The wealthiest and the special interests. D thats whats going to be draft if she is confirmed and if the bill passes. It is her nomination for debatea right now. We should make no mistake she is going to be in charge of the the specifics. If trump care passes under section 132, the new administrator would give states a green light to push in the a high risk for the historical record shows these highrisk pools are a failure when it comes to offering good coverage is affordable. The new administrator will be in charge of section 134 and could decide exactly how skimpy trump care plans and how much more it will be forced to pay outofpocket they would handle section 135 for Health Insurers for those approaching retirement age. That is just the start. The fact is trump care is about enormous tax rates for the fortunate few financed by cutting medicaid and hurting of older people and those who were of modest income. Ms. Verma and would have the job of implementing this at the centers for medicare and medicaid services. My view is the senate cannot debate this nomination without debating the trump care program. Itself because it will be a hugm beginn so today im going to walk through some of the specificsem with respect to trump care beginning with the scheme that i call robin hood in reverse. If you look at the fun, it is ay clear that this is an eyepopping transfer of wealth, away from older people, women and kids from the most vulnerable, directly into the wallets of the fortunate few. No part of the bill shows this medica more clearly than the fact it steals from the Medicare Trust fund to pay for a tax cut thatka goes only to the most fortunate, only those who make a quarter Million Dollars or more per year. Mr. President , everybody in america who brings home a paycheck has a little bit taken out each and every time forub. Medicare. It is right there on the pace of under trump care, the only people who are going to see a. So medicare taxcut are the people who need it least. I want to repeat that. Everybody in america, when they get a paycheck, they see a medicare tax and everybody pays it and we understand why its so important. 10,000 people turning 65 every day for years and years to come. The only people the only people who will get that that medicare taxcut who need it the least. Those who go to the fortunate few will take three years off the program to pleading it in 2025 instead of 2028. That particular cut breaks a clear promise not to harm medicare. All through the Campaign Candidate trump was very firm he said and i quote, you cant get rid of medicare. Medicare is a program that works. Im going to fix it and make it better but im not going to cut it. T they lasted about 6. 5 weeks into the Trump Administration before it was broken. The bottom line is trump care va rates medicare. A raise medicare and causes harm to medicare in violation of an explicit trump promised during e the campaign and brings medicaro three years closer through crisis to pay for a tax cut for the wealthiest in america. So you have this enormous eyepopping transfer of wealth from working people and seniors and people of modest means to the most fortunate and somehow people have asked for to say childcare bill . I dont think so. It is a huge, huge windfall for the fortunate. Theres also the tax break on investment income. Once again, this is a break that will only go to the most fortunate among us. Ea but the investment tax break, the overwhelming majority of the benefit come in nearly two thirds available go to the top one 10th of 1 of earners in of america. Ey so that looks like an awful lot going to the fortunate few, mr. President. But we are not even done there. On top of all of this, there is yet another juicy tax, this tims for insurance executive salaries, another juicy tax cut for executives making over 500,000 per year. It is not just medicare and its getting rated under this trumpce proposal appeared some of those hit the hardest by trump care are those approaching retiremenr age. If youre an older american of modest income, 55 or 60 come youve got to get insurance in the private rk. Trump care is going to cause your price has to go through tht stratosphere. Parts of my home state, a especially in rural areas a sixyearold who brings home 30,000 a year could see their insurance costs go up by thousand dollars or more. Much of this is due to what we call in h. Tax, a key part of trump care. Its another key part of what ms. Verma will be in charge of implementing. It will give the green light to charge older people at times as much as they charge younger people. So if you are a person of modest means a few years away from qualifying for medicare and your insurance premiums jump by 80,000, that means youre just out of luck. You will be locked out of the jt system. Youre basically going to have to hope that you just dont get sick before you are eligible for medicare. Those tax credits you hear so much about from trump care to advocate are going to be of much consolation to you. Thats because trump care puts a hard cap on your tax credit asha an older person to 4000 the odds are good that it wouldnt come close to covering the expense of a decent insurance plan. Now i am going to turn to medicaid because trump care doesnt just make make little changes around the margins. It doesnt strengthen our preserve the Program Covers 74 million americans. Mr. President , trump care his medicaid like a wrecking ball and it has particular implications for seniors and im going to walk through those. But medicaid nursing home benefit is very much at risk now because of the trump care cut as it relates to medicaid. Medicaid picks up the bill for two out of three nursing home patients. These are the people who raise kids, put them through school,ho script and say about a code. These are the people, mr. President hu in kansas and oregon across the country never went on a special vacation good they never bought a boat. All the dead was scrimped then save and educate their kids. But the fact is growing old in america is pricey. After a few years of balance beam the food bill against the medical costs, what happens is n lot of seniors jessica lost their savings. Mr. President , when i was director inside my state and duplicated everywhere was older people walking every single week on an economic tight rope, balancing those food bills,ills. Medical bills and the medical bills against the rent bill and they just couldnt keep up. And they burned through all of their funds. They burned through their modest savings. So when its time to pay for turn to medicaid. Today in america, the medicaid nursing home benefit is a guarantee that those Vulnerable People committed people walking on the economic tight rope, that they are going to be taking care of. D trump care breaks the medicaid nursing home guarantee and it goes even further than not. A lot of states worked hard as well as those with disabilitiesb maybe instead of living in a nursing home or institution had rather be in the community. Maybe they would rather live at home where they are most comfortable. Trump care could mean that those home and communitybased choicet could disappear as well. So what we are talking about, mr. President , with these cut iy medicaid in a time when a campur in oregon and across the country, what we try to build for older people as theyd continue on their services. Therell be to home. There would be a wide array of choices is enough money to fund these choices and continue on my concern is there is not going be enough money for any of these h choices. Not going to be enough money for the nursing home benefits. Not enough money for home anduf communitybased services. Suffice it to say my own home state has indicated to me that they are concerned about the cutback in a home and communitybased services. Nobody wants to see older people get nickel and dime for the basics and home care they rely on an good nursing home benefits. Yet when it comes to medicaid, trump care would effectively end the program as it exists today, shredding the Health Care Safety net for older people and millions of others under of countries. It puts an Expiration Date on the medicaid coverage that millions of american cut through the Affordable Care act. For many, it was the first time they had Health Insurance. It brought an end to an era where if those individuals could turn only to emergency care. T and now they will cap the budget and squeeze that squeezes the more until Vulnerable People will just not be able to getartu care. The program is particularly important for seniors and disabled and i want to make sure that people understand what it means her children as well, for those in the dawn of life as well as those in the twilight. Medicaid pays for half of allemr birth and kids make up half of medicaid enrollees. Its important to remember that in many cases, these are kids that are to have the odds stacked against them. They are from lowincome families, foster kids, kids with disabilities. We know they are already facinga an uphill climb. Medicaid has been there now at the Affordable Care act to make sure they could see family per session nurse. Pediatric specialists. That was just unheard of for these youngsters, mr. President , afford and when the kidneys emergencyar care, medicaid is what makes it affordable. Trump care puts that in danger. I talked about what it means for older people and what it means for disabled and what it means for kids and im just going to keep on telling, mr. President because now that we have the hard numbers in, the hard numbers have arrived in real time of the Budget Office that is charged with giving us this analysis. Its important to talk about what it means because budgets are not just facts and figures and paper appeared they are about your hopes and aspirations and the hopes and aspirations ive had on those days when i was direct to your to make sure people had affordable, quality, Decent Health care choices because in america if you dont have your health, you are really missing much of what makes life so special in our country. So the bill also takes an enormous toll in other areas. I want to mention next opioid abuse. I flashed the medicaid, trump care will make americas epidemic of Prescription Drug abuse related that even worse. The paper this morning had account about how families were losing most of their children to opioid addiction. Most of their children lost to opioid addiction. On the front pages of the paper, medicaid is a key source of coverage for Mental Health and Substance Abuse disorder treatment, particularly after the Affordable Care act, but and millions who need it. Republican state lawmakers to their credit have spoken out on this issue and frankly it ought to be ahead scratcher for anybody who are in them or is the last president ial race when a parade of candidates rolled through state after state in the primary race that had been hit hard and all those candidates and ill promise the one who had spoken previously and how they would help solve the Opioid Crisis. Candidate trump was one of the most outspoken saying he would fix the Opioid Crisis. He was the guy who could and the scourge of drug addiction and get americans the help they that need. Instead, what we have is trump care that makes the Opioid Crisis worse and there is no getting around it. Trump care puts states of the unimaginable position of havinge to decide whos medicaid to flash. Will they tell seniors immersing all benefit is no longer the guarantee and they will have to get in a long waiting line for an opportunity to get a place in the local nursing home . Should they tell pregnant women that they are no longer covered . What about telling mothers and fathers their kids are cut off and theyll have to hope for the best or make their way back to the emergency room. And the final point that really deserves discussion and hasnt e gotten much in the finance staff working on it and trump care creates a disincentive to work because i think trump care and ms. Vermas role implement tenet will have a substantial effect on entrepreneurs. Today i medicaid you are able to pick up a few extra hours of work and accept that higher paid job without the fear and lose access to care. Under the Affordable Care act, a most help when it comes to paying insurance premiums. A lot of persons can get Health Insurance for less than 100 a month. Those are walking an economic tight rope bringing home barely more than the minimum wage. They dont get the most help. O they could see their insurance costs go up by thousands and thousands of dollars each year, which would effectively mean that could be locked out of the health care system. And millions of persons, saying i medicaid is suddenly look a lot more attractive, making a little more money and losing medicaid coverage could mean losing access to highquality health care altogether. My view is no one has been able to counter this. Trump care and effect would keep americans trapped in poverty. Entrepreneurs and americans who want to go back to school to pursue a degree would face the same dilemma. Somebody wants to quit their job and pursue their treatment started their own business to be able to do it. Without a fear that they would be able to add a longer afford health care. Trump care makes and sharon affordable for those purposes. Child care will be the big issud on ms. Vermas place if she is confirmed this afternoon in the senate to administer this office. We all understand that this bill has taken a pounding from all sides. A lot of republicans and those who are conservative republican. Democrats are united. Io the aarp, the american hospitals association. Have all come out against the bill. Not any surprise to me. The Health Care Legislation is x primarily about labeling of big tax breaks for the fortunate few. Thats what this socalled Health Care Bill does. And is financed by raiding medicare, cutting medicaid and hurting older and sicker and lower income americans. Ut a lot of happy talk about why you want to support this bill. When i tried to do a layout the broken promises. This weekend, for example,ices nobody will be off finished in the process we are going through, understanding choices they can reflect the kind of coverage they want for themselves and for their family. That state and for the health and Human Services is disconnected from the feds. The simple math is trump care forces millions of people come out are people, affluent peoplee to pay thousands of dollars more for their Health Insurance. The omb director, budget director vic maldini was pressed on why and the response was trump cares about access and tht bill helps people get health care instead of coverage. We all understand access doesnt mean a lot that people cant afford to get coverage. Thats the future trump care is going to break for millions of americans. During i asked ms. Verma the most basic questions during her confirmation hearing so we can get an insight into how she would approach these issues. A i asked for one example. These are not got your questiong mr. President. These are questions you ask when you want to know about a Program Involving a trillion dollars. An example is verma about what you would do to bring down thei cost of prescription medication. I particularly would like to see more transparency and lifting this cloud of darkness surrounding how medications or price. She didnt have the answer to these questions. Here is where the nomination stands. Ms. Verma gave the committee virtually nothing to go by in terms of how she approached thif job. The fact that if confirmed should be one of the top officials to implement trumps care that slashes medicaid and kicks millions of americans off their health plan to pay for a tax cut for the wealthy. So i am unable to support this t i urge my colleagues to oppose it. I ask unanimous consent to be allowed to enter additional statement into the record and i yield the floor at this time. Without objection. But a classmate, nancy pelosi