Transcripts For CSPAN Democrats Hold Hearing On Impact Of House-Passed Health Care Bill 20170510

Pennsylvania, wisconsin. We are glad to have the great lakes represented here today. We thank everyone for tuning in to the livestream. We hope you will share your story. Please go to americaspeaksout. Or trumpcare. This is an ongoing conversation that we want to have, not just today. We know that there are other Critical Issues that have come up, but we feel it is so important that we remain focused on one of the most important issues to all of us as americans and our families. The ability to see a doctor, take our child to the doctor and have a for double medical care when you need it. Last week, republicans passed a bill that is a triple whammy for families. In my state of michigan and across the country. Higher costs, Less Health Care, forto pay for tax cuts millionaires and billionaires. Unless you are a very wealthy person, trumpcare is a bad deal. 24 Million People will lose insurance. Medicaid will be cut by 880 billion to pay for the tax cuts for the very wealthy, leaving millions of seniors and Nursing Homes, children, people with disabilities and working families with Less Health Care or no coverage at all. Seniors get hit with a huge tax, paying five times more for health care than younger people. Employer coverage is at risk for tens of millions of americans, and no preexisting conditions are not really covered. As democrats, we know that we need to Work Together to continue to make Health Care Including americans, outofpocket drug costs. That is not what the Republican Administration is doing. The Trump Administration is working overtime to administratively unravel our Health Care System. They limiting payments to companies that guarantee preexisting conditions and other things are covered. No longer doing strong outreach so younger and healthier people are part of the insurance pool. The new secretary of health and Human Services has cut enrollment time to sign up, in half. Why . So Insurance Companies will stop participating in the marketplace, and the republicans can say, its a mess. People cannot get affordable insurance. Obamacare is failing. We know that health care is affordable to all of us and our families. We continue to hear your voices. Republicans held no hearings, no public discussion. They didnt wait for the analysis by the Budget Office of the cost and impact on people. That is not how democracy is supposed to work. That is why we are so grateful. You have traveled here today to share your stories with us. I would now turn to the Ranking Member of our leader and the finance committee. For what you are doing. Im happy to be here with my partner, senator murray. Inaudible] friends must not filibuster friends. I will be short and make a couple of points. The reason it is so important to have all of you here is that political change is not top down. It doesnt start in government buildings or trickles down to the grass roots. It bottoms up. As all of you, with your terrific organization, go out and mobilize, go to community meetings. Go to marches. Rally for the agenda today, it will make a huge difference. People are paying attention. I will touch on that. I want to come back to the point that senator stevan know senator stabenow has made. Billions of of dollars in medicaid cuts and the hundreds of billions of dollars in terms of tax breaks for the fortunate few for the wealthy sides of the same point. If you cut medicaid dramatically, people will suffer. This idea of giving thousands of dollars of tax relief annually to the most fortunate and most wealthy defies common sense. It does not past the smell test. You are hearing talk about how maybe the Senate Republicans will rewrite the bill. As of this afternoon, there is no evidence that they are moving hundreds of billions of dollars in tax cuts and medicaid. The last point that i would like to mention is that when i was home, and a described this as a we wentuffering generation by generation. If alld be very helpful of you might consider that. No one knows more about this than senator hassan. We have 40 of the School Districts getting help. That is an area where the medicaid cuts will hurt. 18 and you have a brush with cancer and are cured, these folks are able to redefine preexisting conditions, those High School Students may carry that cancer condition like a Scarlet Letter for their whole life. Then i talked about workers. The far right are trying to say that you guys are homefree. On house will lift the cap outofpocket costs that people can pay. This means that the cap which limits how much you can pay, it will be busted. You get a cancer condition, and you will bust that cap in a hu rry. Finally, the indignity, with respect to Nursing Homes. Medicaid pays for two out three of the nursing home beds in america. This is pain and suffering that spans generations. Senator murray, senator stabenow, and i, between us, are on the committees that will deal with it. Were lucky to have our colleagues with us. Chair stabenow, senator murray, thank you so much. Sen. Stabenow senator patty murray, our ranking democrat, our leader on the health committee. Sen. Murry thank you for your leadership in putting this together today. Im grateful to all of our witnesses, especially those of you sharing your personal stories. Im hearing from people like you whose lives will be at risk. Hear especially often is worry about people who could withstand the skyrocketing premium, and higher outofpocket costs would pass. Trumpcare would end the guarantee of the essential Health Benefits and decrease the availability of tax credits. Families at risk of losing access to Mental Health and Substance Abuse Disorder Services or Prescription Drugs would be in trouble. Up one costs will go middleclass, and trumpcare would be especially devastating for Older Americans by allowing plans to charge higher premiums, brazing raising what is known as the age tax. What is clear is that trumpcare is not about helping patients or families, but is about President Trump getting his way and delivering massive tax cuts to trump companies, Insurance Companies. It is not good for patients or families. My hope is that todays hearing will help bring more discussions that will allow Senate Republicans to get them the me ssage that they should drop their damaging, politically motivated effort to undermine our Health Care System in ways that raise costs. I hope it will work with us to continue fixing the Health Care System. I am confident that millions of people who have been speaking up and making themselves heard will continue to do so and are repaired toand are hold for and are prepared to hold republicans accountable. I think all of my colleagues who are coming, and are here now. This is one of the most important things to families that we should be talking about. Sen. Stabenow we are grateful for all of our colleagues who have joined us. We stand united in our concern and our determination to make sure that people in this country, that we all have the health care that we need. That we are working together to make things better. I will introduce everyone. We will start with mrs. Johnson. Cindy johnson is from bloomington indiana. Cindy will share her familys story of fighting for health care for her daughter. Gina washington. She will share her story with Preventative Health and family planning. Excuse me, planned parenthood. Carol hardaway. I think we have two additional michael dunkley. I will turn to senator kaine for this one. Michael has a very powerful story. He shared it with a because i put a story on my Senate Website and i asked people to share what would happen to them if the aca were repealed as the house did and as we fear the Senate Republicans are trying to do as well. He is a fulltime caregiver for his wife, who has ms. At age 64, he was diagnosed with cancer. Dealing with both being a health care caregiver for a wife with a serious condition, and a cancer diagnosis, that is more than anybody should have to bear. Dealing with a system with a humane Health Care System versus one with no health care safety. Et is dramatically different sen. Stabenow next we have teresa miller, the pennsylvania insurance commissioner. She will speak about the Health Care Markets in pennsylvania and how trumpcare will affect her state. Senator casey was singing your praises and so grateful for your being here today. Nelson. On rod president and ceo of his company in michigan. I want to thank you for being here. Congratulations on your hospitalon as world leader of the year. We are privileged to have you with us today. Rod is here to talk about the challenges for rural families in accessing quality care. Ms. Johnson thank you so much. It is my great privilege to be with you this afternoon. I want to thank senator stabenow for this invitation to share my story. Its my parents were among working for. Working poor. I became the first person in my family to go to college. I worked as a math teacher for a number of years. When i wanted to start a family, i discovered i would have a baby girl with down syndrome, my life changed dramatically. It became very clear after her birth that i would need to be a stay at home mom. We went from being a stayathome a twoincome family with no medical expenses, with single income family massive medical expenses. I renumber opening up an envelope i remember opening an envelope from the hospital with a bill for 64,000, just to rent the equipment at the hospital the month before. I began to realize this was our new reality, because more bills would soon be showing up. The lifestyle and worked so hard to attain was slipping away. Over the next several years, the bills added up. There were many expenses that the insurance did not cover. ,edical equipment outofnetwork specialist, therapies, specialized feeding supplies, and more. Our outofpocket costs are spiraling with no end insight and my daughters condition was deteriorating. We took out a home equity line of credit because the cost of my daughters care was fast approaching the lifetime cap. Then came the Affordable Care act in a gained peace of mind knowing that lifetime cap had been eliminated. After eight years on a waiting list, a daughter became eligible for medicaid disability. That covered much of what private insurance did not. That covered a much greater financial future for my family. I have reentered the workforce and have made progress paid down our debt and even saving for college for my other children. Im grateful for the protections of the aca. I know and love in their stories i share with my consent. For my son am a his fifth grade classmate he has epilepsy and lives in the same as mrs. Senator young. For my former colleague, who stutter a court daughter requires a tracheotomy. For my friend in indiana whose quadruplets sons, two of whom are on the autism spectrum and one of whom has Cerebral Palsy has been able to seek employment and live more independently in their community. Whom iriend in louisiana only know through facebook has many medical struggles struggles. His son has a mental condition due to a rare disease he contracted at three months of age. My my friend here who has back. The mother of this beautiful 11yearold who was born blind and has Cerebral Palsy and microcephaly. For my own precious daughter with down syndrome who had Successful Surgery last year and is attending school fulltime and speaks with pure joy but the friends she is making. Parent, nothing else matters when your child is sick. Caruldve sold my house, my , i would have done anything to make sure my daughter had access to the care she needed. No ferret should ever need to ife that worry and wonder they will have the lifesaving provisions that their child needs. The Affordable Care act meant the difference between life and death for my daughter and Financial Stability for my family. It is given us a chance to seek a financially secure life that would have been hard to achieve otherwise. Whatever iso do necessary to preserve the provisions of the aca, those with preexisting conditions of coverage for essential Health Benefits. I urge you to reject anything to funding including the per capita models would reduce access for people with disabilities, low , ande households, seniors expectant mothers. I ask you to encourage health care for americans because we do everything we can to keep it cover heads of. Thank you for your time and consideration. Thank you. We apologize for the microphone going on and off. Thank you for your testimony. Mrs. Walking to. Thank you for inviting me to be here today. Share my story with all of you. My name is Gina Walkington and i am mother to three rambunctious, energetic, amazing voice. I am here today because i know that if i did not have access to planned parenthood in my 20s, i would not be a mother today. In two dozen six, when i was 20, my best friends and i made appointments at planned parenthood. We went for three reasons. At 20 i was uninsured. Though i was insured through my parents commit the topic of sexual Effective Health is not something we ever discussed. The sliding scale of transparency at planned parenthood was essential to me as a 20yearold woman. A week after i had a pap test and got a supply of control. A week after planned parenthood called to explain that my test came back abnormal and they found precancerous cells in my cervix. For a 20yearold woman in college that is terrifying. So many things run for your head when you hear precancerous cells will stop i knew that if it were left untreated, i might not able to have children. As a 20yearold, i hadnt really thought about kids. I wasnt sure if it was something that i wanted, but when faced with it being taken away, it suddenly becomes very precious to you. The clinician at planned parenthood walked me through what to do next and helped me move quickly so the cells did not have a chance to spread. Ofm now a healthy mother three. Had planned parenthood not been so affordable to me my life might have turned up different. Had i waited to get care, i could have lost the ability to have children, or even died. I am not the only person who can say that. Met, party ms. Christie, went her name is christy, went to get a pap test at planned parenthood. She had cancer cells that were far more developed. She was able to get them removed, and is here today, but is not able to have children. If she were here, she would tell you that planned parenthood saved her life too. Hadly 72,000 people earlystage cancer or abnormalities in 2014 alone. I joined with four of those to draw attention to how essential planned parenthood is. Through the network, i met a woman who could not get an appointment to check out the lump in her breast for three weeks. She called planned parenthood and they got her in that day. Amet a woman who at 19 had footballsized tumor on her ovary. Wouamerican Health Care Act on p able to rely the republicans supporting this bill have suggested that those people could go to Community Health centers. Riley there are two qualified Community Health centers that provide screenings and Birth Control. They have said that they would not be able to accommodate the patient load from planned parenthood as they are overloaded and refer many to planned parenthood. For women, it should not be treated as a luxury. It is irresponsible and dangerous to block access to an woman because of where they live or how much money they make. Arehink of my three boys who here because of the care that i received. Im telling my personal story because i have learned to be brave. I need to speak up because there are millions who need care that planned parenthood provides. Im asking you to be brave, for me, for my community, please stand with planned parenthood. Sen. Stabenow you are looking at a lot of people here. And a lot of brave people here. I mentioned earlier that senator van hollen would be joining us. Inhofe senator van n thank you for telling your personal stories. That along with my colleagues it will be that personal testimony that you provide that will turn the tide. Statistics about the , but you can tell that story in human terms. Fisherolleagues, carol is here to tell her story. Ms. Fisher thank you for convening this critical hearing and for the opportunity to share with this house repeal bill would mean for me and my care. My name is carol hardaway. When i was 32 years old i reached into my babys crib only to realize i could not feel him. My arm felt like it was asleep. I grabbed my son with the other hand and did not give it much of a thought. Ithin minutes after arriving could not hold the glasses and shakers i needed to do my job. Something was wrong. The tested me for everything, stroke, meningitis met you name it. Latersent home a week with no diagnosis. Four years later, i had issues with my vision. It began to rapidly deteriorate taking me from nearperfect vision to near legally blind. I went to an optometrist. He passed me to an ophthalmologist, then retina specialist, then a narrow ophthalmologist. Euro ophthalmologist. The scan showed tiny specks on my brain. Clearly multiple sclerosis. As you know, ms is a debilitating mobile disorder. For me it is led to fatigue, increasingly painful spasms and the occasional attack, which is an intense period of heightened systems. It does not define me, but it informs how and when i live. 1995, i lost my Health Insurance when my husband and i started our own business. Andg with my debilitating chronic conditions, i survived two heart attacks. Risklified for the high pool. I needed declination letters, declining letters from health Insurance Companies. That shouldnt be too hard. Yes, xyz company, like to enroll in your plan. Female, nonsmoker, two heart attacks, high blood pressure, depression, oh, and multiple sclerosis. Every insurer i called laughed at me. That is what health care in america meant before the Affordable Care act. That changed in 2010 when president obama signed the aca into law. I could not be more grateful for him than every other senator and staffer in this room who made that happen. My health continued to deteriorate, but i finally had hoped. I had to bring a stool to the because i was not sturdy enough to get back up. I could pay the bills, but i could always go in and sometimes when i did, i fell. Taking lunch plates and my dignity down with me. Rick perry chose politics over the people of texas. It became painfully clear that the only way i could get care, was to leave my home and move to maryland. Upjanuary 19, my son showed to my home in texas with a moving truck. The High School Football team came over to load the truck and this began my journey to receive Quality Health care. Within two weeks, i started receiving treatment for ms, 24 years after my initial diagnosis. My weekly shop manages my symptoms and significantly cuts back on my spasms. I am able to work as a process to teacher. When my Health Declines every six months, my meteorologist orders and antiinflammatory steroid infusion. This dramatically improves my energy, speech, and overall function. The House Republican health or appear Health Repeal bill cuts medicaid even when President Trump promised he wouldnt. Under the plan, i would be the biggest loser. Not only would i lose my medicaid, the new age tax would make treatment completely unaffordable. I will tell you the same thing i told my congressman before he shut off his phone lines. The House Republican Health Repeal plan would put me in a wheelchair. Those who say that medicaid is broken dont know how it has fixed me. As i stand here 63yearold w a working woman with msi ,medicaid is working. Medicaid expansion wit is my lifelineh ms. Ms, Medicaid Expansion is my lifeline. I will be happy to answer any questions that you may have. Thank you. [applause] good afternoon afternoon, thank you to senator stabenow for inviting me to participate in this discussion. My name is michael dunkley, i am 64 years old, and i live in alexandria, virginia. Im here to tell you my experience with the Health Care System over the last several years. In the summer of 2014 i was experiencing increasing back pains which i attributed to my declining physical condition, but over the summer it became worse and worse. Your story is so resonant, because my wife has been battling multiple sclerosis for 24 years. Hers is in the more advanced stage. She has been on Disability Insurance for some years now and i am her caregiver. She convinced me to go see a doctor. He initially thought that it would be a hernia. They did a ct scan, and on fr iday, after i got home, the phone rang and they said the doctor would like you and your wife in his office on monday morning. Would you like to speak to the doctor . Hernia, youget the have masses all over your chest wall. Youll have to start thinking differently. Have a good weekend. Monday morning he throws up a bunch of stuff on the screen and cancer, thirdlung stage, who is your oncologist . He got me to see an oncologist immediately, and after a series of many tests them a it was determined that i had nonhodgkins lymphoma, large cell, stage four. I asked what was stage five. His office overlooked Arlington National cemetery and he said, that is stage five. My father is buried there. It would put us together. Within a day or two after was the first day you could register for the Affordable Care act. I got two thirds of the way through the system and it stopped working, but i knew that it would not take effect until january 1. The other thing that was running along is at this point i was unemployed and i was paying for medical insurance through my cobra plan. Withrly december, i spoke a representative at healthcare. Gov and in 15 minutes i was completely registered and had a brandnew plan that would take effect january 1. December 31, my cobra expired. A minute later i had a new plan that with the subsidy, i was paying 575 per month. I had a plan with a zero dollar 50ctible and a outofpocket limit. Months, i had a round of chemo that generated charges of 35,000. I had another round of chemo and on february 14 the next year, my oncologist reformed me that i was in informed me that i was in 100 remission. This membrane cancer had spread throughout my lungs, my stomach. The bulges were due to lymph nodes that are normally the size of a grain of rice, to the size of a lemon. There are crushing my vertebrae come up my spine, my ribs. Transfersal series of that the informal care act gave me got me through the first chemo that the Affordable Care act gave me, got me through the first chemo. Because of the chemo, both of my hips broken had to be replaced. That generated another 140,000 in progress in charges. I am in remission. I am able to continue my lifes takingf loving my wife, care of and helping her, and i am so honored to be able to speak out. There are millions of voices, stories that are far more complicated, but they come down to a bottom line, sailing on this ship of life together. Lets help everybody as we go along. Getting back to the Affordable Care act. Both components protected me. I could not be declined for a preexisting condition. I was in the middle of chemo with massive cancer everywhere. They pay for the procedures, 35,000 here, 5000 there. I will turn 65 next month and i will be going off the exchange and going on to medicare. The only way that we can endure is with a singlepayer system. To invest in the health of the people makes the body politic healthy. The nation will thrive. When people are sick, they cannot function, they cannot perform, it is a drain. I look forward to seeing the patient Affordable Care act strengthen. Sen. Stabenow we are so pleased that you are here and doing well. Commissioner miller . Miller thank you for the opportunity to be here today. I applaud the committee for holding this hearing to highlight the Significant Impact that repealing the Affordable Care act and replacing it will have on millions of americans. I am honored to be on a panel with so many brave people next to me. Before the aca, six people could not get Health Insurance due to a preexisting condition, or they paid significantly more for it. They could face annual and lifetime limits. Women would often seek higher coverage costs than men and not have access to contraception or maternity care. Critical Services Like Substance Use Disorder Treatment and Services Like Prescription Drugs were often difficult, if not impossible, to find coverage for. More than 16 of americans nationwide went uninsured. Since the acas passage, the national uninsured rate has fallen to 8. 6 . Pennsylvanias rate has dropped to 6. 4 . In my written testimony, i provide statistics on how millions of pennsylvanians have benefited from the aca. As this hearing demonstrates, what is critical is that we dont lose sight of the fact that behind these statistics are real people come a real human beings who will be significantly impacted the changes to the system. I will not tell you that the aca is perfect, but the narrative that the republicans in washington are pushing it is failing, and unless Congress Takes action, it will implode, is false. Millions have benefited from the aca and the employer markets have seen a moderation of cost since passage of the aca. There are legitimate issues with the individual market. Market heavily subsidized through the aca. It is this small population that do not have access that the market may not be serving as well as it could. While individual markets are facing issues, in pennsylvania, i can tell you that the market will not implode unless the federal government takes adverse action like refusing payment for cost sharing reductions that would cause it to implode. Instead of having the conversation about how we make sure that everyone is served well by the system solving the real problem, we are talking about repealing the Affordable Care act and replacing it with a system that could result in 24 million or more people losing insurance. I want to offer context on some aspects of the bill that passed the house last week. Her has been a lot of talk and a lot of confusion about how the aca does or does not protect people. Many of the republicans who that for the a hca insist people will not be adversely impacted. With the addition of a lastminute amendment last week, states have the option to return world. Eaca outes would be able to opt of the Health Benefits requirement meeting consumers with Significant Health needs could be playing more for less robust coverage. These that receive waivers would be required to establish high risk pools. Historically, high risk pools have not proved to be an effective way to cover highrisk individuals. One thing is clear. There doesnt ever seem to be enough money to run these high risk pools in a way that truly are tax people with preexisting conditions. There was premiums, coverage limitations and enrollment caps to address funding issues. It shifts the cough shifts the cost to consumers. Movesonally, the ahca subsidies away from premiums that help lower premiums to adding flat tax credits based on age and eliminates that which helps low income americans pay for outofpocket costs. It is hard to see how these changes do not result to the preaca world where more people opt to go without care because they are concerned about the cost. The aca is not perfect, but the ahca is not the solution. Instead of talking about a plant that will remove 24 million americans coverage or shifting the cost to consumers, we should be talking about common sense changes. It will ensure the promise of the aca. The health care is a reality for all americans. Much, before turning to mr. Nelson, annette senator Maggie Hassan is going to have to leave and wanted to say a few words. We thank you for your passion and strong leadership. Sen. Hassan thank you very much. Mr. Nelson, i will get a report on your testimony. To echo what my colleagues have throughout ourle country stand up and speak up about what their real experiences are like, that enables us to make change. I have shared some of the experiences of some of you at the table. We share special children. I look at health care from the perspective of a senator, former governor, and the mother of a palsyman with cerebral whose condition is stable thanks to the health care he has received. You are all speaking about the value of health care to all of us as individuals. To us as a community of americans who know that we need to be healthy to thrive together. I am very grateful to all of you. I look forward to working with you and so many other americans who are speaking up about their experiences. About what the aca has meant to them. Commenting as you did but the fact that the aca isnt perfect, but there are ways to improve it. Lastly. It is the priority that i bring to the senate on behalf of of the people of new hampshire. Medicaid expansion made possible by the aca is absolutely critical to new hampshires ability to fight the heroine and Opioid Crisis. I want to make sure i am expressing for all of my constituents how important the aca is as we combat the terrible epidemic. I thank you for being such a strong advocates today. Take care. Sen. Stabenow thank you senator hassan, and mr. Nelson. I recognize that. That is the Upper Peninsula of michigan. Mr. Nelson thank you for the opportunity to speak to you this afternoon. This is an incredible privilege. My name is rodney nelson. I am the president and ceo of this Health System in michigan. Our main campus, built in 2010 with Usda Rural Development funds, includes a 48bed nursing home, a 15bed critical access hospital that provides 24 hour emergency room care particularly for rural patients within a 30 mile radius, and the aliens of visitors who come to that region annually. We also operate the mackinac medical center, the mac in a city clinic, and the area pharmacy which is opening mid june with the support of the drug program. For the first time in 18 years that i have lived in saint agnes , our community will have access to Prescription Services on saturdays and sundays so that they dont have to drive 60 to , to thes roundtrip snyders, walmarts, etc. In surrounding communities. The second floor of our hospital is automated occupied by the sault ste. Marie Tribal Health services. They donated the land the hospital is on. They contributed funding. They are a separate entity. They are licensed separately, credited separately, but we Work Together. We share a board room together as a symbol of the relationship. We have patients who travel 70 miles one way for chemotherapy. There are communities like trout lake and curtis michigan that are 35 to 50 miles away. Surgicale Outpatient Services for the first time in the Community Since 1980, so our community doesnt have to travel. Of theificant provisions Affordable Care act are stripped away, mackinac straits will anticipate cuts in the millions of dollars. Among the services that could be discontinued could be the chemotherapy program, the Pediatric Program that employs a physician assistant and a parttime position at a seven day walk in clinic. Many other services would have to be drastically cut back. The american Health Care Act as passed by the health house city,be detrimental to my to the county, and hospitals across the state. Not only does the ahca reduce funding for medicaid, but traditional Medicaid Programs as well. , 7. 9 of ourounty residents under 65 are enrolled in the healthy michigan plan. Michigans Medicaid Expansion. Because of a trigger in the Medicaid Expansion law, michigan is most likely to lose the healthy michigan plan effective january 1, 2020. Under the ahca, this means that 7. 9 of my community loses coverage overnight. It does not include those who will lose coverage under changes that could be made to the individual market and the cost of coverage. This is immensely frustrating after the effort we expended in the eastern Upper Peninsula to enroll individuals in the health care benefit. For three hospitals and the sioux tribe that worked together to do this. We have seen a 50 decrease in the number of people coming to the hospital without an insurance cost an insurance card. If 100 people came without a card in 2013, in 2015, it was only 50 people coming to the hospital without some coverage. The ahca undoes most of that progress. Countyh 2017, mackinac had a 20. 5 unemployment rate. 83 in the state of michigan. The current plan makes a huge difference to their ability to maintain their health, to find employment while our area continues to struggle with economic recovery. The ahca is doubly cruel because mac in a countys Health System is the largest employer of the county with 300 perdiem employees and a payroll in excess of 40 million. In a county of 11,000 people in a town of 2500. Costs are operating vested in our employees. The ahca limits Health Benefits for the people who can least afford it and continues to reduce medicare reimbursement for our overall Health System. Michigan hospitals will give up 10 billion in medicare reimbursement between 2010 and 2026 under the Affordable Care act. This is the hospital contribution to coverage expansion. While the ahca it limits the bulk of coverage expense and, it makes cuts to our existing program, and keeps cutting the hospital reimbursement. Michigan hospitals keep paying for coverage that no longer exists. 2026, the 24and hospitals in Congressional District one will see cuts of more than 500 million. These were expected to expand coverage by extending coverage. Hospitals will retain revenue necessary. Despite the medicare reductions. Accessible Health Care Services will not be available for our communities. Since 50 of our operating expenses are for salaries and benefits, with cannot afford to find adequate savings to offset this tragic and financial impact. We are vested in a healthy community. And the ability of our patients to have access to Health Care Services when they need it and it is critical. It is not a wealthy area. Bankrupt a can family, one bankruptcy could mean the end of a small business, job loss, more downward pressure on the overall economy. The ahca threatens coverage and our Health Care System. It is that simple. Thank you. Sen. Stabenow thank you very much for that testimony. And we will not turn to questions and we will call on colleagues in order of them coming into the room. Myself, then senator murray, and then other colleagues. I want to welcome people who have been live streaming, we are glad to have you with us. We have had several thousand so far tuning in and we would welcome you to join in the conversation by joining america speaks out or trumpcare. I am glad he mentioned jobs, obviously the most import bank qualitys to Affordable Health care, but this is also an issue and we know under what was passed we are told this could process 3 million jobs across the country. You had the largest employer in your county. I is him for a lot of other communities, that i know well around michigan, that the same thing, right . In other communities as well . Mr. Nelson that is correct. Sen. Stabenow if you are not there, the doctors are not there and the jobs are not there. I did want to ask about another impact, you have a great nursing home, and i am wondering about the impact of the medicaid cuts on your Nursing Homes and the patients you serve. Mr. Nelson i asked that of our administrator. We have a five star rated facility. It took about five years to get that. Through the dedication of staff. And i asked if we have cuts what will happen and he said, you have two choices, either you residentscare, or will suffer. Where do you cut in a nursing home . You cut staff, that is the only place you can really cut. See, 95 k if, lets and we have 48 beds, what kind of care can we give or expect to give if we cannot pay employees . Either we will invest and to take care of seniors, are most vulnerable, or we will not. I do not understand, there is not a choice. Sen. Stabenow i understand. We know the majority and longterm care and nursing home care are receiving care through medicaid, so this is very serious for seniors. Thank you. If planned can parenthood did not exist at all in your area, how would you have gotten your Health Screening . I believe i would not have. I wast time, being 20, not thinking that i was going to get the results i did. The driving force to going was having a place like planned parenthood where you could get Birth Control and std testing. Safe, save, screenings and private, judgment free. So i believe i would of just waited. And if i did, who knows where i would be. Sen. Stabenow we are glad they had a clinic and you did not wait. Mrs. Hardaway, could you talk about more about your experience in the high risk pool . We are hearing talk about preexisting conditions still covered, even though we know as a fact that is not true in terms of it being part insurance and that costing more and maybe even bankrupting people in the process. Could you talk more about what your experience was . First found out about the high risk pool, i thought there is an opportunity. Looking into it further required a 15,000 annual deductible. I have not made 50,000 a year for a long time 15,000 a year for a long time. I fall into the cap. It was approximately 600 a month premium. With the treatments i am not receiving to the Medicaid Expansion in maryland that it could not receive in texas, one of those treatments would cost 15,000. Just one. The high risk pool, it is high risk and very high cost. Affordedld not have even if i, even if it was available. Sen. Stabenow thank you very much. One more question. I will turn to senator murray. Diagnosed with cancer in your early 60s and we know that to Health Care Plan allows discriminate and charge you up to five times more, or if there is a waiver, unlimited amounts of money. What would that kind of an age tax on your healthcare have meant to you and to your family . Dinner 1, 2014 when cobra had expired, that plan was a hundred 75 a month and i had a 15,000 outofpocket limit. And i had a health plan. Company, i would have had to pay for the process myself without insurance, but if it had been five times greater cost, the plan i was on was a platinum plan i chose through health care. Gov. 575, the normal cost is 1100, so multiply it by five, close to 6,000 for a months worth of health care, which is actually less, again with the deductible and outofpocket. It is catastrophic. You are under so much strain when you are diagnosed with cancer, especially stage four cancer, that you become sort of focused on just every moment of every day. And who have the knowledge that again during that time, when health care. Gov was about to take affect, a gave me some restful sleep. Without knowing that that was going to happen, if things had stayed the same, despair, english, anguish. Again, my wife was taking care of me during the chemotherapy. I lost 30 pounds in 30 days. I could not walk. It was pretty rough. But this new plan, such as it is, is so do coney and in a way that it just coney and, in the way that it distributes the pain, we will all experience pain in life the longer we live. To me these are questions that should not even be asked. As a child, my favorite story was the emperors new clothes. When you see something that is so obvious, that person is ill, lets help them. It is basic human decency and empathy. That is why that is what i felt was absent in what has been proposed with no hearings, affecting 20 million or 30 million americans and they do not even have a hearing. The amendment process as far as i understand was limited. The dead of night this thing appears and to be honest from what i have read, i cannot find a copy of the current legislation because it does not exist on the capital website because of the amendment. They do not have the final pdf. What is in itnow per se, but the senate plan that will materialize somehow, there are no female members of the staff, i understand that there are female senators. Sen. Stabenow there are. Yes. [laughter] again, as we said earlier, this is a nonstarter. The Affordable Care act has worked, it is not perfect, but a step in the right direction. It comes down to basic human decency for our fellow citizens, fellow travelers on this great voyage. A healthy, compatriot is you walk for together. It is not a zero sum. Thank you. Sen. Stabenow thank you. Senator murray. Sen. Murry thank you all for sharing your testimony and stories. I am listening to you and miss johnson i am positive that you never expected to have a child on medicaid. I hear so many comments from people about medicaid, we can cut it, those people can get a job i mean, we should have a banner here that says here but for the grace of god, to remind people what can happen. We need to remember that. Mr. Duncan, your stories hit me because my father was diagnosed with multiple sclerosis. We had seven kids in the family paid my family do not expect family. My family did not expect that. This was before the aca benefits and i remember my parents struggling so mightily, turned down by Insurance Companies, not going to the doctor. My mother broke her foot once and never went to the doctor. Limped for years. Never got her foot set because it was one more bill they could not afford. This is before aca. This is america, that we should not have that. I remember asking my parents, how are we going to get through this . Are crawling to medicare. We do not want to go back to back and we shouldnt have to. We are a much cap a much better country than that. I appreciate you coming and reminding us how but for the grace of god and that we have a responsibility to make sure that nobody in this country lives hoping to crawl to medicare. So thank you. All of you. Thank you ms. Walkington fred talking about planned parenthood. It has been lost in all the other things. The fact is, the house bill will take 2. 5 Million People away from access to health care. You talked about the privacy that is so important, that is why you went there. I hear the rhetoric around it, you can find another place. But you said you would not have gone. You would be a statistic that is extremely expensive. I have even loss of life, because you did not go, because you did not have the capability to go someplace where you felt where you could get the kind of care and privacy you needed a. So i am deeply concerned. And you have talked, you have a Cancer Survivor Group through planned parenthood, which is awesome. You must hear it all the time from people. Let me ask you the question i hear from the other side, you can go summer else, what to those people tell you about going somewhere else . Um, that is really not a possibility. I live in a very rural area in wisconsin, i live in speaker paul ryans district. People in rural areas struggle to get to their doctors. I know the last thing the majority of my neighbors would want is less access to health care and less access to doctors. Ofaw a poll that said 55 the constituents of paul ryan are against defunding planned parenthood. The Community Health center in my area, which is there are only two of them in the district that provide Reproductive Health care and cancer screenings, so it would be comparable to planned parenthood. They have waiting lists that take weeks to get in. So you do not know what can happen in those weeks, how things can spread. If you are a young person, like i was mullah can change in a week. You forget me decide not to make the appointment. Especially people who are sick or. Sicker. Like some of my friends from the cancer network, Cancer Survivors Network of planned parenthood. You cannot wait several weeks and planned parenthood can take patients sooner and that is the standard that all Health Care Centers need to be held to. Sen. Murry thank you. Mrs. Johnson, i want to ask, because this is one i understand a lot about, cutting the essential Health Benefits that thoseuse did, hit preexisting conditions, which we are talking about. But it would also deal with a Lifetime Benefit cap taken off because of aca. How would that have impacted you . Monthsnson there are when my daughters medications cost more than my husband makes in a month. Eliminating essential Health Benefits, the measures that keep people healthy, that is unconscionable to me. So, we struggle to keep her healthy. Again, there were a lot of things not covered by insurance. A lot of things that were. Were soe had there many expenses piling up besides what was covered. But when you look, when you look at the numbers under the policy, if she had reached her lifetime cap, the family would have lost their health care coverage. Not just my daughter, it was kind of collateral damage. Everybody in my family would have been without health care. And because by some Insurance Companies having down syndrome itself is considered a preexisting condition. I have a friend who was denied coverage when their child was theywith down syndrome, were told they could not but the child on the family policy because they were born with down syndrome. It is there from the beginning. So, and these Health Care Costs for these families pile up so quickly. And the annual caps are literally the lifeline so they can make sure that they can pay for medication that month, or their treatments, or whatever it is they are needing access to that month. Sen. Murry thank you. Thank you again to all of you. We really appreciate it. Sen. Stabenow senator booker . Sen. Booker it is tough not to get emotional when you hear these incredible stories and i want to thank you all for your testimony today and you know, it hits home because the stories you share our stories that i and seen in my own state from people who tell me that the Affordable Care act literally, once they were able to sign up, it changed their lives. You are struggling and you all tell the story so courageously, that to struggle with an illness alone, but to add on the anxiety, the stress and the worry, i would even say the trauma of not knowing if you are going to be up at the balance your illness with rent, or with about a dadyou talk with parkinsons and i was just speaking with my mother about fighting to hold onto dignity, and to do the things that people take for granted. And to think i live in a country where, this is what got me last guy, because i am just a that was taught to love and respect everyone, but to watch people pass a piece of legislation and literally not even know what the hell it would do to the country into their constituents, and to be able to shut out the voice within their own districts. Of democrats, republicans, independents, people who do not give a damn about politics but want to stay alive. Said to have you all be willing to come here and tell your stories, you know, we have been talking about this a lot. Just a group of friends, sitting with people i have come to love in washington. And i want to repeat the urgency for more people to follow your lead and to tell your story. We just need more americans to be willing to let folks know what this really means, not in data, not with statistics, but railamerica voices. Because you cannot listen, you know, i cannot listen to you without hurting. Just listening to what you endured. I mean, first of all you give, talking about gender, you give a model of manhood of your willingness to fight your own illness, to be the kind of husband to your wife and profess the love you have. So i just want to take a moment to ask more people to do what you all are doing. We do not need a hearing. We are talking about millions of americans in during enduring anxiety right now watching washington, d. C. Hold their families in the balance. I am hoping more people will post their stories like we heard hollandsenator website. We are asking people to put this out. We should have the largest hearing in the history of america with more people willing to push their testimony out there, share their stories. That is what i want, because i cannot sit through listening to your truth without feeling everything i believe the country should be and stand for at risk. And the commissioner said it, this is not a perfect law, the aca, but if we take all the ground we have gained and allowed to go backwards right now, to thrust other americans, and im not just talking a handful, i am talking about millions of americans back into the reality. And this crazy idea that somebody that get the disease is somehow lesser, or it is their fault, that they should suffer a million orthat should have to pay for your medical costs . I apologize for using all my time to not ask questions, but miss johnson, you are just telling the story of your friends, people you know. This is the most evil type of privilege. It says if a problem is not affecting you were my family, that it is not that much of a problem. But, you can beat sam well sure damn well sure that if it was a congressperson and their health or the health of a spouse, and this will affect them, you can be sure they would not have passed this law. So this is a time where silence is, is the worst enemy of what we are trying to do. We need more people to speak up and speak out, because this is a test of what kind of country we will become aware is our heart and compassion, do not tell me the nation that can send human beings to the moon, that can map the human genome, that can literally have the Largest Military force known to humanity, cannot design a Health Care System, that cannot protect the most vulnerable citizens. I do not want to hear another mother tell me about the fear they have another child will not be able to live free, or healthy, because we designed a system that shuts them out. I just want to thank you for your stories and your testimony in a pray to god that we can get more people to do the same so we have a chorus of love and conviction that is so loud no congressperson or senator can shut out the truth that you all are giving us today, because there is no way anybody would believe that we cannot figure out a way to provide coverage for all americans. Thank you very much. Sen. Stabenow thank you. And i would say amen. [laughter] sen. Stabenow thank you. Senator kaine. Sen. Kaine thank you. Thank you to all of you. I want to pick up on what my friend was saying. Ms. Johnson, as you are testifying, tears started rolling down my face. I have heard a lot of stories like this. The reason i was crying, the people that passed this law could care less what any of you think, what any of your experiences are. When a house was considering the first version of the bill they had three hearings. There was a hearing in the energy committee. It did not allow any patient witnesses. There was one in the same committee in february on the collapsing health market, they allow to somebody from the American Cancer Society and an insurance commissioner to speak. And there was another hearing on the individual mandate and they did not allow patient witnesses. When the version came up that they voted on, they do not have any hearings. They did not have any witnesses. They did not allow any amendments. They did not even wait for a cbo score to tell them how many people would lose insurance, how much more people would pay, and how folks with preexisting conditions would be affected. They do not care one bit what any of your experiences were. The reason we invited you here today is we are afraid the same thing will happen in the senate. When the Affordable Care act was passed in 2010, let me tell you the way the democrats handled it. Hadsenate finance committee 53 hearings. The Senate Health committee had 47 hearings. The final senate bill on the floor included 147 republican amendments that were offered by republicans and the past. Pas sed. And even though they made a political decision to oppose the bill on the floor, they proposed amendments that the democrats considered in good faith, and in writing the bill the democrats that wrote it in 2010 included stakeholders like you and listened to them to try to craft a bill. We have invited you today because we are afraid what we are hearing from our republican colleagues, that they have their group of 12 guys trying to come up with a bill. That they can put onto the floor without hearing from one of you about any of your experiences and without allowing any amendments. That is what they are trying to do. You sow what happened when the house passed the bill after refusing to listen to any of you. They went to the white house in a bus and they had a big, big celebration, like they had landed on the moon or something. This from a president that said over and over again, nobody is going to lose coverage, nobody is going to pay more, nobody with a preexisting condition will ever get kicked around because of that. And the bill that they celebrated down at the white house did not just break those promises, it shattered them into a million pieces and then drove over them with a bulldozer. That you can be darn sure we are going to do everything we can to make sure that we listen to you and that america listens to you and we will not for a minute entertain anything in this body, if we are given the chance, and we will yell as loud as we can and take the chance, we will not entertain anything that will bring the promises that the president made. Why would we vote for or allow something to pass that shatters promises he made to the american public, we will hold him accountable and make sure we do not do anything that does not meet those promises and your stories make a difference. Thank you. Sen. Stabenow thank you so much. You can hear the passion, all of us, so appreciative you are here. We are absolutely committed to doing Everything Possible to move forward, rather than backward on providing health care for people and making sure it is affordable. Senator franken. You fornken thank having this hearing. And thank you to all of you for your moving testimony. Know, i see that mr. Nelson you were the Rural Health Care leader of the year, is that it . Mr. Nelson yes senator. Franken yes. So minnesota has a lot of rural Health System. [laughter] franken understand that. [laughter] sen. Stabenow yes. Sen. Franken when i went around minnesota during the first round of this bill, i heard from hospitals, Nursing Homes, clinics, that this was terrible. Systems. Health in terms of employing the number of people that you employ. What would it do to your system . Mr. Nelson we would have to come up with a strategy to make cuts. I grew up in the Upper Peninsula and there are seven other hospitals up there that exist in counties that have some of the highest unemployment rates in the state. Hometown women in my in michigan that travel 100 miles to deliver their babies to marquette, and sometimes to the suit sioux. We have delivered three babies in our Emergency Department in the last three years. We delivered a four pound p remie in our facility on mackinac island. If 50 plus is on medicaid and medicare, it will have a devastating effect on us and the communities not only across the Upper Peninsula, but you have 425 critical access hospitals serving rural america. Those hospitals will be hit hard. Sen. Franken that is exactly what i hear. Commissioner miller, you said, i how the lawe heard has helped people, you said it was not perfect. You testify that you have a sustainable market in pennsylvania, but they are arguing that there is a death spiral. I think they asked you to what extent has republican efforts what rolethe market, they have played in driving out up the cost of the individual market and making it increasingly unstable, i am referring to the republican , andts to block payments the administrations refusal to commit to costsharing, reduction payments and etc. . Ms. Miller thank you for the question. There is no question, although i mentioned we have a market on its way to being a stable market in pennsylvania, there is no question those actions have impacted our market in pennsylvania as well the individual markets across the country. And i think in pennsylvania and in markets across the country, one of the impacts is that families have not had as many choices as they would have otherwise for health plans, because all their actions have made the individual market an unattractive place to participate, simply not a market that a lot of Companies Want to be in. I think it is an important point, because the very people who are claiming that obamacare is failing are the very people that have done everything they can to undermine the law every step of the way. Sen. Franken exactly. Ms. Miller eliminating, not paying that were made. They knew what they were doing. Not giving assurances to those Insurance Companies that the reductions will continue. These are payments that help low income people pay out of cost when they go to get care. And those Insurance Companies, once again, the republicans who have done this, they know what they are doing. Have beenese actions very targeted. The goal has been to undermine the individual market and to make obamacare fail. Unfortunately, in some cases, they have gotten close to actually being successful. I think the good news is in places like pennsylvania i have worked very closely with our carriers recognizing that this is not been a very attractive market to participate in because of a lot of these actions. And we feel like we have put our market on a path to stability and it is really all the uncertainty and discussions happening in washington dc right now about repealing the aca that is causing companies to continue aboute that conversation whether they want to continue participating in this market. I feel optimistic that the companies in pennsylvania that are still on our exchange, we lost two of them last year, but we still have five and i am cautiously optimistic they will remain for 2018. But we are going to get plans and rate filings on may 22, that is the deadline, we are a week and a half away from getting those. Sen. Franken they are living under this uncertainty right now. Ms. Miller and they do not know what the rules of 2018 are. The republicans have made this as unattractive as they possibly can, and despite that, in places like pennsylvania we still feel like we are getting back to a more stable market. Sen. Franken i am finishing. While we sit here tearing up, i want to thank you for your testimony, they are cackling. Is really reprehensible and thank you all. Sen. Stabenow thank you so much. Senator . Ay you make us feel better. You are like walking, talking antidepressants. You give us a reason to know that we have to, we have to to makeery single day sure that the house of , their healths care bill never becomes the law of the nation. And we are going to do that. We are going to fight every single day. Key their plan is a simple plan. By 880 billion, for the poor, for the sick, for the elderly, for the disabled, for our veterans. Breakackage that as a tax for the wealthiest people in our country. Ist is immoral, that inhumane. And we will not allow that to happen. If you could please republicans in the heart, you will break your toe. How they can harm the most vulnerable for in creating a tax break for the most well off, the most healthy, the most wealthy in the history of our country is absolutely, totally wrong. But they do it, because they harbor an agent animosity towards everyone of these programs that they want they never wanted to be put on the books. Medicare, medicaid, all these programs. So they will do their best to leave these as relics to what they look like today. If they could be successful. But we will not let them do it. We are going to fight every single day to make sure it never happens. So the senators who you see here today are going to make sure that that does not happen. But we are going to need the whole country to rise up. Cruelty,against their against their intent, which is not to help people, not to make people healthier, but in fact to create the funding for our tax breaks for the tax breaks for those that do not need it. I would like to turn for just a second to this Opioid Epidemic and the fact that 2. 8 million americans right now receive coverage for Addiction Treatment in the Affordable Care act. If they are successful, they will put into danger the treatment that those 2. 8 million americans are now eligible to receive. So commissioner miller, could you please take that issue and tell us from your perspective what the consequences are to all of those people who receive that coverage, if it is removed and they are not covered for treatment in terms of what the impact would be on the individual and their families . Ms. Miller thank you for that question. This is a huge concern for us. Access to Mental Health and Substance Abuse Disorder Treatment, those in the preaca where Services People do not have access to and in pennsylvania the Opioid Crisis is having the same time packed as across timsame impact as across the country. We have had over 175,000 accessvanians have because of the Affordable Care act. In pennsylvania, one at a summit 5000 people would be the 175,000 people would be the thirdlargest city in the state. The impact this is having on families and communities is unreal. So eliminating or putting at risk coverage for the services is unthinkable at this point. I sincerely hope that is not where we end up going. Sen. Markey if people were dying across the country at the same rate they are dying in massachusetts it would be 100,000 deaths a year from opioid overdoses. Dying from sentinel in their system. We need more treatment, not less. There is not enough treatment today, much less stripping away the protections that these families receive from the Affordable Care act. Thank you all for being here. That is just one example, there are so many more of how it transforms peoples lives, because that law is on the books and how their lives would be transformed again if it was taken off the books, in a way that was so horrific it is imperative we work every day to make sure that they are not successful. So thank you for being here. Sen. Stabenow thank you so much. That reminds me of when i was in the Upper Peninsula a few weeks ago talking to Small Businesses and i asked their number one challenge and they said the opioid addiction and how it is affecting their ability to get employees, and wanted to see more treatment and prevention and education. Thank you so much for raising that. Senator blumenthal. Thank you for being with us. Sen. Blumenthal thank you. Thank you for having this hearing, which i think is so important because we are trying to educate americans about the reallife consequences of this bill, as my colleagues have mentioned before now. They have been very eloquent. I cannot match their eloquence particularly reverent booker eloquence, particularly reverent booker. I have been talking all day and im getting tired of hearing myself speak. And we are here to listen to you. My question really is, if you have any suggestions for us, how we can raise these issues with americans so that they better understand. Obviously, you have friends and neighbors, they know your situation, or maybe they do not. People do not walk into the supermarket and start shouting cancer,relative who has or a child with down syndrome, people tend to be private. And i am wondering how we can make more americans aware of the really powerful stories you have brought to us. I am very grateful you are here. But you have said just as for us . But do you have suggestions for us . The idea of having a portal available where people can upload,peak and perhaps you know, 30 years ago i worked in communications and the first cell phones we sold i worked with beepers. Today, everybody has phones that can broadcast in hd. The main thing is that people feel isolated and they do not have a portal or something that you mentioned, the earlier, where the shared stories make you understand that you are not in it alone. Illnesses and particularly in particular become departmentalized. You focus on getting through that day. And then you have uncertainty in the laws have not been revealed and things are done in darkness and those people feel alone. So if there was a way people could safely share as much as they wanted to, privacy is important to people, but without knowing what the person next to you is experiencing you have no way to walk in their shoes. I get back to empathy of being able to understand that we are all connected, together, and i am hopeful that i am revealing it back to what was said in a hearing, have you no sense of decency, shame . That goes back some years. Mccartney i think. Mr. Dunkley it was. It broke that story to the point where people said, my goodness, this is not right. You feel so alone when you are fighting your own battle. If there were ways that people could talk anyway that it adds to the shared a story, that gives us more information to make correct solutions, i am curious, is there any timetable whatsoever before whatever is going to be produced by the senate actually hits the floor . My understanding is it cannot be filibustered. Several e at least and i hate that word because where is the human heart, you mentioned it is made of stone, but i still believe everybody feels this pain. We share together and hopefully we can get some hearts too soft soften and do the right thing. We appreciate the help that you will provide. One person standing on the corner, you might reach five people. Through the power of the connected world, one statement can reach billions in minutes. So all i came here today to do was tell the truth, my story and it did not need embellishment. It is real and ongoing. I feel encouraged that there are mechanisms and people who care who have access more to the levers of real power. So we live in Interesting Times and i look forward to a successful docking in some land of happiness and safety. Blumenthal thank you for that eloquent statement and your courage and strength to come here, all of your courage and strength to be heard today, because i do think that your stories, and we will make sure they are communicated. Effect. E an i am thinking more not of what we do in the United States maybe with a slightly higher platform, but still a single entity, what we can do to spread the word. We are having town halls around my state and asking people to come forward with their stories. I am amazed by how many of those stories Concern Health care. And how many of their fears and apprehensions Concern Health care. It is not just the folks sitting at this table. Ands really widely felt again, many thanks for your help. Sen. Stabenow thank you so much. And let me stress again that we invite people to join us at america speaks out or trumpcare. I welcome people coming to my Senate Facebook page. The website, as well. As i know my colleagues do. I think we have at least one other colleague that will be joining us in a moment, so i will ask a couple more questions. And i want to indicate mrs. Johnson as the aunt of a wonderful young man, a nephew that has down syndrome, who is now 30 years old and doing incredibly well and working and he codirects the Michigan State University Pet band pep band at basketball games and we are so proud of him, gary is doing incredibly well. Fortunatelyly and has a dad with insurance that was willing to cover him. But it was really just good fortune that that happened at the time. We have talked about medicaid, which is so critically important, but we also know that the majority of people get their insurance through their employer and one concern i have that has not been focused on a lot about the House Republican bill is that there is a gigantic loophole in it where they speak about the state can get a waiver to make it even worse by waving everything, but they do not talk about the fact that if you are a multistate employer, which we have one, we are proud of our manufacturers in michigan and other states, and the loophole says if you are in a state, just one state, maybe you are in five states with your business, but one of those states decides to do a waiver that you essentially can pick that state as your domicile for health care. Then all of your employees are affected by not having the essential benefit package, maternity care, Mental Health, addiction services, maybe hospitalization, Prescription Drugs, all those things we consider basic care. And we go back to the days of wayne you could get of when you could get a policy, i remember summoning people saying, i have had this for a long time and then i got sick and found out it did not cover hospitalization. Isi feel like the ad on tv where they tell you, it covers zombies if you get attacked by zombies, but it does not cover anything else. We do not want to go back to those days. So i am wondering, commissioner miller, if you could speak about those people who have employer sponsored insurance and how you would see these changes in health care affecting them as well . Ms. Miller thank you. We do talk a lot about the Significant Impacts on people who have medicaid coverage and of those who have coverage in the individual market, but we certainly know that those are not the only markets impacted. Trumpcareto the cbo, will likely result in fewer people getting coverage through their employers because the proposal eliminates the employer mandates, which will likely result in more employers not offering coverage. I think that is certainly one impact that could be a significant one. And you will see more people in the individual market and running into the same issues we have talked about with the individual market as well. Sen. Stabenow correct. Thank you. Thinkat affects do you that waving the Prescription Drug benefits would have on afividuals ability to prescriptionsford afford prescriptions . Ms. Miller i will talk about an individual, linda, a 60yearold who has multiple sclerosis. We have heard stories on this today. Called techn a drug exadera. A called t she was told it could cost as much as 12,000 a month without insurance. This is only one of 15 drugs that she takes. Without drug coverage, even if you consider the discount programs she would have available, it would be easy to say that the drug cost could be as high as 20,000 a month. As a person that has had ms for 24 years, she relies on these medications for her independence, so i think you would find that many people would not be able to afford Prescription Drugs without access to Health Insurance that covers this benefit. Perception drugs are a critical part of care for people with health needs across the board, people with cancer, diabetes, high blood pressure, hepatitis c, all these people need medications to stay healthy. We also know that Prescription Drugs are the Fastest Growing cost in our system and we know that there are drugs with very high prices, so i think the impact on consumers of having to pay these costs directly would be devastating in a lot of cases. Sen. Stabenow thank you very much. What does yourm, regimen of care look like for you on a daily basis . What does that look like . Asked this i was question last week at Bloomington Hospital as i was giving a talk there to physicians, nurses, social workers, people working for child protective services, a whole set of what the system of care kind of unit is in our local community. I actually put it back to them and said i want people to take a guess on the number of appointments my daughter had in february, the shortest month of the year. I started taking comments from those in attendance and finally i spoke back and none of them had gotten it, 27 appointments that my daughter had just in february alone. I really cannot overstate how that affects my ability to work outside of the home, because the level of care my daughter requires, not just every day but just getting her to appointments, there is just a great deal of time and resources that that takes away from other expenses that my family faces. So we get up, we rise early because she starts her day with a one hour flush, a daily infusion that takes about one hour. I do a dog and pony show to keep her attention during that time. We then take her to school. She is at a Specialized School currently, we cannot get transportation, so i will drive her or my husband each morning. And almost inevitably there are multiple appointments throughout the day that i will need to go and pick her up again and take her to different clinics more to get an xray for her ongoing treatments, for her g. I. Issues and such things. That is a normal day. Just today on the way over here, as we were walking to this room, i got a call from a specialist to discuss the changes to her medication dosages. Course,par for the there is not a day that goes by that i do not speak with one of her specialists, or get a bill in the mail, trying to continue to provide what i believe is the quality she needs and deserves. Sen. Stabenow thank you so much. She is lucky to have you as a mom. We have been joined by senator elizabeth warren. Welcome. We have had a wonderful hearing, very powerful testimonies, and we are so glad you could be here. Sen. Warren thank you. I want to say thank you for pulling this together for everyone, how much this matters. These are hard to do. The senator has been trying to get it together so we would have a chance to put real faces behind the story of what happens if the republicans are able to repeal health care for so many millions of americans. I am also grateful to all of you for being here, im sorry i was not here for all of the testimony, as i am sure you heard there is a lot going on today. But it does not mean that we can turn away from this critical issue. It has not even been a week since the republicans voted in the house to tear up our Health Care System, to rip away coverage from those that need it most, to open the door to discrimination based on preexisting conditions. And now that they are going after medicaid and private Health Insurance, including employersponsored Health Insurance plans, no one is a safe, no one is safe and that has to be the message we underline today. Republicans are not just taking away health care coverage, they are also tearing apart the Financial Security of millions of american families. A law that says Insurance Companies cannot charge people more if they have a preexisting condition, or they cannot stop paying benefits for people who have cancer or his medical bills exceed a certain preset dollar amount, is not just a health care law, it is a law that protects people from crushing medical bills, from home equity lines of credit that could cost them their homes from foreclosures, and ultimately for many from bankruptcy. I want to see if we can explore that a little bit more. I know that you testified earlier mrs. Johnson about the kind of the time before the Affordable Care act and medicaid were available to you, when your family struggled financially to try to make sure that you are covering your Daughters Health care. Can you say in the say a bit about what it feels like when your family is in that position . When you know that the choices you must make for the health of your familysput entire Financial Security at risk . The things you think about at 3 00 in the morning. Ms. Johnson thank you senator. You do, because you are not asleep, because you are up and concerned about how you will pay bills that keep coming relentlessly. That i have a kind of saying in our house, when your child is turning blue nothing else matters. For years, that is kind of where we were, trying to make sure that if she was not breathing well that we attended to that and there were times i did not have room to really think much about the financial devastation it was causing to my family, because we were spending weeks in the hospital trying to keep her alive. So when i would go home and find in my mailbox literally a stack of medical bills i cannot tell you what that would do to my spirits. I would feel crushed, to be honest. Yet i had to pick up and keep going for the sake of my daughter, because i did not know when the next hospitalization was coming. We carry on. Sen. Warren a reminder of how important it is to have medicaid, how important it is to have Health Insurance all around. Ey, over the last few years you have received bills for its helens for tens of thousands of dollars for your cancer treatments and hip replacement surgery. If you had not had insurance for these costs, can you say in word about what you would have done, what your life would be like . Mr. Dunkley it would be different, much worse. My wife suzanne, who has multiple sclerosis, i am her caregiver. Iting the cancer diagnosis, was very advanced and i was very close to death, the mental strain just from that, but i knew that the of portable care act was coming of the Affordable Care act was coming online and at the cost i was able to afford, in the new world say if they would offer me a policy it might be five times as much, which without the subsidy would be close to 6,000 a month. My wife is on Disability Insurance and i am on Social Security currently, i would like to get back working again, i do audiovisual work and i can work at home. She needs me, and i would not be anywhere else. That is where i want to be, by her side. But from what i understand, the new law is heartless. And i went from a seven and a half 5000 are deductible to an deductible to a 18750, which i passed because many chemo was around 35,000. We would not be in our home. We wouldve had to sell it under extreme duress. We did have family and friends that set up a temporary gofundme site. These are eyes flows on the river ice flows on the river you to hop from one to the next. Anytime we can focus on her own Health Weather than the clouds of uncertainty, rather than the clouds of uncertainty, and my wife is hard to go to sleep because you wonder what you will read tomorrow. Sometimes it is worse than you might have imagined. So without the Patient Protection of the Affordable Care act i probably would not be here to speak with you today, i would not have gotten finished with my treatment, the cancer wouldve probably killed me or we would be living on the kindness of others, and i would like to be able to pull my own weight, to be participatory, and that is where i think sharing our stories, we are not alone but we need a mouthpiece, a way to get the story out. And i am just glad to be a look to talk, my story is simple, but it is the truth and there are millions more like me. Thank you again for listening. thank you. Warren access to health care is a matter of life and death. Mcconnell did not show up to todays hearing. To hear fromw up any of you. I want to ask for anybody who would like to answer, if senator mcconnell were here, what would you like to say to him . He is about to make the decision in the United States senate about who goes forward on health care revision and what that revision is going to look like. If any of you have a short statement you would like to give to him, i would like to be will be here it. Were going to record these for him. The one thing i would like to say is why . When was the last time that you were told you could not go to a doctor . Because they didnt take your health care . Medicaid is not for the poor. Its for those of us who need health care as desperately if not more so than anyone else in the country. Commissioner miller was talking about her friend whose medications cost 20,000 a month. Im an ms patient. Be aut them i would not contributing member of society. I would be in a wheelchair. I dont want to be in a wheelchair. I enjoy working. Im a substitute teacher. I love them. They are my joy. The fact that i have medications ,vailable to curb the tremors it is daunting when youre working with a fiveyearold and they are always like are you ok . They are babies. Haveut that i could not that gift. I would like to ask if he would walk in my shoes for one month. I had a devastating incident where i had an exacerbation. To the point were i could not pick my foot up high and to put my own pants on. That is not ok. Thats not ok. Thank you. Anyone else have a message . Thank you for giving me the opportunity to say this. This bill is terrible for women. Locking access to planned parenthood blocks access to preventative care, cancer screenings glue which save my life and takes away essential Health Benefits. Having a csection would be a preexisting condition, surviving Domestic Abuse would be a preexisting condition. They are all horrible but collectively they are atrocious. Is because this is so devastating to women there needs to be women at the table. When they are considering this bill, considering revisions, women need to have a voice. Thank you. Steven thank you. Senator warren thank you. Anyone else . I would tell senator mcconnell to set aside ideology. To bring in Health Care Leaders like rick pollock and American Hospital association and learn about the complexity of health care. I would ask of a approach it like michigan did. You had a republican governor working with a Senate Minority leader. You have the support of senator peters, senator richards. It was a bipartisan bill. They involved the Michigan Health and hospital association. Think hd association. It was a group effort. There were factions of the Republican Party that did not want to pass, but it was a senator that through the vote over. That is what i would recommend. Sen. Warren that is how we did in massachusetts. Governor,epublican democratic legislature. We believed that health care is a basic human right. Everyone,coverage for and find ways to lower the cost to make it happen. Not get ite we did right the first time. We had to amend. We try to do that in i bipartisan way and make it work. I think its a powerful point. Have we gotten everybody who wanted to speak on this . One more thing. I never expected to be in this job in the United States senate. I worked as a law professor for most of my adult life. I researched white people were broke why people were broke. Bankrupt are pretty much like everyone else. Middleclass folks who get a decent education, who have good children,homes, have and get hit hard often with a bad medical diagnoses that turns them upside down financially. Its one of the biggest reasons families declare bankruptcy when i was studying it. Because of Serious Health problems. Acte the Affordable Care was passed bankruptcy filings have declined for six straight years. Bankruptcy filing rates are now 50 lower than they were when the aca was arrested doctor. I dont want to go back to the days when families risk losing everything if they got bad news from a doctor. For theit is immoral richest nation on earth to say to millions of people that if you get a bad diagnosis, you could lose it all. Your savings, your home, your future. You are the people who came here to put a face on what it means to have health care in america and im deeply grateful for you for doing this. Believe me. We will be fighting on your behalf and on behalf of all the people you have spoken for today. Thank you for being here. Thank you. Im so glad you are here. I cant help but share a brief story of my family. My nephew and his wonderful young wife just had a little baby girl. She was born with half a heart. She spent seven months at university of michigan Childrens Hospital with her mom and dad by her side. Its amazing how life works. Pediatricis the intensive care nurse. He has been by her side when i think about this, i think about if there were caps on treatment, if there were , she hasing conditions one more surgery to go through. If in fact my brother who would do anything in the world for his family had had to pay for that, he would have and we could have seen a bankruptcy. Because of the incredible costs. This ought to be something we celebrate. This is what it is all about. There is i want to end in terms of differences in philosophy right now between what we are seeing coming from the republicans in the house and where we are. My Wonderful Technology keeps bouncing here. When they passed this in the house, this is what made my hair turning red. There was a quote in the paper, republican u. S. Representative crowed the bill under consideration would allow Insurance Companies to require people who have Higher Health imsts to contribute sorry. People who have higher Health Care Costs to contribute more to the insurance pool, reducing the cost to those who have lived good lives. Has lived aandniece good life. Each of you, your daughter, each of you have lived a good life. Those kind statements dont belong in our great country when were looking at something that fundamentally is, should be a privilege for those who can afford it. Thank you so much. We will keep fighting. We hope you will keep speaking out. I hope folks will go to america speaks out or trumpcare and lets continue this discussion. [applause] [inaudible chatter] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] [captions Copyright National cable satellite corp. 2017] last thursday, the house began work on their version of the health care bill. They will not release an analysis of that house passed the weekill two weeks, of may 22. This democratic meeting, they were able to hold this in the capital today. A number of official hearings were not held or were ended objectionslation to by democrats over the firing of james comey. Dick durbin of illinois objected to what is a routine requests allowing committees to meet while the senate is in session. It forced the cancellation of senate hearings, ending early on a couple of hearings. The focus has been on the hearing of the firing of james comey on the senate floor this afternoon. The minority leader outlined the next three steps related to that. Schumer Democratic Caucus met to discuss the circumstances of mr. Comeys dismissal by the white house. There are many questions to be answered in many actions to be taken. We will be pursuing several things in the coming days and weeks that we decided in our caucus and we will have more to say about those next