jessica and her family. Mr. President , i know jessicas story is one of thousands. I hope my colleagues across the aisle think of jessie and her family and the millions of americans like her who have so much at stake while continuing to secretly rewrite our countrys health care laws. Thank you, thank you, mr. Presir listening, and i yield the floor. Ms. Stabenow mr. President. The presiding officer the senator from michigan. Ms. Stabenow thank you, mr. President. First, i want to thank the senator from nevada. We are, first of all, so pleased that she is here and her voice is so strong for the citizens of nevada, and appreciate very much her comments this evening. Mr. President , im rising this evening to talk about an issue that affects every single person, every Single Family in michigan and all across the nation, and thats health care. And i feel very confident that i can say that each one of the 48 members of the democratic caucus, each and every one of us would love to be on this floor working with republican colleagues across the aisle to lower the cost of Prescription Drugs, to lower the outofpocket costs of health care, to create more competition, more insurance choices for people in the insurance pools that are there, to basically fix the problems. But were here, and im proud to be with colleagues tonight, because we are not willing to support anything that unravels the Health Care System, raises costs, and takes away health care for people, that on top of that gives a tax cut to the wealth yet americans, insurance executives, pharmaceutical companies with the dollars that are cut. So here we are. The house has passed a bill that in fact raises costs, takes away health care, gives the tax cut i talked about. Now the republicans have a Health Care Bill, but they wont let us see it. Im the ranking democrat on the house subcommittee of the finance committee. You would think that someone would have reached out to have conversations with me. About and the members of our subcommittee and the members of our whole committee. But that has not happened. So theyre letting the Trump Administration see it. But not the American Public. Theyre letting k street lobbyists see it. In fact, thats probably where ill get a copy first, is through lobbyists. But not the American Public who will lose their health care and pay more. If you have cancer and youre not going to be able to get coverage, if youre going to potentially be dropped or now a preciftion preexisting condition or get a cap put on for the number of cancer treatments that you can receive, i believe you have a right to receive this bill. If you have epilepsy and will lose your insurance, you have a right to see this bill. If youre a woman who will be charged more for insurance and be considered to have a preexisting condition just because you are a woman, you have a right to see this bill. And if youre a senior whose rates are going to go skyrocketing upwards, you have a right to see this bill. But the sad fact is republicans dont think the American People have a right to know or to see this bill, or to review it, or to comment on it, to have a chance to give their opinion on it. The difference in process couldnt be more clear between the way the Affordable Care act was originally worked on for about 18 months and then passed, and whats happening right now. In 2009, republicans called for a fair, collaborative and deliberative legislative process. And i agree. In fact, we all agreed. From 2009 to 2010, the Senate Finance Committee Held more than 53 hearings on health reform. Hearings, open Committee Meetings, work sessions. As a new member of finance at that time, i was involved in every single one of those, hours and hours and hours of listening, deliberating, people sharing their opinions, debating. Counting the Health Committee deliberations, there are 100 hearings and Committee Meetings before the bill was finalized and debated to be reported out of committee. 100. The republicans had had no hearings zero hearings no public meetings; zero public meetings. During the finance committee markup, when we were working through and voting up the bill, we considered 135 amendments often late into the night. The final senate bill included 147 republican amendments. Until the end, we were trying to do everything we could to get bipartisan support when it was clear that politically there was not a desire. Even with 147 republican amendments in the bill to have a bipartisan Health Care Bill. But republicans wont even allow us to see the bill, let alone amend it. Now, our position is very clear. If there is no hearing, there is no vote. You need to show us the bill. But theres, i think, a really good reason that they wont show us the bill. They wont let us see it because its a disaster for the American People. Its a disaster for people in michigan that i represent, from the house bill, we know that 14 million fewer people will be insured after the first year. 23 million fewer people will be insured after ten years. Now this may change somewhat back and forth. We have no idea. But we know the general framework that the senate is working in is the same general framework as the house. We know that in 2026, according to the budget office, 51 Million People 51 Million People under the age of 65 will be uninsured. No insurance. Were told that premiums would go up 20 next year and states would be allowed to opt out of Key Insurance laws that protect consumers. To really understand what that means, that means all of the decisions about your care go back to the Insurance Companies. Not your doctor. You know, laws that protect people with preexisting conditions, gone. Rules that prevent women from being charged more, gone. Laws that prevent seniors from being charged more, gone. And the way it used to be is if you got sick, the Insurance Company could decide to drop you. Itit it was the insurance comy that said how many cancer treatments that you were able to receive or Mental Health visits, if any, you would receive. And you always paid more than for physical health. The same with addiction. This all goes away with whats being talked about here. In other words, costs are going to go up and care is going to go down. And to add insult to injury, all of this is going to go to tax cuts for multimillionaires and billionaires and Drug Companies and Insurance Company. While somebody is losing their nursing home care, their cancer treatments, Maternity Care, children unable to go to the doctor and parents forced to go back to using the emergency room. Mr. President , i want to share what these changes would mean for people in michigan. There are so many people ive talked to, so many stories that ive heard. I received a letter from a woman in michigan p named amy who owns a small retail business, has Health Insurance through her husbands job. Small business owner. Amy has chronic myeloid leukemia. It ising managed with a medication that costs it is managed with a medication that costs 20,000 a month. Not a year. A month. After her deductible and 10 copay, she said she quickly reaches the maximum outofpocket expense on her insurance each year. Amy wrote preexisting conditions, maximum outofpocket costs, lifetime caps are important to me. Without them, i could never afford my health care. Without the Affordable Care act, i could quickly bankrupt my family and still die. Please consider my situation when deciding your vote on any changes to health care. I need your help. I want and need to stay alive and raise my children. Health reform allows amy to stay on her husbands Insurance Plan and pay for the cancer treatments that are keeping her alive. The republican plan would put people with preexisting conditions like cancer at the mercy, again, of Health Insurance companies. Heres another way the republican plan would hurt michigan families. Thanks to the Medicaid Expansion , 650,000 people are newly covered under what we call healthy michigan, the healthy michigan plan. And the good news is 97 of michigan children can now go to the doctor. They dont have to wait and go to the emergency room. If they have a cold, their mom or dad can take them to a doctor. They can get Preventive Care rather than waiting until something awful happens and go into the emergency room. And whats the good news for the state of michigan out of that . Michigan will end up this year going into next year with 432 million more in the treasury. Taxpayer dollars that arent going to have to be used on health care. , because the right thing was done, creating a way for children to see a doctor. And what has happened . We have a 50 reduction on folks going into the emergency rule oe emergency room that dont have insurance, and it saves money when you do that. The number of people treated has gone down 50 . The number of people treated without insurance. You know, the great thing about health care to understand is that if we ignore it, it doesnt mean people dont get sick, that they dont get cancer, they dont need to have a nursing home or that their child doesnt get sick. If you just ignore it, the costs go up because people ultimately use the most expensive ways to get treated. If you actually plan it out and do the right thing on the front end and people can see a doctor and they can get the checkups and the care that they need and the treatment they need, you actually save money. Thats thats the example of the state of michigan. But it would end the Medicaid Expansion. One young man in michigan, only 19 years old. He was living with his mother when he was diagnosed with testicular cancer. He didnt have a way to get to his appointments or treatments. Thanks to healthy michigan, he was able to get treatment. He is now free from cancer, has a job with benefits, and is engained to be married engaged to be married. Healthy michigan and the Medicaid Expansion saved this young mans life. The republican plan would end the healthy the healthy michigan plan, ripping coverage away from 650,000 people in michigan, including cancer patients. And for what . For what . To pay for tax breaks for Drug Companies and the ultra wealthy one more time. This means michigan families will be unable to care for their loved ones when they need it most. In january i led a forum on health care prices. And a woman told her story. Ann was ttioned was diagnosed with multiple sclerosis when with we when she was 14 years old. Medicare and secondary insurance cover most of the costs of her medication, which costs an astonishing 75,000 a year. Thats nearly her entire household income, including Social Security benefits. Ann had opinion caring for her aging mom when her moms dimentia worsened and didnt know where she would find the 6,000 a month to pay for nursing home care. Fortunately anns mom qualified for medicaid, which three out of five in michigan are getting nursing home care because of medicaid, including anns mom. And this nursing home care paid for the final three years of her life. Heres ha ann what ann said. It was only because of medicaid that she was able to get the help that she needed at the end of her life. I dont know how i could have cared for my mom on top of managing my own care. My family would have lost our home and all of our savings trying to keep up with their bills. Medicaid helped ann care for her mom at the end of her life. This is a good thing. Again, the republican plan would cut medicaid by 834 billion. Thats the house plan coming over. We dont know how much will be cut here, but we know whatever will be cut will be used for tax breaks for Drug Companies, insurance c. E. O. s, millionaires and billionaires. How does that reflect American Values . In conclusion, republicans are hiding their bill because they know it is a bad deal for american families. It is a bad deal. The president of the United States called it mean. I agree. It is mean, and its definitely a bad deal for the people i represent in michigan. Costs go up, care goes down, and a tax cut for the millionaires and billionaires. We are better than this. Our nation is better than that. Its time for republicans to show us the bill so we can work on it together together, give us a chance give the American People a chance to have input, to say what they think before its forced on them in a secret process thats rammed through this floor. And its time to move beyond partisanship to get something done for the American People. Again, i know that the 48 Democratic Senators in this chamber want to work on lowering the costs of Prescription Drugs and reducing outofpocket costs and helping Small Businesses that want to provide coverage for their employees and making the Health Care System better. Lets stop this bad bill and Work Together on behalf of the American People. I yield the floor. The presiding officer the senator from massachusetts. Mr. Markey mr. President , when a pope dies, the cardinals meet in secret to elect the next pope. A white cloud goes up in smoke. When the Senate Republicans meet together in secret for a Health Care Bill to cover the sick and elderly, thats what goes up in smoke, all of that coverage. The only thing more secret than the republican Health Care Bill is Donald Trumps tax returns, and we might need, ultimately, to have a special counsel to go and find out whats inside of that Health Care Bill because right now the democrats dont know, the American Public doesnt know. No one knows whats in that bill. While we may not have details on the republicans secretive proposal to repeal and replace the Affordable Care act, we know that they are not completely rewriting the housepassed legislation that eviscerates reduces coverage and all those families caught in opioid crisis. This bill is being done in complete ka lambty and it is calamity and it is being done in secret. Right now the press is being stifled. The white house didnt even let reporters audio tape the press briefing today. Last week the Senate Republicans tried to keep the press from asking questions of senators in the hall. They dont want the press to know about this bill or to cover it. But for families who could need treatment for opioids, the republicans want to take the money from substanceuse disorder coverage and care and to use it to offset a 5. 5 trillion tax cut for the healthy wealthy and for massive corporations. That would be cruel, it would be immoral, it would be inhumane. Like President Trump himself, it would be mean. We know the Opioid Epidemic knows no demographic, it has ruined lives of men and women from lexington, massachusetts to lexington, kentucky. It is an equal opportunity destroyer. Thats why one of the reasons combating the Opioid Epidemic has been bipartisan. The comprehensive addiction and recovery act was passed by the president. It passed the senate 922. And six months ago the Senate Passed a 21st century cures act bill 945. This bill quickly became law and allocated 1 billion to states to provide muchneeded resources to help them address the Opioid Epidemic on the ground and in their communities. Yet today Senate Republicans are singlehandedly looking to betray that progress, erase it from the history books. They are doing so by crafting in secret a bill to gut medicaid and repeal the Affordable Care act and replace it with a shell that hides a tax break for the wealthiest people in our country, people who do not need or deserve a tax break, especially if its coming from the Health Care Coverage from those people who are sickest, those people who are oldest, those people who are most disabled, those people who are most vulnerable to having an addiction to opioids and need treatment. It would be wrong to take their money for that Health Care Coverage and give it as a tax break to the wealthiest billionaires in america who already have enough money for their Health Care Coverage. That would be a death sentence to the 2. 8 million americans with Substance Use disorders, including 220,000 with an opioid use disorder at risk of losing their Insurance Coverage all together in order to ensure that their Family Member could get treatment. For those who do manage to get Insurance Coverage, trumpcare will make it more expensive to get the treatment and the care they need. The Congressional Budget Office explicitly said that out had outofpocket spending could increase by thousands of dollars per individual in any one given year for a disease as critical as an opioid use disorder, any delay in treatment can be the difference between life and death, not to mention that because trumpcare reduces protections for people with preexisting conditions, even those with insurance may find out that the coverage they have wont work for them when they need it the most. Under the republican proposal a Substance Use disorder could be classified as a preexisting condition and therefore you cant get coverage for it. The Congressional Budget Office also said that trumpcare would slash medicaid by 834 billion permanently, decapitating medicaid, decapitating. They say they are moving to a per capita system. Another way of saying that if youre an ordinary person is decapitation for medicaid for the families across our country who need it. And if this becomes law, there is no norcan for medicaid. Once it is cut by trumpcare, it is dead. Those devastating cuts would grind the progress and bring the access to opioid treatment to a screeching halt and kick people in treatment to the curb. Medicaid spent money for access to care, access to recovery and access to hope for millions of americans. Medicaid can cover inpatient detox treatment, access to noloxone. Additionally medicaid pays for onethird of the medical medicaid assisted treatments in the country more than any other payer. In massachusetts medicaid pays for nearly one half of the medicaid assisted treatment. One half of the people who get medicaid assisted treatment for opioids, for addiction will lose their coverage and then the republicans are going to take the money they save and then give it to the wealthiest people in our country who also need the same coverage, leaving them with the money needed for those who are the other one half who wont have it. And what happens to those other individuals . It could be a death sentence without treatment. And those of us from states hardest hit by the Opioid Epidemic, hear how it has helped to save lives. There is one story of a mother whose son became addicted to opioids after getting a prescription from a Family Member. Through medicaid he was able to help treat his Substance Use disorder. His mother dawn said, quote, he has done very well with his recovery, but i fear without Insurance Coverage that he will not be able to continue his counseling and he may lose everything that he has gained and fall back into the cycle of addiction. His medical insurance is literally his lifeline. Please dont abandon my son and others like him who need medicaid assistance to continue their fight against addiction. Instead of recognizing the importance of medicaid for families like dawns across the country, republicans are proposing to starve this lifesaving program through trumpcare by cutting more than a quarter of its budget. Because thats not enough to fund the massive tax breaks that republicans want for their donor friends, President Trump has proposed to cut the program by an additional 600,000, leaving medicaid a shell of its former self. Although republicans refer to this as capping the medicaid program, for dawns son what that really means is they will decapitate his access to medication assisted treatment, decapitate his ability to seek counseling, and decapitate the peace of mind dawn receives in knowing her son receiving the help he needs. We also have to consider the Affordable Care act prevention of Public Health fund and its role in the Opioid Epidemic. It is the feder federal governments single largest investment in prevention. Since 2010, massachusetts has received more than 95 million through the prevention fund. Importantly, for massachusetts, nearly 4. 5 million has been given to the Preventative Health Services Block grant that has helped the state respond to the heroin, Prescription Drug and fentanyl crisis. Eliminating this fund will only hurt our ability to respond to the opioid and other drug epidemics popping up in every one of our communities. We should not be building bridges to recovery with money that is stolen from those programs in order to be spent on a wall that is going to pretend to block the drugs from coming in from overseas. We should be building bridges to recovery, not walls to isolation. And instead of more commissions, we need more commitments from the administration and Congressional Republicans to not undo the progress we have made in preventing and treating Substance Abuse disorders. Its unfortunate that republicans who have touted our progress on opioid issues arent standing up to the policies in trumpcare that would negate their hard work. By supporting this, they are betraying the families and communities who have suffered from the relentless grip of Substance Use disorders. When discussing the opioid crisis, the only thing the g. O. P. Stands for right now is gutting overdose prevention. Thats the new g. O. P. , gutting overdose prevention. While devastating, this isnt surprising for those of us who have been watching many Congressional Republicans salivate over ways to annihilate medicaid for decades. Republicans harbor an ancient animosity towards medicaid, raiding the medicaid hoppers achieves two of their goals. First, it kills a lifeline for more than 70 million lowincome and working class americans. And second, it provides the g. O. P. A piggy bank to aid their donors and pay for these tax breaks for their friends. In fact, trumpcare alone would provide the wealthiest individuals and National Corporations with over 660 billion in tax breaks over ten years. Included in this figure is the repeal of the Health Insurance tax which gives a 145 billion tax break to insurance conglomerations and their c. E. O. s. Millionaires will get a tax break of 50,000 per year, more than three times the income of most medicaid beneficiaries, and the top 400 highest income earners would save 7 million in taxes annually. All of this comes at the expense of the 23 million americans who will lose Health Insurance coverage under trumpcare. Dont let the g. O. P. Fool you. Trumpcare is not about creating health. Its about concentrating wealth in the hands of a small number of americans. Its about making middle class and working americans pay for a tax break for people who need it least. We can do better than that. We owe it to the families of the 33,000 americans who died from an opioid overdose last year. The proposals under consideration with republicans is going to only add to the tally of overdose deaths. Were hearing that Senate Republicans could create an opioid fund as a paltry attempt to appease those who have called out the cruelties in this bill. That extra funding would be crumbs. It would be like trading a full body cast for a bandaid, like trading land for a couple of beasts, like trading land for a tricycle. We will not be fooled. We know it took republicans more than a year to agree to providing the funding for emergency opioid response in the cures bill. One can only imagine how long it will take to get any money the republicans are promoting as a consolation prize out to the communities who need it. We know a vote for trumpcare is a vote to perpetuate overdose deaths. Passing this bill will be just aiding and abetting one of Public Healths most wanted and most notorious serial killers. Americans from both Political Parties are not fooled by President Trumps tax cut shell game on the backs of families and communities that have been ravaged by opioids. Thats why democrats will continue to be a public megaphone and shout from the rooftops that eviscerateing medicaid to give a tax cut to the healthy and wealthy is mean, it is inhumane, it is immoral, and we are not going to stand for it, and the American People are not going to stand for it. The best vote i ever cast in my political career, thats 41 years in congress, was for the Affordable Care act. The second best vote i will ever cast is to block the repeal of the Affordable Care act because of the good which it has done for tens of millions of families in our country who otherwise would not have the coverage they need. Mr. President , i yield back the balance of my time. Mr. Sanders mr. President. The presiding officer the senator from vermont. Mr. Sanders let me thank the senator from massachusetts for his very cogent and important remarks, and let me just start off by asking the president , asking the leader of the republican party, what are you afraid of . What are you afraid of . Health care constitutes onesixth of the american economy. It impacts every man, woman, and child in our nation, and yet, we have 13 republicans, all men, working behind closed doors to produce legislation which will be brought to the United States senate at the last moment so the American People dont know the disaster that it is. You know, what politics is about or should be about is if you are proud of what you do, you tell the world about it. You explain to the American People, to your constituents why this is what i am proposing, this is how i voted, and this is why it is good for the people in my state and in my country. But it should tell every american, whether you are a democrat, a republican, or an independent, whether you are conservative or progressive, it should tell you something that major, major legislation is being written at this moment, and most republicans dont have a clue as to whats in that legislation let alone americans, let alone democrats, let alone the average american. So i say to the Republican Leadership what are you afraid of . Bring that bill out. I am a member of the health, education, labor and pension committee. The Health Committee. The Health Committee. It is supposed to be the committee in which we deal with health issues. I see senator murray here is the Ranking Member of that committee, and she will concur with me that that committee has held zero hearings. It is the Health Committee. We have not had one hearing to ask members of the administration, people throughout this country what the impact of this legislation will be on the children, on the elderly, on working families, on those who have chronic diseases, on ordinary americans. What impact will this legislation have on the lives of 300plus Million People . We have not had one hearing, not one open discussion. And i should think that every republican should be embarrassed by this. I know that many of them are embarrassed about it. So before there is any vote on any health care legislation, we need to have a series of hearings to discuss the implications of what that legislation is about. Mr. President , as i think you have heard, during the debate over the Affordable Care act, and i am a member of that committee we had 47 bipartisan hearings, not only in the health, education and Labor Committee but also in the finance committee, other committees. There were roundtables, there were walkthroughs of the Affordable Care act. There was a consideration of more than 300 amendments, some 150 amendments offered by republicans were accepted. In 2009 and 2010, the finance Committee Held 53 hearings, meetings, negotiations and walkthroughs on the Affordable Care act. That committee marked up the Affordable Care act for eight days. A markup means you accept amendments, you have debates on amendments. That was the longest markup in 22 years, and adopted during that process over ten republican amendments. When the bill was considered on the senate floor, the senate spent 25 consecutive days in session on health reform, the second longest session in history. And oddly enough and interestingly enough, many of my republican colleagues during that process after 25 consecutive days on the senate floor, after numerous hearings in the Health Committee, in the finance committee, there were senators who said there wasnt enough time. They were saying this is such an important piece of legislation, its going to impact so many people, we need even more time. Senator enzi said, quote, cutting off Senate Debate and deliberation with the budget reconciliation process would shortchange legislation with enormous impact, end quote. Senator Lamar Alexander said, and i quote, i dont think people are going to feel as good about a bill that restructures onesixth of our economy, that affects every single Americans Health and the Health Care Bill is being written behind closed doors and the Democratic Leaders office. So, in other words, you had Republican Leaders thinking that the hundreds and hundreds and hundreds of hours of discussion and debate on the Affordable Care act was not enough, and i find it amazing that those same republicans seem to think its okay for legislation to be written behind closed doors and not have one single committee hearing. Now, the truth is, mr. President , i can understand why republicans do not want open discussion and open debate on this issue. Because the bill that they are working on, which is based on the disastrous bill passed in the house last month, is a bill that would do incalculable harm to people all over our country and really should not be considered as a Health Care Bill. How do you talk about a socalled Health Care Bill when you throw in when you are throwing 23 Million People off of Health Insurance . When we talk about a Health Care Bill, the assumption is we are improving health care in america, not doing what the Republican House bill did was to throw 23 million americans off of Health Insurance. Surely that is not improving health care for the American People. Cutting medicaid by over 800 billion. And god only knows what the implication of that will be for the children, for the elderly, for people who are in nursing homes. Youre not improving health care when you defund planned parenthood. And after all the rhetoric here about choice, choice, choice, we want the American People to be able to go to their provider of choice. Oh, 2. 5 million women today who get their health care through planned parenthood, i guess their choice doesnt matter. And we hear about the needs of working class people. We have a candidate donald trump who talked about the needs of working class people. The House Republican bill and we think the senate bill will be very close to it, substantially raised premiums, substantially raised premiums for older workers, and that is why, among other groups opposing the house bill, the aarp made the point that this would be a disaster for older workers. The truth is, mr. President , this is not a Health Care Bill. This is a tax break for the rich and multiNational Corporations bill. This is a bill that would provide over 200 billion in tax breaks to the top 2 . This is a bill that would provide hundreds of billions of dollars in tax breaks for the Drug Companies and the Insurance Companies. The last information i received, the pharmaceutical industry, the major five Drug Companies made over 50 billion in profit, but this legislation would throw americans off of Health Insurance to get the Drug Companies even more profit. This legislation, the house bily the bill being worked on behind closed doors is not only opposed by the aarp, the largest senior group in america, it is opposed by the american cancer society, by the american heart association, by the American Lung association, the Cystic Fibrosis foundation, the march of dimes, the national m. S. Society, the american medical association, because the doctors know what a disaster this will be for health care for millions of americans. The American Nurses association and the American Hospital association. All of these groups who are the pillars of health care in america saying no, no. This is a disastrous bill and yet we have the Republican Leadership and a dozen or so members working behind closed doors. Mr. President , nobody here has suggested that the Affordable Care act should not be improved. In my view it should be improved. In my view deductibles are too high. Copayments are too high. Premiums are too high. And certainly the fact that were paying twice as much as any other country for Prescription Drugs, that has got to be dealt with also. So the task right now among sensible people is to put on the table and to be honest about it what are the problems of the Affordable Care act . How do we lower deductibles . How do we lower copayments . How do we control escalating costs of health care . Those are reasonable questions that honest people should debate but the answer is not to throw 23 million americans off of Health Insurance. That is not a solution to the problem. That is an insult to the American People. Let me just conclude by stating this. Our job right now is to make sure that the disastrous republican proposal never sees the light of day. And i would urge my democratic colleagues on behalf of the American People, the vast majority of whom know how bad this legislation is, that we have got to stand up and fight in an unprecedented way to make sure that that legislation never sees the light of day. And after we win that struggle, i would hope that we would come forward as a nation and join every other major country on earth, whether its canada, and i live 50 miles away from the canadian border, whether its the united kingdom, france, germany, that we would join every other major nation on earth and say that health care is a right of all people, not a privilege. If you are an american, you are entitled to health care. You should not be one of the 23 Million People thrown off of health care bringing the total of uninsured in america over 50 Million People. That is outrageous. So, mr. President , i think youre going to hear the American People stand up loudly and clearly, demand transparency, demand serious debate on an issue of this consequence and i think at the end of the day this legislation will be defeated. Thank you. And i would yield the floor. A senator mr. President . The presiding officer the senator from washington. Mrs. Murray mr. President , democrats come to the floor this evening as a voice for the people that we represent to fight back against republican plans to jam trumpcare through this senate, increase health care costs, and hurt families across the country. Because Republican Leaders may hope nobody pays attention, they can hope they can go into these secret rooms and cut secret deals and come out with a Trumpcare Bill that they can jam through before anybody notices. Were not growing to allow that to happen. We are here. Were going to fight back and i can only hope that just a few republicans decide to listen to their constituents, reverse course, and work with us to improve health care instead of standing with President Trump to destroy it. Mr. President , i want to start by talking about a constituent of mine whose story i heard and whose voice and perspective should be a part of this debate. Her name is lisa. Shes from spokane in my home state of washington. Lisa served our country in the navy for six years. She goes to school. She works part time. She says she relies on medicaid to afford the health care she needs, and she is very worried that if trumpcare passes, she would not only suffer from cuts to medicaid but she could lose her coverage altogether because. Like Many Americans she has a preexisting condition, asthma. Lisas not alone. There are millions of people just like her in Washington State and across this country. And each of them, every patient, every family has a stake in this fight. They deserve to be a part of this debate, and they have a right to know how trumpcare would impact them if its signed into law. Mr. President , that shouldnt be a partisan sentiment. Ive heard republicans come to the floor time and again demanding transparency, railing against secrecy, calling for hearings. One republican senator who is now the chairman of the senate Health Committee came here to the senate floor back in 2009 to blast democrats for writing an amendment, quote, in secret. He said, and i quote, none of us on the republican side knew what was in it, and he accused democrats of trying to pass our bill, quote, before the American People find out whats in it. Well, mr. President , my friend, the chairman of the Health Committee, is certainly not alone. Back then the current republican majority leader said, and i quote, this is a massive piece of legislation that seeks to restructure onesixth of our economy. Its being written behind closed doors without input from anyone in an effort to jam it past not only the senate but the American People. Well, mr. President , that was not true back then. We held dozens of bipartisan hearings and meetings over months and months and months, but it is what republicans are doing right now. The chairman of the senate Health Committee whom i respect and never think he would be a part of an effort like this told me he was not planning to hold a single hearing on trumpcare. The chairman of the Senate Finance committee where a lot of work on this bill should be getting done told my friend, the senator from missouri, he wasnt going to hold a hearing either. There are reports now that republicans actually have a text of their bill. Something is written and almost ready. Democrats dont get to see that bill. People across the country are being kept in the dark. Republican leaders are treating it like President Trumps tax returns and not allowing it to see the light of day. It is absurd and it is unprecedented. We could be just days away from a massive bill being jammed through this senate and Many Republican senators are telling press and constituents they couldnt even say what was in the bill if they wanted to because they havent seen it either. This bill is so secret, even President Trumps top health advisor, the secretary of health and Human Services, told us in a hearing last week he hasnt seen how trumpcare is being changed in the back rooms of the senate. So, mr. President , let me ask this. Why are Republican Leaders so focused on keeping trumpcare work secret . Why are they keeping it locked down so tight and not letting people see whats even in it . What are they so ashimmed of . Ashamed of . Well, one Republican Senate aid was quoted defending this and i quote, we arent stupid. In other words, republicans know it would be, quote, stupid to put this bill in the public because they know that people across the country, the people they are supposed to represent, would hate it. That explains a lot. Republican leaders, those who are writing this Trumpcare Bill in secret, no they would not be able to go back home and defend it. They know the more people learn about whats actually in it and what the fine print might mean for them and their families, the more people back home are going to rise up and fight back. So they want to keep it wrapped up tight under lock and key, no hearings, no scrutiny, no public input. When they first announced their secret working group, not any women were in it. Republican leaders are in their back rooms desperately trying to cut those final deals, doing whatever they can to bully those last few republicans into supporting something they know their constituents will hate. Mr. President , were here tonight to say enough is enough. This has got to end. Health care is too important and trumpcare would be too devastating to allow this kind of secrecy to continue. Mr. President , we dont know exactly what is in Trumpcare Bill being written in secret but you know what . We have a pretty good idea. No matter how much lipstick they put on this pig, based on everything we have heard, this is going the this is going the same way trumpcare went in the house, and the impact on patients and families would be just as bad. Higher costs for families, especially seniors and people with preexisting conditions, higher costs. Insurance companies no longer required to cover basic health care. You know, things like Maternity Care or Mental Health services and much more. Women would lose access to see their doctors and the care they need at planned parenthood. And millions of people across the country would see their medicaid coverage taken away. That means people nationwide who are finally getting treatment for Substance Use disorders like opioid addiction or Mental Health care or access to a primary care doctor under medicaid are going to lose that access. Mr. President , this would be so devastating for families across the country. Over the past year ive met so many families in my home state who have lost a loved one to the opioid crisis, in bellingham, in spokane, community after community the storys always the same. I heard directly from people on the path to recovery, like tyler in yakama or michele in the tricities who told me how getting treatment changed their life for the better. Mr. President , i couldnt imagine any senator would want to go home, look in their constituents eyes and tell them they helped pass a bill that would take away the tools those communities need to fight this crisis. But that is what my republican colleagues are planning to do as we speak. And lets remember all of this damage would be done why . To give a massive tax break to special interests in the Health Industry and hand President Trump a hollow political win. Mr. President , it is truly shameful and it needs to stop. Last week we learned President Trump is now saying that the house bill is, quote, and i quote him, mean, mean. Well, that is certainly an understatement from a president who doesnt often do subtlety and its surprising to hear after we all saw him celebrate the house bill at the white house when it passed. But heres the truth. The house Trumpcare Bill isnt just mean, it is devastating. And the senate Trumpcare Bill is going to be just as bad no matter how they try to spin it or how many side deals they cut to claim its changed. So, mr. President , i have a message for Senate Republicans who are so ashamed of what whats in this bill that theyre keeping it secret. Its not too late to change course. Its not too late to bring this process out from the shadows. It is not too late to be honest with people across the country about what you are doing. It is not too late to listen to the voices of people like lisa. Its not too late to abandon this plan to jam trumpcare through congress. And if you do that, if you stop, democrats stand ready as we always have to work with you to actually make health care more affordable and accessible for patients and families across the country. Mr. President , people across the country are watching. They are paying attention to this. They are not going to allow republicans to slip this through without any scrutiny. And we democrats are here to say loud and clear were going to keep fighting to make sure they have a voice. Thank you, mr. President. I yield the floor. A senator mr. President . The presiding officer the senator from connecticut. Mr. Blumenthal thank you, mr. President. Im proud to join my colleagues tonight because this nation stands at a precipice on the verge of a tragic mistake, about to embark on a travesty that mocks the democratic process. Truly the combination of secrecy and speed are a toxic recipe in our democracy. Secrecy and speed will bring us recklessly over the edge of that precipice to tragic mistakes that belie and betray the people of america and the values that we all share in this chamber because they are basic to the american way of life and health care is a right. It should be recognized as a right. And the goal of extensive and comprehensive Insurance Coverage has to be ultimately a goal that we share in common. But right now we are speeding secretly toward a betrayal of American Values and even of our constitutional duties. Im deeply disappointed that the secrecy employed by my colleagues has brought us recklessly and rep hencably rep hencably to the verge of gutting the Affordable Care act. The absence of hearings before the committee, the absence of public debate, the absence of any text of a bill that can be debated and offered for Public Comment leaves us without a democratic bedrock principle of listening to the people of america and listening to the people who are most affected, who know the most, the experts and the patients. In fact, it is the patients who deserve to be heard here perhaps most of all. And yet my colleagues on the other side of the aisle seemingly will go to any length to suppress the create that the cruelty that lies in their alleged Health Care Bill President Trump has called mean. And that