This amendment could take away the bill for the rest of the way. Mr. President , i yield the flol floor. We are working on a version of the healthcare bill theyve been talking about today and i know my colleagues are going to try to say they are projecting and want to ensure people with preexisting conditions so they dont have to pay through the nose, but i think the president called the house version of this attempt a very mean therell, and i think the original senate bill was just as mean if not meaner and a number of people that were cut off of medicaid over the period of time to be left without access to care. Todays bill also includes an amendment or a package of ideasi by my colleagues from texas and utah, a provision that allows intruders to sell junk insurance to the markets as long as they offer at least one plan that is real insurance and they could also offer if bunch of plans that are not really insurance. , that is they could cover just one or two things into yes they would be cheaper but if they dont consider them insurance, how are they insurance . The whole notion being invested into this bill is very problematic. Under junk Insurance Plans you can limit or deny coverage of benefits including hospitalization, preventive care, Prescription Drugs, a laboratory care, Substance Abuse treatment. So, that is what you could lim limit. Sim these plans could charge people more worthy knight and based on preexisting conditions and also offer policies that pay out less than 60 of healthcare expenses leaving the beneficiary within unbelievable and unsurmountable deductible that would make it hard for them to pay a. Its such a regional entity in the state of washington andbout seattle. They told me about the debilitating disease this child was born with and how many surgeries she had had. Literally the brain treatments she has had to receive she told me and her mother told me if there have ever been any kind of a lifetime cap, we would have exhausted them in the first few years. Im so proud she came to see us today and is continuing to talkw about why not counting the plans would be devastating to somebody like her and we dont want to create the markets of insurance. We dont want one that is the real plan of insurance and the one where everybody here goes and buys insurance that they say is not real insurance and i think probably the last couple of days people said we will put a bunch of money and to help the market. I think ive talked to my insurance commissioner from the state of washington and he says when you dont spread out risk youre not going to have a market and or going to create problems. So the notion that you think catastrophic outofpocket cost borne by the individual patients i think is wrong or that the higher premiums and deductibles could be covered. So they dont even count as insurance and everybody that iso in the realtors market would end up having to pay more. So the bill explicitly states that noncompliant plans will not count as credible coverage for the purpose of individuals demonstrating that they have insurance. So if you see that marketed and you buy into it because you think it is cheap and this is the greatest thing ever, then you try to enroll in the comprehensive plan, there is a good chance you will get a lot out of period of six months before you can get coverage. Now, why am i here talking about this . Because the state of washington tried this. We tried this approach in the 1990s after the state had passed a major healthcare reform bill in the 1990s and then a group of state legislatorslo allowed these plans to be sold along with Compliance Plans. Guess what happened . All of the insurers in the state pulled out of the individual Insurance Market and it debts spiraled and ensued because the cost of that individual markets was so high and so great they could service it so they said if i have to offer a complianceo plan along with this insurance, i cant make it work because it costs so much we are not staying. So, this important experience sp taught us that isnt a way to h spread risk and i am concerned he might heard from a number ofi advocacy groups not just a young woman from the Childrens Hospital who came to see me today, but Patient Advocacy groups, consumer groups and Health Insurers themselves like the American HealthInsurance Organization blue cross blue a shield, aarp, the americante cancer society, american actioni network, American Diabetes association, american heart and lung association, Cystic Fibrosis foundation, march of dimes, national ms society, National Health council, National Coalition for women with heart disease. All of these individuals do not like this idea of junk insurance, of saying you can have a Compliance Plan and a marketplace where there are things that are not really insurance because then people will buy a bunch of things that are not really insurance ann have the ability to get caught up in care and runoff uncompensated care and then youre going to make the markett unsustainable and unsupported and the rates will go so high people are just going to pull out. A group with ten of the leading advocacy groups also wrote about this when it was proposed as an amendment people were saying under the amendment, Insurance Companies would be allowed to charge higher premiums to people based on their Health Status in addition to opting out of the protections in the koran small such as a guarantee of the Health Benefits of those things i was going over a few minutes ago. And that would mean an annual or Lifetime Coverage cap. So they go on to say that separating from the preexisting conditions would also lead to severe instability of Insurance Markets, and this is unacceptable. Yesterday the American Healthh r Insurance Plans were, quote, allowing Health Insurance products governed by the sizes and standards to further destabilize the individual market and increase cost for those with preexisting largest conditions. So, that is the largest Health Insurance group in the country and they are saying this. So, if they are telling us in advance this is going to really destabilize the market and cause problems, we should listen because right now, what we have had is an expansion of medicaid and covering more people,nd raising the gdp and helping areas of the states and countries creating more stability. Weve had some challenges in the individual market we should back and drive down the cost of the Delivery System by continuing to improve it but the notion that this is a fake for the individual market when the providers are telling us it is going to. I believe the goal should be trying to drive down the cost. To get people supporting thel senate proposal. I have said numerous times we save 2 billion in the state of washington by three balancing people off of nursing home careo and onto communitybased care. Ot its a great concept. Look, we have a lot of people who are going to live longer. We have baby boomers reaching retirement. Ic the amount of people that will demand service is whethe servicn medicaid or medicare is going te be and increase because of the population bubble. Re we should be doing things to drive down the cost of care. There are great ideas. I got some of those in the bill and we ended up passing those things and some states are working on that. About ten to 15 states are actually working on the concept of rebalancing to the communitybased care and making longterm care more affordable. I guarantee we have to do that. But if you permanently cap the cut, youre going to have veterans that use access to medicaid to care. Youre going to get people who need opioid treatment. T. I find it interesting you know, weve had this program over c here. I see my colleague from michigan on the floor. D youd we call it the health clinic. He would say okay theres a bunch of money in this bill,il apply for Opioid Health and they say okay we are going to get 10 million. First thing when you walk in the door of the opioid clinic is going to say are you on medicaid or not and if youre not on medicaid, youre not going to g get any opioid help. So the notion that we would cut people off of medicaid but put more money in the opioid problem is not what we need to do to solve our challenge here. What we need to do is make sure that we are delivering the most costeffective care as possible, and make sure people are gettinf access to care and thats why ive been all over the state of washington and ive met so many people at Healthcare Facilities who told me some of their highest costs for patients that continually came to see them in the emergency room may be 300 times a year because they didn. Have coverage and they drove up the cost of everybody and then they said they finally got this person on the Medicaid Expansion and guess what, they dont have the costs anymore in their hospitals and facilities andan theyve driven down the cost. Se i dont want to see people get kicked off of medicaid or see it cut in a declining budget. I want it to improve medicaid and make it more Cost Effective and utilized to support. Estimates on this proposal are that the colleagues on the other side of the i o medicaid cuts would be 772 billion for medicaid over the next decade and the federal investment would be cut by 35 in the next twooj decades relative to the current production. So that is a lot of consequence for the medicaid population and i think thats why we have so many groups and organizations here anxious about this proposal and where we go. We definitely want to talk to our colleagues. As one former cbo director said, the junk insurance is a recipe for a meltdown. This is someone who served in the past republican administrations and i take theie word seriously. I think what we need to do his Work Together tisWork Together t we get a program that addresses our most fundamental issues, the challenges in the individual market, keep addressing how we keep and destabilize the population on the most affordable rates there are and keep the things that we know have worked very well like the Medicaid Expansion. It has worked and supportive people and help us stabilize the market. I will remind my colleagues they state of new york took one position of the buildinprovisiod 650,000 people in new york on a very affordable Insurance Plan and we think those are the kind of things if you are andi individual in the market you should be able to get the same as somebody that works for a large employer. You should be able to go in and buy in bulk as a group of people and you should get a discount. Thats what we think will help us in the individual market to drive down these costs for what has been 7 of the market place. I urge my colleagues to reject this latest proposal and lets get serious about fixing the things that we know we can fix and improve upon but lets keep for the american people, for the over 22 million americans who are very nervous about this proposal because they know they are going to get cut off of care lets not do that to them. But to improve where we need to go in the healthcare arena and not think that a junk Insurance Program or cutting people off is the solution for the future. I think the president and yield the floor. First i want to thank my friend from Washington State who has been such a leader on health care and looking at the chart. It reminds me of the cause i used to get in the Affordable Care act to. They called me up and said i paid into intranasal fees here is and covered one day in the hospital. Hospital. Either never having that conversation with somebody, or nobodies in the hospital. Thats what you call a junk Insurance Plan and the idea that ca this latest version of the bill would allow that to come back so that somebody has the false confidence that if they pay 30, 40, 50 a month and think they have veterans and then somethins happens that will be legal aga again. That would be legal again under this proposal, and i am deeply concerned about that. Im obviously rising to talk about the Republican Health care bill. I dont believe it is a health care bill. But that is what we are debating is whether it will be taken away. But i would rather be doing is working with my friend. We worked on many things together so i would rather be doing that than debating what we are debating. I would rather be focused on how we lower the cost of Prescription Drugs which is the cost i hear about the most from my constituents or other outofpocket costs because we do have situations where they are too high in the Insurance Market and medicaid will do nothing about that. Im anxious to do that and i want to ensure and make sure we are talking about building on healthcare coverage, wearing cost, capping Prescription Drugs costs but instead it will take away we know that from the nonpartisan congressional budget office. We dont know yet how many under the current version but we knowt at some point we will get a score on that in the budgetir i office and they dont need to do that too tackled on the cost of pani she was panicked and affair with the help of medicaid Health Insurance and others who are deeply concerned about their car family members. This is called a better care act, but theres Nothing Better about it. Democrats have ideas to actually make the Health Care System more better by making premiums more f affordable. Senator shaheen of hampshire introduced the marketplace certainty act and costsharing payments that were part of Health Reform that they would remain in a stabilizing way that they could be counted on. This would offer peace of mind to families and stability to the an markets. The introduced the individualpl health Insurance Marketplacewou improvement act which would create a permanent Insurance Program that we had before it was changed two years ago to bring down premiums for. They might be able to come in and fix that in a way that is more beneficial to families and the Healthcare Options for all act would allow people who live in a county without an injured are on the extreme should they dont have anybody in this private individual marketplace e exchange, no insurance company, so they could sign up for the same Exchange Plans that we have. There are people being covered,o we hear a lot about people in iowa for instance even though there may be no private Insurance Companies doing the private marketplace option to. To address this issue in the don short run. Nd they know how unpopular the bily is and a new poll found that only 12 of americans support this bill. Its so unpopular theyve been trying to get enough votes to ca pass it they keep hearing about the changes that unfortunately none of these amendments make it better. I mean, its not enough, he said. I appreciate the focus on that. It is a horrible epidemic in michigan and across the country, but certainly is not enough to make up for the huge cuts to the medicaid insurance of healthca healthcare. As the senator indicated. The other proposal now that we understand is in the new bill as i mentioned before will give insurance to freedom to once again refuse to cover basic Health Services like Maternity Care or Addiction Treatment as long as one plan that they offer among many would include services and essential healthcot benefits and there would be onec highcost plan that would actually cover things thatthis families need. In the association they wrote that their plan is unworkable as it would undermine preexistings protections, increase premiums and destabilize the market. That is what is viewed as this great new provision in the bill. He added the result would be higher premiums and increased federal tax credit costs for coverage available on exchangess and insurers exiting the market or pricing coverage out of the reach of consumers. In other words, premiums wouldpe skyrocket. People who take Prescription Drug medications, people with chronic conditions. Everyone else would the afford the junk insurance policy that didnt really cover anything and they feel okay unless they got sick and we are stuck with a fragmented destabilized Insurance Market. Remember preexisting conditions, this would bring them right back. This bill is wrong for many people but let me mention alicia. In 2011 she was an americorps member serving in lansing who didnt have Health Insurance. When she started feeling tired all the time and losing weight, she went to the center forh Family Health in jackson. Diagnosed with stage fou hodgkins lymphoma. The center for Family Health helped her get coverage through medicaid and care at the university