Healthcare (Executive Session)
Mr. President, there is a possibility that by the end of next week, the Senate will have a vote again on a Republican healthcare bill assembled in the dark of night by one party, without a full account of what the bill would do. It will be…
Mr. President, there is a possibility that by the end of next week, the Senate will have a vote again on a Republican healthcare bill assembled in the dark of night by one party, without a full account of what the bill would do. It will be a shameful return to the same process the majority used to try to ram a bill through in July, unsuccessfully.
To consider a bill like this without a full CBO score is worse than negligent; it is grossly irresponsible. We were told yesterday that CBO may be able to provide a baseline estimate of the cost of the bill but not the coverage numbers or a detailed analysis of how the bill would affect Americans' healthcare choices.
We are talking about one-sixth of the economy; we are talking about the healthcare of the Nation; we are talking about the lives, day in and day out, of millions of Americans who need healthcare; and we are not going to really know what the legislation does.
Senators will be voting blind. They say justice is blind, but the Senators on the other side of the aisle should be walking around here with a blindfold over their eyes because they don't know what they are voting on. Maybe they don't care. I don't know how any Senator could go home to his or her constituents and explain why they voted for a major bill with major consequences to so many of their people without having specific answers about how it would impact their State.
What we do know is that this new TrumpCare bill, the Graham-Cassidy legislation, is worse in many ways than the previous versions of TrumpCare. The new TrumpCare would devastate our healthcare system in five specific ways.
First, it would cause millions to lose coverage.
Second, it would radically restructure and deeply cut Medicaid, ending the program as we know it. It has been the dream of the hard right to get rid of Medicaid, which could happen, even though it is a program that affects the poor and so many in the middle-class--nursing homes, opioid treatment, people who have kids with serious illnesses.
Third, it brings us back to the days when insurance companies could discriminate against people with preexisting conditions. The ban on discriminating against people with preexisting conditions would be gone. We have had a lot of promises from the other side that they would never vote for a bill that didn't protect people with preexisting conditions. That seems to be going by the wayside in a headlong rush to pass a bill so that they can claim a political victory. What about that mom or dad who finds out his or her son or daughter has cancer, and the insurance company says: Yes, we will cover you; it will cost you $50,000. And they don't have it, so they have to watch their child suffer. This was an advance that almost all Americans supported. It was an advance most people on the other side of the aisle believe in--gone.
Fourth, the bill gets rid of the consumer protections that guarantee Americans' access to affordable maternity care, substance abuse treatment, and prescription drugs. All of those could be out of any plan. You can pay a lot for a plan and not get much for it in this bill.
Fifth, it would throw the individual market into chaos immediately, increasing out-of-pocket costs for individual market consumers and resulting
in 15 million people losing coverage next year--15 million people.
On the first point, the new TrumpCare would cause millions to lose health insurance in two ways: first by undoing the Affordable Care Act's major coverage expansion under Medicaid and premium and cost- sharing assistance, instead putting that into an inadequate and temporary block grant, and, second, by radically restructuring and cutting the traditional Medicaid Program through a per capita cap.
We don't have a CBO score yet, and we may not get one in time. But previous CBO scores of similar schemes have shown that 30 million Americans could lose coverage under this bill--30 million Americans--10 percent, approximately, of our population.
On the second point, the new TrumpCare would end Medicaid as we know it by converting Medicaid's current Federal-State financial partnership to a per capita cap, which cuts current Medicaid funding levels on an annual basis. This is a direct blow to nursing home patients and folks in opioid treatment, and CBO has said that 15 million fewer people would receive Medicaid under similar proposals.
On the third point, the new TrumpCare actually brings back the ability of insurers to discriminate against folks with preexisting conditions, as I mentioned.
Fourth, the new TrumpCare would no longer guarantee consumers affordable access to maternity care, substance abuse, and prescription drugs.
Fifth, like previous repeal and replace, it would immediately eliminate the individual mandate, which would raise the number of uninsured by 15 million, relative to current law, in 2018 and increase market premiums by 20 percent.
So vote for this bill, and right away 15 million will lose coverage, and premiums will go up by 20 percent. People who vote for this bill are not going to be happy with its results. Each one of these five things represents a major step backward for our healthcare system, bringing back discrimination against folks with preexisting conditions and ending Medicaid as we know it. These are overwhelmingly popular with Democrats, Independents, and Republicans. The hard right doesn't like it. The big financiers of the other party don't like entitlements, but Americans do. We are going to go backward--backward. We are going to go backward and not even know the effects.
Why is the other side rushing this through? They are ashamed of it. They need to have that political scalp: See, we abolished ObamaCare. But what they are putting in its place, even for those who don't like ObamaCare, is worse. They don't want to know that. The joy they will have--misplaced joy, in my opinion--of abolishing ObamaCare will evaporate quite soon when their constituents feel the effects of this bill and they hear about it from average folks who are so hurt.
The Washington Post summed up Graham-Cassidy yesterday. They said the bill ``would slash health-care spending more deeply and would probably cover fewer people than the July bill--which failed because of concerns over those details.''
Republicans couldn't garner the 50 votes for their various healthcare plans earlier this year because of how much damage those plans did to Medicaid, how they rolled back protections for preexisting conditions, and some opposed it because the process was such a sham. Well, all three conditions are here again with this bill: cuts to Medicaid, no guarantee for preexisting conditions, a sham of a bill.
There is a better approach. Right now, Chairman Alexander and Ranking Member Murray are working in a bipartisan way--holding hearings, working through committee, coming back and forth between the parties with discussions. Each side is going to have to give; that is how it works around here--or should work--in trying to get a proposal that will improve things. That is the kind of legislating many Members of the Senate have said they want to get back to. That is the kind of process worthy of the world's greatest deliberative body.
After a rancorous and divisive healthcare debate, which took up the better part of this year, Democrats and Republicans have been working in good faith to come up with a bipartisan agreement on healthcare in the HELP Committee. The Republican majority would toss all of that away if they pursue Graham-Cassidy next week the way they are pursuing it-- returning to reconciliation, not working in the committees, no CBO report, making a mockery of regular order.
I hope, for their sake and the country's sake, my Republican friends will turn back from this new TrumpCare and join us again on the road to bipartisanship. We have seen bipartisan sprouts bloom in the last month. Graham-Cassidy would snuff them out. Nobody wants that--nobody.
I yield the floor.