Cassidy is going to walk you through the details. Rick santorum is going to tell you how history is on our site that ron johnson is going to talk about numbers because thats what he does in dean heller is going to tell you about how this is a good deal for the country as a whole and im going to start with the following proposition. If you believe repealing and replacing obamacare is a good idea, this is your best and only chance to make it happen because Everything Else has failed except this approach which will work if we get behind it. If you want a singlepayer Health Care System this is your worst nightmare. Birdie, bissinger dream of a singlepayer Health Care System for america so we need people on board now to stop what i think is inevitable if we fail which is singlepayer health care for all which is the end of quality and the end of a sustainable federal budget. There are three choices, prop up obamacare, ernie care for our bill. Thats where you are at. Count me out for propping up obamacare. Hell no to birdie care. Count me in for an idea that gives a patient a voice they would never have and Single Payer Health care. Count me in for people in my state making a decision about health care verses some bureaucrat in washington. There is a lot of fight left in the Republican Party when it comes to repealing and replacing obamacare. The reason i know that is i spent all of august talking about our stated nobody was very happy with the idea that the Republican Party after seven years promised to repeal and replace obamacare, made an effort and bailed and apparently are ready to quit. The question is there anybody left in washington to repeal and replace obamacare of . Is there any fight in the Republican Senate, in the white house . I can tell you there are a lot of colleagues that are dying to have another shot at health care there are a lot of colleagues of mine that would like to talk about taking money and power out of washington and returning it to their state, closer to the patient and in the hands of people they can actually complain to. Under obamacare if you dont like it who do you complained to . You can complain to me but i dont run obamacare. Under this lock grant approach which bills will describe to you you can plane complained to the statehouse or present who probably lives in your neighborhood and goes to the same hospital as your family. You can complain to a governor that you can vote for. Under birdie care you complain to a faceless bureaucrat. There really is no innovation. Under this approach 50 states have the chance to deliver Health Health care and overtime guess what . Some will be geared out better than others. Those who do badly well copied those who do well. Under obamacare you know better than the bureaucrats most liberal member of the house and the senate. This is the defining site for the future of health care and the Republican Party. We refuse to quit. We have been working on the bill that i think should have been our first approach to rip repeal and replace obamacare, not our last but it is now our last. For states under obamacare get 40 of the money. New york california massachusetts and maryland. If that bothers you this is the chance to do something about it. If you live in a state and you want to keep sending money to maryland, new york, massachusetts and california, then vote for bernies bill, prop up obamacare. If you believe your state should have more money, more flexibility and more choice then vote for our approach. I have been involved in a lot of things in the last 20 years. This is the most important thing i believe i will ever be involved in in the United States senate. I know what awaits our country free fail. The consolidation of health care in the hands of the federal government from cradle to grave. Unlimited, unsustainable spending that wrecks the federal budget. There are two approaches to take care. We deal with medicaid and a very reasonable fashion more flexibility, more control and begin to slow the growth of medicaid down. If we do nothing by 2027, a decayed will be over 650 billion in spending. We are spending 549 billion today on the military. Let me say that again. To do nothing means well be spending more in the next decade on medicaid than we do to defend our country. This bill changes that. 40 of the money under obamacare , wheres that chart . 40 of the money under obamacare goes to for states. We level out spending 10 years from now, 2026. Every state gets basically the same contribution from the federal government that will allow you to adjust for risk if you have an older population, sicker population you can get more money. The goal is by 2026 to make sure that every patient no matter where you live is basically the same contribution from the federal government. A i both think most americans believe thats fair. Our bill levels out and inequity in funding that allows flexibility that obamacare would never embrace. He gives patients a voice in the health care they will never have their Single Health care payer system and from my point of view its the best and last hope for the Republican Party to show that we have ideas and that our ideas are better than our friends on the other side. The last thought, liberals will fight like tigers to the bitter end to get what they want. To those in the Republican Party that feel like we have not fought as hard as we could, you are right. To those conservatives who feel let down by this debate you have every reason to be let down. Here is my call to the Republican Party and to all who believe that health care should be closer to the patient and not stuck in washington. We need your help. The only thing stopping us from having this idea standing on the floor of the United States senate is lack of leadership. Bill cassidy. Thank you for being here. You may know that ive worked in the Louisiana CharityHospital System for 25 years and it was a system that was basically if you are poor thats where you went and i learned that the politician controls the dollars the system lights up to serve the politician. If the patient controls the dollar the system lines up to serve her. The thing we are trying to do is give the patient the power. We want the system to line up with that patient wherever she may live. Some will say my gosh whats wrong with the status quo . We should continue. This is saying out there that obamacare only works if you dont and i will give you an example of a fellow who is a talkshow host in louisiana. He is a selfemployed person. His premium per year is over 40,000 with a 5000dollar deductible and an additional deductible. Think about that. Hes going to face 50,000 a year between his premium and his deductibles. The mortgage of a 500,000dollar home. Louisiana is considered to be one of the states in which the individual market is working relatively well. It doesnt work if not. We try to change it. That selfemployed person wherever he or she may live will have the ability to have Affordable Health insurance. By the way i could have chosen partisanship or the news york times editorial opined draconian cuts because we havent used the bill yet. With all due respect to the Editorial Board of the news york times you havent seen the bill how do you know they are draconian cuts . Our democratic colleagues have accused the partisanship and let me say you havent read the bill yet but let me get to some numbers. What we do is we equalize the treatment of whatever the patient lives. She currently lives in the state representative by democratic senator which doesnt understand medicaid they do far better peer by 2026 wherever she lives where they are blue states or red state shall pay the same amount of money provided for her care. We dont think a blue states are or red states in this bill we think of american patients and those who are eligible should get the same. One example the difference between what we provide versus what they will receive under the status quo is indiana will receive one point 3 billion more in 2026 relative to the status quo a state representative by Democratic Rep or senator. Wisconsin 1. 1 billion, virginia 2. 7 billion more than 2026 alone under our plan relative to the status quo. This is not a partisan bill. This is a bill about the american patient wherever she lives. Let me ask this in fairness tim kaine the senator from virginia said hed didnt accuse us of partisanship but he wished there would be a Better Process and senator carper said he wished that there would need aid a hearing on our bill and i agree. Lets not be disingenuous. So far from the other side of the aisle there has been no cooperation whatsoever when it comes to addressing the issues of someone like him who is paying 50,000 a year under the status quo. As far as the policy itself all the dollars we repealed an individual mandate be repealed an employer mandate. Those penalties go away. We get rid of the medical device tax and we take the dollars and we split it among the states. The way we decide what state gives what has he look at everybody in the nation who earns between fifth he and 138 of the federal poverty level. Then we take each of that National Population and that is where you begin. Beginning in 2021 the dollars are allocated the pentagon what percentage you have of the total National Population within that income level. The state can spend it on those who were a little bit richer or a little bit less rich but thats where we decide to spend it and thats how we divide the money. Beginning in 2022 i think you put in a risk adjustment so the states that are older and sicker end up with a little bit per patient and those who are younger and healthier but everybody will get the mean of plus or minus 10 . We also toured the end began to say that the allocation of state has enrolled a lot of people do get a little more. If they get less people they get less. Why . As much as the cbo is going to ding us because free repealed the individual mandate jonathan gruber, the architect of the apa has an Article Research in the er which is published in the new england journal of medicine as well who said the effect of the individual mandate in improving enrollment. No statistically significant effect of the individual mandate improving enrollment. What does happen is that the governor gets on board. If the governor gets involved it happens. In our state we have a new governor who decided to expand medicaid. Louisiana enrolled 350,000 people in 18 months. The governor is on board so we incentivize governors to enroll. Toward the end the amount of money you get will depend upon those u. N. Role but we are conservatives. We dont think health care is so enrollment counts finding a patient who has benefits is enrolled in the va. A person who could get it through her employer because she had extra money for premium support can receive premium support in order to get it through her employer. She mentioned incorporating ted cruzs bill which allows the state to put money in the account for the person to purchase her own insurance. Our goal is to give patients the power. We think this is a great reform and i will now turn it over to dean heller. Bill, thank you and lindsay thank you. I want to thank my colleagues and former colleagues for getting with you today what i think is a very important moment last night i did my week we tom homan things and i had a nurse on the phone and the nurse said, finally ended the ram cassady johnsonville Congress Gets it. They finally understand whats good for america and finally they understand whats best for the state of nevada. Back in 2012 when obama was running for reelection and running against romney and obamacare has been in place for two years. If romney doesnt when its going to make it very tough to reverse obamacare as we know it today. Think it is proven that has been as varied difficult task. In fact right now republicans have come up with two plants, two plans. One to repeal and not replace, one to replace it not repeal. Thats what we have been through for the last eight months. Finally we have come up with a third option and that is to repeal and to replace. I will tell you this. Obamacare has not worked and i give you a couple of examples. A couple of months ago 14 of 17 counties, 14 of 17 counties in nevada will go in the first of next year through with the work of my office and the Governors Office we were able to provide a single carrier that would work for those 14 of 17 counties but unfortunately we found one carrier which means theres no competition and there are no choices and you know thats only going to increase costs in those 14 of 17 counties. Another example of how this doesnt work for all nevadans we spend in the state of nevada over 18 million by individuals, about 80,000 of them because the chance for the product that the government tells them they have to buy. So they are paying the fine. Most would make less than 50,000 a year. Over 80 of them make less than 50,000 so the least fortunate have to pay this fine. They have to pay this fine because they cant afford to pay for this product that the governor government says that they have to buy. As i said obamacare does not work for all nevadans. Last week and this is even more interesting to me that has had an interview and a host of the show said in a discussion with senator reed a couple of years ago, he said senator reed said the singlepayer systems ultimate goal was that the obamacares ultimate goal was to become the singlepayer system so seven years ago we set up a system and the purpose of it was to get to a singlepayer system quoting the majority leader of the senate at that time. Think about that. That was the goal to put together piece of legislation that was going to fail and obviously thats working now. I dont think americans deserve that and frankly i dont think nevadans deserve it also. We need to find a way forward and figure that out through Graham CassadyHeller Johnson. This plan is the way forward. Its the most reliable, workable solution to achieve our Health Care Goal reforms and it returns powers to the state provides ultimate flexibility to governors and legislators regardless of whether they have expanded medicaid or not. Under this proposal nevada receives more funding than we currently do under obamacare. More money to Cover Health Care costs as they see fit. This is the way forward. This is how we are going to move not only Health Care Forward but America Forward to having a Health Care Plan that works for everyone. And with that. Thank you dean. I want to thank city for all of his hard work, Lindsey Graham for selling the program Rick Santorum and dean heller in terms of their effort is doing with senator graham said is their last chance at repealing what i think has been a law that is done a lot of harm to a lot of americans. Some some good but its also done a lot of harm. These guys have that mentions the numbers another want to disappoint. 50 billion spent on medicaid in the next 10 years, and nine years ago we are spending 200 billion. This year we will spend 400 billion, clearly unsustainable. From my standpoint of represent the state of wisconsin, we didnt need obamacare. According to Wisconsin Department of Health Services and their Families Health survey obamacare 94 of wisconsinites had Health Coverage all or part of the year. Under obama cares up to 96 . They now have coverage because of obamacare but over 100,000 wisconsinites 82 of those make 50,000 a year and like us than the average premium increase throughout america according to hhs wisconsin previews have by and large double because of the artificial nature and the architecture obamacare. In many cases printers have tripled. Bill clinton was talking about obamacare. This craziest thing in the world he was talking about the forgotten and abundant people who are out there working 60 hours a week. Opinions have doubled or tripled in their coverage cut in half and they cant afford obamacare. Those forgotten men and women like peter people like Vernon Sherry wrote to me they literally had to cash in their for a win k. To build their house. They may close to 60,000 a week a year sorry. They had to pay back and cash in their 401 k and lose their house. These are the forgotten men and women of obamacare of that were forgotten by bureaucrats in washington d. C. Those men and women wont be forgotten by governors and state legislators because the governor will be far more responsible. It returns that power to the state. To make states more responsible, more responsive. Hopefully those premiums will come down because states will be granted more flexibility and of course it will be a whole lot fairer. In wisconsin wisconsin because Governor Walker we are the only state that close the recovery gap. People working low the poverty level. It has good flexibility but when it got no credit for it to a vendor Graham CassadyHeller Johnson will be a whole lot fairer process in states like wisconsin doing right to their constituents will be granted the funding for that. This is a far fairer process. Let me conclude by pointing out with senator graham also said. My republican colleagues, this isnt quite good enough. It doesnt do enough for repeal. This is our last shot. It comes from a manufacturing background. Its a vast improvement, n