Mr. President, I rise to speak briefly about the American Health Care Act that was passed last week in the House of Representatives. I thought a lot about this bill over the past few days and over the weekend. I talked to friends, I read…
Mr. President, I rise to speak briefly about the American Health Care Act that was passed last week in the House of Representatives. I thought a lot about this bill over the past few days and over the weekend. I talked to friends, I read about it, and I did as much analysis as I possibly could, given the fact that we don't have a Congressional Budget Office analysis of this complicated and important piece of legislation. I have concluded that it is the most ill-conceived, damaging, and downright cruel piece of legislation that I have ever seen a legislative body pass in my adult life.
It drastically cuts support for Americans' ability to obtain health insurance. In Maine--again, as near as we can tell, because we don't have the final analysis--the preliminary numbers are this. Maine, under the Affordable Care Act, through the payments to individuals and other support, is receiving about $354 million a year coming via the Affordable Care Act. After this bill, it appears that the number is $80 million a year--$364 million to $80 million. That is almost an 80- percent cut. No one can tell me the people of Maine are going to have better healthcare with an 80-percent cut in the funds going to support their ability to do so. It just doesn't make sense.
The way this bill works is, it is a tax on the elderly. Under the Affordable Care Act, there is a rule that policies for older people, 50, 55, 60, cannot exceed three times the rate of policies for younger people. We all know that younger people's policies do in fact cost somewhat less because they tend to be healthier, but the rule was no more than 3 to 1. Under the bill that was passed by the House last week, it is now 5 to 1. That is an elder tax, and Maine happens to be the most elder State in the United States. If they had taken a blank sheet of paper and said: We want to write a bill to harm the people of Maine, it would have been this bill.
There also is a massive cut to Medicaid--$880 billion--and the sponsors to this bill claim that they are helping the deficit. How are they doing it? By
shifting the cost to the States--shift and shaft. Balancing the Federal budget by simply taking costs that are now borne by the Federal Government and passing them off to the States is not responsible fiscal policy.
Why don't we just have the States fund the U.S. Air Force? That would save us billions of dollars a year--probably $100 billion a year. Shift that to the States--and $880 billion shifted to the States.
Then there is what I call the figleaf--the preexisting condition provision which talks about the Maine plan, which was a plan that preceded the Affordable Care Act, which did give protection for preexisting conditions, but it was adequately funded. It cost about $64 million a year to fund our preexisting plan. Again, because we don't have the precise figures--but it looks like under this new bill, that $64 million would be $20 million, one-third as much, a two-thirds reduction. It is not a real preexisting condition plan; it is a figleaf. It is to say to people: We are covering preexisting conditions--nonsense, not true.
Of course, the final piece of this bill is a massive tax cut for the top one-tenth of 1 percent of people in this country. They will not even notice it, but the people who lose their healthcare will notice.
Now, under the Affordable Care Act, there is a list of essential benefits which includes mental health and substance abuse. That is a big deal. That allows and assures people to have coverage for these very damaging and dangerous, in the case of substance abuse, conditions. Under this bill that passed in the House, States can waive those provisions and the waiver is very easy. The standards for the waiver are very easy, and if the Federal department doesn't respond in 60 days, the waiver is automatically provided. In those States when they have a waiver, mental health and substance abuse services could be covered under a specialized plan which would be very expensive. By the way, this waiver covers both the individual market and employer-based coverage. How many people will be impacted? We do not know because we do not have an analysis from the Congressional Budget Office.
I want to talk for the remainder of my time about opioids and what this bill would do on that.
We are in the midst of a crisis in Maine and across the country. It is the most serious public health crisis in my adult life. In Maine, with regard to substance abuse and overdose deaths, you can see what has happened in the last 5 years. More than one person a day is dying of an overdose. Across the country, it is four an hour. We have turned ourselves inside out in this country in order to deal with the threat of terrorism, for example, which was entirely appropriate. Yet what if we had a terrorist attack that was killing 37,000 people a year across our country, and we were just sort of going along, business as usual?
I have been working on this issue since I got to the Senate. I have been meeting with people throughout Maine--in hospitals and in recovery--and meeting with families and parents and law enforcement. The one thing that comes through loud and clear is that treatment works and that we need it and that we do not have enough available beds in Maine and across the country.
This is a terrible disease, but the most tragic thing of all is when someone finally reaches the point at which he is ready to ask for help and he is told ``Sorry, there is a 3-week wait'' or ``There is a 3- month wait.'' That is when lives are lost and families are destroyed.
Treatment does work. I have met with people for whom it has worked and changed their lives. I have a friend in Portland named Andrew Kiezulas, who I believe is graduating this weekend from the University of Southern Maine. He has been through this. He has been to the bottom, and he is now on the mountaintop. He knows treatment works, and it has made a difference in his life. Without it, he would not be where he is today. Justin Reid, another young man from Southern Maine, was in the throes of addiction and escaped. He now runs a sober house and volunteers for a program with his local police department.
Access to treatment is much easier with health insurance and with sufficient Medicaid support. The House bill simply makes it more difficult to access treatment. It penalizes the very people who have taken the hard step to say that this is what they need.
Let me tell you a story. Matt Braun is from Cape Elizabeth, ME, right outside of Portland. In 2009 Matt entered treatment for opioid addiction. His parents, who were strong, middle-class, professional people, purchased what they thought was good health insurance for their family. After 5 days of treatment, they received a call that the insurer was not going to pay for any more. We have decided your son only needs 5 days. His parents argued, and the medical staff argued. They finally won. They got 7 days of treatment. Those extra 2 days made a difference.
The insurance company said that it was not going to help, that he was going to be a chronically relapsing, drug-addicted person, so they were going to stop at 7 days. They said he would not make it. His parents did not give up.
Matt stayed in treatment and has been sober ever since 2009. He is successful. He is getting ready to take the MCAT. He wants to go to medical school. His goal is to approach addiction from the perspective of a health professional and offer care and support to people who are struggling in the way he did.
``It is frustrating how insurance companies dictate what treatment looks like and what a life is worth,'' said Matt.
Getting treatment for substance abuse disorder is not easy, but this bill, the American Health Care Act, which is a misnamed bill--it should be the American Take Away Health Care Act--only makes it worse.
On top of all of this, the administration has recently indicated that it is talking about essentially dismantling the Office of National Drug Control Policy--the highest level to be working on this problem in a coordinated way in the Federal Government. Here we are, in the midst of the most serious drug crisis in the history of this country, and the administration is talking about gutting the very office that is supposed to lead the fight. It would have been as if, in the middle of World War II, we had abolished the Department of Defense. It makes no sense. It is moving in absolutely the wrong direction.
By supporting this healthcare bill--or non-healthcare bill--in the House of Representatives, which will drastically cut Medicaid, drastically cut reimbursements for health insurance, drastically limit the availability of coverage for preexisting conditions--by the way, drug addiction could be one--and drastically eliminate the essential benefits provisions of the Affordable Care Act, we are just making it worse.
The Office of National Drug Control Policy has things like the Drug- Free Community Support Program, which administers small grants to small towns. That can make a real difference. Last fall, 18 Maine programs each received $125,000, and the DFC's 2014 national evaluation report said that there was a significant decrease in the 30-day use of prescription drugs for youth in communities with one of these programs.
Prevention is one of the things we need to work on, and it is one of the things we need to understand. Yet talking about this problem is not going to solve it. Treatment is going to solve it. Money for treatment is going to solve it. Beds for treatment are going to solve it. Detox centers are going to solve it. More resources to law enforcement are going to solve it. More resources to the Coast Guard, in order to interdict drug shipments coming into this country, are going to solve it.
There is no single answer, but at the core is commitment. Passing this bill from the House, which drastically undermines all of those elements of treatment and prevention, and then talking about dismantling the office that has led this fight in the entire Federal Government, is beyond comprehension in the midst of where we are.
If this graph were doing this, if it were going down, I would be OK with it. But it is not going down; it is going up. It is getting worse, and we have to deal with it.
As we work through this issue of healthcare--hopefully we are going to start with a blank sheet of paper over here--I hope we will bear in mind that one of the most serious health problems in the country today is opioid
abuse. This is not all about ideology, and it is not about policy. It is about people. It is about Matt, and it is about Andrew. It is about the thousands and millions of people across this country who are struggling, who want to lead productive lives, and who want to contribute to their communities. All they need is to have that moment when treatment is available, when a helping hand is available, when caring is available to help them escape the throes of this terrible disease and rejoin their communities and their families. That is what we have to keep in front of us as we work here in this body. We can make a difference in people's lives, but in leaving them behind, we will certainly not do so.
I yield the floor.
I suggest the absence of a quorum.