Of americans who have been let dow down, not to mention deceived by the promises of obamacare, and its absolutely critical that we fulfill our commitments. This is not just about moving past the failures of obamacare but also laying the groundwork for providing americans access to better care. Weve said all along that we have four principles. One is to help stabilize the Insurance Market so People Living in iowa, for example, would make sure they have a place they can buy Health Insurance. Its about getting premiums lower, by eliminating mandates and making it possible for people to choose alternatives that happen to suit their needs at a price they can afford. Third, we said we are going to continue to do everything in our power to protect people with preexisting conditions so they are not afraid about changing jobs and being excluded from the new employers Insurance Coverage because of something that was we protect people against the preexisting conditions exclusion. Ke fourth, what we said we want to do is we want to take medicaid, and essential safety net Healthcare Program to make a sure we put it on a sustainable path. I know there are some in washington d. C. Who think we can continue to spend borrowed money endlessly. We cant. It really jeopardizes the very viability of some of our most essential safety net programs like Social Security, medicare, and medicaid in this instance. What we have done, what we intend to do, working with our colleagues in the house is to put medicaid on a sustainable path while we grow the expenditures to medicare each year and over a tenyear period by 71 billion. Tting those who say we are somehow getting medicaid or we are cutting medicaid, i think simply we have to deal with those facts and i havent heard a satisfactory can explanation for how you can conclude that somehow we are getting medicaid or cutting itie when we are actually making it sustainable in the long run. Throughout this process, what i have learned is that senators have a lot of different ideas, and everybody has come to the table to try to help make this better. Proces i would say unfortunately our democratic colleagues have chosen not to participate in the process. This would be a lot easier in the product we come up with would be a lot more durable over the long haul if democrats would work with us. The fact is, in this amendment process that we are engaged in the will be engaged in this evening, any senator, democrat or republican, majorityment Minority Party member can offer an amendment and get about. I dont really understand why our democratic colleagues are sitting on their hands and wont participate in the process. I fear what they want is to change nothing about the structure of obamacare, notwithstanding the failed experiment of the past seven years, and then what they want to do is come back and throw money at the Insurance Companies under these cost sharing risk pools. What we we are willing to do what we need to do to stabilize the Insurance Market, but im not going to vote for an Insurance Company bailout without reforms. Uents leader mcconnell reiterated yesterday that our constituents are counting on us, and i can tell you the 28 million texans that i have the privilege of representing are counting on me and senator cruz to do our part to come up with a solution. So is the texan whose premiums have tripled and lost as doctor counting on us. The er employee who witnessed the emergency room busting at the seams with medicaid patients, people who ostensibly have coverage but cant find a doctor who will accept the new medicaid patient so they go to the emergency room. So is the Small Business owner that was forced to fire employees to avoid a 100,000 fine. That person is counting on us too. As is the young woman coming out Nursing School who is forced to change her plan three times, only to end up with a plan with Coverage Options she didnt want at a price she could barely afford. She is counting on us too. My constituents in texas and americans across the country are counting on us. D they are sick and tired of the bickering and the lack of productivity here in washington d. C. , and i dont blame them one bit. They are counting on us to free them from some of obama cares mandates that force them to make very tough economic decisions. Like the 28 Million People under obamacare who either pay a fine, about six and half million or the rest who claim hardship exemptions so they dont have to buy insurance. But in texas alone, there are more than 400,000 texans who earn less than 25000. Year, who cant afford to buy the insurance so they pay the fine to the government. Their government fin finds them for not buying a product they cant afford. Now is the time to deliver some relief to our constituents. They are counting on us to keep the deeply personal choice of healthcare plans andr doctors in their plan hands and not the federal government. It is time to deliver. My goal is to make sure we find a solution and get it to the president s desk. One of the most offensive parts of the Affordable Care act, or we should call it the unAffordable Care act since premiums have gone up 205 since 2013. H people were told that familyly of four would see a reduction of 2500 a year have seen their premium go up by more than 3000 and there are a lot of stories, im sure even in this room and this chamber were people have seen their premiums go up, up and up along with their deductibles, basically denying them the benefit of their insurance, but the individual mandate is a prime example of government getting in the way of individual freedom and the right to choose. The socalled individual mandat mandate, we really should call this the penalty that government imposes on its citizens for failing to purchase a product they dont want and in some cases dont even need. But it forces them to do so at a cost that was crippling and continues to be crippling for many individuals and families. Here is a shocking statistic. An estimated 8 million americans pay the Fine Associated with this mandate each year. 8million americans ared penalized by their own government. Theyre forced to pay a fine that can be used on coverage that might actually suit their needs. If obamacare would make it possible that the market could prosper and Insurance Companies offer a variety of products at different prices that they could choose from, maybe some of these folks could take the money theyre paying their own government as a penalty and actually buy mandate. Then there is the employer mandate, this is one of the most pernicious of the w mandates because i remember sitting with a friend of mine who hope happens to own a small Architectural Firm back when obamacare past and i explained if you have more than 50 employees then you have to buy or provide obamacare compliant health care for your employees and he said well, i may have to lay some people off because we have 54 employees so i have to fire at least four of them to get below the 50 threshold to avoid the fine and the insurance that i cant afford to provide for my employees. Lil this has literally been a job killing employer mandate. This is not some benign requirement. This has been one of the reasons why the economy has been so anemic, even since the Great Recession of 2008 and this is why so many people feel like the economy has not really covere recovered because it hasnt provided Job Opportunities and larger wages. This mandate is stifled business growth, especially among Small Businesses that are the primary job engine of our economy, and often time jobs were cut to avoid encrypting the business through obamacare fines. So americans have been forced to their own government no less. Government is supposed to serve the people, not the other way around. Nd americans have been forced by their own government to live under mandates and taxes and broken promises and collapsing markets for too long. This week is about keeping our promises, demonstrating that we can govern, even without the assistance of our democratic colleagues, and paving the way to tackle other important issues like tax reform, infrastructure construction, things we need to do to keep the economy growing and moving forward. We will be hearing more about a possible solution and a way forward, something i call the freedom to choose plan where we free the American People from the destructive impact of the socalled individual mandate. Te we free small employers from f the employer mandate, letting them hire the employees they need and not having to choose between that bankruptcy. And yes, we will push more power out of washington d. C. Back to the states. I know based on the Public Opinion polling ive seen,r sta people sure trust their statear a lot more than they trust washington d. C. When it comes to healthcare. We need the insurance commissioners, but a viable market to provide to them. It would be better if we could all come together to find a solution and engage in debate and pass the final product and get it to the president s deatdesk. Thats how the legislature is supposed to function. Unfortunately we are in unusual times when almost half of the senate refuses to participate in actually, they will be actively trying to undermine our efforts to come to the rescue of the people who are hurting as a result of the deception and the failures of obamacare. I dont know how you explain that. You certainly cant explain it to constituents like i have, and i bet you a dollar every single one of the senators was trying to blow up this process and undermine the progress were making, i bet they have constituents back home who are suffering the same way my constituents are, but the turning a deaf ear to them and saying you know what, politics and party and ideology are p more important to me than addressing the needs of my constituents. Mr. Pres i yield the floor. The senator from louisiana. Thank you, mr. President. Mr. President , i wish i could stand here today and tell you that the Affordable Care act, socalled obamacare has worked. I wish i could sit here and tell you today that the American People were better off as a result of the Affordable Care act. , but i cant do that and it gives me no joy in having to make a statement. Now, as you know, not a single republican voted for the Affordable Care act. Affordable care act was passed in obamas suggestion by the democratic members of theey house and the senate. They had a majority and in this body majority rules. I dont want to subscribe to the president or to her democratic friends, any ill motives whatsoever. They wanted what was best for the American People. It wasnt a question of bad motives. It was just a bad idea. Didnt work. Let me say this another way, i believe that president obama and our colleagues on the democratic side of the aisle in the United States senate and in the United States housema of representatives passed obamacare with the best of intentions. But you know what, 150 years ago, mr. President , i know you also happen to be a physician, 150 years ago doctors used to b believe their patients andio they stopped doing that. Hey they didnt have any bad motives in doing it, they did it because they thought it would help the patients. Kille it killed many of them. So, they stop doing it. We were told when the Affordable Care act, socalled obamacare, i dont mean any disrespect and calling obamacare, president obamaers himself refers to it as obamacare, when the united c states congress, democrats and the United StatesCongress Passed obamacare, i remember well what we were told because i wanted to believe it. The president said, if you like your insurance plan, you can keep your insurance plan. I think he meant that at the time. Turned out not to be true. The president said if you like your doctor you can keep your i think thats what he wanted, but you couldnt. He said, the Affordable Care act would cover every american and cut the cost of a typical families premium by up to 2500. Year. Not not even close. He said, president obama said it would bend the cost curve for healthcare. He said without adding one dime to the deficit. None of that was true. I think h i think the president meant it at the time. I i think he wanted it at the time, i know i did, i know you did, but he just turned out not to be true. The simple fact of the matter is, i think every reasonable person that the Affordable Care act has not worked for the American People. Lets talk about the exchanges. As you know there are two parts. There are the exchanges for which people go and buy insurance directly from an Insurance Company, and theres the Medicaid Expansion. I want to talk about the exchanges for moment. In 2016, under obamacare, we started out with 281 Insurance Companies offering insurance to the American People. Good start. The problem is, now we have 141. They are dropping like flies. In my state in louisiana, we are down to three. Cou a third of all of the counties in america have only one choice. One Insurance Company that will still write insurance. Many have zero, none, not a. They cant get insurance at all. They been given a bus ticket n but theres no bus. In louisiana, let me talk about our state for a moment, in louisiana, premiums have gone up 123 on the exchanges since 2013. That is an average of 3600 increase. Plan. Nationwide, the average obamacare plan now cost 105 more than when it started. That is 3000. Person. Whats particularly incredible to me mr. President , you knowo these statistics better than i do, in louisiana, we have,000 136,000 people who, rather than buying insurance off the exchanges, have chosen to pay the fine. Let me say that again. 6,000 pe 186,000 people in my state have looked at the insurance offered to them with the subsidies and said we would rather pay the fine. Of that 136,000 who said i will pick the fine instead of the insurance, of that 136,000, 84 make 50000 or less. 48 of them hav make 20000 or less. You know what that tells me . That tells me 136,000 people in my state, most of whom are too poor to be sick, they looked at the Affordable Care act plan and said we can afford it. Wed rather pay the fine. We are better off paying the fine. Their outofpocket, the money for the fine, and they still have insurance. No reasonable person would call that a success. Mr. P let me give you a couple more examples. Er we talk around here in concepts, and we all know what were talking about, but the average american who gets up every day and goes to work and paces for her taxes and tries to do the right thing by their kids and tries to save some money for retirement, they dont have time to dealing concept. They just want to know what kind of Health Insurance do i have and whats it going to cost. Let me give you some examples right now from louisiana. This is brought to you by the Affordable Care act. Lets suppose im a 60yearold nonsmoking mail living in baton rouge louisiana. Im making 50000. Year mr. President. Dn according to healthcare. Gov, according to healthcare. Gov the cheapest and most basic plan available to me would cost me 689. 14. Month, with the 4500dollar for a total of 9000. Year. Im living in baton rouge, making 50000 and the federal government said we have a great deal for you. Past 9000 and we might be able to give you some healthcare for that 9000, what do i get . Suppose i say okay heres 9000. The note know where im gonna find it because im only making 50000 a year and the government is taking some of that for taxes, but i find 9000. You know what i get. I get for doctor visits i get to lab tests i get nine Prescription Drugs and additional metal cost for a grand total of 100. Thats not insurance. That is giving someone a bus ticket without a bus. Lets suppose im a 50yearold female. I dont smoke im living in lafayette louisiana which, as you know is to the west of baton rouge. Im making 50000 a year in lafayette. The most basic plan in lafayett lafayette, once again, im 50 years old im not 60, im a female and i dont smoke. The most basic plan i could get would cost me 450 a month in premiums with the 4800 deductible. Thats a grand total ofnto 6550. Ive got to come into my pocket for 6550 before i can get any kind of Health Insurance. Mr. President , thats not Health Insurance. I would remind you, you know this as a physician whos been on the front lines caring for people, and god bless you for that, you know as well as i do, the options i just described, there the cheap ones. Theyre the most affordable ones. Thats the best case scenario. Nobody wanted this. I know president obama didnt want to turn out this way. I know our friends on theor democratic side didnt. They wanted what was best for america. It wasnt a bad motive, it was just a bad idea. What do we need mr. President . Everybody has their own opinion of that and thats what we will try to convince each other over the next fewll days as we vote. De i think in the Healthcare Delivery system we dont need more government. I know some of my friends on the democratic side, they think they have the solutions, and i respect