Quorum call mr. Casey mr. Pres mr. Carper mr. President , i ask unanimous consent that i speak as if in morning business. The presiding officer without objection. Mr. Casey the republican bill, and im referring to the House Republican bill that the senate now is considering in addition to other ideas is in my judgment not really a tax not really a Health Care Bill but a tax cut bill. Its a tax cut bill for the super rich, not only the rich but the wealthiest, literally the wealthiest few americans while increasing costs for middleclass families. It gives states the options forker for allowing you states to discriminate again like they did before the a. C. A. Was passed. And also would allow those same policies to devastate our hospitals, particularly those in rural communities. I live in a state where 48 out of 67 counties are in fact rural counties. The republican bill would rip away health care according to the Congressional Budget Office, would rip away health care from 23 million americans. Heres what that means in pennsylvania based upon the Congressional Budget Office numbers. Up to 770,000 pennsylvanians would Lose Health Insurance by 2026, if the bill were to pass. 48,000 pennsylvania seniors on medicare could lose access to Services Covered by medicaid. Third, 52,600 pennsylvanians with disabilities could lose medicaid coverage. I live in a state where according to the center on budget and policy priorities, over 722,000 pennsylvanians with disabilities rely on medical assistance for their medical care. Medical assistance is the state version of medicaid. So we know that if you are a he a child, far he a senior, or you have a disability, Many Americans in those categories of course rely upon medicaid. We also know based upon the c. B. O. Numbers that 180,000 pennsylvanians could lose being a test to Substance Abuse care now provided by medicaid. Weve heard a lot of talk and a lot of work actually in this chamber, in this body as well as the other body, in the last year on the opioid problem. We have democrats and republicans focusing on a Major National problem, an Urgent Public Health problem, and weve made some progress. Not enough but some Good Progress on opioid legislation. All of that would be badly, badly undermined, if we made the changes to medicaid that some want to make here, because of the Significant Impact that cuts to medicaid would have on the challenge of reducing the opioid crisis. So even the possibility that this bill might become law is, in a sense, destabilizing and destabilizing to a marketplace, a health care marketplace, thats been better each year we move forward from the passage of the a. C. A. In 2010. Just last week the Pennsylvania Insurance Department a nnounce nnounced announced average proposed rate increases for Health Insurance premiums for 2018. Heres what the heres what the Pennsylvania Insurance Department told us. If we maintain current law, premiums will go up 8. 8 in pennsylvania under current law. If the republicans get rid of the costsharing subsidies which many seem to either want to get rid of or want to ignore, will be creating uncertainty, if those costsharing subsidies are thrown out the window, premiums will go up two and a half times as much by over 20 . So so far 8. 8 under current law, 20 just based upon the costsharing costsharing subsidies being taken away. Third, if the individual mandate is repealed, premiums will go up almost three times as much, by 234 . By 23 . And if you get rid of both the costsharing subsidies and the individual mandate, guess what . Pennsylvanians premiums in our state will go up by over 36 . So we got a basic choice to make, at least as it relates to pennsylvania. Current law, its 8. 8 . We should try to bring that document i think there are ways we could Work Together in a bipartisan fashion to bring that document but if you go in the direction many want to go, especially on the republican side, undermine or do nothing about costsharing, get rid of the individual mandate, premiums go up 36 . So folks can make their choice go up about 9 or go up 36 . It is a real simple choice, and theres basically two options. The bill that was passed in the house will destroy the lives of many vulnerable pennsylvanians. P what should we do about it . Work the first thing we should do with the bill is throw it in the trash heap. Thats where it belongs. And i hope thats where Senate Republicans are headed and that theyre going to start over on a new bill, because the bill that was passed in the house is very bad for the country. We know that among the three million pennsylvanians with preexisting conditions are two remarkable young women whose mother first contacted me in 2009. Stacey ritter, from mannheim, pennsylvania is a mother of three children, including her twin children. Hana and madeleine were dig knowed with leukemia when they were just four years old. You can see their picture there at that time. I guess about eight years ago now. Stacey and her husband went bankrupt did went bankrupt, trying to pay their daughters medical bills. She wrote at the time, without health care reform, quote, my first of all will be unable to afford care. That is if they are eligible for care that is critically necessary to maintain this chronic condition. Now, fortunately, things have changed in the last eight or so years. Fortunately hana and madeleine are healthy young women now, freshmen at Arcadia University and are doing well. They rely on the Affordable Care acts protections to ensure that they have access to affordable coverage, whether they are on their parents planning or purchasing a plan in the individuals market. As you can see on my left, a picture of hana and madeline today, as college freshmen. Without the Affordable Care act, they could be denied Health Insurance, as their mom said, they could be, quote, punished and reject because they had the misfortune of developing cancer as a child. Unquote. The republican bill passed in the house would put them at risk of being denied Health Insurance or charged more because they are cancer survivors. I dont know why anyone would support a bill that would do that. Just a number of months ago, i received a letter from pam simpson, from chester county, pennsylvania. Pam and her son roane, have their story to tell. Rowan is five years old and was diagnosed with autism. I talked about him before on this floor and in other places and what the Medicaid Program means for rowean and his family. Medicaid provides Important Services for rowan and others with disabilities, enabling rowan to go to preschool and allowing his mother to work. Here is what his mom said to me. I wont read the wheel whole letter. The first page is, rowans life before he was diagnosed with autism, all the challenges he and his family had. Rowans life after diagnosis of autism but then ultimately when he received medicaid or medical assistance, as we call it in pennsylvania. Heres what his mom told me in the letter after he received word that he was going to be enrolled in medical assistance. Im quoting now, late january 20106616 i applied for 2016 i applied for medicaid, which is medical assistance. We were able to obtain wraparound services. She is services included a behavioral specialist consultant, and a therapeutic Staff Support worker. Then she goes on later in that paragraph to say that these two features in the overall wraparound services, these wraparound services, quote, have been a godsend, unquote. Then see says, im, quote, thrilled by rowans daily progress. I cannot say enough great things about this program. Without medical assistance, im confident that i could not work fulltime to support our family. Our family would be bankrupt or our son would go without the therapies he sincerely needs, unquote. Hereheres the last line of her letter. Quote, we are desperately in need of rowans medical assistance and would be devastated if we lost these benefits, unquote. Referencing medical assistance or medicaid, the same program at the state level. So you have two families now totally reliant on these programs, either the a. C. A. More broadly or in particular the Medicaid Program. Both families referencing bankruptcy bankruptcy because of Health Care Challenges in the life of that family. One that would be on the brink of bankruptcy, rowans family, and the other that actually went through bankruptcy because of those Health Care Challenges. No family in the United States of america should have to worry about going bankrupt because of a health care problem. Were well on our way to solving these problems and no one should pull the rug out from under those families. But, unfortunately, when it gets to this legislation, thats exactly what could happen to many of them. Ill give you a third example alex. Recently i met alex, who is from southeastern pennsylvania, nine years old. And he has downs syndrome. Heres what a nineyearold wrote. Although i have a medical diagnosis of downs syndrome, i am an excellent student. I got 100 on my spelling tests. My students and teachers and everyone around thought from the beginning there was nothing i could not do. I am able to get a good education because of the supports that i get from special education. Thats why i am very concerned about possible cuts to medicaid funding in our schools. Medicaid funding in schools is a very, very important part of what makes it possible for us to receive successful education at school and become contributing members of our society. End quote. Thats a 9yearold in pennsylvania reminding us about this important program. Alex has tremendous potential that would be in jeopardy by the proposed cuts to medicaid. Number four, peg fagan, a pennsylvania y the republican bill includes an age tax that will allow insurers to charge Older Americans up to five times more than younger americans. Peg is from bucks county, southeastern pennsylvania. Shes a threetime cancer survivor who could not afford Health Insurance prior to the Affordable Care act. She is approaching medicare eligibility but still has a few years to go before shes old enough to enroll. Peg was able to find affordable Health Insurance thanks to the a. C. A. But under the republican bill, she could once again be discriminated against for being an older adult, an older adult, and another possible object of discrimination would be because she is a cancer survivor. That was the old law. Thats where we were before, that Insurance Companies were allowed under the law to discriminate in that fashion. They could discriminate against you because you were a woman. They could discriminate against you because you had preexisting conditions. They could discriminate against you because you were a cancer survivor. They could discriminate against you because of your age and so many other circumstances. I thought we were beyond that. I thought we had finally cured that problem. But some want to go back in time. So the c. B. O. Tells us the republican bill would rip away health care from 23 million americans. I just went through some pennsylvania stories. Weve go to a lot more and youll be hearing them. But for hana and madelin and rowan and peg, we should ask ourselves a couple of basic questions. Health care for those pennsylvanians should not be made worse and they should not be made worse off in order to give the top. 1 a 200,000 giveaway. Thats what the first version oe Health Care Bill would do. It would give the top. 1 an average tax cut of 197,000. I exaggerated. I said 200,000. Lets be exact. 197,000 each. Why would we take away health care or even risk or create uncertainty about health care for hannah and madeleine and rowan and alex and peg because some people around here want to give tax cuts to the tune of hundreds of billions of dollars to very wealthy people. Thats not what i call a Health Care Bill. So the senate has an obligation, in my judgment, both parties, to stop this bill from it being enacted into law. We cannot allow this legislation to pass or anything like it to become law. So i ask each member of the senate to consider these pennsylvanians and plenty in your home states and the countless more like them who are anxiously hoping and praying that this congress will not vote to take away their health care. Mr. President , i would ask consent to continue my remarks but also to ask consent that the following remarks would be placed in a separate portion of the record. The presiding officer without objection. Mr. Casey thank you, mr. President. I want to rise as well today to express my support for the drug and other treatment courts, including veteran treatment courts in pennsylvania and the more than 3,000 across the nation. Just last month during National Drug court month, drug courts across the country held graduation ceremonies to recognize individuals who completed this rigorous treatment program. These courts would serve about 150,000 people a year, hold offenders with Substance Abuse and Mental Health disorders accountable for their actions through strict supervision while also connecting them to the treatment they need. More than 1. 25 Million People have successfully graduated from drug and treatment courts those programs, i should say, and are now on a path to recovery. Research has demonstrated that drug and other treatment courts not only reduce crime but also reduce spending by slowing the cycle of recidivism. Drug and other treatment courts also are an important resource for Law Enforcement and Community Stakeholders working to combat the opioid epidemic. Opioid addiction is a growing Public Health crisis in pennsylvania and throughout the nation, and it demands real action. As public officials, we had an obligation to ensure that the resources and policies are in place to fight this scourge so that more families wont have to endure the heartache that comes with losing a loved one to addiction. Veteran treatment courts are innovative and collaborative programs to address some of the unique challenges that face our veterans community. There are approximately 22 million veterans in the United States. Pennsylvanias home to nearly a million. The majority of veterans return to our communities as leaders and lead exemplary lives. However, not every veterans path is straightforward. That is why we need to make sure the right programs and support are in place. According to the department of justice in 20112012, approximately 8 of the total incarcerated population of the u. S. Were, in fact, veterans. These veterans found themselves serving time in correctional facilities because they had not received the treatment that they needed. While this represents a small, very small percentage of veterans, its important that we support programs like veterans treatment courts. For veterans who face significant obstacles returning to civilian life, including Mental Health concerns, posttraumatic stress disorder or Substance Abuse issues. These treatment courts can have lifelong impact on a veteran by helping them get out of the criminal Justice System and get the necessary treatment that they have earned. Its our obligation to work every day to ensure veterans are receiving the care and support they deserve. There are many stories from across a state like pennsylvania and across our country that exemplify why these veteran treatment courts are critical. Just give you one. Shortly after Michael Collette i from colletti from mog county received a discharge from the coast guard, he found himself in the grips of a serious addiction to opioids. To support his habit, michael started stealing from his employer, resulting in his arrest and jail time. His crimes were caused by his opioid use disorder, and michael found himself in the Montgomery County veterans treatment court. Finally, given the accountability he needed and connected with the benefits he earned as a veteran, michael began the process of leaving behind his life of addiction and crime to start a new path. Today Michael Colletti is a partner in a successful Small Business and a mentor to others in his community struggling with their own Substance Use in that community. He says of the veterans treatment court, quote, i wouldnt be here without the support network from the court. I wouldnt have my girlfriend. I wouldnt have my beautiful place. I wouldnt have my career. And most importantly, i wouldnt have the sound clarity of mind to be myself again. Now i am committed to paying it forward, unquote. I and i know many others are proud to support a recent letter led by our colleagues senator klobuchar and senator wicker highlighting the importance of funding the Drug Court Discretionary Grant program and veterans treatment courts. As we go through the appropriations process, i urge my c