Transcripts For CSPAN2 Senators Schatz Booker And Others On Affordable Care Act Replacement 20170620

Cable Television Companies and is brought to you today by your cable or satellite provider. Senate republicans are planning a vote on a Health Care Law repeal and replace as early as next thursday. The legislation has not yet been made public or scored by the congressional budge office. Monday budget office. Monday Senate Democrats held the Chamber Floor to speak on the republican effort. Minority Party Members are protesting that Senate Republicans have not held Committee Hearings on the repeal and replacement legislation. Next, a portion of monday nights debate. We democrats are here on the take a stand against a bill thats a disaster for our o Nations Health care. Medicaid patients, families with loved ones in nursing homes, people who struggle with opioid addiction, women who rely on planned parenthood, people who work in the health care industry. And so we stand with them and for them f tonight. But we also stand for the American Public who is being left in the dark about what trumpcare will mean for them. This is not the normal order of senate business. The republicans are going about this in a way that is so procedurally flawed that it is an embarrassment to democracy itself. They are hidingoc this bill. Theyre hiding this bill because people will beus outraged when they find out whats in it. Thats why a republican aide said that they arent releasing the bill because, quote we arent stupid. Think about a what that statemet means. T first, it means they have a bill. Finish second, it means they think its political suicide to make the bill public. And so they are bypassing the normal and necessary process needed to make good legislationh the way you make legislation is you allow the sun to shine in. And that starts with hearings. Every legislative body in theun country from a school board to a county council has hearings because we figured out that for all of our flaws, we figured ouh that over the centuries that you need hearings. Not just to placate the masses,r but to figure out whether your legislation is any good or not. Republicans have not held a single hearing on trumpcare. Ne no one knows no one who knowt anything about health care is s allowed to say anything about this bill because they arent even allowed to see it. But anyone whos ever tried to understand the American Health i care system knows that its complicated. The president d s said so himsel. You need expert testimony, you need public input, and you need t time to talk to your home state. Thats the way you get a gooduc product. R but republicans have totally bypassed the two committees that exist to consider legislation like this. Think about it. Under normal circumstances this legislation would be in the finance and Health Committee jurisdiction. There would be hearings and there would be a markup. But thats not the process thats being used. Theres no markup, there are no Committee Hearings. Itsri just 13 dudes, and they e rushing to d pass a bill without women, without democrats and without input from the American People p. Heres the order of thee. People who get to see the Health Care Bill; 13 men in secret, republican lobbyists, politico, republicans, democrats and then the American People. This is shameful. This is a violation of the way democracy itself should work. When they are done, the product will be the fruit p from a poisonous tree. It cant be good, because the process that produced it was is so flawed. There are many, Many Americans who dont support this bill k h and im going to highlight three groups who stand to lose. People who are going to pay more for their insurance, lose their insurance altogether or lose their ability to choose their provider. Families wont be able to afford nursing home care for their loved ones or pay the hospital bills for a parent after she has a heart attack. Americans with preexisting conditions will struggle to buy insurance because Insurance Companies will be able to charge more for conditions like diabetes or cancer or asthma. Women will be blocked from crediting annual checkups or cancer screenings at their local planned parenthood clinic. All of these people stand to lose if the bill moves forward. Second, you have people whose jobsse may be at risk. Health care makes up about onesixths to onesixth of the american economy. You can bet those jobs will be affected by this bill. One study found that trumpcare will take away nearly one o million jobs by the year 2026. Were supposed to be helping american workers, not taking away their jobs or making itak harder for them to get health care. Finally, this bill hurts the working poor. These are the people who will struggling even more under trumpcare. And i dont know why we wouldou punish them. Why would we leave them withha nowhere to turn or . I know that millions of americans feel the same way i a do. They care deeply ant the poor, the vulnerable and the sick among us. Newsstanding up for their neighbors. One woman named jessie went to a town hall, and she said its my understanding that the aca mandate requires everybody to have insurance because h the Healthy People pull up the sick people, right . And as a christian, my whole philosophy is pull up the unfortunate. The individual a mandate, the Healthy People pull up the sicks people. If we take those people and put them in a high Risk Insurance pool, theyre costlier, and theres less coverage for them. Thats the way its been in thei past, and thats the way it will be again. So we are effect ily punishing our effectively punishing our sickest people. And i end the quote. Look, we may not agree ongr policy, but i hope we can agree onon the process. So what will it take . What will it take for this process to be restored and for trumpcare to be considered in the waypc that it ought to be considered . The answer is actually very straightforward. We need three republicans. It only takes three republicansa and you can be a or person who hates the Affordable Care act or has mixed feelings or anywhere in between. It only takes three republicans in the United States senate to restore the United States senate itself, to restore the hearing process, to restore Public Confidence and restoresa bipartisanship. All we needal are three republin senators to say i wont vote for anything if there hasnt been a public b hearing. I wont vote for anything thats beingn jammed down americasg throats. I wont vote for anything without being able to go back home and figure out how it wille impact my states hospitals. This is not an unreasonable ask. Were just asking for three republicans to say lets be a senate again. Lets restore order and transparency and to things the righton way. Because thats the only way this bill will not be a total disaster. Is i yield the floor. Mr. President in. Senator from new jersey. Im grateful for the recognition. I amsefr grateful for my colleae from hawaii. Really my colleagues from across the country who are going to be coming to the floor tonight. This is going to be a long evening because there are a lot of f folks who are frustrated. Now,no its not just frustration about the actual bill itself. A lot of this frustration right brokenness of this process. Be a process that is right now about secrecy, a process that has been conducted behind closed doors, in back rooms, aot process thats not reflective of our history, our traditions ore many of the calls from bothot sides of the aisle that in my shortterm time in the Senate Hearing an echo, a chorus of myo colleagues on both sides of the aisle who talked about regular order, regular order, regular order. Several ofse my colleagues and i earlier were asking for unanimous consent, trying to use the process ofro the senate to bring about a better process, a process that would bring this legislation out into theat lighd of day and create an opportunity reflective of the American Health carere act where we would have people able to put input into this process. A debate would happen,n discussion would happen. And, actually, we would come about with a bill the American Public would see go through the debates. In fact through the process. Y the very Constitutional Convention of this country, perhaps some of the biggest issues ofge humanity, were debad in an open forum. We have records of those discussions, records of those deliberations. Everything from the representation that each state should haveat to issues as profoundue as slavery were right there out in the open. Tonight its remarkable to me, its almost tragic to me to see a process that is to is broken that ispr so broken, a process that is so secretive, a process happening in back rooms and everything that americans dislike about politics of old. People working in secret on a bill that theyre going to try through congress withno no public input, no hearings, no meetings, no markups, no debate, no public accountability. And so therell be a lot of voices tonight. Sure, speaking about the realities of this legislation. Ne im one of those folks. I came from a Childrens Hospital this afternoon with parents, with children that w suffered accidents, Car Accidents and more telling meho how they were relying on medicaid. I think its onedi of their most terrifying things thats about to happen. Because people look at the house bill, a bill that our president even called mean, and theyre communities, fearing formi families like theirs. Understand the substance ofil this bill should have many country were going to be when you just look at the house version of the bill. Itte violates our common values and ideals as a nation. To give massive tax breaks worth hundreds and hundreds of thousands of dollars to the wealthiest and at the same time cutting the social safety net at a degree that we havent seen in my lifetime. The substance of this is frightening, but the process to me, it violates the values that iow know so many of my colleagus hold. That any of us watching this happen in an objective way would criticize this process. So we know the starting place in the house. Ou we know the details of that bill. 23 million americans losing Health Insurance. Ghe the gutting of medicaid by 800 billion. Throwing onesixth of our economy into cry is sis. Crisis. But its a process that eat fundamentally thatssp fundamentally at odds with the principles and the values especially of this body, the senate. When i was running for this office, i had so many people come to me and say this is thehe greatest deliberate deliberative body on the planet earth, the senate. Which slowed things down. The saucer that cooled the tea, as our ancestors called, this body it has a history for grappling with issues. I but this process is so at odds with everything that i believe about this body and how its supposed to operate. The senateth is meant to be a place of careful consideration,c of debate, of discussion. Now, the history of this body and its debates and discussions is reallyy interesting. The longest consecutive session in Senate History was a debate during the First World War about whether to arm merchant ships. Thats s the record. And by the way, issues of war and peace, i would hope that w theyd bring about substantive, deliberative debate, discussion, open air. This body is probably in fact, the elder statesmen and women in this body as ive talked to them both sides of the aisle tell me sometimes the most difficult decisions theyve made are involving war and peace. But what is interesting if you look at the history of the body, the longest debate, con executive session debate consecutive session debate, wass about war and whether to arm merchant ships in the First World War. E the second longest debate in Senate History was actually health care. Or, more specifically, it was t the Health Care Debate in 2010 about the Affordable Care act or socalled obamacare. In fact, here we are looking at the process that seems to be screaming something to the floor, no hearings, no markups,m no committee sessions. Screaming to the floor in the shadow of the second longest consecutive session of debate. That, to me, is a contrast that speaks volumes about the wrongness of this moment in history that anyone objectivelyi standing back would agree and concur that for something that is f so deeply at the core of wt our country is about, we literally founded this nation because of life, liberty and the pursuit of happiness. Life. And what more fundamental aspect of life is there . A critical constituent part of that has to be how we preserve life, how we embolden life, what is our state of our health care. For this great, historic, deliberative body to be doing that without so much as a pause, with the Brilliant Minds on bote sides of this aisle work the thoughtful people on both sides this aisle, people who have come through portals and processes where they expose themselves and their lives to public discussion, public debate, thats what a democracy is. Thats what this republic isun founded upon. Not secrecy, not back rooms. This body reflects the best of what democratic d principles ar, and now were rushing something through. That fundamentally affects life. And were pushing it to floor with an insult to our history, an insult to our values. Said before, but iha remind you that the Affordable Care act had a lengthy process before that near recordbreaking consecutive days of session. The senates Health Committee held 14 bipartisan round tables, 13 bipartisan hearings, 20 bipartisan walkthroughs and considered nearly 300 amendments. Finish the Affordable Care act actually accepted over 160 amendments, 160 republican amendments to shape the bill. The finance Committee Held 17 round tables, summits and hearings, 13 member meetings,ri bipartisan meetings and walknews, 38 meetings and walkthroughs, and the longest markup in over 20 years. In the end, the Affordable Care act went through a lengthy process through which the policy experts, market experts, medical professionals, health nonprofits, insurers, hospitals, families all came to this senate and put forward their input and their ideas. This wasnt a republican bill or a democratic bill on thems politicians themselves. America was invited to the table. And hours of hearing records show that people finish whether the bill ended up reflecting their ideas or not, they had their say. Thats whats beautiful aboutir this democracy. Is the dignity and the voice and opinions of others is i was mayor of newark during the time that t this process was gog on. And people of my community were rivetted by it and knew that issues that would affect their life or were going on here in the United States w senate. At a time that the number one reason for personal bankruptcy in my state was people declaring bankruptcy because of their insurance bill. Something that because of their Health Care Bill. Something thats not happening now at those levels. People who are caring and concerned about what was going on and representatives from my Community Came down. Aw i saw how that process shaped the bill. I saw how republican ideas shaped the bill. I saw how hospitals and insurers and advocates and doctors and nonprofits, the aarp and others let their voices be heard, shaped the process, had input, had voice, their dignity and perspectives were respected. Mr. President . Me yes. Mr. President , would my colleague yield for a moment . The majority leader has returned to the floor tour hear a unanims consent yes request, actually hem i fully yield to the majority leader. Without objection. Thank you, mr. Er president. This weekend i i was out doing town halls in rural oregon. I was in clement county and lake county and grant county andma wheeler county, counties that on any map would be described as solidly red. And at my town halls, people were turning out with one huge anxiety, and that is the healthl care bill that might be considered next week with noco consideration in committee, no consideration for amendments, no opportunity for experts to weigh in and most importantly, no opportunity for the citizens of america to weigh in. And so two veterans came up to t me after one of the town halls at the paisley saloon, and they said does d. C. Understand the despair, the anxiety in rural oregon over this Health Care Bill plan . And the answer, of course, at this point is, no. But we hope the answer will be yes. And then i was y visiting ais nursing home, and two different to noted that virtually everyone on longtermc care was there through medicaid. And they said, you know, if we lose medicaid, were out on the street. As woman, deborah, said to me, she said ill be out on street, and i cant walk so thats a problem. Well, yes, it is a problem for folks in longterm care to behy dumped onto the street. And thats why at this moment im canning for our normal process for any asking for our normal process for any bill, certainly a major bill, to get thorough, democratic consideration in this beautiful, we the, people, democraticte republic. And that mean Committee Hearings that means experts testifying. Experts and that means input from citizens. So thatshy why i ask unanimoust consent that no motion to proceed to calendar number 120 a h. R. 1628, the American Health care act, be in order until the bill has been the subject of executive session meetings inan the committee on finance and the committee on Health Education and labor and pensions. During which amendments from the majority and the minority have the opportunity to be presentedn and considered, and the American People have a chance to weigh in. And the bill hasil been reported favorably from the committee. Is there objection . I object. Objection is heard. Mr. President . Gentleman from massachusetts. Thank you, mr. President. Mr. President , whenr i was home in massachusetts this weekend, i constantly had i people coming p to me asking me about the secret republican Health Care Bill. What was in it . How was it going to affect their families . Because, to use Donald Trumpsre word, theyre afraid that its goingg to increase premiums, and that would be mean, that its going to make it possible for insurers to deny coverage forou preexisting conditions, and that would be mean. That it would create an age tax for older americans. That would beea mean. Ut that it would cut medicaid coverage or if grandma is and grandpa to get a nursing home bed iff they had alzheimers. That would be mean. And so the question that kept coming to me all weekend recurring was is this secret bill really meant to cut all of the funding that goes for the poor, the sick, the elderly, the disabled so they can give tax breaks to the wealthiest people in america . Can we get that out that people can see that . Ai and they also said to me that they didnt want to be fooled because their fear is trumpcare ash much a Health Care Bill asm Trump University was a college w institution and that there really isnt any Real Health Care in it and that its cruel, its inhumane and its immoral. So were demanding that the republicans show us the bill. Th that the American Public canan see the American People can see thehe bill and they can understand what its in c it. Because whats in it, because the consequences to their Families Health is so dramatic. I ask unanimous consent, mr. President , that the calendar 10 h. R. 1628, the American Health care act, be referred jointly to the committee on finance and the committee on health, education, labor and pensions with r instructions to report the bill with changes c to eliminate provisions that, one, increase Health Insurance costs; two, reduce coverage; three, make healthes care less affordable fr those with preexisting conditions; and, four, reducean tax liabilities for corporations and individuals with incomes i ask unanimous consent, mr. President , that that motion be put in order. Is there objection . Mr i object. Jection . Mr objectiones is heard. Senator from new jersey. Thank you very much, sir. Im just recognizing that my more senior senator is here from delaware, so idd like to suspd atul this time in deference to n opportunity for the senior senator from delaware to haver w few words. I i want to thank my friend from theg senator from delawaresd recognized. Ha thanks so much. Thank my friend very much for yielding. I take the train back and forth from time to time to goer to our states, im going to take the train later on tonight. Thank you for letting me have a few moments to say this. I was elected in 2000, i got here in 2001. But 2 two days after i was elected, i wrote, i called tom t daschle who was the democratic leader in the senate, and i said to him i, i understand that what i need to do iss to explain my committee c selections, what my choice and my preference is for committee. I have to present those to you. M and he said, yes, you shoulde give me a letter today. Presiding officer, im not sureo how you work it on the republican side. D thats the way we did it here and, i d presume, still do. Io said my first three choices, my first choice would be the finance committee, and my second choice would be the finance w committee, my Third Committee would be on the finance y committee. He said, so does everybody else. You have to get in line. E. So i did, and it took me eight years. I got on some great committees. In the interim, including thelu Banking Committee and commerce, public works, homeland curt and Governmental Affairs security and Governmental Affairs and others as well. Aging for a while, mr. President. But eventually i got on to f finance, and i got on the finance committee in 2009. And thatat was the year we had a new president , barack obama, new Vice President , joe bidenning. And the biden. And the idea was the hope from our new leaders was that wed to something that, gosh, president e since harry truman wanted to do, and that was t to provide Health Care Coverage for just about everybody in our country. We werent sure exactly quite how to go sur about it, but we d bit of homework, and befound 1 that in 1993 when we found in 993 when first lady hillary clinton, she came up and worked on something called hillarycare, and thean republicans felt like they had to come up with an alternative x. That was provided by the people at heritage, a republican think tank. What they came up with reallyad had, like, five components to it. And itom was introduced as standalone legislation by john chafee,le cosponsored by construction grassley. And hillarycare, in the end, cant goer anywhere, the chafee bill didnt go anywhere, but it lived on beyond 1993. And when mitt romney ran for was governor of massachusetts, he was going the run for president , he took that 1993 legislation which called for creating in every state exchange, marketplaces, large purchasing pools wherela people who didnt have Health Care Coverage could buy their healthi Care Coverage in a respective state. The 93 legislation also had sliding scale tax credits so that people buying their coverage in the exchanges could get a a tax credit to help buy down the cost of coverage. And the idea was that folks whose incomes were lower wouldow get a bigger tax credit, those whose incomes got larger and larger would eventually nothe qualify for anything at all. The 93 legislation that mitt romneya borrowed was the idea om having individual mandates so people, everybody hade to get coverage in massachusetts. And they didnt, they had to pay a fine. And the idea was that they we need for folks to get coverage, we need to make sure thesexc exchanges if were going to have them in the states, how people sign up for coverage in the exchanges when they would get sick and theyre going to run up the tab a lot for insuranceon companies. Insurance Companies Said we d cant make money doing that. Well, inn massachusetts they had the individual mandate. They also had an employer mandate that said certain number of employees you have to provide coverage for your. People. You dont have to pay for it all, but you have to offer them coverage. Last thing they had, mitt romney took from the governor romney took from the 93 legislationan from senator chafee and others the ideani that Insurance Companieser could not deny coverage to folks with a preexisting condition. Those were, those were mitt romney thought those were pretty good ideas, and he made them sort of the centerpiece of whatt they call romneycare in massachusetts which became law and, ultimately, extended coverage to a lot of people that didnt have it. Initially, they didnt do a real good job on affordability, and o one of the reasons was becausey im told by folks in m massachusetts the fine was associated withh the individual mandate and it wasnt very big. Eventually, it scaled up. But it took a while to get to the point where young people said, you know, im paying this fine, i may as well get coverage and get something for myrrh money. And romneycare ended up being pretty success. Ve one of the linchpins he used for running was, look, weve already provided Health Care Coverage for people in my state. In any event, in 2009 i ended up on themm finance committee, and you know what . We spent a huge amount of timein in 2009 trying to figure out what this Health Care Plan should look like. That ourur new president , new ve president wanted us to do. It looked a lot like what was offered in 93. And it looked a lot like what was actually adopted and workedt i think, with relative success in massachusetts. We held a whole lot of hearings, and the reason why im goingr back to this, i remember being on the finance committee foree week after week after week we had round tables, discussions,or meetings off the floor, on the floor to talk about does this make sense or not. Ot we went for an extended period of time, period of mr. President , where we had three democrats, three republicans on the committee whl i met with endlessly to try to figure out the compromises were. We ended up having extensivein markup, voting, debating the legislation in both the financeo committee and over on the Health Education, labor, pension committee. People had thetu opportunity tom offer amendments. A number of amendments were offered, adopted by democrats r and republicans alike. I dont remembero exactly, mr. President , but i seem to recall the Health Committee something 300 amendments adopted, 160 by republicans that were adopted. And long story short, finally had a chance to finish the debate and became law. I know the republican friends dont think they had much of a chance of being involved, but ia recollect having been there, there was a lot of involvement by both sides. I thought at times that the w debate on this legislation would never end. It finally did, and we finally passed it on a very close margin. The reason why i bring this up, first year on finance committee. Ed i loved it. I loved it. D and i was on it with senatornd stab now and a number of others, and we were actually legislating. It wasti fun. It was challenging. And we wereer trying to develop cop seven discuss. Conconsensus. I want us to do that again. I want us to do that again. Asnk good as we think that the Affordable Care act i know its not perfect. I think everybody in this c chamber knows its not perfect. The idea of preserving what needs to be preserved, fixing what needs to be fixed, thats what we ought to be about. And as senator as our republican friendsre are, yall just cantl this by ourself, and as smart ai we like to think we are, neither can we. Tt in this case, wed be a lot better off by doing this together. And ihu know our leader, chuck schumer, senator schumer, hasseo asked the republican has askedhi the republican leader to meet later this week, maybe thursday, i think, in the old i Senate Chamber and just talk it over. Just talk it over. I dont know if john kennedy used to say people wet shouldnt be afraid to negotiate, we shouldnt you know, a great quote, great quote about being afraid. And he said we should never be afraid to negotiate or talk. And ir think that probably pertains to us today. So i want to thank the senator from new jersey for yielding his time to me to give me a chance to say something. Again, for my republican colleagues, i was over in africa a couple of years ago, tanzania, for a National Institute seminar. Learned a lot ant africa. But one of the things i learned id never heard before. If you want to go fast, go alone. If you want ge to go far, go together. Something this important, we need to go together. And well be glad that we did, and i yield, yield back. Thank you soso much. A mr. President. T senator from california. Senator [inaudible] you talked. About tanzania. It reminds me of a greeting thae ive often heard from people who live in various african countries. Youve probably heards. It, but when you meet someone for the first time instead of what we wouldld normally say pleased to meet, you, the greeting back iss see you. I see you. And i. Think that really is part of ourof concern here. Do we see the people who will be impacted in the way that they are actually living their lives . And do we understand if we seed them that this bill will not be in their best interests in and right now, for example, we know 13 senators, all republicans, are crafting a bill which would restructure our nations entire Health Care System. Which when you add up what americans can spend on hospitals, doctors, Prescription Drugs and all the rest, we understand that it makes up a onesixth of our economy. It would affect the lives of grandparents, those who are in need of care giving, our children struggling with asthma or opioid abuse, our spouses who may be battling cancer. And what i is equally distressig is that this bill is being written in secret. The chairman of the finance Committee Says he has not seen the bill. The secretary of health and Human Services says he has not seen the bill. The American People, the people we all represent, have certainly not seen thet bill. Well, i think American Peoplede deserve better. B this bill is being written entirely along partisan lines without any attempt to to bringt democrats onboard. And the American People deserve better. B this bill is being written and rushed through the senate with hardly any time to debate the cost or the details of this. Proposal. And the American People deserve. Better. Now, i remember when oures colleagues across the aisle said the Affordable Care act was being rammed down the American Peoples throats in the middle of the night. Well, the aca went, in fact,ug through 106 public hearings. It incorporated more than 170 republican amendments. The whole process took an entire year. But this Health Care Plan involves no hearings, no bill text and no transparency at all. As United States senators, we were sent here to represent the more than the American People. Represent the American People. We answer to the American People. So why are my colleagues fromre across the aisle trying to put t one over on the American People . Ive met folks all across california and this country, and they see whats happening. They know that if this bill were as wonderful as its proponents p would like us to believe, itbe would be out in the open. The American People deserve greater transparency. But even though the authors of this proposal have tried to conceal the details of their plan, we know enough to know this bill would be nothing short of a disaster. We know because weve been told that its about 80 same as the bill that was passed by the house, a bill so catastrophic that oftenen the president of te United States who hailed its passage now calls it, quote, mean. We know that it would throw 23 million americans off their Health Insurance within aal decade. Including putting four to to five million californians at risk of losing coverage. We know itwe would raise costs r middle class families and seniors in every county of california. Average monthly premium costs would go up while Financial Support to pay premiums would fall. We know it would put americans with preexisting conditions atd risk and leave people who need ma n Maternity Care or opioid treatment without coverage or force them to pay huge outofpocket costs. We know it would cut about 834 billion from medicaid. Which meansan less money for families to pay for nursing homes, to support children with special needs or to treat Substance Abuse. Bless you. And that is another reason we need the Affordable Care act. [laughter] to be in mace in a way that we fix w whats wrong but we mend whats broken but not repeal it altogether. Ii recently visited the Martin Luther king jr. Outpatient center. Everyone from the doctors to thg patients can tell you that when 46,000 californians excuse me, 4,600 californians are dying every year from Substance Abuse and opioid overdoses, it is wrong and irrational to cut medicaid. So it really c makes you wonder why would anyone support this bill . Bill help real with real challenges . At a health carallingly in Los Angeles Health care rally back in los angeles in january, i met a woman named tanya. Shed signed up for insurance just long enough to see a doctor. Shed then havene a few test doe and fill aip prescription. Then she would realize she couldnt pay and couldnt afford to pay for the insurance beyond she said its, quote, the worst feeling in the world to have to tell your doctor who is trying to make you well that you cannot afford the treatment prescribed. Ny tanya told me, quote before the Affordable Care act livingg without Health Coverage was a nightmare in this country. But she went on to say that has all changed, and thanks to the aca i can now see a doctor when i need to, monitor my condition and stay healthy so i can keep working and contribute to ours nations economy. If my colleagues in congress, and she referred to them as if the republicans in congress repeali the law, i dont know what i will do. So i ask, how does the Republican Health care planhe hp tanya . Another woman, christa, told me, quote i am married with four children, none of whom and one of whom a 10yearold type i tie bettic. Ty he die wettic. Ui he required daily active insulin management to i stay alive. 24 hours a day, 7 days a week. She went on to say health care is not optional for us. Even with Health Insurance,ur diabetes management is the type of thing that t can bankrupt yo. Without Health Insurance, i cant imagine what i would do. She went on to athe aca is a huge the aca is a huge relief for my family. So i ask, how does this bill help christa and her family . Thenhe theres roett in marin county. More than sevenmo years ago he s diagnosed with leukemia. Roett is 9 years old. He says cancer cells are the bas guys. This is what he wrote me. E. For three and a half years i took chemo to get the bad guys out. I had more than 1,000 doses ofhe chemotherapy. My parents had to tell my for that i might die of cancer. And then he went on to write, thanks to myy doctors and nurse, my family and friends, my church and my community and the Affordable Care act, now im and then he writes gone with the cancer. Finish i have a preexistingon condition. Thanks to the Affordable Care act, my parents dont have to worry about losing coverage. A 9yearold, roett, is showing us the way. But howbu does this bill help roett . Now, i dont know the Party Affiliation of any of these folks. I dont know if theyre democrat, i dont know if theyre republican, i dont know if theyre independent, i dont know if theyre members of the green party. Im not asking them those questions. Im asking n them how are youm doing, whats helping you, what do you need and how will this impact you. And i know that im just one of two senators that they have. And when it comes to their needs and their need to be represented inhe the United States congress and their need to be heard and their need to be seen, Party Affiliation should not matter. There are needs of the American People. And regardless that of who they vote for in a partisan election, i am certain of this this Health Care Plan that is being proposed by my colleagues from across the aisle will not solve their problems. And it will only create, in fact, more problems and potentially devastate peoples lives. So to my colleagues, i say this shouldnt be a matter of supporting this bill supporting this bill if youre a republican or objecting just because youre a democrat. This is about whats right and whats wrong. If you know this bill is bad, stand up and stop it. Speak that truth. Now is not the time to keep quiet and hope nobody notices. Forget the politics. Forget partisan pressure and talk radio and primary ads. Instead, just listen to the voices of the American People. Not just in california but in nevada, in arizona, and ohio, in alaska, in maine, in pennsylvania, in west virginia. Because they have made themselves overwhelmingly clear. Only 20 of americans support this bill. Se the majority opposes it in every state in this country. F it is the least popular piece of legislation in modern history. Im asking you to think about the American People. Im asking you to think about tonya, think about krista, thina about red living with leukemia since he was just two and half years old, undergoing to a half hour infusions every night with such incredible bravery. Icans let the determination of americans like him bring us together, a nineyearold boy who tells us in his words, dont repeal the Affordable Care act, improve it. Because we all agree, daca can be improved. It must be improved. It isnt perfect, and im ready to work with anyone who really wants to make it better. Instead of playing politics,pu instead of playing politics wita Public Health and peoples lives, we can actually Work Together to strengthen our Health Care System. In fact, im proud to have recently cosponsored a bill with senator Dianne Feinstein at a a number of my democratic colleagues. Our bill would make it safer and easier for middleclass americans to buy insurance if they currently dont qualify for any health paying their premium. These are the kind of Solutions Democrats can get behind. These are the kinds of solutions that would help and not hurt the people we represent. N we took an oath to represent all the people, so i am asking every member of this chamber to think long and hard about the consequences of this bill. Think about the responsibility weve been entrusted with. We owe it to the American People to tell the truth, not to hidete it. We owe it to the American People to solve real problems, not to manufacture new ones. We owe it to the American People to do the job we were sent here to do. I urge my colleagues, vote down this bill and stand up for the people we represent and serve. I yield back. Mr. President . Senator from nevada. Thank you, mr. President your i rise to join my colleagues today to speak out on behalf of of the secret health care. Presd legislation that republicans are attempting to jam to the senate americ consideration. This is an insult to the American People. It is a shameful abdication of the role as a u. S. Senator to represent the concerns and priorities of the people of a state and country. We were elected to be a voice for the people of our individual states, and what i am hearing is loud and clear from my state, keep the Affordable Care act. Do not repeal it. Keep it and Work Together to improve it. Like my colleague, mr. President , i would like to share the story of one of the many nevadans who have contacted me to share their story about dacal and why they so desperately want to avoid its repeal. Jessica and her husband on aad brewery in reno nevada and i war lucky enough to get to meet and speak with her in person when i was home last month touring the Community Health alliance meetiw center. After meeting with her i had thi opportunity to sit and talk with so many incredible people, doctors, nurses, people who care about the very faces of women, men, and children were talking about tonight. His is w but this is jessica has led her to be in this is what i would like to share with you, what you wrote to me. Dear senator cortez masto. Im a resident of nevada, a Small Business owner and a mother. I am writing to express my views about the Affordable Care act. V the Affordable Care act has had a tremendously positive effect on my life, and i would like to share my story with you. The Affordable Care act save my Small Business. When the Patient Protection and Affordable Care act was signed0 into law in 2010, and when it was upheld by the Supreme Court in 2012, has been and i were in the planning stages of our smal, business at the time my family was provided Health Insurance through my corporate job. Knowing the aca would take effect gave me the peace of mind to leave my job and become a fulltime Small Business owner. Today, our business, under the rose brewing company, celebrating our fourth year in existence, and were in thel beginning stages of a large expansion which will create many new jobs in reno. This business would not have survived without my fulltime dedication. And i would not have been able to leave my corporate job without the ability to have Affordable Health care for my family. The Affordable Care act allowed me to start my family and ared healthy way. As my husband and i prepared to sign up our first year of health care with the aca, we found out that i was pregnant. Prior to the aca Health Insurance, insurers were allowed to consider pregnancy a preexisting condition. Instead of being denied coverage, or charged higher premiums, i was able to receive appropriate and Affordable Care during my pregnancy through the aca. Affordable care act my life and my babies life. Because 30 weeks into my pregnancy at a regular checkup with our midwife, my husband and i were advised to see a doctor. Since i didnt look sick or feel sick we hesitated but our midwife was positive it would be for the best. Our insurance to the aca allowed us to see the recommendedway th ob gyn. Halfway to our appointment my doctor became very concerned and rushed me into the hospital. My son was born by emergency csection a few hours later. Several doctors agreed that neither the baby nor myself would have survived a further 24 hours of pregnancy. D having Health Insurance through the aca allowed my husband and a to seek treatment and care with it having to worry about the cod affordability of following doctors orders. This is the first time i could say that the aca save my life and the life of my beautiful baby boy. The Affordable Care act saved my Babies Health and provided us with Health Insurance. Thus my son was born nine weeks early and was admitted into the nic you. He stayed in an icu for 32 days and was under constant doctor care. On the time he left the hospital, we had incurred while over 1 million in total costs. The aca allowed him to start his life without a cap on his total lifetime Health Care Coverage. Prior to the aca, many niculimis babies reach the lifetime limits before even feeling the sunshinc under faces. I am eternally grateful for this provision of the aca. One week after bring our beautiful baby boy home from hospital, i find myself in need of Emergency Care for a second time. I suffered a postpartum stroke or, is taken to the emergency room and admitted to the hospital for the second time in two months. O again, the aca allowed me to seek treatment and care without worrying about coverage. Lth ca the Affordable Care act will save my sons health care. My son now has a medical issue with his growth. Should the aca be repealed, amended, or replaced with something less inclusive . This issue would be considered a preexisting condition. The thought of my 18 month old son being denied coverage or potential and not being able to afford the health care offered to them makes me sick to my stomach. Why would our lawmakers vote to take this away from him . I employee to consider the grean length the Affordable Care act has gone to not only improve and save lives in my family, the families across the great state of nevada. Ren i further implore you to consider the children currently. Covered and benefiting from the aca as you contemplate your vote on this significant matter. Islai i strongly urge you to defend this crucial legislation. To many of your nevadan constituents rely on this lifesaving, Health Saving of financial saving legislation. Thank you for reading my story and considering my views per im happy to speak directly with you. Stor family. Mr. President , i know jessica story is one of thousands. I hope my colleagues across thed aisle think of jesse and her family, and the millions of americans like her, who have so much at stake while continuing to secretly rewrite our countrys Health Care Laws. Thank you, mr. President for listening and i yield the floor. Mr. President . Senator from michigan. Thank you, mr. President. First of what you think the senator from nevada. We are first also please that she is here and her voice is so strong for the citizens of nevada, and we appreciate very much her comments of this evening. Es mr. President , im rising this evening to talk about an issue that affects every single person, every Single Family in michigan and all across theal nation, and thats health care. And i feel very confident that i can say that each one of the 48 members of the democratic caucus, each and every one of us, would love to be on this floor working with republican colleagues across the aisle to lower the cost of Prescription Drugs, to lower the more outofpocket costs of health care, to create more competition, more insurance choices for people in the insurance pools that are there. Now, to basically fix the problem. But we are here and a proud to be with colleagues tonight,ha because we are not willing to support anything that unravels the Health Care System, raises costs and takes way health care for people, that on top of that gives the taxcut to the wealthiest americans insurance execs, pharmaceutical companies with the dollars that are cut. So here we are. The house has passed a bill that, in fact, raises costs, takes a way health care, gives the tax cut i talked about. Now we do in the senate. Now, the republicans have a Health Care Bill, but they wont let us see. I am the ranking democrat on the Health Subcommittee of theyo finance committee. You would think that someone would have reached out to have conversations with me about, and members of our subcommittee and the members of our full committee, but that has not happened. So they are letting the Trump Administration see it, but not the American Public. They are letting lobbyists see. Thats probably where i will get a copy first is through lobbyists, but not the rec and public who will lose theirnd health care and pay more. If you cant send your not going to be able to get coverage, if youre going to potentially be dropped or now have a preexisting condition or get a cap put on to the number of cancer treatments that you cance receive, i believe you have a right to see this bill. If you have epilepsy and will lose your insurance, you have if youre a woman who will be charged more for insurance andxi to be considered to have a preexisting addition just you are a woman, you have a right to see this bill. And if you are a senior whose rates are going to go sky rocketing upwards, you have a have a but the sad fact is republican still think the American People have a right to know or to see this bill, or to review it or to comment on it, to have a chance to give their opinion on it. The difference in process couldnt be more clear between the way the Affordable Care act was originally worked on fored about 18 months and then passedg and whats happening right now. In 2009, republicans called fora a fair collaborative and deliberative legislative process. And i agree. In fact, we all agree. From 20092010 the Senate Finance Committee Held more than 53 hearings on Health Reform. Hearings, open Committee Meetings, work sessions. As a new member of finance at the time i was involved in every single one of those. Hours and hours and hours ofst listening, deliberating, people sharing their opinion, debating. Counting the help committee deliberations, there were 100 hearings and Committee Meetings before the bill was finalized and debated to be reported out of committee. E 100. The republicans had had noearins hearings, zero hearings, no public meetings, zero publicmi meetings. During the finance Committee Markup when we were working through and voting up the bill,d we considered 13 135 amendments, often late into the night. The final senate bill included 147 republican amendments. Until the end we were trying to do everything we could to get bipartisan support, when it was clear that politically there was not a desire, even with 147 republican amendments in the bill, to have a bipartisan Health Care Bill. Even but republicans wont even allow us to see the bill, let alone amend it. Our position is very clear. If theres no hearing, therese. No vote. We need, they need to show us the bill. But theres i think a really good reason that they wont show us the bill. S they wont let us see because its a disaster to the American People, here its a disaster for people in michigan that i represent. From the house bill we know that 14 million fewer people will be insured after the first year,ea 23 million fewer people will be now, this may change somewhat backandforth, we have no idea, but we know the generalin framework that the senate is working in, is with the same general framework as the house. We know that in 2026, according to according to the budget m office, 51 Million People, 51 Million People under the age of 65 will be uninsured, no p insurance. We are told that premiums would go up 20 next year, and states would be allowed to opt out fte Insurance Laws that protect consumers. To really understand what that means, that means all of the decisions about your care back to the Insurance Companies. Not her doctor. Laws that protect people with preexisting conditions, gone. Rules that prevent women from being charged more, god. Loss of preventing disturbing charge more, gone. S and the way it used to be is if you guessed it, the Insurance Company could decide to drop you. It was the Insurance Company that said how many cancer treatments that youre able to receive, or Mental Health visits, if any, you would receive, and you always paid more than for physical health. The same with addiction. This all goes away with whats being talked about here. In other words, costs are going to go up and care is going to go down. And to add insult to injury, all of this is going to go to tax cuts for multi millionaires and billionaires and Drug Companies and Insurance Companies execs. While some of his losing their nursing home care, their cancer treatment, Maternity Care, children unable to go to the doctor and parents forced to go back to using the emergency room. Would so mr. President , i want to share with colleagues what these changes would mean for people in michigan. There are so many people i talk to, so many stories that ive heard. I received a letter from the woman in michigan named amy who owns a small retail business, has Health Insurance to her husbands job. Small business owner. Amy has chronic myeloid leukemia. It is managed with a medication costs 20,000 a month. Not a year, a month. After her deductible and 10 s te copay she said she quickly reaches a maximum outofpocket expense on her insurance each year. Amy wrote preexisting conditions, maximum outofpocket costs, lifetime caps are important to me. Al without them i could never afford my health care. Without the Affordable Care act i could quickly bankrupt my family, and still die. Any please consider my situation when deciding your vote on any changes to health care. I need your help. I want and need to stay alive and raise my children. Y Health Reform allows amy to stay on her husband Insurance Plan and pay for the cancer treatments that are keeping her alive. The republican plan would put people with preexisting conditions like cancer at the mercy again of Health Insuranced companies. Heres another way the republican plan would hurt michigan families. Thanks to the Medicaid Expansion, 650,000 people are newly covered under what we call healthy michigan. The healthy michigan plan. And the good news is 97 of michigan children can now go tor the doctor. They dont have to wait and go to the emergency room. If they have a called their mom or dad can take them to a doctor. They can get Preventative Care rather than waiting until something awful happens and go into the emergency room. And whats the good news for the state of michigan out of that . Michigan will end up this year going into next year with 432 million more in the treasury. Th taxpayer dollars that are not quite up to be used on health care. He r because the right thing was done, creating a way for children to see a doctor, and what has happened . With a 50 reduction on folks going into the emergency room. That dont have insurance, and it saves money when you do that. The number of people treatede have gone down 50 picked the number of people treated without insurance. The great thing about health care, to understand, is that if we ignore it, it doesnt mean people dont get sick, if they dont get cancer they have a nursing home or that their child doesnt get sick. If you just ignore it, the costs expe because people ultimately use the most expensive ways to get treated. If you actually plan it out and do the right thing on the front and an people can see a doctor and they can get the checkups and the care that they need and the treatment they need, you actually save money. Thats the example of the state of michigan. But the republican plan would end the Medicaid Expansion, healthy michigan would go away. One young man in michigan only 19 years old shared a story of living with th a single mom whee was diagnosed with testicular cancer. He was working but his employer did not offer Health Insurance. He didnt have transportation to get to his appointment or treatments. S thanks to healthy michigan he got insurance and treatment at Munson Health care in traverse city. He is now free from cancer, has a job with the benefits and is engaged to be married, and we wish him well. Healthy michigan and the Medicaid Expansion saved this young mans life. E the republican plan would end the healthy michigan plan, ripping coverage away from 650,000 people in michigan. Including cancer patients. And for what . And for what . To pay for tax breaks for Drug Companies and the ultra wealthy, one more time. When michigan families will be unabln to care for the loved ones whene they need it most. In january i lead a forum on Health Care Policy anyone can for michigan to tell her story. She was diagnosed with multiple sclerosis when she was 40 years old. She was very, she had very limited use of her arms and legs. It was so grateful that she made the trip to d. C. To share her story. Medicare and secondary insurance cover most of the cost of her medication, which costs antonisn astonishing 75,000 a year. Thats nearly her entire household income, including Social Security benefits. Ann had been caring for aging mom when her moms to mention were sent. United states did no what should find a 6000 a month for nursing home care. How many families are in that situation . Fortunately, her mom qualified for medicaid which by the way, three of the five seniors in michigan are able to get their health care, their nursing home care through medicaid, three out of five are getting nursing home care because of medicaid. Anns including anns mom. And this nursing home care paid for the final three years of her life. A heres what ann said. It is only because of medicaid that shes able to get the help that she needed at the end of her life. I dont know how i could have cared for my mom on top of managing my own care. My family wouldve lost our home and all our savings trying to keep up with their bills. Medicaid helped ann care for her mom at the end of her life. This is a good thing. Icaid but again, the republican plan would cut medicaid by 834 billion, thats the house plan coming over. No we dont know how much be kept here, but we know what ever will be cut will be used to pay for tax breaks or Drug Companies insurance ceos, millionaires and billionaires. Lionaire how does that reflect americanme values . Rican in conclusion, republicans are hiding their bill because they know it is a bad deal for american families. It is a bad deal, president of the United States called it mean. I agree with him. It is mean. T and its definitely a bad deal for the people i represent in michigan. Costs go up, care goes down, all to cut taxes for millionaires and billionaires. We are better than this as a country. Our nation is better than this. Its time for republicans to show us the bill so we can work on it together, together, give us a chance, give the American People a chance to input to say what they think before it is forced on them in the secret process thats rampant through this for. And its time to move beyond partisanship to get something done for the American People. Again, i know that the 48 Democratic Senators in this chamber want to work on lowering the cost of Prescription Drugs and reducing outofpocket costs and helping Small Businesses that want to provide coverage for their employees, and making the Health Care System better. Lets stop this bad bill and Work Together on behalf of the American People. I yield the floor. Mr. President . M senator from massachusetts. Mr. President , when a pope dies, the cardinals meet in secret to select the next pope. A white cloud goes up in smoke. When Senate Republicans meet in secret to craft a Health Care Bill, coverage for the sick, the disabled and the elderly, thats what goes up in smoke. All of that coverage. The only thing more secret than the republican Health Care Bill is Donald Trumps tax returns. And we might need ultimately to have a special counsel to go and to find out whats inside of that Health Care Bill. Because right now the democrats dont know, the American Public doesnt know. No one knows whats in that bill. And while we may not have details on the republicans secretive proposal to repeal and replace the Affordable Care act, we know that they are not completely rewriting the house passed legislation that eviscerates the Medicaid Program and reduces coverage and increases costs for most americans, and for the individuals, the families andag the communities caught in an opiate crisis. This bill will be a complete calamity, and it is being done totally in secret. Right now the press is being stifled the white house didnt even let reporters audiotaped the press briefing today. Last week the Senate Republicans tried to keep the press from asking questions of senators in the hall. They dont want the press to know about this bill or to coved it. But for families who could need treatment for opioids, the the republicans want to take the money from Substance Useso disorder coverage and care, and to use it to offset a 5. 5 trillion tax cut for the healthy, wealthy, and for massive corporations. That would be cruel. It would be immoral. It would be inhumane. And like President Trump himself has said, it would be mean. We know the Opioid Epidemic knows no demographic, economic or political boundaries. It has ruined lives of men and women from lexington massachusetts the lexington, kentucky. It is an equal opportunity destroyer. A thats one of the reasons why over the last year combating the Opioid Epidemic has been a bipartisan issue. 11 months ago this body passed and said the president s desk the comprehensive addiction and recovery act known as care. This by person law the states responses to the Opioid Crisis and passed the senate 92two. Six months ago the Senate Passed the 21st century cures act bill 94five. This bill quickly became law and allocated 1 billion, two states to provide muchneeded resources to help them address the Opioid Epidemic on the ground and in their communities. Ub yet today, Senate Republicans are singlehandedly attempting to betray that progress come to erase it from the history books. They are doing so by crafting in secret of bill to get medicaid and repeal the Affordable Care that that hides a massive tax break for the wealthiest people in our country. Ee people who do not need or deserve a tax break, especially if its coming from the healthi, Care Coverage from those people who are sickest, those people who are oldest, those people who are most disabled, those people who are most vulnerable to having an addiction to opioids and need treatment. It would be wrong to take their money for that health careea coverage and give a tax break to the wealthiest billionaires in america who already have enough money for their Health Care Coverage. That would be a death sentence to the 2. 8 million americans with Substance Use disorders, including 220,000 with an opioid use disorder at risk of losing their Insurance Coverage altogether in order to ensure that their Family Member could get treatment. For those who do manage to get Insurance Coverage, some care will make it more expensive to get the treatment and the care they need. The Congressional Budget Office explicitly said that outofpocket spending on mentan health and Substance Abuse services could increase by thousands of dollars per giv individual in any one given year. For a disease that is critical as an opioid use disorder, any de difference between life and death. Not to mention that becauseons r trumpcare reduce the protectionn for people with preexisting conditions, even those with insurance they find out that the coverage they have wont work for them when they need it the most. Under the republican proposal a Substance Use disorder could be classified as a preexisting condition, and, therefore, you cant get coverage for it. The Congressional Budget Office also said that trumpcare would slash medicaid by 834 billion, permanently decapitating medicaid. A decapitating. They say theyre moving to a pet capita system. Another way of saying that if youre an ordinary person is decapitation of medicaid for the families across our country whod need it. And if this becomes law, there n is no narcan for medicaid. Is dead. Os those devastating cuts would grind the progress weve made in expanding access to over treatment to a screeching halt, and sick people currently in treatment to the curb. Kick people. Medicaid spend 7 billion in Substance Abuse treatment alone. That money for sold access to care, access recovery access to hope for millions of americans. Medicaid can cover inpatient detox treatments, care coordination, access to naloxone, and additionally medicaid pays onethird of the medicated assistant treatmentstr in the country. More than any other payer. In massachusetts medicaid pays for nearly one half of the medicationassisted treatment provided in the commonwealth. Think about that. One half of the people who getca medicaid assisted treatment for opioids, for addiction, will lose their coverage, and thene the republicans are going to take the money they save and t then give it to the wealthiest people in our country who also need the same coverage, leaving them with the money needed fort. Those who are the other one half who will not have it. And what happens to the other individuals . It could be a death sentence without treatment. And those of us from states hardest hit by the Opioid Epidemic, here time and again how medicaid coverage of the i Services Save lives. Don from swansea massachusetts became addicted to opioids after experiment in with prescription pain pills from a Family Member. Through medicaid is able to his access medicationassisted treatment to help treat his Substance Use disorder. She said quote he has done very well with his recovery so far but i fear that without Insurance Coverage, that will allow him to continue updating his medication and counseling. He may lose all that he has gained and fall back into the cycle of addiction. Is medical insurance is literally his lifeline. Please dont abandon my son and others like him who need medicaid assistance to continue their fight against addiction. Instead of recognizing the importance of medicaid for families like dawns across the country, republicans are proposing to starve this lifesaving program on federal funding, through trumpcare by tagging or than a quarter of its budget. Because thats not enough to fund the massive tax breaks thar republicans want for their donor friends, President Trump hasnt proposed in his budget to cut the program by an additional 600 billion, leaving medicaid i shell of its former self. Although republicans refer to these changes as capping the Medicaid Program, but dawns son, what that really means is they will decapitate his Access Communication assisted treatment, decapitate his ability to seek counseling and decapitate the peace of mind dawn receives in the ursinus accessing the help which he needs. We also have to consider the other Affordable Care act prevention and its role in the Opioid Epidemic. It is the federal government single largest investment in prevention. Since 2010, massachusetts has received more than 95 million through the prevention funds. Importantly, for massachusetts nearly 4. 5 million has been given to the Preventative Health Services Block grant that is help the state respond to the heroin Prescription Drug and fentanyl crisis. Eliminating this fund will only hurt our ability to respond to the opioid and other drug epidemics popping up in every one of our communities. We should not be building bridges to recovery with moneyro that is stolen from those programs in order to be spent on a wall that is going to pretend to block the drugs in coming in from overseas. We should be building bridges to recovery, not walls to isolation. Instead of more commissions, we need more commitments from the administration and congressionas republicans canno to not undo te progress we have made in preventing and treating Substance Use disorders. Its unfortunate that republicans who have touted our progress on opioid issues are not stand up to the policies in trumpcare that would negate their hard work. By supporting this they are betraying the families and communities who have suffered from the relentless grip ofbs Substance Use disorders. When discussing the Opioid Crisis, billy thing the gop stands for right now is guiding overdose prevention. Thats the new gop gutting overdose prevention. N this isnt surprising for us the been watching many congressionar republicans salivate over ways to annihilate medicaid for decades. A republicans harbor and animositg towards medicaid, rating the medicaid coffers achieves to their goals. First, kills a lifeline for more than 70 million low income and workingclass americans. And second, it provides the gop a piggy bank to aid their donors and pay for these tax breaks for their friends pick in fact, trumpcare alone would provide the wealthiest individuals and National Corporations with over 660 billion in tax breaks over ten years. Included in this figure is the repeal of Health Insurance taxln which gives of 145 billion tax break to insurance conglomerations and their ceos pick millionaires will get a tax break of 50,000 per year, more than three times the income of most medicaid beneficiaries. And the top 400 highest income earners would save 7 million in taxes annually. All of this comes at the expensa cove will lose Health Insurance coverage under trumpcare. Dont let the gop for you. Trumpcare is not about creating health. Its about concentrating wealth in the hands of a small number of americans. Ricans its about making middleclass and working americans pay for a tax break for people who need it least. We can do better than this. We only to the families of the 33,000 americans who die from opioid overdose last year. The proposals under consideration with republicans is going to only add to the talent of overdose deaths. Were hearing that republicans could create an opioid fund. Al thats a paltry attempt to use those are called out the cruelties in this bill. That extra funding would bel crumbs that you be like trading trading like trading land for a couple of beads come like trading a cadillac for a tricycle. We will not be fooled. We know it took republicans more than a year to agree to providing the funding for emergency opioid response in pictures bill. One can only imagine how long it will take to get any money republicans as a consolation prize out to the communities who need it. We know info for trumpcare is a vote to perpetuate overdose deaths. Passing this bill will be just aiding and abetting one of Public Health most wanted and most notorious serial killers. Americans from both political b parties are not fooled by President Trumps taxcut shell game on the backs of families and communities that have been ravaged by opioids. Thats why democrats will continue to be a public megaphone and shout from the rooftops that eviscerating medicaid to give a tax cut to the healthy, wealthy is mean, it is inhumane, it is immoral, and were not going to stand for it, and the American People are not going to stand for it. The best vote i ever cast in my political career, thats 41 years in congress, was for the Affordable Care act. The second best vote i will ever cast is to block the repeal of the Affordable Care act because of the good which it is done for tens of millions of families in our country who otherwise would not have the coverage they needy mr. President , i yield back the balance of my time. Mr. President . Senator from vermont. Let me thank the senator from massachusetts for his very cogent and important remarks. Let me just start off by asking president , asking the leader of the republican party, what are you afraid of . What are you afraid of . Onesixth of the americanac economy. It impacts every man, woman and child in our nation, and yet we have 13 republicans, all men, working behind closed doors to be brought to the United States senate at the last moment so the American People dont know the disaster that it is. Shoul politics is about or should be about, is it you are proud of what you do, you tell the world about it. You explain to the American People, your constituents, why this is what i proposing. Is this is how i voted, and this is why it is good for the people in my state and in my country. Eric but it should give every a american, whether you are a democrat, republican or and independent, whether you are conservative or progressive, it should tell you something that major, major legislation is being written at this moment, and most republicans dont have a clue for whats in that legislation, let alone democrats, let alone the average american. So i say to the republican afr leadership, what are you afraid of . Bring that bill out. Im a member of the health, education, labor and pensions committee. Ommittee the help committee. The help committee pick it is supposed to be the committee in which we deal with health issues. I see senator murray here, Ranking Member of that committee. And she will concur with me that that committee has held zero hearings. It is the help committee we have not had one hearing to ask members of the administration, people throughout this country, whats the impact of this legislation will be on the children, all the elderly, on working families, and those who have chronic diseases, on ordinary americans. T what impact will this legislation have on the lives of 300 plus Million People . We have not had one hearing, not one open discussion. And i should think that everyhem republican should be embarrassed i know that many of them are embarrassed about it. So before theres any vote on any health care legislation, we need to have a series of hearings to discuss the implications of what that legislation is about. S i mr. President , as i think you dg have heard during the debate over the Affordable Care act, and i am a member of that committee, we had 47 bipartisan hearings not only in the health, education, and labor committee, but also in the finance committee, other committees. There were roundtables. There were walkthroughs of the Affordable Care act. There was a consideration of more than 300 amendments, some 150 amendments offered by republicans were accepted. Finae in 2009 and 2010, the finance Committee Held 53 hearings, beatings, negotiations and walkthroughs on the Affordable Care act. That committee marked up the Affordable Care act for eight days, a markup means you accept amendments, your debates on amendments. That was the longest markup in 22 years, and adopted during the process of ten republican amendment spirit when the bill was considered on the senate floor, the senate spent 25 consecutive days in session on Health Reform, the second longest session in history. And oddly enough and interestingly enough, many of my republican colleagues during afr that process, after 25 consecutive days on the senate floor, after numerous hearings in the h. E. L. P. Committee come in a finance committee, there were senators who said it wasns enough time. They were saying this is such an important piece of legislation that would impact so many people, we need even more time. Senator enzi said, quote, cutting off Senate Debate and deliberation with the budgetorta reconciliation process would shortchange legislation with enormous impact, end quote. Senator lamour alexander says ethical, i dont think people are going to feel as good about the bill that restructures 16 os is single Americans Health anddo Health Care Bill is being written down closed doors. So in other words, your Republican Leaders thinking that the hundreds and hundreds and hundreds of hours of discussion and debate on the Affordable Care act was not enough. And i find it amazing that the same republicans seem to think its okay for legislation to be written behind closed doors and not have one single committee hearing. Now, the truth is, mr. President , i can understand why republicans do not want open discussion and open debate on this issue. Ed on because the bill that theyre working on, which is based on the disastrous bill passed in l the house last month is a bill that would do incalculable harm to people all over our country, and really should not be considered as a Health Care Bill. How do you talk about a socalled Health Care Bill when you are throwing 23 million3 people off of Health Insurance . When we talk about a Health Care Bill, the assumption is were improving health care in america, not doing what the Republican House bill did was to throw 23 million americans offur of Health Insurance. Surely that is not improving health care for american. Cutting medicaid by over 800 billion, and god only knows what the implication of that will be for the children, forer the elderly, for people who are in nursing homes. You are not improving healthmp care when you defund planned parenthood, and after all the rhetoric you about choice, choice, choice, will direct the people to go to the provider of choice, oh, 2. 5 million women who today get their health care through planned parenthood, i guess their choice doesnt matter. Ut and we hear about the needs of working class people. We have a candidate donald trump who talked about the needs ofg working class people. B the House Republican bill that we think the senate bill will be very close to it, substantially raised premiums, substantially raised premiums for older workers. And that is why among other groups opposing the house bill, the aarp made the point that this would be a disaster for older workers. The truth is, mr. President , this is not a Health Care Bill. This is a tax break for the rich and multiNational Corporations bill. This is a bill that would provide over 200 billion in tax breaks to the top 2 . This is a bill that would provide hundreds of billions of dollars in tax breaks for the Drug Companies and the Insurance Companies. The last information i received, pharmaceutical industry, the major five Drug Companies made over 50 billion in profit. But this legislation would throw americans off of Health Insurance to give the Drug Companies even more profit. This legislation, the house bill, and i think similarly the bill being worked on behind closed doors, is not only opposed by the aarp, the largest senior group in america, it is opposed by the american cancer society, by the american heart association, by the American Lung association, the Cystic Fibrosis in addition, the march of dimes, the national ms society, the american medicalas association because doctors, what a disaster this before millions of americans. E the American Nurses association and the American Hospital association. So you all of these groups who are the pillars of health care in america saying no, no, this is a disastrous bill, and yet we have the Republican Leadership and a dozen or so members working behind closed doors. Now mr. President , nobody here has suggested that the Affordable Care act should not be improved. D. In my view it should be improved. High, copayments are too high, premiums are too high, and certainly the fact were paying twice as much as any other country for Prescription Drugs, that has got to be dealt with also. So the task right now the most t sensible people is to put on the table and be honest about it. What are the problems of the Affordable Care act . How to be lower deductibles . Do how do we lower copayments . How do we control escalating cost of health care . Those are reasonable questions that honest people should debate. But the answer is not to throw 23 million americans off of Health Insurance. At that is not a solution to the problem. That is an insult to the American People. Let me just conclude by citing this. Our job right now is to make sure that this disastrousthe li republican proposal never sees the light of day. And i would urge my democraticic colleagues on behalf of the American People, the vast majority of them know how bad this legislation is and we have to stand up and fight in an unprecedented way to make sure that that legislation never seed the light of day. And after we win that struggle n would hope that we would come forward as a nation and join every other major country on earth, whether its candidate, and i live a few miles away from the canadian border, whether its the united kingdom, rants, germany, that we would join every other major nation on r earth and say that health care is a right of all people, not a privilege. If you are an american, you are entitled to health care. You should not be one of the 23 Million People thrown off of health care, bringing the totala of uninsured in america over 50 Million People. That is outrageous. So mr. President , i think youre going here at the American People stand up loudly and clearly, demand transparency,hi demand serious debate on an issue of this consequence. I do think at the end of the day this legislation will be mr. Defeated. Thank you and i would yield the floor mr. President . Centered from washington. N. Mr. President , democrats come to the floor this evening as a voice to the people that we represent to fight back againstm republicans plans to jim trumpcare through the senate, increase Health Care Costs and hurt families across the country. Because Republican Leaders hope nobody pays attention if they can hope they can go into the secret rooms and kept secret deals and come out with aam Trumpcare Bill that they can jam through door anybody notices. A we are not going to allow that to happen. We are here. We will fight back and i can f only hope that just a few republicans decide to listen to their constituents, reverse course and work with us to improve health care instead of standing with President Trump to destroy it. It mr. President , i want to start by talking about a constituent of my new story i heard and his voice and perspective should be a part of this debate. Her name is lisa. Shes from spokane in my home state of washington. Lisa served our country in the navy for six years. She goes to school. She works parttime. She says she relies on medicaid to afford health care she needs, and she is very worried that if trumpcare passes she would not only suffer from cuts to medicaid, but she could lose her coverage altogether, like Many American she has a preexisting condition. E asthma. Lisa is not alone. There are millions of people just like her in Washington State and across this country, and each of them, every patient, every family has a stake in this fight. They deserve to be a part of this debate and they have a right to know how trumpcare would impact them if it is signed into law. Mr. President , that shouldnt be a partisan sentiment. E ive heard republicans come to the floor time and againalling demanding transparency, railing against secrecy, calling for hearings. One republican senator who is now the chairman of the senaten help committee came here to the senate floor back in 2009 to blast democrats for writing an amendment quote in secret. He said and i quote, none of us on the republican side knew what was in it, and he accused democrats of tried to pass our d bill quote before the American People find out whats in it. Mm well, mr. President , my friend, the chairman of the h. E. L. P. Committee and certainly not alone. Ai back in the current republican majority leader said and i quote, this is a massive piece of legislation that seeks to beg restructure 16 of our economy. It is being written behind closed doors without input from anyone in an effort to jam it passed that only the senate but the American People. Well, mr. President , that was not to back then. We held dozens of bipartisan hearings and meetings over months and months and months, but it is what republicans are doing right now. The chairman of the Senate Help Committee who i respect that would never think he would be a part of an effort like this told me he was not planning to hold a single hearing on trumpcare. Lot of work on this bill should be getting done told my friend, the senator from missouri, he wasnt going to hold a hearing either. There are reports now that republicans actually have a text of their bill. Something is written and almost ready. Democrats dont get to see that bill. People across the country are being kept in the dark. Republican leaders are treating it like President Trumps tax returns and not allowing it to see the light of day. It is absurd and it is unprecedented. We could be just days away from a massive bill being jammed through this senate and many through this senate and many in Many Republican senators are telling constituents they couldnt even say what was in the bill if they wanted to because they havent seen itealh either. This bill is so secret, even President Trump, the secretary of health and Human Services told us in a hearing last week, he hasnt seen how trump carries being changed in the back rooms of the senate. Why are Republican Leaders so focused on keeping trump care worth secret . One aide was quoted defending i the secrecy thing we arent. Republicans know they would be to put a bill of the public because they know people acrosse the country and they would hate it here that it lancelot good they would not be able to go back home and defendant. They know more people learn f about what dennett and what it might mean for them and their families before people at home will rise up and fight back. They want to keep it wrapped up tight under lock and key, no hearings, no scrutiny, no publit input when they first announcede their secret working group, not even any women were in it and Republican Leaders in the back room desperately trying to cut those final deals doing whatever they can with the last fewituen republicans in to supporting something they know their constituents will like. Mr. President , this has got to end. Hope there is too important an trunk it would be too devastating to allow this kind of secrecy to continue. Ide mr. President , we have a prettyi good idea. No matter how much lipstick they put on, and theyve done everything we have heard. This is going to say my trump care went in the house and the impact on families would be just as fair. Higher costs for families, especially people with preexisting conditions. Higher costs, Insurance Companies no longer required to cover basic Health Care Like Maternity Care or Mental Health services and much more. Women would lose access to doctors and the carriers they need at planned parenthood and millions of people across would see their medicaid coverage taken away. Opio are finally getting through for Substance Use disorders likees opioid addiction or Mental Health care for access to a primary care doctor under medicaid would lose access. Hom over the past year, so many families in my homes they who same theyre always the same. Ive heard directly from people on the path to recovery, but thw tricities who treat me how getting treatment changed their lives for the better. Mr. President , i could imagine any senator will want to go home, look in their constituents i can tell them they have to pass a bill that would take away virtual communities need to fight the crisis. That is what my republican colleagues are fighting to do as we speak. E lets remember all of this damage would be done. Why . Lt to give a massive tax break to special interest in the Health Industry and President Trump a hollow political win. Mr. President , it is truly shameful and it needs to stop. Last week we were president te trump is now saying the bill is, and i quote him, mean. That is certainly an understatement from a president and its pretty surprising after we all celebrate the house bill at the white house when it passed. Heres the truth. The house trauma care bill isnt just mean. It will be just as bad no matter how they spin it or how many side deals they cut to claim its change. Mr. President , a message for Senate Republicans who are so ashamed of whats in the bill because they are keeping it secret. It is not too late to changepro course. It is not too late to bring this process out from the shadow. It is not too late to be honest of people across the country about what you are doing. It is not too late to listen to the voices of people like leen said. Its not too late to abandon this Plan Committee jim trump care through congress. If you do that, if he stopped, democrats stand ready as we always have two work with you to actually make health care morepa affordable and acceptable for patients and families across tht country. Mr. President , people across the country are watching. They are paying attention to this. They are not going to let republicans to slip this through without any scrutiny and we democrats are here to say loud and clear we are going to keep fighting to make sure they have a voice. Thank you, mr. President. I yield the floor. Nthal t mr. President. , senator from texas. S thank you, mr. President. Im proud to join my colleagues tonight because this nation stands at a precedent on the verge of a tragic mistake, about to embark on a travesty that mocks the democratic process. Truly, the combination of secrecy and speed are a toxic recipe in our democracy. Secrecy will bring us recklessly over the edge of that precipice to a tragic mistake that the lie and betray the people of america and in the values we all share because they are basic to the american way of life and health care is a right. It should be recognized as a right. The goal of extensive and comprehensive Insurance Coverage has to be ultimately a goal that we share in common. Right now, we are secretly towards a betrayal of American Value and even of our constitutional duty. I am deeply disappointed that reck colleagues has brought us recklessly and reprehensibly tof the verge of cutting the Affordable Care act. The absence of hearing before the committee, the absence of public debate, the absence of any of the bill that can be debated and offered for Public Comment leads us without a democratic bedrock of listening to the people of america and the people who know the most, the expert in the patients. In fact, it is the patients you deserve to be heard here, perhaps most of all and yet my colleagues on the other side of the aisle to suppress theleged cruelty that lies within their alleged Health Care Bill. President trump has called it an understatement. It is cool beyond words and costly in dollars and cents because it will be no more sin. The Health Care Issues that canm be prevented and made curable. Lets be clear, the secrecy making decisions about the entire Health Care System with medica beneficiaries, from people with Substance Use disorders from patients struggling with Mental Health illness, within a disease at all is irresponsible and cosl devastating, truly cruel and costly to our democracy. The way these discussions have been done are staying on this body to every american that relies on us to make decisions that are in the best interest of their family as well as themselves. My colleagues seemingly would be for two grand and russia deeply flawed and unpopular bill through this body, ignoring the will of the people they represent. That is a sad day in this chamber. Not for their own sake, not fort our sake, but for the individual recovering from Substance Abuse disorder, and medicaid, for the mother of a little growth a preexisting condition terrified of how she will pay for her care and they will do so now because of the Affordable Care act. The woman who is at a planned parenthood clinic today receiving mammograms and other cancer screenings and other Preventive Health care testingid because of the coverage provided to them by medicaid and the Affordable Care act. The funding planned parenthood, risking against preexisting ar conditions, eliminating the guarantee of essential Health Benefits like Maternity Care isr a war on Womens Health care and a disservice to our democracy done in secrecy. My colleagues across the aisle may succeed in getting our nations help your system, but the people who pay the highest price will be ordinaryir americans, working men and women and their families who now have Health Care Coverage to prevent moores eeriest elements and who will now go without it. Secrecy is the reason i convene an emergency field hearings on health care today in connecticut on very short notice, literally 24, 48 hours. People came from across connecticut at 9 00 a. M. On a monday morning. Putting together the logistic and the outpouring of anxiety and anger was remarkable. The eloquence and power of the insight offered by people about the situation as well as about others as they advocate. Then he decided to stay and stand even though the room afforded inadequate numbers was standing room only and they literally screamed out the door. The stories they told are worth it and we have an obligation to listen to these americans. I told them that i would personally bring their voices to the floor of the United States senate and in the coming daystho and people need to hear of a beautiful young woman whos now incapacitated because she suffered from an overdose after and the effects on others with covers for Addiction Treatment and abuse treatment eliminated. They need to hear these stories are what i will be recounting and the coming days as a share word for word their fears, anxiety and apprehension and their worry for america about what will happen if the Affordable Care act is repealed and guided. We must improve and make sure it is worthy of the great goalie share, but not destroy it and building on it, coming together is what we owe the American People. This came today to the State Capitol in hartford at my Emergency Health care hearing, recognized if they fail to stand up for planned parenthood or Mental Health for people with preexisting conditions or medicaid or their loved ones battling a dreadful disease. I am so proud of them and the people of connecticut who have spoken out in the dark for the Affordable Care act and im proud to bring their voices here to the united state senate, literally bring their voices here as i will do over coming days. I read into the record and put in the record and as i hold a second hearing later this week because we couldnt hear from everyone who came to speak out and stand up. I hope to my republican, colleagues school stops their denial, ignoring andme to disregarding those voices and recognize they cannot conceal the fact the Affordable Care has helped our nation, gutting it without any Republican Debate il reprehensible. It is a move they will regret. I stand ready to build on the great started made by the Affordable Care act and i hope my colleagues are ready to do the same. But if this chamber proceed down this reckless and reprehensible path of secrecy and speed, towards repeal and getting the Affordable Care act, i promise to do everything in my power and use every tool at our disposal to stop this process. We cannot go about normal senate while so many back in our state demand that we fight and we must fight. I would stand with hundreds of thousands in connecticut who will lose their insurance. Cticua i will stand with more than 20,000 people in connecticut and a million around the country who will lose jobs according to a study recently done at the commonwealth fund, and not as bully to resolve at some point. And i will stand with the people of america and my colleagues who will resist, indeed resist theve secrecy and speed that so deserves the value and trade. Thank you, mr. President. I yield the floor. Over the last several months, theres been an important debate about health care. A debate between those who believe we can strengthen the American Health care system by approving the Affordable Health care act and those who believe that the law must be repealed and replaced. If you listen closely however, the heart of both sides of this debate found oddly the same. The afford. Its the shared concern about the affordability of quality of health care in the recent action of the Trump Administration that